On a pleasant autumn evening on the first of May (May Day) fifty five members of the Matagouri Club motored their way to Balclutha to visit Clutha Health First, have an evening meal and view the Mobile Surgical Services bus. Amongst the fifty five were forty medical and fifteen dental students. This is an annual event sponsored by RMIP. Matagouri Club is the rural undergraduate club of the Health Sciences students of University of Otago. They were presented with the Clutha Health First story by Branko Sijnja who described the community’s efforts to firstly try to save their 120 bed rural hospital and when that proved unsuccessful design a new sustainable community owned model that is now the successful facility occupied by general practices, an inpatient ward, diagnostic services and community services for the people of the Clutha District.
They enjoyed fifty five take away meals lovingly prepared by the Raj Indian Restaurant of Balclutha (no doubt the best Indian Restaurant in New Zealand). Great food, great taste, great portions and great variety.
The RMIP students based in Balclutha escorted the students around the facility and then they visited the Mobile Surgical Services bus which was preparing for an operating list the next day. A very successful day.
Dr Branko Sijnja | MBChB, FRNZCGP, FNZMA, PGDipObst, PGDipRPHP, PGDipGP | Director Rural Medical Immersion Programme
Nixon Garry, Blattner Kati, Muirhead Jillian, Finnie Wendy, Lawrenson Ross, Kerse Ngaire (2018) Scope of point-of-care ultrasound practice in rural New Zealand. Journal of Primary Health Care , -.
New article from UOO rural POCUS group. Not surprising that POCUS used with a broad scope of practice by rural generalists. Central governance good idea.
INTRODUCTION: Point-of-care ultrasound (POCUS) is an increasingly common adjunct to the clinical assessment of patients in rural New Zealand.
AIM: To describe the scope of POCUS being practiced by rural generalist hospital doctors and gain insights, from their perspective, into its effect.
METHODS: This was a mixed-methods descriptive study. Main outcome measures were type and frequency of POCUS being undertaken. A questionnaire was given to POCUS-active rural hospital doctors to survey the effect of POCUS on clinical practice and assess issues of quality assurance.
RESULTS: The most commonly performed scans were: cardiac (18%) and volume scans (inferior vena cava and jugular venous pressure) (14%), followed by gallbladder (13%), kidney (11%), Focused Assessment with Sonography in Trauma (FAST) (7%), bladder (6%), leg veins (6%) and lungs (5%). There was large variation in frequency of scan types between the study hospitals that could not be accounted for by differences in training.
DISCUSSION: Rural generalists consider the broad scope of POCUS they practise to be an important but challenging skill set. Clinical governance, including an agreed scope and standards, may increase the benefits and improve the safety of rural POCUS.
Garry Nixon: The Eric Elder medal address.
Nixon Garry (2018) Rural generalism: the New Zealand way. Journal of Primary Health Care 10, 102-105. https://doi.org/10.1071/HC18025