When state funding for her menopause outreach clinic ran out, Dr Effie Parakilas continued the program with money out of her own pocket.
A GP-led rural menopause support program funded by NSW Health received great reviews from patients and practitioners alike – but that didn’t stop funding from drying up.
Between September 2023 and October 2024, western NSW GP Dr Effie Parakilas was funded to run hybrid telehealth and in-person menopause outreach clinics in the towns of Bourke, Brewarrina and Walgett.
“It became a visit lasting two days in each place,” she told The Medical Republic.
“Running sessions, running consultations, and doing whatever procedures I could do at a general practice level – IUD insertions, endometrial biopsies, things that help the women not to have to leave their town.
“We could investigate and then add information if we needed to refer to a specialist.”
Walgett and Bourke became the two key clinics, with women travelling in from surrounding towns like Coonamble, Lightning Ridge and Cobar.
Dr Parakilas ran the in-person clinics every three months, with follow-up care delivered via telehealth from her main practice, Ochre Medical Centre Cooma.
“[I did] a weekly afternoon session of telephone consults following up those women,” she said.
“I would go into remote desktops for those two practices and then line up the women for telephone consults.
“It was a sort of a hybrid model of face to face plus telehealth, and it seemed to work really well, and we did that for 12 months.”
Testimonials collected by Ochre Health paint a picture of a well-used service.
“Having Dr Effie available as a doctor in Bourke is a massive advantage for our community,” one patient said.
“I suffer gynaecological conditions and my specialist is hundreds of kilometres away. It’s fantastic to see a doctor who understands in-depth those conditions more regularly.
“I also feel comfortable and at ease seeing her about regular issues as she understands my background.”
A patient from Walgett said being able to consult a doctor with expertise in women’s health locally had “significant value”.
“The service she has been able to provide in Walgett enables us to consult with a doctor in our local town and not seek opinions elsewhere,” the Walgett resident of 27 years said.
“I strongly support Dr Effie and the continuation of her service to the local people in the community of Walgett and districts!”
Despite the community goodwill, the state government funding dried up in October last year.
Dr Parakilas told TMR that the discontinuation had been “frustrating”.
“I felt that I’d really only just begun to establish relationships with patients and staff and to develop systems to provide continuity of care,” she said.
“And I have always found short-lived funding programs frustrating, because they are often introduced with a lot of flourish and fanfare and then you never hear about them again.”
So, for the last 12 months, Dr Parakilas has been continuing the program out of her own pocket.
“I pay my own travel and accommodation,” she said.
“I’m going to those towns from Cooma in the Snowy Mountains, so it’s quite a long trip and costs me about $1500 just to get there each clinical visit.
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“I do that about four times a year, and I’ve just decided that’s what I would like to do.
“I’d just like to offer that service.”
Because the Walgett and Bourke practices are universal bulk billing clinics, Dr Parakilas elects to bulk bill all patients.
“That’s what they’re used to, and that just enables equal access to everyone,” she said.
“So that’s what I’ve been doing, and I’ve continued to use that hybrid model of care to really develop relationships and have really gotten to know those workplaces and those patients, and I really enjoy doing it.”
Dr Parakilas said she was happy to work for a reduced income in order to enable the program to continue, given that she was nearing the end of her career.
“If you want to encourage other GPs to take on something like this or to work in that space, then they may not be happy to do that,” she said.
“In terms of what might happen in the future, some funding to pay for accommodation and travel would be fantastic.
“I’m happy to do this, and I’m happy to do it for the next few years, but the funding would mean that other medical providers are enabled to get to those remote places.”
Ochre Health co-founder Dr Hamish Meldrum said successive governments often had different ideas on how to fund projects.
“Often governments do have enthusiasm for certain projects, but they’re not always carried through, even by the same government, let alone when there’s a change of government,” he told TMR.
“With the chopping and changing of funding, it’s hard to build long term, sustainable services.
“We’re very lucky to have Effie, who’s a very committed doctor who has really formed a bit of a connection with these communities, and is electing to partially subsidise this herself.”
TMR contacted both NSW Health and the Western NSW LHD but did not receive a response before deadline.
