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Ways to Improve Rural Health Outcomes...but not this one

****Would $125,000 help employ your next clinician?*****

That is the amount of money on the table being offered by the current government, to attract allied health professionals into rural and remote locations (well basically anywhere other than metro centres) to improve the quality and availability of services. An awesome idea, because the further you move from our capital cities the worse health outcome become, the more expensive accessing health services becomes, the shorter life expectancy becomes and all because access and diversity of health services reduces.

Effectively Triple $$ Dipping

So putting $$ towards employing and retaining allied health professions is a no brainer. Oops, I forgot to mention that the money is only available to GP practices to employ the allied health professionals. Those allied health professionals that have been servicing their communities for the past 5/10/15/ or 20+ years and have been struggling to attract the new generation of professionals, will now have to compete against cash backed GPs to the tune of $125,000. A real level playing field! So now we have a situation where GPs are paid to employ a physio, paid $270 + consult fee to refer to their internal physio (when creating a Team Care Plan under CDM) and will take 30 - 40% of the physios billings each time they are treated by the physio. No need to practice medicine with that sort of $ generating circle. What about the potential conflict of interest! What happened to not treating and billing family, seems a pretty similar scheme.

The reality is that rural and remote allied health practitioners need a unique and broad range of clinical skills and experience, a bit like an ESP triaging in an ED department. Something which only comes with years of training plus years of mentoring. As the medical profession knows from their own experience of training general practitioners, the ideal situation to attract and retain professional staff in the bush, is to provide a structured in situ learning environment, with strong mentoring and solid financial assistance (accommodation, transport, mentoring services). Having experienced a supported, clinically diverse and challenging clientele in awesome locations, it is no wonder 20 - 30% return after graduating. You don't see many allied health professionals mentoring GPs during this 12 month training program (more the shame for them, IMHO) while in the bush. Likewise, it's ludicrous to think that new graduate physios employed by GP clinics under the $125000 scheme, will gain professional appropriate mentoring and training by their employing GPs. They won't have the experience or support, will be under $ pressure to see large numbers of chronic disease clients and most likely burn out over a couple of years. Understandable.

Solution - Easy Alternatives

An appropriate alternative would be to mimic the successful Rural Clinical School of Medicine model where 90 plus students are supported in WA, but instead of creating a rural school of allied health (that would be too hopeful), utilise the universities already involved in co ordinating clinical placements. Funding could be directed and tied to rural placements for allied health professionals (the universities are crying, sorry screaming out for increased clinical placements opportunities) providing finance for accommodation and travel. Remember these students are most likely giving up on their part time job and may need to retain their metro based accommodation while in the bush. Appropriate remuneration for the allied health professionals providing mentoring would need to also be considered.

Another model to consider, again already in place, is a rural scholarship scheme for allied health professionals. Currently the pharmacy profession has available 30 placements of $10,000 for 2019. This means over the course of a 4 year pharmacy degree, a student can receive $40,000 in support if returning to a rural location. The pharmacy scholarship is also linked to a supporting rural scholarship scheme for mentors. Great ideas.

If you are a city based clinician, ask yourself if you would like the government to offer the GP clinic down the road $125000 to put towards attracting and retaining their next staff member - who would just happen to be a physio or other allied health professional. I am sure you can see how non-attractive your 40 - 45% remuneration offer will look in comparison.

What Can You Do?
This is a federal matter, spending your money in an ineffective manner. You can email your federal member and explain this is significantly unfair on established allied health professions (small business owners) in rural and remote communities, and a poor utilisation of your money.

If politicians truly want to improve allied health services, health prevention and clinical outcomes in the bush there are at least 2 easy ways this could be achieved as outlined above. No need to reinvent the wheel, just roll it out a bit further. 

 

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