discovering rural skill levels and knowledge sharing
Dr Erin Harten
On the first weekend of September 2009, St George hosted a Medical Conference that attracted a wide cross-section of experienced medical practitioners, training doctors, medical students, representatives from the Mater Foundation Brisbane and doctors in science and pharmacy. The attendees had flown or driven from either large metropolitan domains or neighboring rural towns. As an intern from the Gold Coast Hospital I was honored to be involved in such an intimate and educational weekend.
For those who are unaware, the township of St George is situated in southern inland Queensland on the Balonne River, approximately 500 kilometers west of Brisbane. The district population is approximately 3,800, and with this rather humble population there is an overwhelming sense of community. The summers are hot and the winters are cold and the sky at night is as beautiful and relaxing as the people who live here.
As a junior doctor, undergoing a 10 week rural GP term in my intern year, I was fortunate enough to be placed in St George. Half way through my placement I have come to admire the dedication and long hours that comes with being a rural doctor in a small town. Under the supervision of Dr Pam Turnock, who has lived and worked in St George as a rural generalist GP for over 20 years, it has been an eye-opening adventure to discover the diversity and quality of skill required to be a doctor in the bush. And it is thanks to Pam and Rural Health Liaison officer Judy Scott, alongside the support of QSQTC that this conference was able to be provided.
The weekend kicked off with a meet and greet at the local bowls club. Rain put a stop to the much anticipated bowls game, but was happily welcomed by the people of St George who have been experiencing drought for some time now.
The conference was filled with lectures from a variety of experts. Dr Russel Land discussed the current state of play of ovarian cancer. Dr Aldo Vacca, an Obstetrician and Gynaecologist talked everyone through vacuum-assisted deliveries, and provided a workshop for development of skills. Dr Sheila Cook (director of Medicine, Toowoomba) discussed in detail medical conditions in pregnancy and thyroid disease. Dr Michael Stowasser, an expert in hypertension, addressed Difficult Hypertension and Dr Danielle Stowasser outlined challenges in prescribing. Mater Foundation Researcher Associate Professor McGuckin gave us a glimpse into the future, discussing Biological Therapies for the treatment of cancer.
On the Saturday night of the conference we shared dinner at the finest restaurant in town. We were entertained with country ballads and sing-alongs, reciting Australian greats like Henry Lawson and A. B. Patterson. Dr Chester Wilson, an avid Australian Poetry lover and poet, led the audience in singing along. Dr Wilson is a rural general practitioner in the true sense, providing GP services alongside basic surgery, obstetrics and gynaecology procedures as well as basic anaesthetics. The food was delicious, the mood was light and the people were friendly.
Of all the events of the weekend I was probably most impacted by a speech from Dr Jim Baker, founder and pioneer of the Flying Obstetrics and Gynaecology Service better know as FOG. Dr Jim Baker started his flying obstetrics service in 1988 in a twin-engined 6-seater airplane. He worked 24 hours a day, 7 days a week providing specialist obstetric and gynaecology services to all the women of West Queensland, revolutionizing women’s health service and bush hospitals. To his patients, colleagues and training doctors he was a source of constant support and inspiration.
Dr Baker discussed the changes that face medicine as we know it today. He asked the question to all doctors sitting before him, ‘Is your best good enough?’. In his appraisal of the changing times he shared many stories about his time as a doctor flying through Western Queensland. One of these I will share with you.
When seeing a patient, Dr Baker incidentally observed “hell of a wrist… twisted, angulated…”, Dr Baker asked “what happened to your wrist?”. The Patient replied “oh, doc, had a bust-up with a horse a few years ago… I had a real NASTY fracture … Dr Smith was here then… he had a hell of a time trying to fix it… 5 or 6 goes at different times…. Sure, it doesn’t look much, and aches a bit at night, and I can’t move it all that well…. But Dr Smith- he did the best that he could!”
Dr Baker continued: “The people of Blackall weren’t fools, they knew I didn’t know it all… and by God I proved them right, on a number of occasions over the next 5 years, but they knew that I was doing the best that I could, and THAT was good enough….”
“….but is your best good enough TODAY?”
He offered that every doctor could only do the best that they could do in the circumstances they were in. He observed that there is a new era of medicine evolving, where doctors are a service provider and patients the consumers. As consumers they deserve access to the best level of health care available. But I wonder with all the medico-legal issues facing medicine today if anyone’s best is good enough anymore? With an audience of doctors sitting before him that have dedicated a life to providing the best level of health care possible, I think everyone wondered when their best stopped being enough.
After the weekend finished I walked away feeling motivated and enthusiastic for the future ahead. I was in awe of the calibre of the speakers that had dedicated their time to share their wealth of knowledge, and their eagerness to develop future professional relationships so the rural communities surrounding St George would have better access to specialist care. Above all, I feel privileged to have spent a weekend getting to know a group of people all working towards the same goal: To provide the best possible level of health care to Australian people no matter where they live. And if we start believing that our best isn’t good enough, then our patients (not our consumers), will be the ones that suffer.
|Case study contributed by Central and Southern Qld Training Consortium|