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Mike Miller

Rural hospitals in New Zealand usually serve a population of 50-100000, compared to Australia where there are many smaller hospitals in rural areas.

In New Zealand Rural anaesthetic departments are almost exclusively staffed by specialist anaesthetists or full time medical officers. In Australia by contrast there are a lot of part time GP anaesthetists.

Staffing Rural anaesthetic departments has always been difficult, especially in areas of the country not seen as desirable to live in. Attracting New Zealand graduates to these areas has always been difficult and most specialist posts are filled with overseas trained anaesthetists. Keeping these posts filled is essential if we are to continue to provide high quality anaesthesia by medical specialist staff. In a recent survey of members this was the preferred option rather than explore the nurse anaesthetist model.

Problems recruiting NZ specialist anaesthetists include the perception that working in a rural hospital results in professional isolation, excessive after hours on call, lack of formally trained anaesthetic assistants, and involvement in the Intensive Care Unit. Other adverse factors are the distance from extended family and friends, and perceived difficulties in moving back to a main centre in the future.

There are however many advantages in working in rural areas including a great lifestyle with less time spent travelling, good schools, a more personal collegial relationship with other medical and nursing staff. Many rural areas have private facilities and those that do not may offer an enhanced salary package to compensate.

The key to the ongoing sustainability of a medically provided anaesthetic service of excellence in rural areas is the recruitment of young New Zealand graduates.

In my opinion rotation of registrars through rural areas is highly desirable to give the exposure to this type of practise.

Exceptional conditions of service and a reasonable after hours roster are also extremely important factors in recruitment of specialist. Adequate CME entitlements and provision of locum cover is equally important.

All in all rural anaesthesia has a lot of positives to offer young anaesthetic graduates.

Time of Presentation
Saturday 7 May 2005 - 1530-1700