Indigenous Australians suffer a disproportionate burden of disease and access fewer medical services than the general community. This problem is exacerbated by the remoteness of many Indigenous communities. Various outreach programs attempt to provide increased access to specialist services for some remote communities. Outreach services have been shown to increase opportunistic interventions while reducing patients’ need to travel to hospital or require hospital admission. For Indigenous communities, they also tend to be more culturally appropriate than mainstream hospital outpatient visits.
In this way, outreach work is the cornerstone of specialist medical services to some of Australia’s most disadvantaged. 
The Medical Specialist Outreach Assistance Program (MSOAP) brings together salaried and private specialist physicians and paediatricians to work in partnership with State and Federal Governments and local healthcare teams to deliver services to rural and remote communities. The College has long supported the provision of specialist services to rural and remote communities via outreach, particularly where those services build capacity in the local health workforce. The College particularly supports measures to target Aboriginal and Torres Straight Islander communities. 
In May 2009, the RACP provided comment on the Commonwealth Department of Health and Ageing’s (DoHA) MSOAP policy framework. Those comments remain relevant and are attached again herewith. 
This paper addresses a subsequent consultation – the draft MSOAP Indigenous Chronic Disease (ICD) guidelines. The College is a stakeholder with a key interest in providing medical specialist services to rural and remote Australia and as such appreciates the opportunity to provide comments on the draft.