The passion and politics of rural medicine

Professor Dennis Pashen recalls getting ready to dive off the Queensland coast only to be interrupted by a woman giving birth.

It happened more than once.

“They would get the call, attach the boat and hang around until she delivered,” Prof Pashen recalled to AAP.

“It was a bit annoying, but that’s exactly what I signed up for.”

Such was the life of a young doctor in 1975 in Ingham, a sugar cane growing region in northeast Queensland.

The city’s hospital had open porches and was “insect headquarters”. A small team of doctors took care of everything from childbirth to catastrophic injuries in train crashes to treating rare tropical diseases.

The interesting work and embrace of the Italian migrant community kept him in the small town, 100 kilometers north of Townsville, for two decades.

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“It was a warm, encouraging fellowship. My daughter had sugar cane farmers as godparents,” he said.

Prof. Pashen was born a “bush child” in Cloncurry and has worked in the regions for almost five decades, most recently in Tasmania.

The Rural Doctors Association of Tasmania named him Rural Doctor of the Year this month and said his continued commitment to accessible healthcare has made him a national “icon”.

As federal and state parliament inquiries revealed the dire state of rural health systems, Prof Pashen urged politicians to give rural Australians the care they deserve.

“Rural communities are an invaluable resource for our country and they are being badly done, there are fewer and fewer things to support them.”

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Prof. Pashen has long been at the forefront of filling gaps in healthcare in regional Australia. He ran James Cook University’s Center for Rural and Remote Health at Mount Isa before moving to Tasmania, where he championed an agricultural generalist training programme.

He said he was constantly frustrated with governments supporting old, “failed” solutions.

“Nobody wants to try new things,” he said.

“We tried new things that were well judged, well appreciated, only to have them killed by politicians who lacked the courage to believe.”

One such idea was the introduction of physician assistants, health workers who can handle primary care and administrative tasks to reduce a physician’s workload.

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The program failed to get off the ground in Queensland after opposition from various medical bodies, fearing it would be an expensive short-term fix.

The Albanian government’s move to classify more urban centers as priority areas for labor, potentially drawing doctors away from the regions, only adds to other recruitment barriers such as high university debt and low incomes, he said.

But he is determined to see young doctors into retirement and encourage them to find meaning in rural health.

“Communities really stand behind their doctor and that’s what keeps you there.

“It can be tough, but you never get bored.”