Not a week goes by without more media reports, research papers and public inquiries into the state of health services in regional and rural Australia.
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Each one paints a bleak picture of the lack of services, in some cases for even the most basic medical help in rural areas.
An ageing population combined with an ageing medical workforce and a critical shortage of rural based GPs to take on the ever increasing workload has led to the current dire situation where your postcode can determine your health outcomes.
Could one solution to the current crisis be the use of virtual clinical services?
According to Singleton based GP Bob Vickers there are great benefits offered to regional and remote communities through tele-health.
Dr Vickers holds a Fellowship of the Australian College of Rural and Remote Medicine and has an Advanced Diploma in Obstetrics and Gynaecology.
Like many of regional based GPs he has worked in a private practice and at the same time provided care at his local hospital as a visiting medical officer.
He has witnessed and experienced first hand the difficulties faced by so many doctors trying to provide the best care for their patients which means working excessive hours covering both private practice and on-call shifts at the hospital.
Dr Vickers has previously spoken out about the urgent need to find solutions for hospital medical services that don't mean GPs work those excessive hours which in the worst case can result in poorer patient outcomes.
NSW Labor's shadow health minister Ryan Park quoted the Bureau of Health Information (BHI) latest Healthcare Quarterly report, to highlight the immense pressure the NSW health system is facing.
In rural and regional NSW a concerning pattern has also emerged which shows that the percentage of patients who spent over four hours in the Emergency Department had increased:
- In Western NSW 1 in 4 of patients spent over four hours in the emergency department
- At Maitland Hospital 57% of patients spent over four hours in the emergency department
- At Gosford Hospital 54.1% of patients spent over four hours in the emergency department
- At John Hunter Hospital 51.1% of patients spent over four hours in the emergency department
- At Wyong Hospital 48.6% of patients spent over four hours in the emergency department
- At Tamworth Hospital 45.4% of patients spent over four hours in the emergency department
To address these alarming statistics, and reduce the amount of patients presenting to emergency departments, Dr Vickers says that tele-health may be a method to deliver a wide range of medical services.
Tele-health is a service he is now providing to patients across the country and one he believes is particularly suited to areas of critical shortages such as mental health and women's health.
In women's health he works for Marie Stopes Australia providing tele-health consultations for remote areas.
"Women in these part of Australia are often forced to drive four to six hours to see a GP whereas I can provide a tele-health consultation and they don't leave home," he said.
"This improves their access to medical services and therefore improves their health outcomes."
As to mental health Dr Vickers used an example of a single mother who needed to see a GP due to mental health issues.
"Lets say she has three young children and lives more than 30 minutes away from a GP," he said.
"So normally she would have drive herself and her children to the appointment and then attempt to discuss her health with the GP along with caring for the children in the consulting room.
"Doing this consultation via tele-health means the mother can have her children in their home far happier than being at the practice. There is no travel involved and the mother is able to spend her time actually talking to the doctor - interruptions are far less and the result in a far better consultation for the patient."
He described tele-health as being far more flexible for both the doctor and the patient, requiring far less administrative costs and being a lot more efficient.
"The burn-out of GPs in rural and remote areas is well documented, so we need to come up with answers that must be implemented as a matter of urgency," he said.
Earlier this year Dr Vickers was a locum for a week covering Coober Pedy in remote South Australia from his office in Singleton.
"No travel and accommodation costs were incurred all I required was an office, computer, webcam and good internet service," he said.
To answer concerns about how the system works using video assessments he said, for example he was able to diagnose a patient with rheumatic fever, through asking specific questions and obtaining medical records, which ensured the very sick were sent to hospital.
Its a system he believes could cover regional hospitals for night shifts therefore easing the burden on local GPs.
"Its takes a minimum of 10 years to train a GP so we aren't going to find replacements quickly for many towns where their GPs are retiring especially as we already have a critical shortage of medical staff." he said.
"With training and up skilling for our nurses and the right technology tele-health maybe one part of the solution.
"Its also gives these areas access to medical specialists and allied health services."
Commenting on the specialists he said they would be well suited to tele-health due to their years of experience and knowledge especially in diagnostic skills.
For our First Nation communities he said tele-health could offer a break through in improving their current poor health outcomes when compared to other Australians.
Louise Nichols
From cattle to coal. Once a specialist agriculture writer today its about community, in particular, the Upper Hunter. I have lived and worked in the region for more than 30 years. Land use issues and the future direction of our region. But you cannot take ag out of the picture - our food and how we grow it is the basis of all life. Covering the Hunter and Mid North Coast rural issues is now part of my role with ACM.
From cattle to coal. Once a specialist agriculture writer today its about community, in particular, the Upper Hunter. I have lived and worked in the region for more than 30 years. Land use issues and the future direction of our region. But you cannot take ag out of the picture - our food and how we grow it is the basis of all life. Covering the Hunter and Mid North Coast rural issues is now part of my role with ACM.
