“Continuity of care is one of the best things about being a family doctor. You don’t just assess and treat patients and send them off never to be seen again, you follow them up and see if your treatments have worked, analyse their results and work with them to help fix their problems.”
Today, as we celebrate World Family Doctor Day (May 19) as an opportunity to acknowledge the central role of family doctors in the delivery of personal, comprehensive and continuing health care for all patients, it’s that sense of community that drew Flinders graduate Dr James McLeod back to the Riverland of South Australia following the completion of his training.
Dr McLeod (BMedSc ’06 and (BM, BS(GradEntry) ’09) is a Rural General Practitioner whose special interests include complex general medicine and chronic disease management, skin surgery and palliative care.
He is a part-time GP Consultant at the Riverland General Hospital Emergency Department while also working in conjunction with other senior GPs at Renmark Medical Clinic to teach Flinders University medical students and junior doctors completing their training through GPEX, Rural Doctors Workforce Association and the Riverland Academy of Clinical Excellence (RACE).
“I wanted a tree change and wanted to challenge myself,” Dr McLeod says in explaining why he chose to study medicine at Flinders and be part of the rural program. “I loved my year as a student in Renmark and it is one of the main reasons that I came back.
“I certainly enjoyed my years studying at tertiary hospitals, but I find that too many things in medicine and surgery are becoming overly subspecialised and I didn’t want to restrict my scope of work to only one part of the body. I think I am a generalist at heart and being a rural GP suits me well.”
Stepping up to the challenges of rural medicine and helping shape its future
Being a family doctor and a rural GP is rewarding work he says, but it doesn’t come without its challenges and can at times be hard work.
Requiring the ability to know how to manage anything that walks through your door is often a daunting proposition for junior doctors because of the breadth of knowledge they must hold, but once that knowledge and skills base is developed, they soon become confident in managing any patient presentation.
“For the presentations that you don’t know how to manage, your colleagues (both near and far) are always there to help you out,” Dr McLeod says. “These difficult presentations though are what make the job so interesting and they are the best ways to learn and further perfect your craft.
“You also get to interact with their treating allied health, medical and surgical specialists and often learn quite a lot from them too.”
Dr McLeod this year began working as the Flinders Rural and Remote Health SA MD Rural Stream Clinical Educator for the Riverland and teaches junior doctors in the RACE program.
The draw to taking on the role of teacher stemming from the workforce shortage in rural areas becoming critical and wanting to be part of the solution to fix that.
“It has always been hard to get doctors working rurally, but over the past five years or so we are finding so many junior doctors really struggle with rural general practice because they just aren’t getting exposed to it during medical school or their junior doctor years.
“I love teaching and I believe I have one of the most interesting jobs going around, so I really want to get others involved.
“Teaching is also a nice break from the daily grind of work. I am finding it fun and challenging as my pupils are rather clever and they always ask tricky questions – they keep my knowledge base sharp and keep me enthusiastic about my profession.”
For those who Dr McLeod can’t coax back to rural areas, he says he’s confident that through the MDRS program those students will have a much better understanding of rural health issues and hopefully do something from afar to help their rural colleagues and patients.
Self-contained regional care
Living in Renmark with his young family, the rural lifestyle is one that suits them all well with the River Murray, school, playgrounds, friends, shops and work all within a 400-metre radius of their home – with the added benefit of fishing, campaign and exploring the Outback just a stone’s throw away.
Starting some consults querying the latest fishing spot hot spot or discussing the latest local farming issues Dr McLeod says it’s easy to relate to the patient base in a landscape surrounded by the river, fruit blocks, vineyards and picturesque scenery – plus the work is far more interesting.
“I have worked in city GP practices and the biggest annoyance for me was that when patients presented acutely unwell, the treatment was usually just to call an ambulance and send them to a tertiary hospital emergency department.
“In rural areas we do not have that luxury, those complex presentations have to be managed locally. We can admit to our local hospitals, and we frequently manage very complex problems and very sick patients. If we cannot manage the patient locally then we call on the Royal Flying Doctor Service or Medstar to retrieve the patient to Adelaide and that process is often very intense and interesting.”
Managing the varied problems in such a relatively resource poor environment comes as one of the most rewarding aspects for a doctor in a rural or regional community – a community they are part of and connected on a personal level.
“Being able to do home visits including in home palliative care is also very rewarding, patients certainly appreciate it too and relationships that we form with many of them are very special.
“Overall, the job can be very challenging mentally, emotionally and physically, but it is very rewarding and not everyone can do what I do, so I wear that as a badge of pride.”