BONDED MEDICAL PROGRAM

BONDED MEDICAL PROGRAM

Bonded medical program (BMP) is a proposed health system reform by the Australia government where the graduate medical students are bounded by legal contracts to serve in the remote, rural, and regional areas where there is a shortage in the workforce. On the other hand, risk analysis is termed as the process of identifying and evaluating potential issues that could negatively affect a project or business initiative from thriving.

Comprehensive Risk Estimation

An estimate of 20% of the population in Australia lives in the remote and rural regions. These proportions of people face poor services in comparison to the people in the metropolitan areas. In addition, the outer and inner regional communities have a high incidence rate of chronic infections. There is a need for an increased medical workforce in the rural areas of Australia due to the large poor health conditions of the people.

Majority of the Australians living in remote and rural regions often travel for a long distance in order to access medical services. Similarly, on the basis of 2005-2010 AIHW survey, 57% of people who live in the remote areas tend to move in the regions that are less remote to be able to obtain proper medical services in the situations of chronic infection such as end-stage renal disease (ESRD) (Australian Institute of Health and Welfare, 2016).

Risk likelihood

There is a possible likelihood of the risk being realized due to an insufficient workforce in the rural regions. Therefore, there is a developed need to progressively assess this medical program in order to improve service delivery. According to the 2015 AIHW health workforce analysis, the number of medical experts working per person in the cities is 4.1 per 1000 in comparison to 2.5 per 1000 in the remote and rural (Australian Bureau of Statistics, 2015). From the survey, it was valid that with an increase in the level of remoteness, the number of medical specialists declined. Inadequate medical services attributed to the fact that people in remote regions of Australia have a minimal likelihood to access hospital procedures and routine screening programs.

Impact

However, this program is at risk since its success in recruiting upcoming rural health experts has not been positively proven. The numbers of students who complete the BMP program or Medical Bonded Rural Scholarship (MBRS) reduce due to withdrawals, which are a breach of contract. Thus according to the Australian Institute of Health and Welfare (AIHW) survey in 2017, there were a total of 414 withdrawals, 151 undertaking rural return of service (RoS) with only 9 participants completing the program. The majority of the students who withdrew from the program believed that RoS limited their family options and career ambitions in regard to education and employment. On the other hand, there has been stigmatization on the students who have completed the BMP program, thus perceived to have not qualified for the scholarship program. This will negatively impact their rural RoS.

Risk level

There was a high-risk level of the program due to compliant from the doctors in the remote and rural training association on the reduced standards of care in the rural regions if the students remain in the program unwillingly (Walters et al., 2016). Some of the students have preconceived attitudes and ideas in regards to working in rural regions, which may hinder the delivery of medical services to the community. Additionally, some of them feel isolated in the rural regions and are have been kept away from their close family members and friends; thus, the level of service delivery will decline to heighten the risk. Lack of rural experience and the high workload that the medical professions encounter make them be reluctant in their service delivery. This is because they cannot cope up with the huge number of patients who require treatment due to their low number of inadequate medical resources.

Management Plan

The people in Australia deserve proper access to medical services regardless of their localities. Therefore, it is important to support justifiable evidence-based programs that will enhance the uptake of medical experts in the rural, regional, and remote regions in Australia. Hence the bounded programs play a major part in the adoption of this strategy. To reduce the number of withdrawals from the program, it is essential to adopt measures such as providing the MRBS scholarship to the students who have positive experience and exposure in regards to the clinical practice in the remote regions (Grobler, Marais & Mabunda, 2015).  Moreover, encouraging the students who have been admitted to the program to be positive and avoid negative sentiments in regards to rural experience. Minimization of stigmatization, negative sentiments, and thoughts will enhance a genuine desire and positive attitude of the students who would wish to join the program (Playford, Ngo, Gupta & Puddey, 2017).

BMP is a legitimate agreement; thus it is essential for the students to receive a piece of legal advice before taking part in the signing of the contract. Therefore bonded medical doctors and students require extensive support and awareness when in search of a career and legal planning advice. Since accessibility, cost, and limited knowledge can be a potential barrier. Finally, implementing penalties on the students who withdraw before or after completion of their programs before engaging in rural RoS. This penalty entails the student paying an equal amount of cash that could have undertaken him to complete his medical studies if he had not received the scholarship. This strategy will facilitate the students to make a comprehensive decision before applying for the MRBS scholarship (Calder et al., 2018).

References

Australian Bureau of Statistics. (2015). National health survey: First results, 2014–15. ABS Cat. No. 4364.0. 55.001).

Australian Institute of Health and Welfare. (2016). Admitted patient care 2014–15: Australian hospital statistics. Health services series no 68, Cat. no. HSE 172.

Calder, R., Glover, J., Buckley, J., McNeil, J., Harris, B., & Lindberg, R. (2018). Better data for better decisions: The Case for an Australian Health Survey.

Grobler, L., Marais, B. J., & Mabunda, S. (2015). Interventions for increasing the proportion of health professionals practising in rural and other underserved areas. Cochrane database of systematic reviews, (6).

Playford, D., Ngo, H., Gupta, S., & Puddey, I. B. (2017). Opting for rural practice: the influence of medical student origin, intention and immersion experience. Medical Journal of Australia, 207(4), 154-158.

Walters, L., Seal, A., McGirr, J., Stewart, R., DeWitt, D., & Playford, D. (2016). Effect of medical student preference on rural clinical school experience and rural career intentions. Rural and remote health, 16(4).