Synergy and sustainability in rural procedural medicine: views from the coalface.
OBJECTIVE
The practice of rural and remote medicine in Australia entails many challenges, including a broad casemix and the remoteness of specialist support. Many rural practitioners employ advanced procedural skills in anaesthetics, surgery, obstetrics and emergency medicine, but the use of these skills has been declining over the last 20 years. This study explored the perceptions of rural general practitioners (GPs) on the current and future situation of procedural medicine.


METHODS
The qualitative results of data from a mixed-method design are reported. Free-response survey comments and semistructured interview transcripts were analysed by a framework analysis for major themes.


METHODS
General practices in rural and remote Queensland.


METHODS
Rural GPs in Rural and Remote Metropolitan Classification 4-7 areas of Queensland.


METHODS
The perceptions of rural GPs on the current and future situation of rural procedural medicine.


RESULTS
Major concerns from the survey focused on closure of facilities and downgrading of services, cost and time to keep up skills, increasing litigation issues and changing attitudes of the public. Interviews designed to draw out solutions to help rectify the perceived circumstances highlighted two major themes: 'synergy' between the support from medical teams and community in ensuring 'sustainability' of services.


CONCLUSIONS
This article presents a model of rural procedural practice where synergy between staff, resources and support networks represents the optimal way to deliver a non-metropolitan procedural service. The findings serve to remind educators and policy-makers that future planning for sustainability of rural procedural services must be broad-based and comprehensive.
The University of Queensland Rural Clinical School Research Centre, Toowoomba, Queensland, Australia. andrew.swayne@uqconnect.edu.au
Andrew
A
Swayne
Diann S
DS
Eley
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010821:Physicians, Family / Q000523:psychology / Q000600:supply & distribution; D011793:Queensland; D019035:Rural Health Services / Q000458:organization & administration / Q000600:supply & distribution / Q000639:trends; D012424:Rural Population