17th Wonca World Rural Health Conference

‘High Performing Rural Teams and Rural Workforce: Getting The Balance Right’ Webinar

December 5, 2020
Bikash Gauchan


Nepal: Bayalpata Hospital: Nyaya Health Nepal

PowerPoint Presentation

Chat Transcript

Chat Transcript

01:05:35 Ewen McPhee: Yes 40 degrees
01:25:45 Ewen McPhee: Excellent presentation – Bikash, I would lobe to receive your references.
01:25:48 Ewen McPhee: Love
01:26:09 Nandita: Very thought stimulating talk!
01:26:13 Zakiur Rahman: Excellent presentation Bikash
01:26:26 Pratima Durga: Thank you, Dr Bikash. Great presentation!
01:27:10 Ewen McPhee: Bikash makes an important point about the need to create a whole of health care team, that these issues ca not been fixed by Doctors alone.
01:27:19 Bruce Chater: great presentation
01:27:42 Nandita: Additions that I think would be relevant to your talk are:
01:28:19 Nandita: Basic laboratory services along with radiology & telemedicine
01:28:20 Jerry Cowley: Bikash- really excellent presentation. Very well put together -comprehensive and highly informative. Thank you.
01:28:30 Joseph Scott-Jones: thanks Bikash – I’d like to ask about “mentoring” that you talked about.
01:29:00 declanfox: Re Ewen’s comment, indeed we need as physicians to learn to trust our colleagues to a greater extent, we need true collaboration to help deal with the awful shortage of workers (especially doctors) in remote and rural practice
01:29:28 Joseph Scott-Jones: what training in “mentoring” do you recommend? how is this achieved in rural Nepal ?
01:30:24 Bikash Gauchan: Jo, mentoring is not formally being trained in Nepal.
01:30:33 Bikash Gauchan: We have exploring
01:35:12 Bikash Gauchan: We keep exploring
01:40:08 Jerry Cowley: Bikash -Can new technology such as Zoom be of use in continuing medical education in Nepal?
01:40:23 Bikash Gauchan: Yes. Jeery.
01:41:00 Jerry Cowley: Thanks Bikash.
01:41:37 Joseph Scott-Jones: hi Bruce
01:42:21 Elhadi Miskeen: hi ..I have comment
01:47:01 Bruce Chater: Facing rural needs clinical courage Konkin J, Grave L,
Cockburn E, et al. Exploration
of rural physicians’ lived
experience of practising
outside their usual scope
of practice to provide
access to essential medical
care (clinical courage): an
international phenomenological
study. BMJ Open
2020;10:e037705. doi:10.1136/
01:47:34 Joseph Scott-Jones: I know that in many countries there are challenges with using team approaches – we are learning more amd more that the medical person in the team is not always the best person to lead a team or project – it takes courage to divest power to others in the team – Bikash has talked before about the importance of recognising the fact that everyone has expertise and skills to bring to improving outcomes for people – I think the idea of deliberately supporting team members offering mentoring and support to others is vital.
01:47:48 Nandita: Thanks for this Bruce
01:48:28 Pratima Durga: Thank you, Bruce, for the reference.
01:49:36 declanfox: and more than just the clinical practice in rural and needing courage to take on problems—there is the need for the course to let go, to consider if I am the best person to directly do this clinical task. Runs counter to the standard thinking about rural doc doing everything but given the incredible shortage of doctors willing to work in rural, is there any other option? I agree Jerry—even here in N. Ireland we are facing recruitment issues.
01:57:47 Joseph Scott-Jones: yes @declanfox I think one of the fantastic things about @bikash abs his approach is the creation of sustainable team based approaches – his service requires his comprehensive skills but could not work without the whole team being supported and deliberately developed
02:02:17 declanfox: and a team approach increases sustainability as in long-term survival. A service crucially dependent on “The Doctor” will likely die if the doctor leaves, dies, gets sick or retires.
02:04:00 Bruce Chater: the elements of clinical courage in the papper are Standing
up to serve anybody and everybody in the community;
Accepting uncertainty and persistently seeking to prepare;
Deliberately understanding and marshalling resources in
the context; Humbly seeking to know one’s own limits;
Clearing the cognitive hurdle when something needs to be
done for your patient; Collegial support to stand up again.
02:08:16 Anthony Cordero: Hi. Anthony from the Philippines.
02:10:48 Joseph Scott-Jones: it’s very interesting to see how much there is in common between countries with vastly different resources
02:11:19 Nandita: Agree. So much to learn from each other!
02:11:34 declanfox: Yes, similar problems the whole world over!!
02:12:03 Ewen McPhee: That is a great concept Jerry. We have used punative measures to restrict doctor numbers, it would be better to understand and fund what the expected need is for a community.
02:12:44 Joseph Scott-Jones: the common need I hear is for the service to be built on the service needed by the people & built on the people who are in the place
02:13:00 declanfox: In rural N. Ireland our problem is a bit different—young doctors just don’t want to go rural—so practices are dying or being taken over by bigger ones to try and maintain some kind of service.
02:14:24 Nandita: If you make rural healthcare attractive with perks this may change. Not sure how that could be done though
02:14:47 Ewen McPhee: We have a Rural Generalist program and I spent time with 21 young Interns last week teaching them about obstetric emergencies. THey were all extremely keen to go rural (15 women and 6 men)
02:15:23 Bikash Gauchan: Wow Great work Ewen
02:15:23 Joseph Scott-Jones: yes I will never forget visiting Mindanao in the Philippines – community responsive care in action
02:15:29 Ewen McPhee: There is a way forward and it requires Recognition. remuneration, the establishment of culure of lifelong support and learning
02:16:15 declanfox: Agree Ewen, it needs a decent system and way of doing things. Difficult with political short attention span!
02:16:18 Bruce Chater: agree Ewen
02:16:27 Ewen McPhee: https://ruralgeneralist.qld.gov.au/
02:16:51 Joseph Scott-Jones: Bikash you are an amazing professional- a five star doctor in my opinion thank you !
02:16:55 Nandita: Thank you Bikash!!
02:17:06 Bikash Gauchan: Thank you so much everyone
02:17:10 Jerry Cowley: If the proper supports are there for rural practice it will encourage young doctors to go to rural areas, Thnks everyone.
02:17:15 Ewen McPhee: Thank you Bikash
02:17:20 declanfox: Thanks for the link Ewen. And great presentation Bikash, thank you very much indeed. Thanks to all for great discussion.
02:17:40 Prof Elizabeth Nwasor: Good meeting 😌
02:17:44 Nandita: Thanks Ewen!
02:17:48 Prof Elizabeth Nwasor: thanks
02:17:55 Ewen McPhee: You can save the chat by clicking the three little dots to the right ->
02:18:00 Tamkin Khan: happy christmas all
02:18:02 Prof Elizabeth Nwasor: from Abuja Nigeria
02:18:04 declanfox: Morning, afternoon, good night!
02:18:32 Bruce Chater: we save the chat automatically if anyone wanst it