Telehealth: Defeating the tyranny of distance

  • Older man in chair looking at laptop with woman at desk

Ed Kerry and Dr Kavita in Flying Doctor Remote Specialist Appointment

Chris De Sair
Digital Health Services Manager, Royal Flying Doctor Service Victoria.

Telehealth is a powerful tool in the fight against health inequality. It enables precious health care resources to be distributed across vast distances and reduces the burden on patients and the heath system.

In global terms, Australia boasts a higher per capita count of doctors than many countries, with 37% more than Canada, 29% more than the USA, and 24% more than the UK, as per the World Health Organization. Yet, despite this abundance, health care access remains unevenly spread.

According to the Department of Health and Aged Care, Australians in very remote areas have access to 45% less primary health care than their urban counterparts. The Royal Flying Doctor Service’s (RFDS) Best for the Bush research shows this leads to females in very remote areas dying 19 years earlier than those in major cities. For males the gap is 13.9 years. Moreover, both sexes in remote areas face a mortality rate 1.5 times higher than that of urban dwellers.

It's not that rural Australians are innately unhealthier, it’s that they face systemic issues that their city cousins don’t. Where I live in Melbourne, there are around 40 GPs spread across five clinics within a five-minute drive of my house. However, the tyranny of distance and the smaller populations can mean a very different story outside of the capital cities.

Once such example is Ed, a resident of the Mallee and the local bus driver. Ed needs regular checkups with an endocrinologist to maintain his driver's license. A trip to see his endocrinologist in Melbourne would require a nine hour round trip, generally requiring an overnight stay to remain safe with his travels. However, for the last four years Ed has used the Flying Doctor Remote Specialist service from his local health service, some 15 minutes from home. In doing so, he meets with the local diabetes nurse educator in person and follows it up with a quick telehealth appointment with our endocrinologist, all accomplished within an hour.

Telehealth not only removes the structural limitations imposed by geographical distance to patients, but also offers flexibility to clinicians. Attracting clinicians to live and work in regional locations is a global challenge. With telehealth, clinicians can live where they want and work there’s greatest need. At RFDS Victoria, our clinicians live in Sydney, Canberra, Melbourne and everywhere in between. Nevertheless, all of them are working in the regions without having the burden of travel.

It's for these very reasons that telehealth transforms health care into an instrument of a fair go. It gives freedom to clinicians who can choose where they live without shouldering guilt. It empowers patients to live where they desire without facing early mortality. It enables working individuals to prioritise their health without sacrificing their livelihoods.

For those of us who have the privilege to work in a health service, we must embrace an even greater responsibility in using this platform to dismantle the systemic barriers that perpetuate health inequality. No longer should the tyranny of distance dictate the quality of health care one receives. With telehealth, distance is set free, and so too are the prospects for health equality.


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