Challenges in Practising Allied Healthcare in Rural Australia

The allied health professionals such as apsychologist, occupational therapists and so on are operating throughout the vast remote geography of rural Australia. Unlike the nurses or any other medical personnel, they operate on a much widespread area providing support to the old and the disabled people. The job of the allied health professionals is to work with a wide range of disabilities both acquired in life and from birth disability. The acquired disabilities mainly include disabilities from various accidents such as spinal cord injury and amputees in most adults. However, they work with disabled children as well who have developing disabilities from birth such as autism, cerebral palsy and so on.  The main aim of the allied professionals is to help their patients overcome their issues and lead an as much normal life as they can. The therapists are required to provide the help on time so that the problems of the disabled do not pile up resulting in requiring more allied health professionals. This study discusses the various issues, which the allied health professionals face during their delivery of service. The study also contains some recommended solutions, which are to be used to solve these issues.  The relation of the Wakeman’s definition of rural health to the present health of rural Australia has also been presented in the study.

Practising health service in the rural areas of Australia can be very challenging. The main issue, which the allied health professionals face, is the unavailability of enough health professionals from whom the patients can access therapy. Research shows that not enough people choose to be an allied health professional in rural areas as a career. However, the people taking up this choice are not retained properly in their respective fields. Although the AHP workforces operating outside the urban areas receive extra attention from the NDIS scheme makers.

With the introduction of the National Disability Insurance Scheme, the demands for these special services are expected to go up. However, with the increasing demand, the quality and the availability of the service providers are expected to decrease as there is already a scarcity of therapists. Australia is facing an increase in the ageing population, due to the increase in life expectancy through the advancement of the medical field. It has been predicted that in the coming years there can be an abrupt increase in demand of the disability services. To have the maximum impact of the AHPs over the rural population, they have to create a sufficient group of skilled health professionals. On the other hand, the various rural governing organizations are afraid that the vast increase in demand will put the rural people in adverse conditions, as there will be competition for getting better services.

Impact of National Disability Insurance Scheme on Demand for Allied Healthcare

The AHP workforce is concerned with a distribution issue i.e., proper distribution of the skilled professionals along with the necessary resources required at their disposal to treat the patients.  Research proves that although there is no actual shortage of professionals on the speech therapy and physiotherapy field there is a huge misdistribution according to the needs of the people. Most of the AHPs practice in urban areas so the rural AHPs serving in the rural areas have to serve people over a large area. This is affecting the quality of service, which the people are receiving. The people are also not able to access any specialist therapist for their disability, as the AHPs have to treat all types of patients.    

It is very difficult to retain the AHPs in rural areas because of several factors such as they do not have any such job satisfaction, and they are not remunerated properly and on time, limited career growth and so on. They find practice very difficult in remote areas, as they do not have any colleague to help them or any senior to ask for an opinion. They have to trust their own judgment and take responsibility for the patient. They have to spend too much time travelling, as there are no proper means of transport in the remotest of Australia. Even the cost of living is much higher in rural areas. All these reasons compel the AHPs to practice in the urban areas rather than the rural areas. It has been proved through various researches, that professional development of the AHPs can be helpful in retaining them in the rural areas. In this way, both the health professional and the patients in the rural area will be benefitted.

Healthcare practice in rural areas can be very challenging. The AHPs are often put in charge for the well-being of an unknown community. Therefore, they have to create a good impression of themselves amongst the people of the community. Sometimes, the people of the community do not welcome the AHPs so then it becomes even more difficult to reach out to their patients. The health professionals receive a wide variety of patients with various diseases, so they should be able to handle all types of patients or they should refer the patient to a specialist. The rural people are often facing an issue of awareness about the services provided by the AHPs, so the patients might not directly approach them. The therapist has to spread information about the services they provide and information about some common disabilities that can be treated with the help of various therapies. The AHPs will also have to look into the community engagement issues, which might help in treating the patient by helping them, get back to a normal life through community engagement.

Uneven Distribution of Allied Healthcare Professionals

The case study deals with the various challenges, faced by allied health professionals while delivering medical services in rural areas. The allied health professionals have to encounter multiple problems out of them the most important one is the lack of AHPs in the required areas. The AHP workforce does not have enough skilled professionals to cater to the needs of rural people. Moreover, most of the AHPs reside and practice in the urban areas and so there is an uneven distribution of specialists. Retention of the AHPs in the rural areas is getting difficult due to the adverse living conditions present there. The AHPs are not provided with any career growth options, they have to adjust in high-cost living conditions and so on. Even when the community does not welcome the professional, mingling with the members of the community becomes another challenge. Due to these problems both the patients and the health professional has to suffer, as the quality of the treatment gets worse as the therapist has to handle a large number of patients without any proper job satisfaction. The professionals also face certain personal problems while serving these areas such as they feel isolated from their friends and their family, they might need some professional help from their colleagues and seniors, which they are derived from. All these causes might lead the healthcare professional to depression.

Geography

The rural population of Australia is very scanty and spread over a large area. According to the Wakerman’s definition of rural health isolated geography has a huge impact on the practice of the AHPs. The communities in the rural areas reside over a vast area in groups keeping a large distance between them. Therefore, the practitioner has to travel long distances to treat the patients. So this long-distance travel affects the treatment of the patient as the therapist is not able to visit the patient regularly.

Strong multidisciplinary approach

The AHP workforce should be able to provide a multidisciplinary service to its patients. The therapists are ought to receive different kinds of patients having different issues and from different cultures so they need to have an understanding of all kinds of diseases. The therapists should also be quite competent with the communication skills so that they are able to communicate the condition of the patient to its family keeping in mind the cultural gaps.  

GP substitution

The GP of a certain area cannot be substituted although the AHP present in the area can carry out the general duties of the GP. The basic function of a GP besides being the Doctor in the rural area is to bring the community together by resolving the issues in the community. The GP also tries to educate the rural population and help them in the management of various communal programs.

Retention of Allied Healthcare Professionals in Rural Areas

Practitioners requiring public health skills

The AHPs should be acquainted with information regarding some of the common diseases so that they can provide some information to the public about it and help them with certain general ideas to combat such diseases.

Professional isolation

The AHPs practising in the rural does not have any extra help or support from their seniors or any colleagues. Therefore, they have to trust their own judgment while treating a patient. There are high chances that the treatment procedure might go wrong in that case, the AHP is a complete cut off from the professional network.

Extended Clinical skills

The AHPs practising in rural areas needs to have some extra skills besides medical knowledge such as acting as a substitute GP, having communication skills, managing various community programs and so on.

Cross-Cultural communication

The AHP of the area might not be aware of the cultural habits of the community, in that case, he should be able to gather information about the various cultures of the community so that it becomes easier to communicate with them. Having a cultural knowledge also provides better chances of being welcomed in the community.

Small dispersed often highly mobile groups

The AHP should try to treat the disease in their area and avoid transfers to any urban practitioner or any specialist as that would reduce the cost of treatment.

High health needs

The AHPs are responsible for the well-being of the community so they have to keep an eye on the overall health of the people to maintain an average health of the community.

The AHP becomes an important part of the community, so they have a huge responsibility vested on them. They have to provide the people with the medical treatments and carry out the additional job of bringing the community together. The AHPs should try to think of themselves as part of the community and treat the people as their own community members.

Conclusion and the recommendation

This study is based on the problems that are faced by allied health professionals in rural areas. The allied health professionals are the therapist like physiotherapist and speech therapists who have a major role to play in the healthcare sector. It is very much important to have proper allied healthcare service in the rural area that will enable the holistic development of the rural health care. It is seen due to geographical, factors and economic factors the allied health professional do not prefer to go to extremely rural areas for their practice. Due to this, there is a huge lack of allied health professionals in the rural areas of the country. This problem has to be taken into account and solved through proper analysis. It is very important to have an even distribution of the allied health care services.  Through proper management and proper delegation of work by the administration, the deficiency of the allied healthcare personnel may be reduced. The proper delegation will result in an even distribution of the allied health care professionals that will help in the development of the rural health care services.

The Australian government must get involved in the proper delegation of the work for the applied health professionals. To increase the motivation of the allied health professionals the wage of the staffs who wish to go the rural sector for service might be increased or the government that may have positive effects on the staffs can give incentives. Proper analysis and monitoring should be done to maintain the equitable distribution of the Allied Health professionals. Rules might be levied on the allied health professionals to work in rural settings according to the demands

The study has enabled me to understand the challenges which the allied health professionals face every day. The challenges, which they face, are a combination of the adversities of a new place, new people and the disadvantages of rural settings. The AHP of a village not only remains just there as their doctor but also have the responsibility of bringing the community together through several methods

Reference

Gallego G, Dew A, Lincoln M, Bundy A, Chedid R, Bulkeley K et al. Should I stay or should I go? Exploring the job preferences of allied health professionals working with people with disability in rural Australia. Human Resources for Health. 2015;13(1).