Dr David Halata & Dr Katerina Javorska are rural family doctors form Czechia. Both of them have been involved in an initiative to improve rural healthcare in Czechia called Go Rural. Dr Halata is the chairman of the Working Group for Rural Medicine in the National society for Family medicine and creator of Go Rural. Dr Javorska is a member of the Working Group on Rural Medicine and has been working with students and young doctors in the Hradec Kralova region.

Episode summary:

00.50  Dr Halata and Dr Javorska tell us how they became rural family doctors and their professional background.

06.20  How is the primary care system organized in Czechia?

11.50  What are the rural health challenges?

17.15  Why did they start a rural health working group in their national society?

20.35  What is Go Rural?

23.55  What have the outcomes been from Go Rural?

28.30  Project in Hradec Kralova

36.00  Where there any challenges to developing the program?

37.20  Is the program having an effect on the development of rural health?

38.45  What have you learned from these projects?

44.15  What is their advice to others who would like to set up similar program?

48.50  What have they most enjoyed about being a rural doctor and their top tips?

Key messages:

Primary care - primary care pediatrician, family doctor, primary care gynecologist, and dentist.

Family doctor team was traditionally made up of a doctor and a nurse.

More recently some practices have started to develop primary care teams with additional staff.

There are two different health care systems, one around university hospitals and another around local hospitals.  Availability and quality of care varies in different parts of the country.

Challenges in providing care for Ukrainian refugees, it was important to build trust with them to provide them with good quality care.

Lack of rural GPs, senior colleagues have retired and no new doctors have taken their place.  This has left a lot of patients without a GP.

Many issues faced in rural areas internationally are similar such as the shortage of rural GPs.

The Working Group for Rural Medicine was established in 2016.  It was important to base their work on data, a lot of things had been made on assumptions rather than data.

Go Rural started in 2018 and focused on students and young doctors to address the rural doctor shortage.  Survey showed that money was not the main motivator, other factors like schools for their children and jobs for their partners were more important.

The pilot program was focused on promoting rural medicine and organizing short fellowships in rural practice.

There has been a high interest from medical students for the short rural internships.

Longitudinal rural clerkships have been shown to attract doctors to work in rural areas. These are not available at present.

The pilot program of Go Rural was run without funding and expenses were covered by the family doctors who were hosting students.

Finding the right mentors to host students was very important to showcase positive examples of rural practice.

Hradec Kralova Project received some funding from the local government, this supported the development of the project by covering costs for mentors, and allowing students to attend a conference. The project started with 15 participants.  Students were surprised by the variety of clinical presentations and work in rural practice.

These projects have helped to support further development of rural health in Czechia and they are now applying for a grant to start a national program.

Following the projects a number of participants became rural doctors.

Larger resources are needed for nationwide impact.  The smaller projects showed that the approach was correct and effective.

There is a need for research in rural practice and good collaboration with universities.

With data they were able to approach the ministry and ask for their support.  Without the data this would not be possible.

A focus on GP trainers is needed in the future and develop them as teachers in general practice.

Advice for starting a similar project: Important to engage and identify the needs of young doctors.  Collect data from the local context. Focus on the quality of the internships and the mentors.  Involve them in real rural work.  The project needs to be fun for students and young doctors.  Engage students in promotion of the project and involve them in project development. Focus on international cooperation and events.

Contact information:

Dr David Halata: https://www.facebook.com/ordinacehostalkova/

Dr Katerina Javorska: https://javorskysro.cz/

Please share and like this episode.  If you wand to learn more about the podcast or share any comments you can do this via email ruralroadtohealth@gmail.com or at theruralroadtohealth.blog

Thank you for listening to the Rural Road to Health!