After my third year of residency I was offered an opportunity to return to UWA to
study law. At the same time I decided to branch out into general practice, armed with some ED time and over confidence.
I got some short term positions in various locations – an inner city large practice,
in Bayswater, Beldon and then a contract was offered in Dr Wendy Rappeport’s small
welcoming practice in struggling Marangaroo, where I worked for a couple of years. Wendy,
the practice staff and the patients took me through an orientation to general
practice that changed my life.
Many times I was out of my depth and only realised how much in retrospect. The most memorable events of my career happened in that northern suburb after dark. Career GPs of course all have a litany of such experiences. Occasional home visits were an education.
There was a young mother in a house surrounded by baking sand with progressing
blindness from retinitis pigmentosa- looking after twin cunning toddlers. They
would silently hide from her so she couldn’t round them up to bring
them to the surgery. They hid when I arrived but chips would bring them out of the cupboards.
The linesman who missed a modecate injection, as his voices had been quiet for a
while, was now refusing to see anyone but his doctor, which to my surprise he
considered was me. The police were in attendance and after a short chat he was off to hospital to get some stitches in what turned out to be his myocardium from a self inflicted knife
wound. He had looked ok to me so lucky someone else checked him out when he
got breathless later at SCGH. His burly mates from work turned up the next week at the surgery to ask how they could help when he came back, to make sure he would be ok next time.
These are the sort of stories that specialist GPs have the privilege and
challenge of dealing with every week. The job satisfaction that comes from filling
that need is enough to keep some doctors sustained when their profession is under
attack financially and bureaucratically from all sides. Salt is then rubbed in the wound when non doctors suggest that we do not understand holistic care or how
to be efficient. Sometimes from people who ignore science, sometimes from pharmacists who should know better.
As we consider the MBS Review, chronic under resourcing, and red tape around communications between health care providers we must not underestimate the need and the complexity of the problems that face these front line doctors and their patients.
I am grateful for my opportunity to spend some years in general practice and for the broadening it gave me – from a resident to a doctor with a better understanding of patients and the social determinants of health. Rotations as a GP Registrar would be a great addition to every training program, with heavy supervision. It would create better doctors of all of us in my view.