500 kilometres from care: why rural rehab can't wait
Updated: Oct 6
When I was seven, my dad had a farming accident that led to an amputation. We lived on a farm, and the nearest hospital that could help him was 500 kilometres away.
The surgery was only the beginning. What followed was months of appointments, follow up care and long drives, each one pulling our family away from the farm and from normal life. I didn't have the words for it then, but I was seeing first hand how much of recovery depends on where you live.
The numbers behind the drive
My family's story is not unusual. Around 7 million people, 27% of Australians, live in rural and remote areas (AIHW, Rural and remote health, 2025). According to the Australian Institute of Health and Welfare:
Life expectancy is 0.5 to 8.6 years lower outside metropolitan areas.
The burden of disease rises with remoteness, from 174 per 1,000 people in major cities to 244 in remote and very remote areas.
People in very remote areas are hospitalised at nearly twice the rate of people in major cities.
Physiotherapists, like most health professionals, are most concentrated in metropolitan areas, and small rural towns have the lowest clinical workforce rates.
Why rehab is where distance hurts most
A knee replacement can be done in a regional centre in a single admission. Rehabilitation is different. It happens over weeks and months, and it depends on regular, structured exercise and on a clinician being able to see how the patient is going.
For someone who lives hours from a physio, that often means fewer reviews, long gaps between appointments and a home program that is easy to lose track of. The result is not a lack of effort. It is a lack of support at the moments that matter.
Bringing the clinic to the kitchen table
That experience is why I started Peak Medical. We built BIBO so the program a clinician prescribes can travel home with the patient, wherever home is. With a smartphone, patients are guided through each session with corrections as they move, and their clinician can see adherence and progress between visits, without either of them getting in the car.
Technology does not replace the relationship between a patient and their physio. What it can do is make distance matter less, so a farmer 500 kilometres from the nearest hospital gets the same structured, supported recovery as someone who lives around the corner.
What clinicians and funders can do now
Ask where the patient lives before planning rehab. Travel time should shape the plan, not be discovered halfway through it.
Default to supported home programs for suitable patients, with a clear way to monitor progress remotely.
Fund the follow up, not just the surgery. Remote monitoring and telehealth reviews are what keep rural recoveries on track.
Recovery shouldn't depend on your postcode. For many of our patients, the best clinic is the one they don't have to drive to.
Hayley Saddington is the CEO and Founder of Peak Medical. Her story was first shared with UNSW BusinessThink.
