Friday, 23 October 2015

Rural towns agree: distance not the main decider in whether to visit the doctor


Research in five rural towns about the factors that influence a decision to visit a doctor for non-urgent care could have major implications for planning primary health care services.

Lead researcher, Dr Bernadette Ward of the School of Rural Health at Monash University, said that, when planning health services, planners and policy makers generally assume that distance to a clinic is the main or only factor in rural people’s decision to see a doctor.

“This study shows that is not the case,” said Dr Ward.



“Data provided by the residents of Stanhope, Birchip and Heyfield in Victoria, and Grenfell and Jerilderie in New South Wales quite clearly demonstrate that people will travel relatively long distances to see a doctor they prefer.

“The distance they have to travel to see a doctor ranks only third in importance – a long way behind preference for a doctor and availability of a doctor.”

Although many published studies highlight the importance of doctor-patient relationships in use of doctors’ services, this is the first empirical study to show how people trade off the different factors that influence their decision to visit a GP.

The results varied slightly between relatively closely settled rural areas and more sparsely settled areas.

In sparsely settled areas, the availability of a GP is ranked slightly above preference for a GP, and well above distance to the service and cost.

“The fact that distance is consistently ranked as less important than availability of, or preference for, a GP suggests that most rural residents accept the need to travel some ‘reasonable’ distance in order to access health care,” said Dr Ward.

What constitutes a ‘reasonable distance’ varied with geographic location: the more sparsely populated the region, the further residents were prepared to travel.

“What it the study does demonstrate that planners need to incorporate other dimensions of access to services besides their availability,” said Dr Ward.

“Optimum use of doctors and other primary health care services relies on providing appropriate care in line with the needs and preferences of individual communities."

The paper – ‘Which dimensions of access are most important when rural residents decide to visit a general practitioner for non-emergency care’ – was published in Australian Health Review. For more information contact Dr Bernadette Ward: bernadette.ward@monash.edu or 0427 059 205.

Friday, 16 October 2015

Act sick to help train a doctor

Volunteer sim patients, Andrew Hood and Alison Sinnott help train future doctors
The School of Rural Health Churchill needs volunteers to play an important role in training future doctors. The site needs up to 50 people, especially men aged 30 to 40, to take on a simulated patient role for part of the students’ end-of-year clinical skills exams in November.

"Sim patients" are trained to portray conditions such as a heart attack, high blood pressure, chest pains or even a broken arm. A clinician then observes how the student records the patient history and treats the “patient”.

Sim patient coordinator, Susan Smith said she contacts volunteers in the demographic needed by the exam scenarios who are then trained in their “illness”.  Some volunteers, like Andrew Hood, have been doing it for years because they enjoy the experience so much.

Andrew, who initially studied computing with Monash University and has now returned to study for a science degree, is from Yallourn North and has volunteered since 2007. A friend from Latrobe Regional Hospital who was involved with Andrew in community theatre suggested he would be ideal.

“I enjoy acting, it’s a great challenge,” he said. “It is also great to help with these students’ education in becoming good doctors.”

He not only volunteers for clinical skills examinations but also on a regular basis throughout the year as part of the students’ training. Andrew says it’s not like learning a script. It is more a question and answer scenario. “You are given initial training to explain the procedure,” he said. “You get used to it fairly quickly and it all becomes familiar. I like it when I am given a more complicated role to give them a challenge,” he said.

Sometimes the volunteers are required to change into hospital gowns and lie on a hospital bed in the simulated ward or may have to present in shorts and a t-shirt to make the scenario more realistic.
Ms Smith said the more volunteers recruited the better. “We need such a broad demographic range and we don’t always need everyone,” she said. “But all volunteers get paid for their time and training.”

If you are interested in being a sim patient volunteer, contact Ms Smith at the School of Rural Health Churchill by phone 5122 7445 or email: susan.smith@monash.edu