New Zealand’s reliance on foreign doctors to plug gaps highlights the need for another medical school

Thursday, May 18th, 2023 | claly44p | No Comments

Spotted in The Conversation this week – an interesting opinion piece by Ross Lawrenson from University of Waikato – take a read and see if you agree?

Congratulations Jane Taafaki on her Exceptional PhD Thesis!

Thursday, May 11th, 2023 | claly44p | No Comments

Exceptional PhD Theses are awarded when all three examiners of a candidate’s thesis agree that the thesis is among the top 10 per cent of theses examined, so it is with great pleasure to congratulate Jane Taafaki on receiving this accolade!

An exceptional person as well as an exceptional thesis, Jane’s PhD is titled The lived experiences of rural Tuvaluans navigating the Aotearoa New Zealand healthcare system” & her Primary Supervisor was Dr Jude Sligo.

Jane asked participants from Oamaru and Dunedin to record their interactions with the health care system through photovoice – a research method where participants use photographs to illustrate their experiences.  Her findings contribute to the increasing body of Tagata Pasifika health research in New Zealand and will make a positive contribution to improved health outcomes of not only Tuvaluans but by extension other Pasifika peoples in New Zealand.

For more information on Jane & her research see the Otago Bulletin here


Postgraduate congratulations to Cook Island’s doctors

Monday, February 20th, 2023 | claly44p | No Comments

Celebrations to Dr Koko Lwin and Dr Te Ariki Faireka on their University of Otago postgraduate success.  At a recent ceremony in Rarotonga Dr Koko Lwin graduated with a Postgraduate Diploma in Rural & Provincial Hospital Practice which he completed in 2021, as well as a Postgraduate Certificate of Clinician Performed Ultrasonography completed in 2022.  Dr Te Ariki Faireka graduated with a Cook Islands Fellowship in General Practice. Present for the ceremony was Otago’s Pacific Island Nation Liaison (Va’a o Tautai) Dr Kati Blattner.

Read the full story here


Cost savings of the rural accelerated chest pain pathway

Thursday, December 22nd, 2022 | claly44p | No Comments

The cost savings of the rural accelerated chest pain pathway for low-risk chest pain in rural general practice: a cost minimisation analysis.

Rory Miller, Garry Nixon, Tim Stokes, Michelle Smith, John W. Pickering, Talis Liepins and Martin Than. Journal of Primary Health Care 2022 doi:10.1071/HC22117

Hot off the Press & available to all at

With a rural accelerated chest pain pathway developed and shown to be equivalent to accelerated diagnostic chest pain pathways in urban EDs for patients with low-risk cardiac events, the team has now surveyed patients to evaluate the potential cost savings to both individuals and the health system.  Despite the low response rate, it is evident that savings can be made at many levels.  This pathway will  now be evaluated across Aotearoa NZ



Introduction. The rural accelerated chest pain pathway (RACPP) has been shown to safely reduce the number of transfers to hospital for patients who present with chest pain to rural general practice. Aim. This study aimed to estimate the costs associated with assessing patients with low-risk chest pain using the RACPP in rural general practice compared with transporting such patients to a distant emergency department (ED). Methods. This was a retrospective cost minimisation analysis. All patients with low-risk chest pain that were assessed in New Zealand (NZ) rural general practice using the RACPP between 1 June 2018 and 31 December 2019 were asked to participate. The costs incurred by patients were determined by an online survey. Patients were also asked to estimate the costs if they would have been transferred to ED. System costs were obtained from the relevant healthcare organisations. The main outcome measure was the total cost for patients who present with low-risk chest pain. Results. In total, 15 patients (22.7% response rate) responded to the survey. Using the RACPP in general practice resulted in a median cost saving of NZ$1184 (95% CI: $1111 to $1468) compared with transferring the same patient to ED. Discussion. Although limited by low enrolment, this study suggests that there are significant savings if the RACPP is used to assess patients with low-risk chest pain in rural NZ general practice.

Time to take a bow, Professor!

Friday, December 16th, 2022 | claly44p | No Comments

Congratulations to Professor Garry Nixon on his well-deserved promotion! We are proud of the Prof’s achievements! An awesome clinician, researcher and leader as well as an all round good bloke!

Garry continues to live and practice as a rural doctor in the same Central Otago community he has always worked in.

His research focuses on health outcomes and improving health services for rural communities like his own. His earlier research centred on point-of-care diagnostic technologies, including ultrasound and laboratory testing, examining their safety and impact on patient care.

In more recent times he has led a team of researchers who have developed and validated a new urban rural classification for health and are using it to compare urban and rural health outcomes and access to services.

He has collaborated closely with rural researchers in other parts of the country including the Far North and Waikato.

He has PhD students researching rural chest pain assessment pathways, the scopes of practice of rural allied health professionals, healthcare consumption across the urban rural spectrum and the workforce outcomes of rural interventions in the undergraduate medical programme.


New chest pain test for rural hospitals and general practices

Tuesday, December 13th, 2022 | claly44p | No Comments

Congratulations to Rory and the team with their successful pilot study, supported by the Heart Foundation, evaluating the safety and effectiveness of an accelerated chest pain pathway, including a troponin test performed in rural settings.  Read more:

A message from Rory:

A sincere and huge thank you to all sites that contributed to this project and made it a success. The primary findings have been published here as an open access article: and covered here in LOFP:

The project is discussed here on the podcast:

We have subsequently been awarded a research grant to implement a high sensitivity point-of-care troponin in 30 rural health facilities across Aotearoa. If you are currently using a point-of-care troponin and are interested in being part of this project then please reach out to:

New Zealand’s rural hospitals in 2021: findings from an exploratory questionnaire survey

Monday, August 22nd, 2022 | claly44p | No Comments

Katharina Blattner, Lynne Clay, Rory Miller, Garry Nixon, Sue Crengle, Lauralie Richard, Ray Anton, Tim Stokes

OPEN ACCESS Journal of Primary Health Care Published online: 18 August 2022

In 2021 I had the opportunity to work with Dr Kati Blattner on a project to explore the place of rural hospitals in Aotearoa, NZ.  My eyes were opened to the uniqueness of each and everyone of our rural hospitals and the challenges faced to provide equitable healthcare.  This short report presents one aspect of the research – a snapshot of how rural hospital leaders perceived the role of their hospital in a time of coronavirus and upcoming major change in the national health system. (L.C)


Introduction. There is a gap in our knowledge of the place and contribution of rural hospitals in the New Zealand health system. There is no current description of rural hospital services, no national policies and little published research regarding their value. Aim. To explore rural hospital leader perspectives of the role of rural hospitals. Methods. An on-line survey of rural hospital leaders conducted to capture perspectives on areas including facility nomenclature; access and equity; funding and the health reforms. Results. Fifty-five rural hospital leaders representing 19/24 rural hospitals responded. ‘Rural Hospital’ was the most common term used to describe facilities with 80% of respondents indicating this as their preferred term. Other descriptive terms varied widely from primary through to secondary care. Respondents indicated that the loss of rural hospital in-patient beds would be unacceptable to communities (median 0, IQR 0, 1). Scores on questions about ‘range of services’ (median 7, IQR 6, 8), ‘accessibility’ (median 7, IQR 6, 8) and how rural hospitals were addressing health equity (median 6, IQR 5, 7) were variable. The process for allocating funds to rural hospitals was perceived as lacking transparency (median 3, IQR 2, 5). National strategy and ‘local governance and control’ were both rated as important (median 9, IQR 7, 10 and median 9, IQR, 8, 10) for a rural hospital’s future. Discussion. By capturing a collective national rural hospital leadership voice, this study facilitates the understanding of the rural hospital concept. The findings inform subsequent research needed to gain a clearer picture of New Zealand rural hospital provision.

Rural Recognition at 2022 RNZCGP: Awards and Honorary Fellowships

Thursday, July 28th, 2022 | claly44p | No Comments


Ma pango ma whero, ka oti te mahi (by black and red together the work is done).

Congratulations to Marara Koroheke-Rogers and Hone Taimona recognised with Honorary Fellowships to the Royal New Zealand College of General Practitioners. Ngā mihi nui ki a koe – huge gratitude to you on behalf of your Otago colleagues and the numerous rural medicine trainees and experienced doctors who have learned from you through our rural postgraduate papers, in partnership with Hauora Hokianga (@hokiangahealth).

In 2006, the Dunedin School of Medicine shifted the teaching of the rural context and Hauora Māori components of our rural postgraduate programme out of a Dunedin classroom and onto the Pa-te-Aroha Marae at Whirinaki in the South Hokianga. This was not just a change in location but a change in direction for the entire programme.

Marara and Hone, with Hauora Hokianga, have been partners since those early days. They occupy crucial roles that link the local health service, the community and the teaching.  Marara and Hone have also been active members of research teams and co-authors on publications.

“Marara and Hone are pioneers in delivering this type of postgraduate medical education. The knowledge they bring needs to be at the centre of all our rural health teaching and research” Associate Professor Garry Nixon, Department of General Practice and Rural Health.



Congratulations to Dr Jeremy Webber and Dr Sean Hanna who were honoured with Distinguished Fellowship awards. The Fellowship is awarded to GPs who have demonstrated sustained contributions to general practice, medicine, or the health and wellbeing of the community.

The next generation steps up. Dr Jeremy Webber was the first person to get a Fellowship in Rural Hospital Medicine the proper way, that is by doing the training programme and he has now turned that into a FDRHMNZ (Dist.)  Jeremy expanded his world view by spending time working in Australia before returning home and almost immediately taking on some important leadership roles, at Taupō hospital, in the Division of Rural Hospital Medicine as Chair of the Board of Studies and the first Clinical Director Rural Health for Hauora Taiwhenua. Thanks for your efforts Jeremy and the great way you approach the people and issues you deal with.  Jeremy is also the packhorse in any Godzone Team and the powerhouse in any packraft. Ngā mihi


Dr Sean Hanna is a Wellington-based general practitioner, who has been the medical educator for Otago’s Rural Medical Immersion Programme since its early days. He is highly respected for his work as a specialist general practitioner in Takapūwāhia Porirua, his commitment to delivering health care to young people, his advocacy for equity in healthcare and his contribution to education. He has also made a significant contribution to rural health both in his RMIP role and as a rural doctor in the Hokianga.




The Eric Elder Medal is awarded in honour of Dr Eric Elder, who was an inspired rural GP affectionately known as the grandfather of vocational training in New Zealand. The medal is generally awarded to a rural general practitioner.  This year the award has gone to Dr Nina Stupples – congratulations Nina!

Dr Nina Stupples has worked in her Westport community for 13 years, providing consistent and quality care to her patients and ensuring they have access to high quality hospital care when required. She has been instrumental in the developing Rural Hospital Medicine in New Zealand, being the Chair of the Rural Hospital Division from 2010 until 2014, laying the foundation for the first truly generalist training programme in the country. The key feature of this programme was combining both Rural Hospital Medicine and Rural General Practice into a single training programme, with dual fellowship being an option in both vocational scopes of practice.

Nina has mentored many registrars in Westport, alongside her day-to-day practice and involvement with the Division, and she also teaches students in the Rural postgraduate programme and Rural Medical Immersion Programme at the University of Otago.  New Zealand rural health has benefitted from Nina’s hard work and dedication to the profession.

Congratulations to Rural Health Researchers!

Friday, July 1st, 2022 | claly44p | No Comments

Our shining stars, Dr Rory Miller and Assoc Prof Garry Nixon are among 22 University of Otago researchers to receive Health Research Council funding in the latest round.  Check out the full report. – well worth it for the photos! 

Awesome to see rural health research being supported!

“Dr Rory Miller, of the Department of General Practice and Rural Health, will assess a pathway to allow patients who develop chest pain to remain closer to their communities and whanau by accessing blood testing technology which is as accurate as those available in urban emergency departments.”

“Associate Professor Garry Nixon, of the Department of General Practice and Rural Health, is seeking to better understand the impact of rurality on health outcomes and healthcare delivery.  Aotearoa has not undertaken much research into the health status of rural communities, so he wants to find out how rurality, ethnicity and socioeconomic status interact to impact on health outcomes and access to health services for New Zealanders, how people move between urban and rural areas when they become unwell, and how much public healthcare rural New Zealanders consume, in dollar terms, compared to their urban compatriots.”