When Leigh Miller APAM and his wife made the decision to return to the family farm in Bingara, in rural New South Wales, their focus was solely on embracing rural life. 

With a population of just under 1500 people, Bingara might not have seemed the obvious place for a physiotherapist from the city to thrive. 

However, Leigh quickly discovered an overwhelming demand for physiotherapy services.

‘I started doing physio two mornings per week, just to see if there was any interest,’ Leigh says. 

‘I was blown away by how quickly I was booked out. It’s extraordinary—it’s been so easy to find work here.’ 

Leigh’s presence turned out to provide much-needed relief to the community, which previously had access to just one physiotherapist, based at the region’s hospital.

Leigh’s journey since the move in 2022 demonstrates the challenges and joys of running a rural practice, the demands of balancing work and farm life and the appeal of small town living. 

His day starts early, often before sunrise, checking livestock and managing farm tasks. 

With 2000 sheep and 800 hectares to maintain, these are no small tasks. 

Leigh divides his working week between physiotherapy, learning the ropes of farming and caring for his two-year-old daughter, who was born not long before the move to Bingara. 

Despite his packed schedule, Leigh’s passion for his work shines through. 

While there are seasonal aspects (‘We’re in the middle of harvest at the moment so I’ll probably see some stiff, sore necks and backs in about three or four weeks’), his patients range from farmers recovering from occupational injuries to elderly residents with chronic conditions and young families.

‘It’s a lot of backs and knees,’ says Leigh. 

‘Farmers spend so much time on tractors or doing repetitive heavy lifting. I don’t see as many sporting injuries as I used to, that’s for sure. 

'On the rehab side I see a few workers compensation patients but generally it’s about knees and hips because it’s an older population. 

'There are plenty of necks and backs, spondylitic stuff, acute discogenic back pain and acute wryneck, that sort of thing.’

The slower pace of rural life allows Leigh to build deeper connections with his country clientele. 

‘Word of mouth is everything here,’ he says, adding, ‘I don’t advertise but I’m still booked out weeks in advance because people trust the care they’re getting.’

Leigh Miller with his wife Steph and daughter Madeline on her first birthday.

Rural healthcare has its challenges, though, from limited resources to professional isolation. Leigh navigates them with determination and creativity. 

He works in with the physiotherapist at the local hospital and another based in neighbouring Warialda, a 30-minute drive away. 

He also works with Bingara’s local council, the Gwydir Shire Council, to gain commercial access to its gym so he can give patients greater opportunities for rehabilitation.

‘Working in a rural area has pushed me to be more inventive with exercise prescription,’ he says. 

‘It’s about utilising the environment and what’s available to get the best outcomes for my patients.’

Leigh also values the collaborative nature of the Bingara healthcare community. 

The clinic where he works, Bingara Community Practice, is community owned and offers significant support in reception and administration, allowing Leigh to focus on patient care. 

However, he acknowledges that access to specialist services and referral pathways would make his role easier.

‘Losing our standalone GP and moving to a locum-based model has been tough. 

'Direct referrals to specialists would streamline care so much for patients here.’

Joining the community

As the local physiotherapist in Bingara, Leigh is very much an integral part of the community and his role has opened doors to meeting new friends, acquaintances, clients and the region’s movers and shakers.

‘Physio is a great way of meeting people. 

'When you first come to the town, you have patients who will drag you down to the local sports teams or community events to introduce you to other people. 

'No-one’s paid to take you along and say, “Look, you’re coming to this event. We’re going to introduce you to some people.” 

'It’s something that never happened when I was working in metro areas,’ Leigh says.

One of the reasons Leigh has not expanded his physio service to more days is that he is also committed to farming the property that he, his wife Steph and two-year-old daughter Madeline call home.

Farming, says Leigh, is still ‘shiny and new’ and he admits he has a lot to learn. However, he enjoys immersing himself in rural life and learning as much as he can. 

Leigh’s ability to explore both farming and physio is largely due to support from his family and from the team at Bingara Community Practice. 

The latter allows him to focus on delivering physiotherapy services to clients on the days when he is not fixing fences, moving stock to paddocks or driving tractors.

‘The support team makes my life easy. They do a lot of the reception work as well so all I’ve got to do is turn up and be a therapist. 

'For someone who owns their own business, geez it makes it easier when you’ve got so many bases covered that way,’ Leigh says.

Beyond professional fulfilment, Bingara offers Leigh and his family a lifestyle they cherish. 

The picturesque river town attracts both locals and newcomers seeking a quieter way of life. 

Leigh notes that the strong sense of community has made their transition from city to country seamless.

‘One thing I love is how welcoming people are,’ he says. 

‘Patients don’t just see you in the clinic; they invite you to community events or sports matches. You really feel like part of something here.’

Leigh’s wife, who also works part-time, enjoys the balance that rural living affords. 

Together, they make time for social gatherings with other young families in their neighbourhood and they take pride in contributing to the community’s vibrancy. 

‘It’s also a very pretty little river town; a lot of people drive through and they go “Oh, this is really nice” and they end up moving here,’ Leigh says.

Leigh working at the Bingara Community Practice.

Growing with the tree change Before the move to Bingara, Leigh was accustomed to working as part of a multidisciplinary team in more populous areas such as Albury and Orange. 

Easy access to rehabilitation facilities and specialist services was the norm. 

But Leigh’s life in metropolitan centres also came with a cost—he would often work long hours, starting at 7 am and finishing at 6 pm most nights.

‘I was pretty happy in my gym environment and I used to just say to my clients, “Come round and we can build up your rehab.”

'But I have to be a bit more inventive with exercise prescription and follow-up now.

'There are so many places to walk around here—it’s really nice and open—so I’ve found that getting people active is easy,’
says Leigh. 

‘Specific exercise prescription is difficult. But as far as general exercise prescription goes, I think people are quite on board with that. And I’m seeing some very good results.’

Leigh says the tree change has allowed him to grow as a practitioner, cementing the skills he learned in his early career and applying them in a less pressured environment. 

While he still works in with an allied health team and uses the gym for rehabilitation of his clients, he has had to be more creative with some aspects of care.

Seeking specialists

A dearth of specialist services in rural and regional areas has been a challenge for Leigh, who took for granted the easy access he had before moving to Bingara.

Access to specialist services in rural and regional areas remains significantly limited due to geographic isolation, workforce shortages and a lack of healthcare infrastructure. 

Patients in these areas often face long travel distances to see specialists, which can delay diagnosis and treatment, exacerbating health inequities. 

Additionally, rural communities often don’t have the breadth of healthcare professionals available in urban centres, leaving patients with fewer options for care.

Recently Leigh saw a client, a mother of young children, who presented with a badly dislocated shoulder that required specialist treatment. 

With the town’s GP about to be replaced by a locum service, getting a referral to an orthopaedic surgeon proved problematic.

There have been other times when Leigh needed to refer clients to specialist services that weren’t available locally or within a reasonable driving distance and that’s something he would like to see change in rural and regional communities in Australia.

‘I’ve reached out to some GPs because we’d love to have that, a full-time GP. 

'But any young health professionals are always welcome. There’s plenty of work available,’ Leigh says. 

‘In the little towns out here you have enough work for a week—and there are plenty of towns in New South Wales that could really use our services. 

'Surprisingly, a lot of them have facilities such as gyms, which makes it easy for us.

‘Because of the rural setting, everyone is so happy to have you here. It’s nice to be part of a business in a community that wants you to be there. 

'In other places I’ve worked, where you have an older demographic with a fairly high socio-economic status, physio has probably
been taken for granted. Whereas here, the community is so grateful for your service.

'When you’re getting a thumbs up just for turning up to work, I reckon that’s fantastic.’

Advocating for rural healthcare Leigh’s experience underscores the need for sustained investment in rural healthcare. 

Incentives like affordable housing, educational opportunities for children and professional development support are critical for attracting and retaining allied health professionals in regional areas.

He remains optimistic about the future. 

‘I think rural physio has so much potential,’ he says. 

‘We’ve got the tools now—online courses, professional networks—to maintain high standards of care even in remote locations.’

For aspiring physiotherapists, Leigh has simple advice. 

‘If you want a change of pace and the chance to make a real impact, rural practice is incredibly rewarding. 

'You learn so much about yourself and your profession when you step outside of your comfort zone.’

COURSE OF INTEREST: Rural refresher symposium 2023.