Solving the rural health workforce challenge, one community at a time with Dr. Cath Cosgrave

This is the Reimagined Workforce Podcast from Workforce Transformations Australia, the podcast for people and culture. Professionals seeking to drive meaningful, impactful and financially sustainable workforce transformation through curiosity, creativity and data science. In this podcast, we hear from talented and innovative people making a positive difference for their people, their organisations and those their organisations serve. They share stories and learnings to help others on their path to transforming their workforce today and tomorrow. Now here’s your host, Kath Hume.

Dr Cath Cosgrave is a respected social scientist with extensive experience in rural community development, particularly in strengthening the rural health workforce. Her innovative Attract Connect Stay framework and Community Connector program have gained national and international recognition. As the CEO of a management consultancy business, Cath provides consulting and online group programs to business owners, CEOs and senior executives of rural health and social care businesses. Her focus is on helping those who are having difficulties attracting and retaining skilled health professionals. Cath works closely with her clients to help build their understanding of the research evidence behind the Attract Connect Stay framework. She helps them gain the necessary skills to craft effective human resource strategies tailored for their unique organisation and community context. Organisations and communities implementing Attract Connect Stay strategies report significant improvements in attracting good fit applicants and improved retention, with eight out of 10 reporting within six months their intention to stay for the medium to long term. Dr Cosgrave has a deep passion for addressing rural access inequities and resourcing challenges. She’s dedicated to supporting rural communities to become thriving and sustainable places to live and work.

Cath calls Bellingin, a small rural town located in northern New South Wales on Gwumbangir country, her home. She lives on permaculture managed acreage with her husband, grows veggies and tries to be a good steward of the land. She is the president of her local community garden and when not working, she loves practicing yoga and going on multi-day hikes in remote places, ideally where there’s no mobile reception. Cath Cosgrave, that is a fantastic introduction. Welcome to the Reimagined Workforce Podcast. Thanks.

Kath, then in true fashion. Too many Kaths, so many Kaths I work with.

But you know, what. There’s so many similarities and the practicing yoga. That hits the nail right on the head for me. So it’s good that our paths have crossed and I think the universe sends people our way sometimes who love and live the way we like to do. So we’ll jump right in on based on that. Can you just tell us a little bit of your background and career story to date?

Okay, so it’s a bit of a checkered career history. So I grew up in Melbourne, in the eastern suburbs quite a privileged middle class life, got sent to a convent school for my whole education and then, with fairly poor career advice, I went off and did an economics degree. But I don’t really know why I have an economics degree. Except for pretty hard working and I seem to have one I would not call myself an economist in any way, shape or form. And then I went and worked in multinationals in the 80s and after a few years then I decided that I’d made a terrible career mistake and I stopped and I went traveling and I decided that I would never work in any capacity that didn’t improve the world. And I went and did a Masters of Community Development with an international development focus and then spent about the next 10 years working in international development using some of those business skills and economic skills that I had. But for good and I’d say for the rest of my life I’ve never actually done any work that isn’t around right livelihoods. That’s really important to me and I want to use the gifts and skills and privileges I have to improve the health care and other professional services for rural Australians.

More recently, we moved Bellingen from from Melbourne about nearly 20 years ago now and predominantly to raise to young men now and to live a life closer to our values and the lifestyle that we wanted to live, and we also were very worried.

And then climate change and what was likely to come, and so at the same time I moved out of international development and moved to rural community development in Australia and spent the last 20 years working in that space, particularly trying to improve health and social care services, and initially with a focus on mental health services and well being. But 10 years ago I got really tired of good projects not being refunded and poor projects being refunded and I would always embed evaluation in all the programs that I had got grant funding for and this frustrated me and I decided that I actually wanted to be the person sitting on the other side, the evaluator or the researcher, and contribute to making sure that good work got refunded. So there was an opportunity at the University of New England to do a PhD.

And I got workforce. And I remember my supervisor saying to me if you do a good study here, it’ll make your career. This is a really under researched, desperately needed, emerging problem in rural Australia. So originally my PhD was I wanted to tell a good news story and it was on why do people stay in, I was looking at community health workforces, so particularly allied health and nursing, were the predominant profession in community mental health services in public, and I’m a qualitative researcher. So I’m a grounded theorist. The closest, if your audience, the best known grounded theorist is Brené Brown, and a grounded theory is about creating theories based on data around what is happening, what phenomenon is happening. So in my case it was why do people stay? Or, as was the case, why were they leaving? And they were leaving and droves. So I developed this theory, which is the basis behind the Attract Connect Stay framework. It took all the elements and has created. You know, what do you need to do to to both attract and retain health workforce, and the stories I was told when I did my PhD were pretty heartbreaking, and a lot of it I would have described as avoidable turnover that if we had done some of the social determinants better and I believe rural communities can do the social determinants much better that a lot of the turnover or the very distressing times in the bad word of mouth that people left with could have not happened, and so people would have had more positive experiences overall. So I’ve made it my life’s work to change that.

There’s a particular story that sits with me. One of my participants in my PhD study Jacob, who was a mental health psychiatric nurse from the UK and he was a new grad and he was in a regional town in Northwestern New South Wales and he’d been there for nearly two years and he was chronically lonely. So there were lots of challenges in the workplace as well, but his main challenge was as a newcomer he was really isolated. I caught up with him on his last day of working. He was relocating to Sydney but he’d spent the last sort of six months driving to Sydney or Newcastle every weekend to have some social connections.

So that one I sort of finished my PhD going that should have never happened and I’m going to make sure on my watch that it never happens again and that’s the..I sit, with Jacob in my heart, around the Community Connector Program, which is an element, or it was one pillar, of the Attract Connects Stay framework, and you know it’s a great delight when I hear that we’re welcoming and connecting workers and their families, every member of their family, to quickly settle in and belong, feel a sense of belonging in rural communities. So, and it’s really lovely seeing the program work and that there’s it’s what I would say a significant missing piece these social determinants of attraction and retention for rural. So that’s me, that’s a long, long answer.

I’ve got so many questions already. I always write questions as we go. I’ll stick to the script for the moment, but I think we’re going to go off script at some point because I’ve got a lot. There’s so much in that unpack. What do you think it is that drives your passion for Attract Connects Stay?

Well, as I was saying, I can see that it makes a difference, that it’s government has focused on the pipeline and training and spent an enormous amount of money on training and pipeline. So there is a lot of that and that’s good work and it does need to be done around the importance of training and identifying that rural people are more likely to to stay if we can train them in place. But they’re not the only people and we have a huge maldistribution issue and we also, there are many people from urban backgrounds who would be very good fit for rural, like myself. They just need the opportunity and we need to make sure that there’s a pathway for them too. So I think we’ve we’ve spent so much on the education and training component and missing this sort of what happens after people qualify and what do we need to support good, good attraction, good recruitment and then, following on, good retention. So it’s a really complex problem because humans are complex and by the time we head into our careers after those health professionals have trained, there’s many things they’re considering and my research, my PhD study, found that people are always weighing up the personal and the professional and they. It’s a balance between those and we can’t forget the personal, and I think that’s somewhere in the last 50 years we’ve focused just on professional factors and we put this real divide between work and work and life, and that’s artificial and so and the other thing is, I’ve identified that things look different depending on your life stage. So you know, I think health services always feel much better after I’ve spoken to them If I say, if you’re getting two years retention out of your early careerers, is you’re doing really well.

Because what really motivates them is experiences. So they want to have a lot of them and looking for a partner. And if they don’t think they’re going to find a partner in your town or region, they’re not going to stay. So we want them to do all of those things, but we want them to leave with good word of mouth and I think with a good program we could probably extend their stay till three years. Some will stay but most will go.

So it’s not really about whether they’re locals or not. It’s about having good work, experiences and career opportunities that come from working in rural. You get fast tracked rural and that’s a real incentive. For middle career, so people who are, I know what I would call a more stable family forming. Now that can be dogs, cats, children, partners, land, it can be everything, but it is a more subtle phase. It’s all about work life balance but in all of across the life course it’s always about career opportunities. We just need to make sure for those people in middle adulthood that there are opportunities in region. So there needs to be good collaboration across health services. That’s hard to do and so we want people to have meaningful careers and be able to step up or move across and so working collaboratively and at a regional all those services working regionally, public and private that will help build those.

I haven’t been able to get to that piece of work, although I’ve identified it, because I’ve been too busy with the organizational component of a Attract Connect Stay and making sure that health services have good cultures and people are recruited and on boarded appropriately so that they have we don’t lay the seeds of turnover intention in those first 12 months and the community connector part or the community in place part, which is addressing the social determinants. But I hope in the last five years of my career some of those things we kind of know what best practices now and we can move to the career part, because I get bored really easily and I’m once I’ve solved something or I think what that’s about as good, we’ve proven the concept, there are better people to continue to roll it out. And I’ll just focus on what’s the next piece of research and that I want to work with, so I am an action researcher. I remain a researcher, although I now work as a consultant. I’ve always got that research head. I’m interested in why something’s happening and building an evidence base around, how we can change it, and I think that’s what makes me quite unique.

We are working from evidence informed human resource strategies and that’s quite new and it works. So that’s the other one around. We’re picking up some of the missing pieces. We’re doing a more evidence informed, evidence based approaches and we’re getting people to think about all the things, not just the work ones.

And the Community Connector program is an important part of that and the community connectors that are the heart and soul of the community connector program, because that’s too much for services to do all of the housing partner employment so we need to do it as a whole community. And because we do partner employment, we need to know about all the industries and all the jobs and all the things happening in the community, not just in health. So health’s a good place to start, but in the end those community connectors end up being able to attract and support anyone from any industry. That’s how it’s been. The longest operating site is in Shepparton and that’s how it’s been operating in Shepparton since the very beginning. So health is about 60% of the health professionals, 60% of the people, that the newcomers, but there’s engineers and teachers and all the others in there as well.

So what you learned is what I’m hearing you say is completely transferable, or are there?

After I finished my PhD I went to the University of Melbourne’s Department of Rural Health, so I was based in the north eastern part of Victoria, so in Wangaratta, and I ran in some programs across Victoria to test whether my theory was broader than mental health. So we looked at the Allied Health workforce and could we strengthen that with my framework and that worked. So when you transfer well and a good ground, it’s very will be. They always will be a resonate, like Brene Browns vulnerability studies.

If you can get to the heart of what, what matters to people and what motivates people, then it has broad applicability. And then more recently we’ve done it. Shepparton was an example of doing an outside of health workforce and just doing it for all newcomer skilled workforces. And it doesn’t matter because yes, there’s some profession specific stuff, but not a lot around the career part perhaps. But mostly the other parts are about being human and wanting to work in good workplaces and wanting to live in welcoming, connected communities and that’s universal. And

So do you think? I don’t know if your research extended back, but I just think of my uncle, for example. He was a school teacher and a principal and my cousins moved around a lot when they were growing up and I feel, like the stories that they’ve got, like they’ve still got friends from lots of those communities despite the fact that they kept moving around. And I wonder if it’s a phenomenon that it’s because now lives are busier and we are more disconnected, or if there’s something that you’ve found that it’s a part of our current day, our modern lifestyle, that is contributing to it, or because it does feel to me like that human element of inviting people in is something that did exist in previous generations but that maybe we’re losing that.

Yeah, I think that is probably the busyness. So I mean, my interpretation of your question is is there something that’s changed in rural? Because we used to do this quite well? Yeah, and I think probably. My response to this is I often say we’ve always done it for new GPS coming to town. We’ve wrapped them up. So in olden days it would have been the male and his wife and we would have a rural community, would have rolled up the red carpet and made sure that they were integrated fully into the community as quickly as possible and their children.

I think what’s changed is what we really need is a multidisciplinary workforce. So this we over emphasize in rural that it’s about a GP shortage. What it really is is a nursing, allied health and GP shortage. To give rural Australians the best health care that I have and to deal with the chronic health issues that we have in greater numbers than elsewhere. We need a multidisciplinary workforce, in particular specialist nurses, diabetes educators, etc. And the whole gamut of allied health the psychologists, the OTs, the physiotherapists the speech pathologists, all of it all of it.

So I think what we haven’t done is caught up with that and it’s not we have what rural towns can still do it on an individual basis but the Community Connector program is about doing it for everyone and systematically, that we take all those social determinants and we put them into a customer relations management system and we make sure that we’re tracking people related to the data that I know that these points, these sorts of things, are happening for people and that within 12 months they’ll start making a decision whether they want to stay or leave. They’ll tolerate some loneliness in that first 12 months. So I think I still believe rural communities are welcoming and my data, or the conversations I’ve had or interviews I’ve had, is that we’re friendly. So I come from a rural town that we want to be friendly but we’re not always inclusive or often we’re not inclusive at all, mostly, I think, because we don’t really see it. We’re in our own lasagna layer of connections, we’ve got good friends and we don’t really need to go outside our own bubble. We don’t see that there are other, we don’t know that there are newcomers here and we’re not being asked to help.

And this is this whole of community approach, because health services and social care services are all under the pump in rural Australia. There are huge. It’s too much to ask them to do all the social too and it doesn’t work. They shouldn’t just make friends in the workplace, they need to make friends in the community and they need to make friends with locals, not just other newcomers, because if they just make friends with newcomers then when one leaves there’s a domino effect and they all leave. So I’m still really hopeful. I’m a glass half full kind of person.

I believe in the good-heartedness and whole-heartedness of rural Australians. We just need to give them a call to action and say you need to do this better. Here’s a program for you. Here’s how we run it. This is an evidence-informed program but you’ll tailor it for your particular strengths and assets that you have in your community and it will be your Community Connector or be one of your standout people that’s well connected and we leverage off all their social connections and networks.

And those people have always existed in rural towns. They’re in abundance. They just can’t help themselves. So sometimes they say to me I can’t believe I’m getting paid to do this. And they are. And we need them to be able to be warm and friendly to newcomers, but also be able to speak to the CEOs and mayors and general managers of the council saying we need these things, and they are a great source of being able to identify and put story around what that housing crisis looks like in practice, what those lack of childcare places, how is it playing out in terms of both attraction and retention? And they tend to end up sitting around roundtable solutions.

So they’re pretty high level and the people who are community connected is a very senior role and yeah, I mean they can differ in age but their temperaments are all tender, but the warm and friendly. You’ve just got to love them. And they’re all different. We have about four operating in Australia at the moment and a few more fairly soon to be recruited. It takes about two years to get a Community Connector program up and running. Yeah, not easy work.

You keep reminding me we went and lived in England. I’ve mentioned it a few times on the podcast. But we went and lived in England for a year. So our four kids and my husband and I and we ended up living on a little island off the south coast of England called the Isle of Wight, And when we first arrived, my youngest son had previously played sport in Australia, so we knew that that’s where a lot of our social connections had come from. So we said right, mate, you are playing rugby, whether you like it or not, freezing cold albeit. And we mentioned it to one of my husband’s colleagues. And so he came and picked us up because at the time we didn’t have a car Picked us up and took us to the Sunday morning training, and had he not done that, we wouldn’t have been able to do that. And just that was just a game changer for us, because then we were then part of that rugby club and then we got to meet more and more people and just that one action just changed the whole dynamic for us.

Yeah, and I think the Community Connector is not shy. They will ask. So what we do make sure is in terms of this. So there’s a whole settlement and support service. So we’re interested in housing, partner employment, getting kids into school, childcare, whatever they need to do to settle well, and all of those things are quite complex in rural. We all know that. I don’t know of a rural town that doesn’t have housing shortages. But in terms of the social connection, which is the next height of Maslow’s hierarchy, we’re going to tend with all those sort of first few things and the housing one is the most important. And then we get on to social connection. And one of the things the community connector does is to make sure that if someone says I’m interested in the yoga, that when they go to the yoga class, whoever it is knows they’re coming and is welcoming. Because this I have plenty of interviews where people have said to me well, I went to the footy club but they weren’t very inclusive. So I sort of still I felt worse actually. So we don’t get many times to get it right. So we’ve got to capture people and it’s never a big ask and I think it’s a pretty. I think rural Australians are used to pulling together and if you ask us something, you know, bake a cake, be friendly, and it’s quite specific what you need us to do. I think we’re all up for it and I think most of us experience this kind of because we move around this loneliness ourselves. I certainly have.

When I first came to Bellingen and 20 years ago, we had no connections here at all, so it’s a pretty lonely first 18 months. But when we went back to Victoria for my post-doctoral fellowship, so we were in rural Victoria for three years. We lived in a town of 150 people. I didn’t make a single friend and I was unlikely to make a single friend and I it was kind of, I was living my research and by the second year, all I did was want to come home and it was all about seeing if we could get this research project completed. I really wanted to do that, but I also really wanted to just go home, and so we got home on about the 31st of December 2019. The fires stopped in New South Wales on the day, so they were all around Bellingen and we were very fortunate not to burn and they started in Victoria and then a couple of months later I got to. I got to stay home for two years.

And it I mean COVID was a blessing because it allowed me to think of new ways to reach every rural community that was interested. And so there are in my Canadian colleagues call it the COVID bright side, the benefits of what came out of COVID and this you know, a multitude of ways of speaking and communicating and getting our message out there I got. I do go to rural communities but it’s expensive for me to go go around. I can do a lot from my office and they’re not my community as I can help guide people on what are the best strategies, but in the end I’m just a guide and facilitator and in the end of their program. We hope to.

The aim is to keep as a member program for so that we know about sites. We’re helping them keep evidence based. That’s really important and that we are tracking what the impact of that program is across Australia, because I think I would really like to see it. My vision in the last five years of working is I would like to see it everywhere across Australia. I genuinely believe it is this never-ending missing piece and that if we have it in place it will support. We really need to do the whole Attract Connect Stay framework without doubt, to really have impact. But the Community Connector program is a good place to start. But then we need to attract better, because there’s no point in having a Community Connector program if you’re not actually attracting any.

And attracting people who align and are going to be more likely to fit in and feel included and have a sense of belonging. So yeah, getting that right.

So I do a lot of training with health services about what that looks like and teaching them to be brave, to actually put it in their selection criteria, and it’s about what fit means and fit is team and organization. It’s, of course, having the necessary skills and experience, but it’s also fit for community and you’re interested in what their interests are and whether your community can meet those. And people sort of say but if everybody’s doing this, then we’ll just have the same problem, and I think there are people that are particularly suited to different types of communities. So you’ll find your community and there’s something a community for everyone. There are workers for everyone, I think.

Where I think this model doesn’t work. For remote, I think outback futures, which has recently got government funding that’s doing a sort of fly in, fly out model. But the clinicians it’s a mental health service. The clinicians have long-term relationships in that community, so it’s the same. So the relationships have been prioritized but they’re dealing with it’s unlikely. I think it’s very hard to get people to settle in remote for long-term. So this is a way of getting over that churn and improving the care that people are getting in remote and that they don’t have to tell their stories again and again to a never ending parade of health professionals, and so I’m really watching that space that they’re emerging in. When I was at the National Health Conference in Brisbane last year, it was the one presentation that I went Oh, that’s an important part. I haven’t got the solutions for remote, but I think you do, and I immediately contacted them and said that and I’m really pleased to see the Australian government has funded that. I’d love them to match funding with further Community Connector program.

At the moment the rural communities to do this I have to do they have to raise from dollar one, however that is, or have a fee for service program. I’m yet to see a standout model, but I think we’re heading for fee for service. It’s cheaper than putting endless ads in seek and you know. So health and social care services can contribute and the community can fundraise, but it would be good to see some matched funding. It’s a lot to cover these salaries.

My back of the envelope figures you need to put one full-time Community Connector and maybe then there’s two part-time. They really shouldn’t be bigger than an LGA it needs. You know you don’t live in a region, you live in a place and those networks are really very specific to a geographically limited place. Yeah, I’d like to see some matched funding of communities and jumping through the ready-set go steps that I’ve set out on the Attract Connects Stay website. If they’re doing that, it would be really lovely to see that that’s respected and they’re assisted. You know, because it’s a real stretch for the rural communities to get. This is mostly the two years that I’m saying that it takes them to get up. There’s a year of getting their funding together and I think it could come faster than that if there was some support, and I definitely mean matched. I think there needs to be some skin in the game for communities. Absolutely Get the buy in.

Yeah otherwise it’s just another program the government’s rolling out.

It’s a grassroots community development program. So I always think that, you know, whilst I’m a rural health strengthening expert, what I’m teaching in Community Connector Program is actually what we’re drawing on is my community development skills and it’s some hybrid of the both. But and I think I’m just the right person at the right time I have both sets and I’m comfortable in both worlds. So I love watching a community get activated and really, from the grassroots, develop something that didn’t exist at all and they’re all uniquely theirs and I think that’s the part that’s fun for me. They’re a bit like I have a whole different. They’re a family and Community, Connectors and communities, but they’re all different, yeah, and so they’ve got their own unique flavour and we really encourage that. Like. So we have guidelines and strategies, but then we need to tailor those specifically for what’s the particular problems they’re facing. So in Glen Innes, which was the pilot set for the FRRR, the Foundation for Rural and Renewal, regional Renewal get funded myself and a team of researchers to pilot this. So the model came from Canada.

So when I went to Victoria to my post-doctoral fellowship, I was, as I said, I was rolling out this program to see if it worked and we could strengthen Allied Health Workforce in public health services in a couple of sites in Victoria. And they said so what do we do about the community and place part of your framework? And I said, oh, I don’t really know. And I went and researched, of course, and I said no, I don’t think there’s any examples in Australia that would suit you or really on the money. So I applied for a Churchill Fellowship to go and investigate that and I was successful.

So I got to travel all around Canada because Canada is a really good sort of cousin for us. It has similar training systems, it’s got well, just replace ice for dry. It’s got huge geographies, an indigenous population, all the challenges, possibly more than us, and it was a really good place to look for solutions. And I knew when I found the Community Connector Programme from marathon, it was a bit like a hunt. People were kind of, oh, this is that. And I was a three month fellowship and I was a bit despondent at the six-week mark I was thinking I’m going to find anything. And then I had this conversation. I so remember having it just going, that’s it.

And so simple. The Community Connector Programme is really simple. It’s about developing a program, contracting a Community Connector who’s local, has really good connections to initially they can do some of the attract. But initially it’s around substantively around the connect, socially connect them and get them settled and make sure, look after them for the first 12 months so that we know if they can do that their intention to stay increases significantly and people who have experienced that program will directly relate it to this concierge support that they got.

So it’s not complex but it’s been hard to make it systematic and how the devil’s in the details. So what are the responsibilities of the Community Connector versus the organizations’? So we’ve got a site that’s really recently merged in the Southern Grampians. This has been working with a health service in that region for a couple of years, embedding the Attract Connect Stay framework across their whole organization and they’re leading on doing that for their putting a Community Connector program for their whole community. And then the first business lots of challenges, lots of oh, that’s your responsibility so. But you know so we’re not. It’s still emerging, but the concept’s proven and it works and it’s a delight. So I don’t get to hear so many Jacobs, I get to hear the opposite, I get to see very I mean my Community Connectors tell me that they’ve got the best job in the world and I know they do, because it’s incredibly rewarding and they can walk down the street and go.

I helped that one and that one

Well look at one married X or whatever it is they get to, really...and can’t believe that they get paid to use that set of skills and I always think it’s funny.

My mum came from a rural town and when you talk to everyone who still lives there, they still refer to everyone. You know, oh, Johnny Smith, oh, he married such and such as daughter and and everybody knows everybody. It’s just. I just think it’s hilarious. They can refer to everybody.

What we’re, but we’re trying to get these people to be locals into that. Yes, fast, like yeah. So there was an example that I was talking about with one of the community this week. It was someone coming to town. She had no luck with childcare or school places. She was told that they were all closed and housing and with the community’s connectors help there are appointments coming, they can get doors open.

Someone was telling me, in Lismore the other day. They were saying that during the floods. So for people who don’t know, we’ve had some really serious floods last year and a lot of the houses were lost in Lismore, and it’s not just Lismore, we’ve also had bushfires and there was a whole lot of disasters one after the other for a long period of time. But they were saying that in the health service they were putting out on their intranet does anyone have spare rooms to rent? And there was a real that wouldn’t be available to the general community, but it was kind of can we help out our own? And you wouldn’t normally be letting that room out, but because we had this heightened demand that wasn’t able to be solved somewhere else, that community came together and they did that, which I thought was just beautiful.

And we were around the housing crisis and particularly new arrivals need short term housing. We’re often now saying you should be exploring within your own staffing while what’s available. Of course you’ve got to check that they’re safe and secure housing. That’s fairly easily done and people want if you ask them, if you ask people, they can go. Oh, that could do that.

So we need, I think, yeah, the solutions are, they’re simple, but we need to make sure that they’re systematised and they’re consistent and everybody who arrives gets the same service. So we don’t there’s no hierarchy, or there’s no health workforce hierarchy, so it’s not just doctors being treated well, it’s everyone and all of it. And then we, you know, I can’t bear to hear about anyone alone. So even if we might have a health workforce focus, if I hear there’s an engineer is getting a loan, I will ask and somebody’s contacted me to say this we, the community connector, will reach out, particularly around the social connection. We can do quite low cost things to get people connected in it, and the bigger the group of those better, because you’re going to meet quite a few people to find your particular tribe. So, you know, the more the merrier really.

And it probably restores a balance to some degree, so we don’t have just the odd person who’s the outsider, but that those newcomers can actually have other people in the mix.

Yeah, make their tribe and they’re great for Intel. You know how are you doing this, so I in the community connector facilitates that, but you know they are nearly all sites run off. Facebook newbies group.

And they have a regular dinner that they get together, I mean. The other one is for those that don’t have much real experience, you know, just helping them have more realistic expectations of what social might look like, that frequently may not just be people in your own age group you need to be more broad minded and that they may not all. You can have good friends that don’t necessarily share all your political views either, and that’s how we all learn to be tolerant of each other and diversity. That that’s. That’s that’s being rural and yeah, and the challenge of living with overlapping relationships and that you know the chances of who you treated also being in your footy team is highly likely.

And I suppose the other one is, I think, going back to your question around have things changed? I think society is changing. It’s more complex and I sometimes rural communities will tell me they have footy and church and we all respect to those. There are many health professionals and many people who aren’t interested in any of those things, and so we must find what people are interested in and this is this good fit part. And making sure for me, if there’s no yoga in a in a rural town, I’m going to be pretty unhappy fairly quickly. And I’m not a good fit for an urban environment because it’s it’s way. I can literally walk out my door and go for a hike what? Well, much more complex if I lived in a city.

So it’s, it’s finding the things that I think those very old fashioned 1950s kind of views don’t help. And the other one is that the workforce is very diverse in terms of gender, in terms of culture and in terms of gender identity and sexual identity. So we also have to make sure queer people feel very comfortable. That’s that’s much more challenging. And there’s quite a bit of homophobia in rural Australia. So we need to identify those quickly and find where their tribe is and help them get to that tribe really quickly.

So, and I think that’s the changes that have happened, but you know, rural Australia isn’t isn’t in the 1950s anymore, and and we have to reflect those changing values and lifestyles and all the things and make sure that and and we’re welcoming everyone and all that diversity and that benefits our communities. So I think there’s an old fashioned view of it’s going to be a GP who comes and works 70 hours a week and runs a single practice world. Those days are gone. It’s going to be part time GPs, a lot of female GPs, working in a practice that’s multidisciplinary, with nursing and allied health, and that’s that’s more what primary health care