Women’s program flying high
After nearly 10 years of operation, a flying women’s health service is going from strength to strength, reports Adam Cresswell
AMEETA Patel thought she knew what poor access to health care’’ meant after living for 41/ years in Alice Springs. Like many outback towns, even quite large ones like Alice, medical and, in particular, specialist services can be limited and oversubscribed.
But after signing up to provide flying women’s health visits as part of a commonwealth-funded program, she realised even that was only half the story.
The women out there are amazing — they are really stoic,’’ says Patel, a GP who works as a medical educator as well as in private practice.
They put off things and try and fix them themselves. They are not at the doctor’s at the drop of a hat, unlike a lot of people in urban areas.’’
Once a month, Patel travels to Tennant Creek, where she stays overnight and spends two days providing a women’s health service.
Although the town already has two GPs, both of them are men— and many women are less comfortable consulting a male doctor for various conditions, particularly those of a sexual nature or which require an intimate examination.
Patel’s visits are part of a national program, originally launched by the Howard Government in 1999, that was designed to address this problem, by flying women GPs into remote areas where patients had no access to a female doctor.
Despite her years of practice in Alice Springs, Patel says she was surprised at the need’’ she found in Tennant Creek for her services, since she joined the Rural Women’s GP Service (RWGPS) program about 18 months ago.
I have done about 100 Pap smears in that time, and there’s very consistent feedback I get that they appreciate the service,’’ Patel says.
Although Patel has diagnosed some patients with non-gender-specific conditions, including diabetes and coeliac disease, the main focus is on women’s issues. As well as reproductive health, and the provision of implantable contraception, problems that patients want to raise include matters such as incontinence.
But men also turn up to the women’s GP service, although in lesser numbers.
In some cases, men don’t like consulting another man about sexual or mental health problems, such as erectile dysfunction or depression. In other cases, men go not because the visiting GP is a woman, but because she is visiting — and therefore the consultation is more anonymous than it otherwise would be in a small town.
Since its national roll-out in 1999 the program has been operated by the Royal Flying Doctor Service of Australia, which won the original four-year, $8.2 million Commonwealth contract. The RFDS has also had the contract successfully renewed since then for two more four-year periods.
John Setchell, general manager of health services for the RFDS’s Central Operations branch, says the clinics have proved popular with several groups, including nurses and other health workers who would rather see a visiting GP in preference to the existing, permanent male GP — who might be their boss, or the person they saw every week at the bowling club, or their husband’s golf partner.
As the obvious benefits to patients, and the doctors who signed up to provide the clinics, some other spin-off benefits had also been identified as a result of the program.
In a number of locations the presence of the female GP program has resulted in that location feeling confident and being able to successfully recruit a permanent female GP,’’ Setchell says.
In South Australia and the Northern Territory (alone), probably three rural locations (have done that) — it doesn’t sound many, but getting doctors out to rural locations at all is impressive.’’
At the start of the program in May 1999 there were 138 locations identified where clinics would be held, a number that has since grown to 294.
Rules dictate where the clinics can go. There must be an existing male GP in the town, to ensure continuity of care; there must be a population of at least 1000 in the town or its surrounds; and the nearest female GP must be over 50km away.
At the moment there are 83 female GPs who provide clinics as part of the program, most of whom are in private practice in urban areas although some are RFDS employees. In 2006-07 they saw 15,450 patients during 984 separate visits.
Even when it was announced the program was greeted with enthusiasm by GPs, no doubt because the scheme has made every effort to avoid antagonising doctors who are already in the field. Setchell says there would be nothing worse than to set up a system where existing male GPs felt their patch was being invaded’’.
Formal evaluations, done both internally by the RFDS and externally by the federal health department, have also returned consistently good results. The findings suggest 87 per cent of patients found the visiting female doctor extremely important to them.
When asked to rate various aspects of their attendance at the clinic, 81 per cent were
extremely satisfied’’ that their health needs were met, 80 per cent were extremely satisfied with the explanation of treatment and 81 per cent were extremely satisfied with the followup advice.
Nell Sproule, who has been the co-ordinator of the program for about a year, says the response from women is astounding’’.
Women ring up, and they stop me in the street, thanking me,’’ she says.
But despite the good feedback from doctors and patients, Setchell says one problem has been the changing aviation environment, particularly soaring fuel costs. In the last contract renegotiation process, for the fouryear contract that began a year ago, the overall funding for the scheme rose to $12.6 million — enough to allow each of the four RFDS sections to add another two locations to their clinic list.
Patel says she will absolutely’’ keep doing the clinics due to the professional satisfaction it gives her.
Even though I’m going once a month, I’m seeing women in follow-up, and over the year I have seen some women several times and been getting to know them,’’ she says.
I’m hoping to be here for a few years at least.’’
Success: The presence of the female GP program has resulted in many areas feeling confident and being able to recruit a permanent female GP