Rural Generalism should inspire us all, not threaten us – Dr Konrad Kangru

Time and time again I see discussion about the role of rural generalists, with many colleagues still disputing the applicability of this position in their own communities, and Health departments or specialist Colleges grappling with how to incorporate RGs into their workforce plans.

As a Rural GP in north Queensland, I’m well and truly in the midst of rural generalist heartland. Our local hospital is staffed exclusively by these marvellous colleagues and is training many more.

Yet, by the Collingrove agreement and the Cairns Consensus, these hospital based doctors don’t really fit the definition at all. Neither do I. But there are hundreds of excellent rural GPs who do but might not think they are. Sadly, I think a somewhat misleading perception has arisen of this new breed of super doctors who have been trained to be all things to everybody, well beyond the skill set of those of us trained in the last century.

A Rural Generalist is a medical practitioner who is trained to meet the specific current and future healthcare needs of Australian rural and remote communities, in a sustainable and cost-effective way, by providing both comprehensive general practice and emergency care, and required components of other medical specialist care in hospital and community settings as part of a rural healthcare team.

Sound familiar?

Rural Generalism isn’t just about doing caesareans at 2am or surgical airway management. It’s about quality general practice extending into acute secondary care, and having the additional skills your rural community requires. Sure, that might be Obstetrics or Surgery. But It might also be your many years of experience in Palliative care, Psychiatry, Aboriginal & Torres Strait Islander health, or numerous others. And while many of us have let the acute care skills we had in our Emergency terms as enthusiastic Residents lapse, it wouldn’t take much to freshen them up.

Heavens knows there are plenty of accessible courses available for that exact purpose, and every doctor always feel a little more confident in themselves overall having that ability once again. Regardless of arriving first at a traffic accident or getting the dreaded in-flight request for a doctor on board, it’s never wasted.

It’s about doing what the patients in your rural community need. It’s not always glamorous, exciting or well recognised. But true Rural Generalism encourages all of us to be the doctor we imagined we’d one day turn into, truly able to deliver cradle-to-grave medicine, and able to use our areas of special interest and expertise to a higher level when the Specialists won’t.

Properly trained and supported, Rural Generalists are undoubtedly the key to Australia’s rural medical workforce for the future. And it might only take a little extra effort to help you join them.

One thought on “Rural Generalism should inspire us all, not threaten us – Dr Konrad Kangru

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  1. I agree with you Konrad that we should celebrate the rural generalist.

    In Australia until the 1990s there were still GPS in the city that had anaesthetic lists in city public hospitals.
    My own GP in Sydney had lsurgical lists in Bankstown hospital into the late 70s and my wife GP delivered all 6 of her siblings in city Sutherland in the early 70s.
    The generalist GP tradition has strong roots in Australia and must return.


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