Dr Louise Stan-Bishop
Why looking after rural doctors is essential for the health of our communities
Rural doctors are often described as resilient, capable and endlessly giving. They are the people communities turn to in moments of crisis and uncertainty - the calm voice in the emergency department, the familiar face in the consulting room, the professional who knows not only the patient, but their family, their history and their story
But behind this trusted role lies a reality that is rarely spoken about: rural doctors carry a significant emotional, professional and personal burden, and too often, they do so at the expense of their own health.
In a recent conversation with Dr Louise Stan‑Bishop, a rural GP working across general practice and hospital care in Western Australia, we explored what it truly means to care for others – and why caring for oneself is not optional, but essential.
A life shaped by rural medicine
Louise’s journey into medicine was shaped early. Growing up on a family farm in Western Australia’s Great Southern region, with a rural GP mother, she saw first-hand both the privilege and responsibility that comes with being a country doctor.
Her career has taken her across Western Australia, into remote communities, through locum work in single doctor towns, overseas to the UK, and eventually back home – where she now balances rural general practice, hospital work and farm life alongside her father.
This breadth of experience gives Louise a clear-eyed understanding of rural medicine: its rewards, its challenges, and its hidden costs.
“I’ve always known I’d come back to rural practice.”
“I like the variety, the continuity of care, and being there for people over the long term – not just a brief encounter and then goodbye.”
The invisible emotional load
One of the most powerful themes to emerge from the conversation was the emotional weight rural doctors carry – a weight that doesn’t end when the working day does.
In small communities, doctors don’t just treat patients; they know them deeply. They see them at the supermarket, at community events, and sometimes at their most vulnerable moments. Decisions are rarely abstract – they are personal, and their consequences linger.
There is a constant internal dialogue many rural doctors live with: Did I make the right call? Should I have sent them to hospital? Was that treatment enough? Will they be okay until I see them again?
For Louise, this emotional load is one of the most challenging aspects of rural practice. While there are moments of immense satisfaction, there are also moments that sit quietly in the back of the mind – unresolved, heavy and persistent.
“There’s always a list of people you’re thinking about.”
“You try to leave it at work, but some cases follow you home.”
When the doctor needs a doctor
Despite encouraging patients to seek care early, rural clinicians often delay care for themselves.
Access is one barrier – distance, workload and travel all make attending appointments difficult – but confidentiality can be an even greater challenge. In close-knit communities, seeing a local GP can feel uncomfortable.
Louise spoke openly about choosing to access healthcare outside her community, planning appointments around travel to Perth and work commitments. It’s a system that works for her – but one that requires effort, foresight and flexibility that many clinicians simply don’t have.
As a result, many rural doctors self-treat, rely on telehealth alone, or delay seeking help altogether.
“Looking back,” Louise reflected, “there were times when, if I wasn’t a doctor, I would absolutely have gone and seen one – but instead, I just pushed through.”
This culture of “pushing through” is common in healthcare – and particularly entrenched in rural settings.
The culture of putting others first
One of the most striking patterns seen across rural healthcare is the instinct to put others first, even when personal care is needed.
Time and again, clinicians will defer appointments, downplay symptoms, or decide that someone else “needs it more”. It’s a mindset born of compassion and responsibility – but one that can become harmful when it becomes the norm.
Louise acknowledged how deeply ingrained this thinking is.
“We’re very good at caring,” she said. “But not always very good at being cared for.”
Over time, this imbalance takes a toll. Burnout, emotional exhaustion and poor health outcomes are not signs of weakness – they are predictable consequences of sustained pressure without adequate support.
Isolation: The quiet risk factor
Professional and social isolation is another significant challenge for rural clinicians.
Louise described how work in single doctor towns, while professionally rewarding, can become deeply isolating over time. Without trusted colleagues nearby, the emotional load becomes heavier, and informal debriefing – one of the most effective protective factors – becomes harder to access.
Even in larger rural centres, building a social network can take years. Professional boundaries further complicate friendships, with doctors often finding themselves caring for people they might otherwise have formed close personal connections with.
“You realise that some people you’d really get along with socially are your patients,” Louise explained. “And once you know someone’s deepest struggles, that changes the dynamic.”
Why caring for doctors matters
Caring for rural doctors is not just about individual wellbeing – it is fundamental to the sustainability of rural healthcare.
When doctors burn out, communities lose more than a service. They lose continuity, trust and local knowledge. Recruitment becomes harder. Retention suffers. And the cycle continues.
Independent, confidential healthcare; long, unhurried consultations; safe spaces to talk; and permission to be a patient – not just a provider – are critical elements of a healthier system.
As Louise’s story so clearly demonstrates, doctors are human. They carry responsibility, emotion and expectation every day. Supporting them to care for themselves is one of the most powerful ways we can support the communities they serve.
Caring for the carers
At its heart, rural healthcare is about relationships – built on trust, continuity and care. But for those relationships to endure, the carers themselves must be cared for.
Looking after rural doctors is not a luxury or an add on. It is an investment in healthier clinicians, stronger communities and a more sustainable future for rural health.
Because when we care for the carers, everyone benefits.
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