Rural Doctors: Outstanding in their field

I HAVE worked as a rural doctor for a decade now – as a GP and in the hospital system – in rural cities and tiny farming towns. I have been mentored by some incredible rural doctors, and now have the privilege of working with my own students as they pass through our local Rural Clinical School. Working in rural health has challenged me in ways I never expected, despite growing up in a country town, and has presented opportunities that I would never have thought to look for had I not been lucky enough to go down the career path ‘less travelled’.

I think it is hard to define exactly what it is that makes the role of the rural doc so unique. There’s the well acknowledged benefits – low cost living, lifestyle, breadth of practice – that I often hear discussed as the main drawcard for a doctor considering a tree-change. Don’t get me wrong, these are all great perks – I can be from bed to work in under 10 minutes if I really try – but there is more to it. It is the undercurrent of being part of something bigger, of working towards the very visible goal of improving the wellbeing of the community you live in.

That sense of community is such an important part of living in rural Australia. It is a hard thing to define, but anyone who lives in a rural town knows the feeling. There is a sense of belonging, of being included in the numbers and of really having a ‘team’ who fight for each other’s wellbeing on a daily basis. There’s only so many people in a small town – every person counts, everyone looks out for each other. Having good access to healthcare is such a fundamental part of what makes a small town thrive – the presence (or not) of a GP in a country town is literally life-changing, and the community will go to great lengths to look after their doctor.

This is apparent within the first few days of setting up practice. Locals will make an appointment just to suss you out. They want to know where you’ve come from, and if you know their aunt’s friend who lives there. They want to know what sport you play, and whether you’re good enough to play for their team in the local comp. They are interested in your family, your pets, your hobbies and your plans for the future.

This can seem quite confronting, even intrusive, to the tentative newcomer. But what is really happening is a not-so-subtle assessment of where you can fit within the town, who you need to meet, what you might be able to contribute to make the community as a whole stronger. You are a citizen of the town, not simply a provider of service.

It is this sense of belonging, of responsibility to your community, that helps many rural doctors push through some of the tough parts of rural life. Many of the significant challenges that come with country life are common to the whole community. When a challenge arises, it is likely that it will affect many in the community, which means there are plenty of people to lean on and look after each other. Lack of rain, loss of a service, the death of a well-known figure, these are felt as a collective. When a rural community suffers, it tends to suffer together, which is a powerful protective factor, especially for the local doctor, who gets a front row view of the hardships, and could otherwise feel very alone.

On the upside, when there is success and celebration, you can be sure it will be written up in the local paper, so the whole community gets to enjoy it. The people of a rural community have a vested interest in each other, because only we truly understand each other’s unique situation.

As a doctor, this means I will often get to see the very tangible products of working through a challenge. When our local health services are in peril, every health worker in the community will dive in and fight to provide for our patients. When a new service in town is secured, we can then watch with delight as our patient can receive care across town, rather than five hours’ drive away. Rural health providers are lucky enough to witness firsthand the outcomes of the work they put in. We are active participants in the change process, not just observers, because like our patients, we too are a part of the community.

Every day I spend in clinical work, I come away feeling like I have contributed to the wellbeing of the people who trust me to navigate the (often convoluted) healthcare system. My role as a rural GP has more facets than I can count, far more than they warn you about in medical school. I am counsellor to the teenager who is struggling to finish school because university seems like a pipe dream that is far too far away. I am strategic negotiator when my patient needs to see a specialist in Sydney, but has no transport to get there. I am a motivational speaker when the aged farmer who doesn’t believe in diabetes has decided to cease his Metformin… again.

Every day requires an improvised solution within the limited resources we have. Every day requires encouragement that going to the doctor is as important as getting the car serviced, and is worth the trip in to town. Every day I am trusted to be an advocate and an ally, who understands the challenges of rural healthcare, because I live with those same challenges.

And every day I am lucky enough to see the payoff for all the hard work in the thriving community I live in.

Dr Lauren Cone is a GP who resides and works in Tamworth, NSW. She is the Clinical Dean at the Peel Clinical School with the University of Newcastle Department of Rural Health, and is passionate about training and supporting the next generation of rural doctors. She also works with the NSW Rural Doctors Network to support the rural medical workforce and encourage new doctors to give rural medicine a go.