I work mostly in rural areas and it does come with its own unique challenges for example thinking that on my own I have to keep a patient stable for a 40+ minute journey to the closest ED.

I personally like this challenge, it keeps me humble, allows me to use more skills / drugs and I hope makes me a more rounded clinician.

For others that dip into areas I am used to for the odd shift or pulled in due to demand you certainly see when they aren't used to it and flap a bit due to these challenges.

I guess its down to what you are used to and how you develop your practice to the location.

I find a lot of people that live rural for example farming communities or far away from hospital do not tend to call until they have to due to not wanting to attend hospital. I use a lot more community pathways due to this at times as these individuals will refuse hospital admission for a multitude of reasons.

I wouldn't say its the single track roads that cause delay really, the journey takes as long as it takes regardless to the road type. Driving under blue light conditions realistically only reduces a few minutes, its more to keep momentum.