What was it like being part of this inaugural and innovative project which resulted in Australia’s first rural respiratory clinic being built in Emerald? 

It has been amazing to see the extent and speed of the community response to this project. The team, from the builders and tradesmen, right through to the clinic staff, have all stepped up to create a clinical service that will help to keep the community safe. As an ACRRM Registrar I feel privileged to be in a position where I can support the community by being a part of this service. The whole endeavour has been quite impressive, and I think we should feel proud of what we have been able to develop in such a short time. Feedback from my patients is that they have been feeling more reassured since seeing the clinic being built.

What role will you play in the clinic?

The Respiratory Clinic is set up to be run in teams of three staff; a doctor, nurse and receptionist. Having a team is essential to allow appointments to be efficient and helps ensure we meet our strict Personal Protection Equipment (PPE) and infection control processes to keep both patients and staff safe. We can also scale up the service easily as we have enough rooms to run two teams and we can even have several shifts a day if needed. 

As the doctor, my role is still that of patient clinical assessment and deciding if they require COVID19 testing based on current indication guidelines and clinical judgement. Most of the appointments are related to respiratory symptoms, however there are patients who have other issues or symptoms who happen to also have respiratory symptoms. As such, we are still able to provide a regular GP service to these patients while also ensuring that we don’t expose any of our usual patients at our main clinic to respiratory infections.

Another important role I have realised is that of providing education to the community. Patients have a lot of questions and even misconceptions about the coronavirus and many want to know if they are at risk (given their specific circumstances) and how to protect themselves. I think now, more than ever, the community role of the rural family doctor is so important as through education we can provide reassurance in this time of uncertainty and empower patients.

How has being an ACRRM registrar prepared you for COVID-19?

My ACRRM training provides me with the resilience and adaptability needed to work in different environments. I am quite privileged in Emerald to work at both the GP clinic and Emerald Hospital which allows me to often manage the same patients across both settings. Recently, some of the same patients have been presenting to the respiratory clinic and I feel being a part of this patient continuity of care is quite special as a rural doctor.

ACRRM training also focusses on teaching registrars about coping with uncertainty. This skill is especially useful given the uncertainty surrounding COVID19 and the continuously changing clinical information and guidelines that is unfolding daily.

What challenges do you expect to face with COVID-19 in your region?

One concern I have is the mental health effects that social isolation will have on the long-term health of the region.  Mental health awareness has historically always been a difficult topic for rural towns and communities and Emerald is no exception. Given the current social restrictions in place, the financial fallout on businesses and unemployment we as GPs have to be even more alert for mental health symptoms when we see patients over the coming months. Though we have some excellent Mental Health staff that work in Emerald I am concerned they may be eventually overwhelmed with the potential aftermath of COVID19.

Do you think the pandemic will change the delivery of rural health long term?

The pandemic has shown how dependent Central Highlands still is on tertiary hospitals in cities to provide certain medical services. Now that all elective procedures and specialist appointments have been greatly reduced many rural patients are finding themselves left with not knowing what will happen to them. It would be good to see long-term changes that include further increases to the capability of locally based medical services in the community. The new Medicare item numbers that have been made available for telehealth consults may hopefully open an avenue for more dedicated specialist long-term support to the region.

Many rural health services have created new business and clinical processes to be able to continue to provide safe patient care. Locally, I have seen process changes at both the GP clinic and Emerald hospital. Many of these processes have been developed by local ACRRM Fellows which I think is strongly indicative of their extensive clinical experience and training to date.

It would be unlikely for all these new ideas and processes to be discarded again in a post COVID-19 landscape as many are quite innovative and will likely have a lasting impact on patient care.

Dr Barlow is training towards Fellowship with ACRRM on the Australian General Practice Training pathway. For information on training towards a career as a Rural Generalist with ACRRM, visit acrrm.org.au/fellowship