Connect with communities through rural general practice in Tasmania
Ochre is one of the leading providers of rural generalist GPs in Tasmania, with over 50 GPs based in 12 Ochre Health clinics and working in various hospitals located across our southern-most state. We are proud to be working closely with the State Government and various vital stakeholders to recruit and retain some of the best primary care talent.
We spoke to Dr Allison Turnock, Medical Director, GP & Primary Care at the Department of Health Tasmania, and Dr Lizzi Shires, Director, Rural Pathways, to find out how this beautiful state offers such incredible and unique training, locum and permanent opportunities for rural generalist GPs and what recruitment challenges Tasmania is facing.
Thank you, Allison and Lizzi, for taking the time to talk to us today. The disparity between metropolitan and rural general practice has been a longstanding issue for rural Australia, with a history of underinvestment and maldistribution of doctors. How has this impacted Tasmania specifically, and what challenges are you facing across the rural generalist landscape?
Allison: The maldistribution of GPs in Tasmania is the same as in the rest of Australia in that our remote, rural and regional communities have less access to doctors than our more urban areas. One of the challenges we face in Tasmania is the entire state is classified as rural, including Hobart. Our current rural classification systems are sometimes not nuanced enough to differentiate between relatively large centres like Hobart or Launceston, and smaller regional towns like New Norfolk or Lilydale. Tasmania is a small state but we have a very distributed population. There are about 540,000 people in Tasmania, with around 224,000 living within Hobart, and a further 66,000 living in Launceston. The remaining population of 250,000 is distributed across far more rural and remote areas.
Our population distribution is different to many other jurisdictions. Here, many small towns are located relatively closely together but aren't big enough to sustain services that you might find in a larger centralised population. So, the rural models here in Tasmania are quite different from the ones in remote WA and Queensland, where you might have hundreds of kilometres between services and relatively larger population groups. This makes our distribution and service challenges unique. Our training pathways and the mix of additional skills posts are different to other jurisdictions to reflect the needs of our rural communities.
Lizzi: If we take a step back, most rural areas across Australia have had issues with rural doctor shortages, and a whole set of systemic problems have driven this. It's no different in Tasmania than anywhere else. Traditionally, medical schools were based in Sydney, Melbourne and Hobart, and there wasn't a focus on recruiting rural students and training in rural areas. Increasingly, however, this is changing, and most medical schools now have an active policy of recruiting and training rurally.
Here in Tasmania, we're running a pilot where you can complete all your medical schooling up on the northwest coast, where there are shortages of permanent GPs. So, you can live, work and train in your communities which is making a huge difference.
So what are the benefits of pursuing a rural generalist pathway in Tasmania?
Allison: The central premise of the rural generalist pathway is that it's based on community need. Most people come into medicine wanting to make a difference in their community. And working in remote, rural, and regional primary care is the most significant way you make a difference to a community because people in more rural areas have poorer health outcomes and less access to services. As a primary care physician in Tasmania, you can transform the health outcomes for a rural or remote community. I think sometimes we lose that message amongst other things. If you want to make a real difference, working in a rural community is a great way to do that.
I have had many conversations with junior doctors about choosing general practice or the rural generalist pathway rather than specialising in a non-GP specialty. For me, general practice offers a wide variety and breadth of practice. You don't have to decide which areas of medicine you want to work in. You can do everything with a broad base of skills that can then be used as a platform to build upon depending on community need. You can be agile and adaptable if the community needs your skillset to change. Your opportunities are limitless, and you can make your career and life what you want.
If you want to pursue your passion for mountain biking or fishing or another of the numerous recreational activities we offer here in Tasmania, there's a community nearby that needs a health service. If you want to provide excellent care and change health outcomes for Aboriginal and Torres Strait Islander people, then you can come here and do that too. Ochre has a practice on Flinders Island and Cape Barron Island and works closely with the Aboriginal community. You can even pursue a career in remote polar medicine from Tasmania, the gateway to Antarctica.
So junior doctors need to think about what they want to be doing in the future. With general practice you have a lot of freedom because you'll have a broad base of skills from which you can adjust to suit your career and community. Rural generalism provides a huge opportunity to make a big difference, regardless of what community you're in.
What strategies do you have to encourage young doctors from mainland Australia to come and work in Tasmania?
Allison: If you are an intern or junior doctor in Tasmania, you can do a 13-week rotation in a rural primary care setting, including in places like the West Coast, King Island or St Helens. These posts are funded through the Commonwealth Government’s Rural Junior Doctor Training Innovation Fund and managed by Ochre. We also have the Tasmania Rural General Pathway Coordination Unit, which Lizzi is the Director of, and the Tasmanian Rural General Scholarships for final year medical students in Tasmania. They receive a yearly payment over the first three years of their training to help support them as much as possible towards being a rural generalist.
Lizzi: One of our strengths is our small and connected state. Our training providers know all our trainees. We can help them navigate through their training and provide individualised programs. Some states have much larger numbers of trainees so don't have that same close relationship. These are some of the significant advantages to our smaller system.
Lizzi: Many of our clinics are in beautiful world heritage areas, and the lifestyle is incredible. We have older doctors moving here looking for a sea or tree change and doctors with young families looking for a more sustainable, community way of life.
The roles are well remunerated, particularly in the more remote areas and the cost of living here is less than on the mainland. Ochre will often provide accommodation.
The real strength in what we offer is that we're a small, friendly, and supportive medical community. We all know each other. If you take a remote locum or permanent role, you're only a phone call away from any advice you may need. So, if you have any issues in a remote hospital, for example, there's a specially dedicated hotline for you to talk to people in ED. There's also a dedicated retrieval service that will talk you through any challenging clinical issues and work with you to retrieve your patients.
We can offer local ED work for GPs who don't have recent emergency experience and might be hesitant about working in a rural or remote area. This enables new GPs to get to know people and the systems before starting their locums or permanent practice.
And finally, what do you think are the main benefits of working with Ochre Health in Tasmania?
Lizzi: There are 12 Ochre Health clinics now across Tasmania and a good variety of locations to choose from. Ochre can offer both short- and long-term contracts in some of the most beautiful parts of the state. This allows GPs the flexibility of both visiting and settling in rural practices across Tasmania. Many GPs don’t want to buy into a practice initially. Working for Ochre allows you to work clinically without making this investment.
Ochre supports training across the state with opportunities for interns, resident medical officers, and registrars to live and learn in rural Tasmania.
Allison: Ochre has also established some innovative models of care and training including strong partnerships between their clinic based in Hobart and some of their more remote areas. For example, the Ochre practice in Hobart is linked with the Ochre Health Scottsdale practice. GPs in Hobart can work with the same familiar clinical systems, but in the rural location of Scottsdale. They get a taste of rural general practice, and the people in the rural general practice have a little bit of increased capacity.
Thank you both for your time.
If you're a General Practitioner and you would like to more about locum work in Tasmania or short-and-long-term contracts, we'd love to hear from you.
Contact Phil Dixon on 0424 550 378 for GP VMO opportunities and permanent rural generalist roles.
To obtain a copy of our Locum Splendour in Tasmania brochure, click here.