This is most evident in general practice and in the public hospital system.
Both are, to be blunt, kept afloat by overseas trained doctors (OTDs) recruited into the Australian system. There has been a boost in medical school places in the last couple of years, but there will be a long delay before this has a positive impact. It takes at least 10 years to train a family G.P. in Australia, and even longer in many other specialties.
The OTDs are generally forced to work in "areas of need" for many years after entry. This entails usually one of two things - being forced to work in our struggling urban public hospitals, or (especially for GP's) to work in a remote and isolated rural or semi-rural area.
If Brits stopped coming here on extended "working holidays" and filling many of our junior grade hospital positions, the entire system would collapse.
What Dr Dork suspects is most challenging for OTDs, however, is that of ending up in the Australian bush for those of a different cultural origin.
Rural medicine in Australia is very different from city medicine. Australia is vast, our population relatively small. And most of that population is concentrated in our urban coastal enclaves. In the bush, there aren't many hospitals. Or many specialists. Ancillary services may be a thousand kilometres away. Our indigenous people, to our great shame as a nation, are plagued by Third World health concerns whilst in our cities there are Botox clinics and 5-star private hospitals.
Dr Dork has worked in the bush. He still does, not infrequently. Dr Dork's grandparents were farmers, yet he still finds it hard at times to connect with and adjust to bush life. He can only imagine how hard it is for those coming to Australia from extremely different cultures in places such as Europe, Africa or even our Asian neighbours.
Dr Dork had this illustrated today quite explicitly. A patient came to see Dr Dork for a second opinion. This patient lived in a rural area, and had been under the care of a doc local to his area for a few weeks. From the name on the documentation shown to Dr Dork, this doc was clearly of Middle Eastern extraction. The care he had provided, as far as Dr Dork could ascertain, was perfectly appropriate.
Yet the patient was rather disenfranchised. Very derogatory in regards to the other doc.
The problem was not clinical competence. Perhaps communication with the patient had not been ideal as there was some degree of language barrier. But mainly, it seemed about race.
Dr Dork treats all his paients the same, he likes to think. Be they saint or sociopath.
For some the mask is harder to wear.