challenges and triumphs of rural healthcare

Growing up on a farm in rural Western Australia shaped much of who I am today. A trip to town was an hour round trip and it would take us five hours to drive to the nearest capital city. After finishing high school, I moved to the nearest city to study. Later, after travelling overseas, my husband and I decided to  return to our coastal hometown to raise our children. I have done all my post graduate studies from my hometown, which was a challenge, juggling work, motherhood and travelling to the city for prac. As my career progresses, I am passionate about not just advocating for optimal service provision in our regional and remote areas, but also equipping my clients and others with the knowledge that allows to them to seek help and problem solve some of the challenges.

Around seven million Australians, 28% of the population live in rural and remote areas (Australian Bureau of Statistics, 2023). While these regions are diverse, the challenges their residents face are remarkably similar: fewer healthcare providers, greater distances to access care, and limited resources. Whilst these figures sound harsh and the challenges are real, it also presents lots of opportunity. Health care providers can make a real difference.

As I healthcare provider working in rural Australia, I see firsthand the need to have a level adaptability. Planning, communication, shared care and providing flexibility in how treatment is delivered can be the difference between a good outcome and a great one.

Unique Challenges in Rural Healthcare

Distance and Travel

Long distances to healthcare facilities are one of the most obvious barriers. In my work, I have referred clients to specialists, only to realise the trip would mean a 10-hour return journey. That is not just time away from work or family; it is also a financial burden when you factor in fuel, accommodation, and other travel costs. Often trips to the closest town or capital city need to be planned well in advance and fit in around other appointments at the same time.

Specialist Shortages

Access to specialist services such as Gynaecology may often be unavailable or have long waitlists for public service. For many regional and remote centres, it is a challenge to attract qualified and experienced health care workers. The areas that the health professionals are servicing are quite vast and for many the wait time may be up to years for a review, with no option of private services without needing to go to the city.

Privacy in Close-Knit Communities

In small towns, privacy can be a significant concern. It is not uncommon for people to hesitate seeking care for sensitive issues, like pelvic health, out of fear of gossip or judgment. It is completely understandable that you may not wish for your pelvic health physio to also be a fellow mum on your child’s soccer team or meeting them in the school car park. Rest assured, that as a pelvic health physiotherapist I take the privacy and dignity of my clients very seriously. When it is our everyday job, we are able to switch into professional mode and our only concern is providing high quality treatment. Your physio is certainly not judging whether or not your have shaved your legs or have matching socks.

Financial and Time Pressures

Rural life often demands prioritising immediate needs, particularly during busy periods like harvest or shearing. In these times, a trip to town can feel like a luxury. Many clients have told me they want to come to appointments but simply cannot justify the time away from the farm or family commitments.

Limited Awareness and Conversations Around Health

In rural communities, open discussions about health are rare. The men and women in our rural communities have faced  hard and unpredictable challenges, and are extremely resilient. There is a tendency to ‘get on’ with things, without complaint. Whilst this can build character, there can be a lack of awareness that comes with less shared experience and, on occasion social isolation.

 bridging the gap

While the challenges are significant, they are not insurmountable. Over the years, I have seen how thoughtful strategies can improve access to healthcare, even in the most remote areas.

Telehealth

Telehealth has been a meaningful change for rural communities. Through video consultations, clients can receive assessments, exercises, and guidance without leaving their homes. While some conditions require in-person visits, telehealth provides an excellent alternative for ongoing care, reducing the need for travel. Many of the local hospitals are now able to delivery the ante natal birth education via telehealth, which has improved the access for so many women.

Building Local Networks of Care

Local healthcare providers like GPs, nurses and physiotherapist are often the first point of contact for rural residents. By fostering strong relationships with these professionals, we can create a more integrated approach to care. For example, local providers can identify issues early, offer initial support, and refer clients to specialists when necessary. With proactive clinicians and early detection, preventative treatments can be very effective.

Education and Awareness

Breaking the silence around health issues is crucial. Workshops, community talks, and even social media campaigns can help normalise conversations about health. In my own practice, I have seen how education empowers people to seek help and realise they do not have to suffer in silence. I have spent time traveling several hours to deliver education talks to rural communities. This not only provides the opportunity for education, it is a great way for locals to get together.

Financial Assistance Programs

Travel assistance programs can ease the financial burden of accessing specialist care, but they are often under utilised due to a lack of awareness and fluctuating levels of funding. Educating rural residents about these programs can make a significant difference. Talk to your local GP about what steps may be required to access some funding.

Supporting Community Connections

Rural communities are built on strong social connections. By leveraging this strength, we can create informal support networks that reduce stigma and encourage people to seek care. For example, local mums’ groups or fitness classes can be safe spaces to discuss health concerns and share resources.

Online resources

For many of my patients it may not be possible or viable to join in a group program or access regular physiotherapy for follow up appointments. I have been utilising online education and exercise platforms such as the Empowered Motherhood Program for many years, as it can assist with providing women with a sense of belonging, commitment and accountability that they may otherwise be missing.

 Living in a rural area should not mean settling for inadequate care. With telehealth, community support, and increased education, we can overcome many of these barriers and ensure that everyone, regardless of location, has access to the care they deserve. If you live in a regional or remote area and are struggling to access the care and support that you need, do not hesitate to reach out to your nearest service provider for support. You may be surprised at the level of innovation we now have available to us in service provisions and how passionate healthcare workers are about providing high quality healthcare.