Central West medical model an example for rural Australia

Clinical supervision improvements key to Rural Generalist success

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Dr John Douyere

Dr John Douyere

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The Central West Hospital and Health Service’s successful medical practice model has been used as an example for the rest of rural Australia in a new Medical Journal of Australia article published this week.

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The Central West Hospital and Health Service’s successful medical practice model has been used as an example for the rest of rural Australia in a new Medical Journal of Australia article published this week.

The article was co-authored by Central West Health director of clinical training, John Douyere, who is also the statewide medical director of the Queensland Rural Generalist Pathway.

In the article, Dr Douyere said improvements to clinical supervision were vital in supporting the rural medical workforce.

He said state governments and the Commonwealth had done all the right things in recent years by investing in infrastructure, medical education and the development of many medical training pathways

“However, the missing piece in many areas of rural Australia is adequate clinical supervision and training capacity,’’ he said.

“In many areas, rapid growth in medical trainee numbers has not been accompanied by growth in supervisory capacity, which limits our ability to fully develop the medical workforce of the future.’’

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Dr Douyere said Queensland’s Rural Generalist Pathway, established in 2007, and Central West Health’s medical practice model were good examples of what could be done to improve training and supervision for medical students and junior doctors.

“The Rural Generalist Pathway, for instance, has helped develop and sustain an integrated service and training program that forms a clear career pathway for supplying the rural generalist medical workforce that the bush needs,’’ he said.

The Rural Generalist Pathway already has produced 118 Fellows, with another 324 currently training.

“A 2013 evaluation of the Rural Generalist Pathway estimated that every $1 invested in the program returned a saving of $1.20,’’ Dr Douyere said.

“Similarly, the Central West Health medical practice model illustrates the important role of rural and remote clinical supervision in strengthening services and developing a self-sustaining workforce.

“In previous years, Central West Health experienced difficulties in recruiting and retaining doctors in the region. A new approach was needed.

“As such, a new medical workforce model was developed.

“This is based on the idea of a group practice where all doctors are paid as senior medical officers, employed by Central West Health and work in our GP practices as well as our hospitals.  

“All our SMOs, all of whom have advanced skills in other areas of medicine apart from general practice, therefore now work as part of a single Central West Health-wide medical pool servicing our hospitals, health centres and GP practices.

“This allows them, as a team, to provide patients with a higher level of care.

“It also allows us to provide patient-centred clinical care that is delivered by appropriately skilled clinicians, in a timely fashion, as close to home as is safe.

“Just as importantly, having such a pool of senior and highly skilled doctors has given Central West Health the capacity to host, teach and supervise the next generation of young doctors.

“That’s why we are now able to host doctors at most stages of career training for Rural Generalist specialty training throughout the region.

“We also have six final year medical students from James Cook University in our facilities working and studying with us for periods of between three and 12 months.

“In addition, we host other medical students from earlier stages of their course from institutions throughout Australia.  These students do shorter rotations of between two and six weeks in our region as an introduction to the West.

“This is a great way of introducing the future generation of doctors to the benefits and advantages of working in rural practice.’’

Dr Douyere said, because of the new strategy, the Central West was seen as increasingly attractive for both senior and junior doctors looking for new challenges.

“We have also seen a steady and significant expansion in our permanent senior doctor ranks in recent years thanks to our increasingly successful recruitment programs,’’ he said.

“This growth in the Central West’s medical establishment reflects the hospital and health service’s successful strategy over the past several years of attracting more doctors by aiming specifically at young Australian graduates and providing them with appropriate supervision in the early stages of their careers.’’

Dr Douyere said both the Queensland Rural Generalist Pathway and the Central West medical practice model were good examples that other rural areas of Australia could well consider.

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