My medical career started when I graduated from the University of Melbourne. After my hospital years at the Austin Hospital and Monash Medical centre, including a diploma of obstetrics, I joined the Family Medicine Program, then run by the RACGP (the forerunner of the current general practice training scheme). I wasn’t sure I was destined for general practice, but there was an FMP rotation at Monash University Department of Family Medicine that looked interesting. Part of that rotation was at Blackburn Clinic. I stayed on at Monash for a few years, then worked as a Medical Educator at the FMP for another couple of years, but I always kept up sessions at Blackburn clinic, and I am still there after 28 years!
I think one of the benefits of general practice is the ability to become involved in related activities. Over the years I have been involved with Divisions of General Practice, then Medicare Locals. I have been a GP advisor to the Lung Health Promotion unit at the Alfred Hospital. I have been a GP Supervisor for over 20 years, and have been on the board of VMA and am now on the EVGP Training board. I have also been the medical advisor for an international amateur golf tournament for many years – unfortunately I hasn’t helped by golf!
Another benefit of general practice is the ability to change your interests over time – the scope of practice is so large, that it is helpful to have areas of particular expertise. My current interests, apart from medical education, are in allergy, asthma, diabetes and dermatology, as well as medical informatics.
People often talk about the flexibility of general practice, and that has certainly worked in my favour. Working long hours at times, but being able to change that when it suits me. I travelled around Northern Territory and WA camping for 4 months with my family when my children were in primary school, and I still had a job to come back to.
Being in a large practice with many of colleagues makes it easier to keep up with changes and share the burdens and responsibility of general practice – there is usually somebody around who can answer questions – often the ones asked by registrars that I can’t answer.
Being in the one practice for so long also has more benefits than disadvantages. Patients are generally well known and consultations are usually part of an ongoing conversation over years. You get to know patients and their families and you also get to know local services and facilities, local specialists and hospitals – so much of general practice is now about helping patients navigate the system. I don’t envy new registrars trying to learn about our health care system. Even now the NDIS, e-health record, codeine rescheduling and changes to mental health care are keeping me on my toes.
My scope of practice is also changing – I recently commented to a colleague I have gone from giving contraception advice to menopause advice, as my patients and I grow older together. I don’t remember completing a death certificate in my first few years of general practice, but now palliative care is a regular part of my practice – unfortunately it is often for patients I have known for many years.