Challenges in the Peripheries

Dr Pragati Gautama


DipObs , DTM&H.


Rural medicine is determined by its social context, and is represented by  both professional and geographical isolation. Include the impact of resource limitation and financial deprivation faced by our communities , and we only then begin to understand the demands on Clinicians prepared to work in these areas; and the need for a broad scope of skills and attitudes to drive innovative solutions when faced with emergency care. While not a qualitative study , this presentation reflects on over 20 years of work in Rural  Hospital  Medicine  and General Practice in New Zealand. Natural Disasters  ( Volcanic eruption in PNG and  the Earthquake in Christchurch ) have also helped me appreciate the role of support services, such as retrieval medicine, and the need to work collaboratively to  improve health care systems, to deliver care in rural New Zealand . My role as a Clinical Director in a level 3 Rural Hospital, while challenging , helps to illustrate the issues that we face when located distant from a Base Hospital, and the imperative  to maintain credentials appropriate to rural practice and the range of clinical presentations we face.

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