How long is too long ?

I wonder sometimes how one knows if you have been in a place too long ... is it when you start getting emotionally attached to the local politics of an area ?

This place suffers from the disease of many ( I can't say "all" as I have not been "everywhere" yet to find out, but it would be fair to say that every rural area I have worked in has so far qualified) rural communities - the lack of resource.

And why would this be so ? ... I ask myself tempting myself to make a gratuitous, opinionated reply ... would it possibly be due to the lack of political will of those possessively grasping the purse strings ? What does it take for the focus of attention to be placed where it needs to be ?

Did you know that this area used to have two helicopters for medical transport ? ... there is no local airstrip so RFDS cannot provide a fixed wing service. Well apparently one of those helicopters is broke (rumoured permanently) and the other has been relocated to Townsville. It also appears that this gap in service has not been compensated for by increasing the resources to the local ambulance service who are now required to do the three hour round trip to transfer patients to the next level of medical care at Cairns. Earlier this week I needed an urgent transfer of a patient to Cairns but because the local service had been already overworked and for safety reasons was off duty, "fatigue leave" I think its called, an ambulance was required to drive the hour an a quarter from Cairns to pick up the patient. Fortunately the delay did not compromise significantly her care, but it could have.

The doctors who work here (currently three but a minimum of four is required for safe, quality service) work, when they do their 1 in 3 nights oncall, can work quite long hours, and sometimes unsafely so ... who provides them with fatigue leave ? .. yeah you guessed right, no one ... well actually they could, but then no one is available to provide the medical service needed (unless of course a doctor was able to come from Cairns to cover the 8 hours fatigue break .. its only a short helicopter flight !!). Maybe the local GPs could organise a roster to help out ?? And of course the penny-pinchers looking at the costs of the services in Mossman are complaining because the medical services budget is running "over budget" ... cut costs ? ... well where are those excess costs ? .. the overtime and the additional cost of employing locums of course. Cut costs ? ... Yes Minister, sure easy, no after hours medical service for the whole of the region, including the very significant population of Port Douglas who would no doubt prefer to travel the 20 minutes to Mossman instead of the well over an hour to Cairns.

Funding needs to be urgently found and committed - not like the funding that just mysteriously disappeared to employ an allied health worker just this week - really committed, to employ four doctors here full time (this would actually be cheaper than the current three doctor costs). This place is the perfect place for advanced rural general practice training leading in the a Rural Generalist specialty recognition. There should be no shortage of people wanting this sort of work - it just needs the funding.

And why not have an intern rotation here ?? ... in the next year or so there is in fact going to be a shortage of internship positions and it appears that only australian citizens will be guaranteed a position. Overseas students paying (very big) money to train in Australia may not be guaranteed a place for their first year after graduation. Give interns 3 months here under the mentorship of the doctors here and they will get a life-time of experience here. There is "good medicine" to be had here for all.

Caveat ... no I did not get paid, bribed or receive favours for this, as those of you who know me will be aware, I speak my mind.