Rural health – quite a different flavour
There are a number of differences between providing primary health care in an urban setting and treating rural patients.
Dr Gayle O’Duffy from the Methven Medical Centre says that working and living in a rural Practice has unique challenges.
“We are essentially caring for our neighbours, so the relationship is different. It helps us see our patients in their social context and make decisions using that information,” says Gayle.
Methven Medical Centre has 4,100 enrolled patients, a seasonal staff influx of around 500 and a variable number of tourists up to 2,000 during winter. Understandably the rural environment plays a large role in medical presentations to the centre.
“Mycoplasma Bovis disease amongst cows and other stressors on the dairy industry are clearly visible in the mental health of our farming population. The shift from sheep/cropping to dairy over the last 10 years has increased our population with many of the dairy workers being quite transitory. This leads to family issues around the instability of their occupation. We also have an ageing population with insufficient infrastructure to assist. There are no Non-Governmental Organisations in most rural environments,” says Gayle.
The centre is also open 24 hours a day and offers ambulance assistance for serious call-outs. Trauma cases that would be sent to the hospital emergency department in towns also go to the local medical centre. Methven Medical provides x-ray and minor fracture management and acute demand home services.
“Our patients have always been keen to be treated at home so we are good users of acute demand with some Point of Care (POC) testing to help us achieve this,” says Gayle.
Pegasus Health created a Rural Health Manager role in June 2014 to better support rural General Practices, particularly those transitioning to Pegasus, of which there were four initially. That number has since increased to 10. Carol Glover accepted this role. The rural practices she works alongside are located from Kaikoura to Ashburton so Carol is often ‘out and about’.
“One of my responsibilities is to help settle a new Practice in with Pegasus. I am their initial liaison point, I answer their questions, look at any challenges they may be facing and identify solutions. Having been a practice manager myself at two large rural general practices in Canterbury, I know the complexities involved. I love my time visiting practice teams – it’s like coming home,” says Carol.
Once the relationship is developed Carol says practices are then linked with other Pegasus personnel including a Partnership Community Worker (PCW), a Practice Support Liaison (PSL) and the Child Health Support Service. All practices are very keen to take advantage of scheduled educational opportunities. The geographic distance of some remote rural practices can make access to these opportunities challenging and Carol is continually looking at innovative ways to make access for these practices more equitable.
Gayle backs up the value of having Pegasus support. She says that it is comforting to feel Pegasus is in the background taking care of general practice – whether that be lobbying, negotiating with the Canterbury District Health Board, or looking to the future for what may be needed.
“Pegasus has resources when we need it. IT help is always greatly appreciated and Support Plus (Human Resources services) has also been an enormous help. The partnership between Pegasus and Canterbury DHB means better access for our patients to health services compared with other areas in New Zealand,” says Gayle.