Why are young doctors not seeking experience in regions of Australia that have such unmet need?
My Island Home is a wonderful song written by Neil Murray when living west of Alice Springs as a member of the Warumpi Band.
It was sung by, and about, George Burarrwanga, the wily and massively charismatic lead singer, and his Elcho Island home off the north coast of Arnhem Land. When Christine Anu sang the song at the closing ceremony of the Sydney Olympics all references to the Western Desert were removed.
Don Reid, a consummate and worldly GP, still looks after Sammy Butcher, the lead guitarist of the Warumpi Band, at Papunya. Don arrived in Alice Springs this year after doing locums in central Australia for many years. Sitting under a crystal sky that lights the hills without the need for street lights, or even a moon, Don says, “I want to get your doctors’ band to come and play with those old fellas at Papunya sometime.”
My heart jumps. We have just walked home from seeing Gurrumul at the cinema (a must for every Australian). It is a wonderful and sad Northern Territory and Aboriginal story of the talented artist Geoffrey Gurrumul Yunupungu. A story of unlikely fame and extraordinary relationships cut so very short by poor health. George Burarrwanga died only four years older at age 50.
The next day I ring the famous Justin Coleman, pianist and singer with the Gpettes, or Cheeky Docs, or whatever. Having started a career in the Northern Territory at Anyinginyi Congress in Tennant Creek, then on to Jabiru at Kakadu, Justin now edits John Murtagh’s text book, leads the Medical Writers’ group and publishes podcasts. I tell him of Don’s idea and he is interested. We need a theme, a reason to gather and engage.
Could we get a new generation of GP musicians to join us and show them the joys of central Australia and the real words to My Island Home?
I am heading to my 40th reunion next week (we graduated very young in those days). It is in the beautiful Barossa Valley north of Adelaide, a region settled first by the Germans (some time ago) and later by graduates of my medical year.
Our reunions are joyous events involving wine, and partners, and led in song by Johnny Wong, a Borneo refugee who came to Australia in the late 1960s. Half of our year became GPs, many adventurous. I am going to ask if any of them would like to come and join us here in Central Australia for a while, working weeks on and weeks off in one of our beautiful remote townships, or in Alice Springs. We need good GPs here.
NTGPE, the GP Training RTO, only had 50% uptake this year. Apparently this was also the case in northern Western Australia and outback Queensland. Why do young doctors not seek an experience in regions of Australia that have such unmet need?
Training in a place such as Alice Springs, (or Tennant Creek, Katherine and Nhulunbuy) offers the opportunity to do all your training in one iconic Australian location, access to good schools, going remote and soaking up the desert.
We have twice the number of medical graduates these days! Where are they going? Not here!
We have 18 overseas graduates again in Alice Springs hospital, just a few years after the graduate numbers increased. I blame the hospitals to a large extent. No belief in clinical acumen; it died in hospitals with immediate availability of massive numbers of tests.
We and a handful of rural specialists are now the bastions of clinical judgment. A paediatrician said to me during a recent meningitis outbreak here in central Australia: “You can’t tell if someone has meningitis.”
I said: “Well, actually, that is my job.”
I have a career 100% sensitivity and (I am guessing) 50% specificity over 40 years. That is what GPs do; we narrow the probability before the specialists see them. If we get it wrong, the consequences are terrible. I remember seeing a patient with chest pain who had come straight from the gastroenterologist’s outpatients to get omeprazole, which was a new drug at the time. For some reason I asked him about the pain, which I slowly convinced myself was angina and potentially dangerous. I sent him to hospital!
So (thinking out loud again) I am wondering, could we get a young group of musical GPs to join some of the Cheeky Docs – we can get some new shirts made – in a tour of remote communities around Alice Springs? Would that open their eyes? Would waking in a swag and seeing the stars rotate in the heavens above, move them?
Would the friendliness and interest of the people we meet pull on their heart strings and make them feel they could spend some of their life learning about unique Australian languages and cultures and providing healthcare where it is so needed? Would some of them fall in love with it all?
In the clinic, an Aboriginal Health Practitioner approaches me for assistance as a 17 year old girl is vomiting and she is worried because the girl has a systolic BP of 105 mmHg. In view of the BP, I suggest a pregnancy test as I am seeing another patient. “It’s positive”, the AHP interrupts me looking perplexed and still holding the urine pot which contains very cloudy urine. Stalling further to attend to my current patient, I suggest a dipstick in the urine as it looks infected.
Two minutes later the AHP bursts into my room again. I say goodbye to my patient. “There are nitrates and leuks, Dr Sam.” I nod. “Oh, and lots of sugar!” My eyes widen. “And her blood sugar is 18.8.” “Ok, I’m coming.”
I breathe in and wonder how to approach this, then imagine that she might be the next great Aboriginal singer from this part of the world. Or painter, or politician.
Dr Sam Heard is a GP in the Northern Territory and Chair of the NTGPE.
Read more from Sam at: http://drsamheard.com
