A Ravensthorpe doctor says a formal emergency responder network that includes rural generalists could save lives on country roads.

Michael Livingston is the clinical director of Livingston Medical and runs 17 rural clinics across the Great Southern and Wheatbelt. He spends hours driving and has experienced road trauma firsthand.

Dr Livingston recalled when a car in front of him lost control on a bend before rolling five times.

By the time the ambulance arrived, Dr Livingston had smashed the window, stabilised the man’s airway, used a portable ultrasound to check for internal bleeding, and was on the phone co-ordinating with the retrieval helicopter from Perth.

“He would have been dead by the time anybody else got to him,” Dr Livingston said.

“I was there by luck, with all my gear.”

By the time the chopper landed, everything was done.

“They were only on the ground for 20 to 30 minutes and they were gone. The chopper responders were raving: ‘Why doesn’t this exist for everyone?’” he said.

Dr Livingston said St John WA had the contract for pre-hospital emergency response.

He said rural generalists, who were experienced doctors with advanced trauma, surgical and emergency skills, were not called to crash scenes.

“I’ve got the skills, I’ve got the gear, and I’m sidelined at the hospital,” he said.

“The patient gets to me when it’s already too late to make a meaningful change.”

Dr Livingston is one of a small number of WA rural generalists who chooses to carry a Sandpiper Bag, a roadside intensive care unit a trained clinician can deploy in minutes.

The bag costs around $9000 and was created by the charity Sandpiper Australia. It was developed in response to the 2007 Kerang rail disaster in Victoria, where local doctors minutes from the scene were barred from attending because they weren’t part of the State’s emergency response.

There are about 50 Sandpiper clinicians in South Australia, the only State with a formal network integrating rural doctors into the ambulance response.

Only around 250 bags are in use across the rest of Australia, most of which are donor and grant funded.

Sandpiper Australia chair Associate Professor Tim Leeuwenburg helped establish the initiative. He said one third of major trauma occurred in regional and remote areas.

He said rural generalists had the skills to help but were being left out of the system.

“We have no real integration of the rural doctor workforce to actually value add on scene, and this is ludicrous,” he said.

“We have retrieval and ambulance services that cannot meet the capacity — they’re too far away. So why not use those rural doctors?”

A 2025 study of WA ambulance response times found median mobilisation time for emergency crews in rural areas was more than three times longer than in metropolitan Perth, before accounting for the distance crews must travel to reach a crash scene.

The Royal Australian College of General Practitioners has backed the Sandpiper concept, but Associate Professor Michael Clements said it also needed State Government support.

The State Government was contacted for comment.