Rural Surgery: The Australian Experience

Department of Surgery, University of Adelaide, The Queen Elizabeth Hospital, Adelaide, Woodville Road, Woodville 5011, South Australia, Australia.
Surgical Clinics of North America (Impact Factor: 1.88). 12/2009; 89(6):1325-33, ix. DOI: 10.1016/j.suc.2009.07.004
Source: PubMed


A significant proportion of the Australian population resides nonmetropolitan regions. For the majority of these smaller regional centers, the surgical service delivery has been traditionally provided by either solo or two-person surgical practices. As medical students' interest in rural practice declined, new models were created to ensure medical care in these areas. This article outlines the past and current state of medical care in rural areas, highlighting models used in Port Augusta, Mount Gambier, and Port Lincoln. It concludes that these models are successful and should be further developed.

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    ABSTRACT: Introduction  Rural and remote surgical practice presents unique barriers to the uptake of the evidence-based medicine (EBM) paradigm. As medical and education institutions around Australia develop practices and support for EBM, there are growing questions about how EBM is situated in the rural and remote context. The Monash University Department of Surgery at Monash Medical Centre implemented a study to explore the current understandings, attitudes and practices of rural surgeons towards the EBM paradigm.Methods  Descriptive survey of rural surgeons based in a tertiary care environment.Results  The overall results of the survey demonstrate that: (1) rural surgeons have a good understanding of EBM; (2) EBM evidence is somewhat useful but not very important to clinical decision making; and (3) while rural surgeons are relatively confident in most sources listed, they are most confident in their own judgment and clinical practice guidelines, and least confident in telephone contact with colleagues. Rural surgeons’ understanding, usage and confidence in EBM purports that rural surgeons have contradictory, ambivalent and complex views of the EBM paradigm and its place in rural surgical practice.Discussion  Professional isolation and context specificity are important to consider when extending the EBM paradigm to rural surgical practice and understanding the EBM uptake in the rural surgery context.
    Full-text · Article · Jun 2011 · Journal of Evaluation in Clinical Practice