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Victorian Rural Emergency Medicine

Victorian rural doctors operate their own community medical practices and cover their local hospitals for emergency situations. Smaller hospitals do not have the volume of work to sustain full time Hospital Medical Officers.

It is a substantial impost for all rural residents to travel 1-2 hours to the nearest available facility for emergency care. Regrettably an increasing number are having to do this. Many locations also do not have their own ambulance stations. Only a small proportion of rural ambulance officers are MICA trained. This means that rural doctors have to attain a high level of expertise in a wide variety of specialities. There has been substantial attrition of trained rural GPs in Victoria and the process to retrain them has commenced formally only in 2012.

Rural doctors are trainers on all the emergency courses and are partners in the Paediatric APLS course. Rural Doctors are welcomed as senior doctors on shifts in Emergency Departments of larger hospitals and are encouraged to periodically do this for ongoing professional development. The RDAV considers that safe working hours are essential and is satisfied that many rural hospitals are modifying their practices to provide good triage of patients presenting, particularly after hours, and to steadily approve team management of emergencies and casualty cases. A 1 in 4 roster is the maximum that should be worked, There need to be industrial conditions to accommodate call out.

Provision of emergency department services to the whole public was a State Responsibility under previous Australian Health Care Agreement until recently. Victoria however consistently avoided this responsibility in Rural Victoria and considered that it was the responsibility of rural doctors as paid under Medicare by the National Government. A substantial shift in the State's position is required in this respect to the majority of rural hospitals, which do not possess State-funded Emergency Departments.

It is not the responsibility of rural doctors practicing in any given town to provide an emergency service but rather the responsibility of the Hospital, as the body delegated by the State, to undertake proper negotiation with local doctors to ensure that services are provided.