Remote x-ray operator radiography: a case study in interprofessional rural clinical practice

In Australia, some radiographic examinations may be performed by rural and remote nurses and general practitioners (GPs), so called remote x-ray operators, where a radiographer is unavailable. This study aimed to investigate the experiences and perceptions of remote x-ray operator radiography from the perspective of rural radiographers, nurses and GPs in New South Wales. Semi-structured, in-depth interviews were performed with 20 radiographers, 10 nurses and 7 GPs. Interviews explored the informants' knowledge, opinions and values, experience and behaviour, and attitudes and feelings about remote operator radiography. Data analysis led to the emergence of three interrelated key concepts, with their relevant themes and sub-themes. The primary concept, "Dimensions of Practice", includes the core principles of remote x-ray operator radiography. The concept of "Service Provision and Equity of Access" includes the realities of rural and remote healthcare, and "Professional Roles and Relationships" the interprofessional interactions that occur. Remote x-ray operator radiography takes place at the intersection of the occupational worlds of rural radiographers, nurses and GPs. Remote operators provide a valuable service but the quality of their radiography is below expected standards. Better teamwork could improve service quality but interprofessional collaboration is stifled by hierarchical relationships. This case study may inform the development of new models of healthcare.