Episodes

  • Profs Sarah & Roger Strasser - Adventures in Rural Health Education & Research

    Profs Sarah & Roger Strasser - Adventures in Rural Health Education & Research
    Jun 20 2025
    Prof Sarah Strasser and Prof Roger Strasser, a trailblazing couple in the world of rural health, rural health research and rural medical education. Episode summary: 01.15 Sarah and Roger share how they became interested in rural health and some key highlights from their careers 15.30 What did they find most rewarding about living and working in rural areas and what was challenging? 20.50 How did they balance all their different roles with their family life? 29.30 What have been the most important research projects that they have worked on? 51.30 What is NOSM and what makes it different from other medical schools? 59.45 What were the enablers for the development of NOSM? 1:05.00 What has it been like to be a woman and trailblazer in the rural health space over time? 1:11.15 What do they see as being the research focus in rural health in the next 5 to 10 years? Key Messages: They have lived and worked in different countries and in different rural and remote communities. They both share a passion for rural communities and rural health. In 1991 the first National Rural Health Conference inspired a lot of activity around rural health in Australia. Monash University developed rural training pathways and the Monash School of Rural Health. Roger became the first Professor of Rural Health in Australia. Roger acted as the Founding Dean of the Northern Ontario School of Medicine in Canada for 17 years. This is a multi-site rural based full medical school. Sarah started her academic journey in Canada by teaching nurses about whole person medicine. She then became regional director of general practice training in Australia and then became the national director of rural health and covered Indigenous health. Sarah later became dean of Health Sciences at the University of Otago New Zealand. Most enjoyed: The sense of space and being part of the community. Having a very privileged role which lets you get to know the deep issues within the community. Using that privilege in an appropriate way and making a difference for the better. Relationships with the people and the community. Community connectedness. Challenges: Lack of child care that works for you. Lack of resources. Realizing how frustrating it is when things that you need on a daily basis run out or are not working, this can be a quick way to get burnout. Balancing their careers, different professional roles, and raising a family was challenging. Work-life balance gives the impression that work is not part of life. Roger prefers the concepts of work-style life-style mix. Research and teaching are integral to clinical practice. In the daily interaction with patients there are often questions that come up, occasionally there is not an answer in the literature or when asking a colleague. This can be part of a new research question to pursue. It is all woven together. It has been wonderful to see how things have changed over time. On one hand some things seem to stay the same, on the other side everything has changed. Over the last couple of years has been going to conferences that are full of people she does not know. Two threads of research. One was a series of studies asking people in rural and remote communities about their needs. They have a security need, they need to feel that there is a safety net. They first need a doctor and a hospital. Then looking at the sustainability of rural and remote services - 22 in depth case studies. Found that the ones that were doing well had active community participation in the running of the health service. Looked at issues of recruitment and retention of healthcare professionals. Explored contributing to factors of success and developed a rural workforce stability framework with 5 country partners. Active community participation again came up as a strong factor for success. The second thead was education and training for rural practice. Recognizing that there is a better chance of medical graduates going into rural practice with early exposure to rural contexts. Rural upbringing, positive rural clinical experiences and postgraduate training that prepares clinicians for rural practice are the three factors that have been shown to be most important. Immersive community engaged education. Seeking out the disconnects and trying to prove alternative ways of doing things. Don't accept things as they are, go and investigate and find out what needs to be done. Communication and dissemination is an important part of research, share what you find with the relevant people. Encourage community engagement and recognize the importance of patients as teachers. Rural practitioners are naturally effective teachers. Doctors more generally after time in practice through their interaction with patients develop a lot of skill in teaching. Importance of having contracts - doctors and the community knew how long they would be there and ...
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    1 hr and 23 mins
  • Prof Bill Ventres - Healthcare on the Margins & Storylines of Family Medicine

    Prof Bill Ventres - Healthcare on the Margins & Storylines of Family Medicine
    Jun 10 2025
    Prof Bill Ventres is a family physician, medical anthropologist and (recentrly retired) Distinguished Chair of Rural Family Medicine at the University of Arkansas in the USA. Episode Summary: 1.30 Bill tells us about his professional background and how he became interested in rural health 04.30 What made him choose to live in El Salvador? 09.30 What has he most enjoyed about living and working in rural areas? What did he find most challenging? 13.45 What is Arkansas like, what is the context there like? 19.00 Storylines of Family Medicine - why did he decide to do this project? 29.45 What are some insights about practicing in rural and remote contexts? 33.05 What insights has he had in his work on rural workforce development? 36.20 What were the main challenges for building a rural workforce? 38.55 What are some possible solutions to rural workforce challenges? 43.30 How are rural and urban practice similar and different? 49.15 What would his top advice be to policy makers? 51.10 Top three tips for students and early career professionals thinking about a rural career Key Messages: He has spent his career working with people who find themselves on the margins of society. He started his work in urban underserved settings. After spending some time in El Salvador he returned to Arkansas and started working in rural areas. He is now a student of Latin American Philosophy while living in El Salvador. Many people in rural and underserved areas feel left out, many people in rural and underserved areas feel on the margins of a greater society, and that the medical system does not really attend to their needs. He most enjoyed listening to the stories his patients told and hearing about the experiences that people had. That is one of the wonderful things about being in a small practice, one really gets to know the pulse of all the people in the community. The biggest challenge were the not so happy stories about access. No one wants to be number one in maternal mortality, it is a problem of rural poverty and exacerbated by a long history of exclusion and structural racism. Arkansas is economically the third poorest state in the USA. There is one larger city, Little Rock, famous for what happened in 1957 when the president sent troops so that 9 teenage black children could attend the local white public school and that was the beginning of desegregation. The rest of the state is rural. Walmart is based in northwest Arkansas, so that part of the state has seen a revival. There is huge income inequality. Storylines of Family Medicine - this is a published series of papers that shares reflections on family medicine from residents and family physicians. For caring for a community of patients the medical model does not work well for the kind of things that we encounter in family medicine. There is a transcendental nature to the work that we do in family medicine. The biggest cultural barrier is between medicine and real people. He was interested in hearing what motivated other people (family doctors), they told their stories of what was the one tenant of practice that motivated them. He asked 136 doctors to share their story in the form of short essays. Family medicine means attending to the needs of the patient whatever they may be in the context at hand. Modern rural medicine uses up to date knowledge transmitted to rural communities, rather than the traditional model which sends rural patients to urban centres. The presence of a physician and the presence of a hospital helps to support small rural communities. The future is in the hands of young family physicians. Find other practitioners who are like you and work together to speak up, advocate and receive support. We all need support, and in rural areas sometimes that is hard to come by. We need to find people who hold similar values and share a similar vision of the importance of the work we do. Challenges are financial, attitudinal, geographical, and unanticipated consequences of AI in medicine. Embed yourself in a community, find a community and do that work. Be open to a different way of seeing that work than what you learned in your medical training. We should be training people to be socially accountable to their community. Understanding the needs of rural communities form the biomedical point of view and the social community point of view. It is important to find people and institutions that are helpful. Finding someone whose ideas can resonate with yours. Some international organizations such as WONCA or TUFT and Deep End Project. Linking with organizations and groups like that to become a collective course. Burnout is about not having true meaning behind the work that you do. Have students in your office so that you can pass things on. People living in the interstitium of society are similar in rural and urban areas. Rural health is being ...
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    55 mins
  • Heather Sherriffs & Dan Martin - ScotGEM & Rural Training on the Orkney Islands

    Heather Sherriffs & Dan Martin - ScotGEM & Rural Training on the Orkney Islands
    May 30 2025
    Heather Sherriffs & Dan Martin are medical students on the ScotGEM training pathway. They share their experience of graduate entry medical training in Scotland, their placement on the Orkney Islands and how this is shaping their thoughts about their future careers. Episode summary: 01.15 Heather and Dan tell us a bit about their professional backgrounds and how they got interested in rural health 03.30 What have they found most rewarding about working in a rural setting? What has been most challenging? 06.45 What is ScotGEM? 09.30 What opportunities does ScotGEM give students? 12.30 How are hospital placements organized? 14.10 How is the course preparing them for working in a rural or remote setting? 16.30 What is Orkney like, the population, geography and care needs? 20.45 What has there experience been with weather and distance? 24.45 Who is part of the wider healthcare team on Orkney? 27.25 What does a standard GP day and week look like on Orkney? 30.30 What has surprised them about Orkney and primary care? 33.50 What are the two or three key learning point that they have gained from their placement in Orkney? 35.32 How has the experience changed their plans for their future career? 40.30 What is their advice to other postgrads who might be considering going into rural medicine? Key messages: Both Heather and Dan had completed different degrees before going into medicine, law and teaching. ScotGEM is a course to prepare students to become a general practitioner in rural and remote environments. It is a graduate entry degree. It is different to traditional courses as your lectures and placements are integrated, you see patients from day one and you have case based learning. The applied nature of the course really supports learning. They also have a longitudinal integrated clerkship in general practice which lasts 10 months. They have had a lot more one to one time with tutors and doctors at the hospital and in general practice, there is more exposure to clinical skills early on. There is more space to explore and try different things during your course. While on Orkney they spend one day a week at the local hospital during their GP longitudinal placement. Heather would be nervous to work in a rural or remote setting if she had never had a placement in that setting before. It is hard to imagine what the job entails if you have not seen it before. This course prepares you really well to work in a rural or remote setting. Dan says it is a certain skill set to be able to go out and stay in a rural or remote settings. Orkney is a set of islands off the northern coast of Scotland. There is a population of about 20000 people. There is an aging population with people needing quite a lot of social care. During COVID people returned to Orkney. The A&E on Orkney is GP lead and when the weather disrupts travel it can be challenging to manage more difficult emergencies. There are four permanent GP surgeries on Orkney and a small hospital in Kirkwall. The hospital has medicine, surgery, emergency and maternity. GPs to normal general practice but also have their specialist interests such as dermatology, mental health, palliative care or women's health. One of the GP surgeries specialize in diving medicine and have a hyperbaric chamber. There is a higher level of responsibility as a junior doctor, you might be the only doctor overnight running the medical and surgical department. The doctors say that they feel well supported. Just take every opportunity that you can get. If you are interested in something, turn up and ask questions. There is a lot that you can do to develop your clinical skills. It has helped them build their resilience. Dan is now considering a career in general practice and public health in a rural and remote context, he has become more interested in this following his placement in Orkney. Heather has always been interested in working somewhere remote or rural but the past year has solidified that interest and given her confidence to take a job in a rural or remote context. Applying to medicine later in life and having some life experience can be a bit of a super power going into medical training. Interpersonal skills and empathy are building blocks that you can use. Contact Heather: hs249@scotgem.ac.uk Contact Dan: dm332@scotgem.ac.uk Thank you for listening to the Rural Road to Health! Rural Health Compass
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    45 mins
  • Dr Iva Petricusic - Rural Health in Croatia

    Dr Iva Petricusic - Rural Health in Croatia
    May 20 2025
    Dr Iva Petricusic is a rural family doctor form Croatia. She is the vice chair of the young doctor committee of the Croatian Medical Chamber and a coordinating member of EUROPREV. Episode summary: 01.15 Iva tells us about her professional background and how she became interested in rural health 03.15 What does she most enjoy about living and working in a rural area? What is most challenging? 07.45 What are the characteristics of the place and community where she works? 13.00 How is primary care organized in Croatia? 17.15 How is family medicine training organized in Croatia? 20.45 What are some of the challenges facing rural communities in Croatia? 26.10 What has changed to improve recruitment and retention into family medicine? 33.00 What would be needed to improve recruitment and retention in Croatia and on the islands? 38.45 What are the challenges faced by doctors thinking about going into rural careers in the European context? Key messages: She would recommend that everyone try living in a rural area to understand the context. Rural areas have a slower pace of living and as a doctor you have multiple roles in the community. As a doctor in the village you are involved with many parts of the patient's life. This can be challenging as you can feel like you are more responsible for them and their health. She often finds herself in situations for which she was not prepared for during her medical training or residency. There are three general practitioners and two pharmacies serving a population of about 5000 people. They also provide care to several nursing homes. Outside of her village there are many places that have been without a doctor for years, they have not had proper medical care, sometimes doctors would be there for a few hours every day or every other day. Young doctors are often placed in such communities and this is very demanding. Local community supported her in getting the supplies that she needed to work but was not available when she arrived. It is difficult to find healthcare workers and attract them to the local region. Not many young doctors decide to stay. Many GPs are retiring. There are 2173 doctors in family medicine in Croatia and the average age is 52 years, of which 858 of those are above the age of 60. It is difficult to find replacements. Slavonia was affected by the war. There are areas that have been abandoned and have difficulty maintaining even a nurse in their community. Croatia has primary care divided into three levels: family medicine, primary pediatrics and primary gynaecology, and it includes dentistry. Primary care is also divided into private and public sectors. However private is not really private, it means that the national insurance company directly has agreements with the doctors working there. In the public sector the national insurance provider has an agreement with the employer that doctors work with. Everyone works for the public sector, but they are paid differently and from the same source. After finishing medical school and internship in Croatia you can work as a GP, in the emergency department or as a prehospital doctor (with the ambulance service). It is suggested but not obligatory to have specialist training in family medicine. Around 1000 of the current family doctors have completed specialty training. The residency program lasts four years, 22 months are spent with a mentor in family medicine practice and 18 months in hospital rotations. There are no rural training pathways in family medicine residency. In undergraduate training there is a requirement to spend 1 week in rural practice. An aging population with multiple comorbidities and complex health needs is becoming more of a challenge. Poor transport infrastructure makes it very difficult for patients to attend secondary care appointments or attend diagnostic tests. Not all villages have an accessible pharmacy, sometimes this means having to organize the medication for a patient to be collected by a nurse, friend or family member who can travel 20km to the pharmacy. Certain tertiary care is only available in Zagreb, 300 km away. This can prolong the time between when a need is identified and a patient receives care. District nurses are important members of the team who can support patient care and share important information about what is happening with patients in the community. Most of the current residency programs in family medicine are funded by the European Union. At present there are about 300 residents in training in Croatia. This is still not enough to compensate for the colleagues that are expected to retire. More local municipalities are recruiting young doctors, such as Istra, they invested funds in this. Local municipalities are looking at how to attract doctors, they offer places in kindergarten for children (childcare is difficult in urban areas), free accommodation, and ...
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    48 mins
  • Prof Bruce Chater - A Story of Rural Generalism

    Prof Bruce Chater - A Story of Rural Generalism
    May 10 2025
    Prof. Bruce Chater is a rural generalist, Head of the Mayne Academy of Rural and Remote Medicine Clinical Unit in Queensland, Australia, and the Chair of Rural WONCA. Episode summary: 01.15 Prof Chater tell us about his professional background and how he became interested in rural health 05.50 What has he most enjoyed about living and working in rural area and what has been challenging? 11.20 Prof Chater tells us how he has contributed to the development of rural practice and rural medical education in Queensland 16.40 What is it like to be in rural practice for 40 years and how do you step down and hand over well? 24.45 How has he maintained the enthusiasm to keep advocating, improving his practice, and teaching students? 31.00 How has he been involved in advocating for better healthcare for rural communities? 40.25 How was Rural WONCA established? 47.15 What have the key achievements been for Rural WONCA over the past 30 years? 51.05 Why should rural clinicians become part of Rural WONCA? 58.30 What are your top 3 tips for people thinking about a rural health career? 1:01.45 Looking to the future Key messages: Rural practice is a chance to have broad skills. I tell my students - Do you want to know more and more about less and less or do you want to spread your wings and be a generalist? When training the key part is that you go to a good place and that doctors are matched well to rural places. The best part about living rurally is the community. What you see is what you get in small communities. The community is genuine and you get to know the people. Continuity of care, comprehensive care and the capability that you can bring to that. You can do a lot in rural areas. Challenges: lack of local education opportunities for children, getting things across to urban bureaucrats - "geographical narcissism", clinical challenges and "clinical courage". Clinical courage - it is about having to step up and do the right thing for someone in your community and it might be about using a skill you have not used in a while. The key element of clinical courage is having a good network of other rural doctors to support you in those situations. Knowing that if you do not do something this person might die. Doctors were isolated and were not a force for good, they had to organize and get together. He was the founding convenor for rural doctors in Queensland and Australia. This led to the formation of the National Rural Health Alliance in Australia. Through the College of Rural and Remote Medicine worked on developing a curriculum for rural medicine. Set up a Statewide clinical network within the Health Department. Developed a model for funding rural hospitals that could be implemented in Australia. Currently also a Professor of Rural and Remote Medicine ensuring there are students in rural areas and making sure there is research about rural areas. Has recently retired and handed over his practice and local hospital to a new doctor - this was a test of the theory and practice he has been advocating for. It is important to have an exemplar practice, rural practice should not be somewhere where you are making a massive income, but you should be well remunerated. You should help people that need help. In Australia there is a mix of public and private practice, he has done a mixture of both and found that this has worked well. Those that can afford to pay for the service and those who can not pay have a good safety net. Be a solution not a problem to the health system. The key has been to get lots of students and young doctors into the practice. Do all the students come back, no, but it is about getting some of them to be inspired to consider rural practice. You can not be what you can not see. The doctor that has taken over his practice came out as a student and then as a registrar and finally said can I take over the practice. Rural generalists must provide general practice, in-patient medicine, emergency medicine, public health and some other special-skill for the community. It bans the boring. You have to protect the next generation. With the doctor that has taken over practice, he spent three years teaching the clinical side of the practice and another three years on how to interact with the health system, interact with management, and have a group of staff. It is important to not be on call all the time. He has looked after his community and they have looked after him. Burnout comes from complete overwork, but it also comes from not being able to express our humanity. They close the practice for half a day every week to talk about their difficult patients, everyone finds that very satisfying. It is important to make sure that the service is equitable across all areas. If you can provide good services then people will stay in rural areas. It is about trying to bring to policy makers the understanding that this is an ...
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    1 hr and 8 mins
  • Ashley Lambert - Rural Health in Medical Education: RHiME

    Ashley Lambert - Rural Health in Medical Education: RHiME
    Apr 30 2025

    Ashley Lambert is a medical student from the University of Swansea in Wales who is currently on the Rural Health in Medical Education track (RHiME).

    Episode summary:

    01.05 Ashley tells us about her background how she became interested in rural health

    02.33 What does she most enjoy about working in a rural area, what does she find most challenging?

    08.40 What is RHiME at Swansea University? How is it different from the standard medical curriculum?

    17.50 Do they have opportunities to connect with other professions?

    19.00 How is she involved in wilderness medicine and does she see it as a part of rural health?

    24.30 What has surprised her during her course?

    27.45 What makes for a great student rural placement?

    34.15 What does she hope her career will look like in the future?



    Key messages:

    The best thing about rural areas is the community and the feeling that everyone knows everyone, and the rapport that you have with patients.

    As a medical student she loves being in a rural area as there are more opportunities for hands-on experiences. However it can be difficult to see patients presenting at a much later stage of their illness.

    RHiME is the Rural Health in Medical Education track at Swansea University. This track offers rural placements and more of a focus on rural health as well as the undertaking the usual curriculum of medical school.

    Regular meetings and collaborations such as mountain and cave rescue, working with rural GPs and district nurses, working on social prescribing, talks about farming and opportunities for different placements in rural areas.

    Wilderness and Expedition Medicine Society has similar aims as RHiME, they encourage people to embrace the outdoors and rural life and to stay in rural Wales. They do a lot of activities, regular group hikes, bouldering, first aid courses, teach people how to tie knots, they also work with rural health doctors and mountain rescue.

    Wilderness and expedition medicine includes a lot of prehospital emergency care. They have medical teaching in the wild such as C-spine management, hypothermia management, splinting, search and rescue, and ultrasound in the field.

    The RHiME track has not made connections with other rural medical education programmes, but they would be interested in connecting with other students interested in rural health.

    The practice made her feel welcome, she was able to sit in with all of the practice staff and see the different way that they work with patients, it was useful to see what all of the different staff did as part of their role. Allowed her to take it at the pace she wanted to and asked her what she wanted to learn. She was given the opportunity to speak with the patient in her own room, make a diagnosis and management plan before discussing it with the GP. The feedback was then very useful for her learning.

    Swansea-Gambia Link is a project that she has been working on which will support student exchanges between the Gambia and Wales.

    Contact Ashley: 2204319@swansea.ac.uk



    Thank you for listening to the Rural Road to Health!

    Rural Health Compass
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    42 mins
  • Dr Jane George - Recruitment and Retention of Rural Allied Health Professionals

    Dr Jane George - Recruitment and Retention of Rural Allied Health Professionals
    Apr 20 2025
    Dr Jane George is a health workforce consultant and academic from New Zealand, specialising in rural workforce and the Allied Health, Scientific, and Technical professions. Episode summary: 01.00 Jane introduces herself using a traditional way 03.10 Jane tells her about how she became interested in rural health 07.15 What does she find most enjoyable about rural areas and what she finds most challenging? 12.50 Why did she decide to focus her research on the rural health workforce and allied health professionals? 15.30 What kind of roles do allied health professionals hold? 18.15 Is there a good distribution of allied health professionals? 21.00 What challenges are facing the rural health workforce? 24.10 Do allied health professionals have access to rural based training or rural training pathways? 26.20 What has she learned through her research about attracting and retaining allied health professionals? 28.15 What factors were getting overlooked and why were they important? 31.34 Jane expands on the themes of her research 38.10 What are her top recommendations for local healthcare organizations and for national level policy? 46.15 What is she working on at the moment? Key Messages: The things she loves about being rural are also the most challenging things. Wide scope of practice and the can do attitude. We are never far from the people we serve. Endless opportunities for advocacy. Surrounded by inequity which provides motivation to improve what we do. Opportunities to challenge geographical narcissism. How do we get better at recruiting and retaining the workforce? This was the question she was searching for an answer for. She chose to focus on what matters to allied health professionals to identify what would best attract and retain them. Finding out what made rural work worthwhile. Allied health professions in rural areas can be pharmacist, physiotherapist, podiatrist, occupational therapists, medical laboratory scientist, radiology technicians, social workers and more. It can be difficult to know what the distribution of allied health professionals is across different regions. The government is working on monitoring this better. Service challenges and professional challenges. The amount of travel that is required, isolation of practice, reduced episodes of care available to stay current. Reduced access to professional development, and a constant need to be pushing back against urban narcissism. Social work is a great example of rural based training, as they have been providing distance training for over 10 years. Speech language therapy has recently developed a distance learning program. She developed 20 recommendations for rural health providers, managers, recruiters and regulatory authorities. Shaped through the narratives of the participants and the key themes of her research. Keyt themes were: 1) sense of connection and belonging, 2) safe and supportive practice, 3) creating roles the people want to go for. Negative press, how rural communities are talked about in the media, we are starting to believe what is being said about rural areas - that it is not as good, that people there are not as skilled, that these areas are not well resources… - we can overlook common sense and practical actions we can take. Important to think about how we value and trust staff, how we help them settle and develop local connections. Do the current policies work for local communities and local staff? Are we listening to local communities and staff, what are they telling us they need? Thinking about if what we are requesting of rural health professionals is reasonable, for example, are staff safe if they are visiting places on their own, how long will they need to travel to do their role, are we making professional support and development available. Recommendations for local health organizations: Reality check - think about is this reasonable to ask of our professionals, are we thinking about staff safety, are we designing the work for the context of rural How are you talking about rural areas? Be mindful of urban narcissism, recognize the strengths of rural communities. Represent rural professionals as valuable and knowledgeable. How you treat people will determine if people come and stay. Involve everyone in decision making. Value the learning needs of allied health professionals and make learning resources available. Recommendations for national policy: Making policies and procedures that are fit for rural communities. It needs to be flexible enough to fit rural contexts Involve everyone in decision making Be mindful of biases, use rural proofing tools to check that you are thinking rurally. Use health equity assessment tools. Education policy and regulatory policy is also important for training and regulation professions play a role in developing and recognizing rural professions, advanced practice and rural generalism....
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    50 mins
  • A/Prof Malin Fors - Geographical Narcissism & Potato Ethics

    A/Prof Malin Fors - Geographical Narcissism & Potato Ethics
    Apr 10 2025
    Dr Malin Fors is a psychotherapist, author and Associate Professor at the Arctic University in Norway. Her reserach focuses on power dynamics between rural and urban areas. Episode Summary: 01.00 Dr Fors tells us about her professional background and interest in rural health 03. 25 What does she most enjoy about rural settings and what does she find most challenging? 05.45 How are challenges different for people living in rural areas regarding mental health? 09.30 What is "Potato Ethics"? 12.45 How does potato ethics show itself in rural healthcare practice? 15.52 How do new clinicians adjust to rural areas and potato ethics? 19.00 Do the differences in approaches to rural practice indicate where someone might practice in the future? What is the role of medical education? 22.15 What is "Geographical Narcissism"? 24.28 What are the power dynamics that geographical narcissism describes? 32.05 How does geographical narcissism play out in the experience of rural communities? 37.05 How does the concept of having a voice play out in rural areas? 40.00 What are some key insights that she has from her research? 44.50 What is she working on at the moment? Key Messages: Research focused on power dynamics, and became aware that power was not only in the consultation, medical records or encounter, but also in the place. Started to discover that "rural place" was rarely described in text books and missing in the discussion on intersectionality and power. Approaches rural health with a psychology gaze. She met her own geographical narcissism as she had an image of the rural world as different, or inferior or that urban standards were more normative. Enjoys that rural contexts mean you always have to stretch yourself and what you do matters, it is challenging and demanding and feels it keeps her mind sharp and developing. The most challenging is the isolation, feeling alone, feeling like the person that is always teaching and mentoring people that do not stay for long. You can feel like it is useless. It can be frustrating to not have an expert team available. People seem to be more ill when they decide to ask for help in rural areas. They are sicker because there is less healthcare. If you wait, mental health can get better on its own or it can become very serious. Colonization of indigenous peoples' lands in Norway, generational trauma following the second world war, the community is underserved when it comes to healthcare and there is a lack of specialists, this can also contribute to how they present to health services. Potato ethics is the ethics of making yourself useful. In Swedish being a potato means that you are not specialized but that you could be used for anything. It can be used in a condescending way, saying that you are not the expert. She combined care ethics and the ethics of consequences to counter the narrative that we who work in rural areas are less ethical in the way we provide care, not meeting urban standards, working on things we are not specialized enough to do, or treating people that are too close to us. Rural healthcare professionals are potatoes, they are versatile, keep track of patients, do all the tasks that are necessary. We often have to do tasks that are not done in urban areas to prevent disasters. Potato ethics is the core of rural healthcare as this is how it is organized. It is a way to describe the core of rural ethics. It is also applicable to different kinds of healthcare settings. We are assessing consequences, we know that if we don't treat the person no one else will, so we do what we can. We can not assume that we have sent a referral and now the patient is taken care of. This is not always the case due to distance or availability. We have to make sure we follow up on our patients. Different professionals approach being in a rural area differently. Some people may start to point out errors and try to say how things are done in the city, pointing out what you should do because they can not see that the system is not working for these populations. While others ask "how can I help" because they get it. Geographical narcissism is the subtle devaluation of rural people, rural knowledge, rural experience and rurality. It is a form of oppression like others being addressed within the human rights movement. It is assumed that no knowledge could come from rural areas, can not do research, can not be in the front and that we need to conform to urban ways of doing things. Geographical narcissism is a way to have a term organized around power themes and to put the urban-rural theme under the intersectional lens. It allows us to use the other movements formulations to talk back i,e blaming the victim, aggression and "urbansplaining". Rural expertise is not thought of as expertise, we are always not reaching the urban standards, however we are often going beyond in a lot of ...
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    49 mins