A case study of the rural generalist-consultant allied health model in the NDIS

Mr Edward Johnson1, Miss Gabrielle Byrne Miss Hannah Jeffery

1Marathon Health, Dubbo, Australia


Many clinicians in rural and remote areas are generalists, such that they have a broad knowledge of many fields of practice. Disability practice requires clinical skills that those generalists do not always have. One way to support those clinicians could be through accessing specialist skills of clinicians who have experience in working with people with disabilities. This paper presents one successful instance of such a relationship.

This was a descriptive case study, focussed on adults with communication goals in a small regional town in NSW. The generalist and the consultant clinician visited the clients together in the first instance. Subsequent face-to-face visits were supported by the consultant clinician via a variety of telepractice modalities before/during/after consultations.

Effective clinical outcomes were achieved, measured through client goals set at the beginning of the intervention.

A GP may refer to a medical specialist in order to consult on complex cases. Those consultations are covered by Medicare, and the specialist charges for that occasion of service. In the NDIS, there is no provision for the allied health clinician with advanced practice skills to charge for clinical consultations with a generalist clinician who provides supports in a rural or remote area. However, the rural generalist-consultant model in this case was shown to be clinically effective, and could provide a means by which the frequency and quality of services in rural and remote communities could be increased significantly.