Value new GP skills to close Indigenous health gap

Australia needs to attach more value to GPs with specialised training to close the gap in Indigenous health outcomes, the rural doctors' movement says

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Australia needs to attach more value to GPs with specialised training in Aboriginal and Torres Strait Islander health to close the “gap” in Indigenous health outcomes, the rural doctors’ movement says.

President of the Rural Doctors Association of Australia, Dr Adam Coltzau, said the new national rural generalist pathway, due in 2020, would open the way for more doctors to do a year of training in ATSI health on top of their GP training and help end the disparity in Indigenous health.

“The roll-out of a national rural generalist pathway has real potential to make this a reality,” Dr Coltzau said, on Thursday’s 10th anniversary of the Closing the Gap strategy.

“On Close the Gap Day, it is important to emphasise that encouraging more rural generalist doctors to undertake specialised training in ATSI Health will be immensely beneficial in helping to close the gap.”

These doctors would be a critical element in coordinating care along with Aboriginal Health Workers, community-based nurses and allied health professionals.

But generalist GPs with advanced skills in Indigenous health, mental health and paediatrics needed the same support and respect as those trained in obstetrics and other procedural disciplines, he said.

“Yet there is still a mindset within governments, and some elements of the health system, that these doctors have not achieved the same level of specialised skills,” Dr Coltzau said.

ACRRM President, Associate Professor Ruth Stewart,  said it was obvious health inequality had worsened in the ten years since the Close the Gap Strategy was introduced.

“The mortality and life expectancy gap is widening rather than improving,” she said.

The rural-oriented GP college, which has fostered rural generalist training through an expanded curriculum of training in advanced procedural and cognitive skills, was actively encouraging Indigeous trainees and ATSI health training.

“ACRRM’s key contribution is in ensuring access for Aboriginal and Torres Strait Islander people in rural and remote communities to well-trained, caring and culturally competent doctors,” Associate Professor Stewart said.

ACRRM’s registrar selection process, implemented in 2017, was designed to encourage Aboriginal and Torres Strait Islander applicants, and to recognise aptitude for Indigenous healthcare, she said.

“Our college aims to recruit registrars motivated to care for Aboriginal and Torres Strait Islander patients; to ensure they are trained to effectively care for these people in their communities; and, importantly to recruit, train and support Aboriginal and Torres Strait Islander doctors to serve rural and remote communities.”

Dr Kali Hayward, president of the Australian Indigenous Doctors Association, stressed the need to encourage young Indigenous people to aspire to careers in health.

“As the old saying goes, you can’t be what you can’t see,” she told The Medical Republic.

To mark the anniversary, Dr Hayward last week took the AIDA board and some 30 indigenous doctors, medical students and allied health workers to Bowraville, on the NSW mid-north coast, for a “health expo” with 300 Indigenous schoolchildren.

“It’s so important to have role models going into the community, “ the Adelaide GP said.

“The kids got to see and speak to Aboriginal and Torres Strait Islander health workers from all different fields.  We had doctors, nurses, midwives, allied health, and sports physicians from the St Kilda football team.”

The children were bussed in from all over the Nambucca valley for a day of activities including applying plaster casts, delivering a mannequin baby, suturing sausages and pre-match exercises with sports medicine practitioners.

“It was inspiring for us to sit down and have a yarn with the kids, and for them to hear our stories and to know a lot of us were in a similar position at school, thinking that we weren’t good enough,” Dr Hayward said.

“It’s about having someone come in and say:  You know what?  You can do it, too.”