IWD: Dr Penny Burns on the ‘significant changes’ to general practice

Sydney-based GP and disaster medicine specialist Dr Penny Burns talks to newsGP about what International Women’s Day means to her, and the significance of the integration of disaster management into the discipline of general practice.
 
Do you usually celebrate or mark International Women’s Day, and if so, how?
‘I don’t usually celebrate IWD but do note it, and my thoughts particularly turn to females in countries where females are restricted from the same privileges as males in access to education and careers and freedoms. Males and females in some of those countries are bravely fighting that oppression now and we need to ready to support their fight for equality in whatever small way we can.’
 
Have you seen significant changes for female GPs in the years since you graduated, in relation to workplace, family, career, education, etc?
‘I have seen significant change for all GPs since I graduated. Evidence-based medicine has become front and centre of everything we do in general practice now and guidelines exist for most conditions. This makes the practice of the generalist nature of general practice clearer.’ 
 
‘I remember Professor John Murtagh telling me that when he was a young doctor there was less guidance available and so he wrote the first edition of what is now Murtagh’s General Practice on paper and carried it down to the editor’s office in two suitcases. This book has now been disseminated worldwide and translated into 13 different languages. That guidance was not available when I studied general practice.’
 
‘One of the things I feel that is less appreciated now in the medicine of general practice is wisdom and practical experience – two factors that I feel are also needed to continue to be appreciated alongside evidence to create best practice general practice.’
 
‘We saw during the pandemic that the evidence was not always immediately available at the time it was needed, and we sometimes needed to rely on the wisdom and experience of our medical colleagues from previous similar events to help guide us through the event.’
 
‘We have also seen increasing specialist areas being supported within general practice, including through the growing numbers of special interest groups within the RACGP, and the experience of GPs that work in these disciplines is supporting creation of guidelines based on the evidence guided by the experience.’  
 
‘I work in both clinical general practice and in General Practice Disaster Medicine (GPDM), which, after decades of background work, is finally being integrated into the discipline of general practice. Previously when disasters struck a local community, the local GP was expected by the community to contribute but was regularly not included in the practiced response, creating a disconnect in patient continuity of care that would have had the potential to affect health outcomes following the incident, particularly chronic care.’
 
‘In terms of changes for female doctors, I have always found general practice a discipline that supported and facilitated female GPs alongside male GPs. Leaving the hospital system in the mid-1980s, where I was constantly aware I was a female, general practice was a great environment to arrive in.’ 
 
‘When working in remote rural areas with the RFDS and in Papua New Guinea, even during the 80s, I did not find being female made a difference, although I did have to deal with morning sickness on retrievals, and when arriving to run an RFDS clinic at a remote outback station not being able to eat the huge offering food on offer to usually male GPs.’  
 
‘The main disadvantage I encountered as a female was in taking the time out to have children, which made starting your own practice or specialising further more difficult compared to those who didn’t have that extra home life activity. However, I also appreciate the opportunity to do this and would not have changed it for the world. When the children were older I managed to fit in a Master’s degree and then a PhD which were facilitated by the flexibility of general practice as a career.’
 
Are there any changes that need to occur in general practice when it comes to female patients, students and doctors?
‘We can always learn and improve and maybe it is that we need to support those female patients, students and doctors that tread a more difficult road.’
 
‘Getting into medicine isn’t easy, completing a medical degree and specialising in general practice isn’t easy, and we particularly need to look at how we can support those from cultures and backgrounds that make this process harder.’
 
‘I think improvements can be made in how the system and requirements for medical practice do not support females in taking time to be pregnant, to deliver and to breastfeed and raise children. This has improved greatly since I had my children but as I watch my daughters navigate the same process, I can see that we have a long way to go.’  
 
As a leader in disaster medicine, how has being a women shaped your trajectory?
‘Disaster medicine has a lot of male leaders in this space. I was lucky to find a strong female leader as a mentor, Emeritus Professor Beverley Raphael, who worked to bring mental health into disaster medicine following the Granville train crash and Cyclone Tracey. She has successfully achieved sustained integration of the discipline of mental health into disaster medicine in Australia, something what we are now in the process of hoping to achieve for the discipline of general practice.
 
‘She was inspirational and together we worked on ways to effect change in the integration of GPs in disasters. Women have a unique understanding of the particular female issues in balancing family and career.’
 
What advice would you give young women who are starting out in a general practice career?
‘Have fun – general practice is a great career that due to its generalist nature, can take you down almost any path you wish to focus on.’
 
‘I would suggest having one or two special interest areas and following them where they take you. Being able to be a specialist within being a generalist gives you the best of both. Of course, life balance is most important and navigating children and career is difficult, but it is so important to hold onto the career because when you emerge from the blur of young children it is wonderful to have such an interesting career to continue.’
 
‘Finally, I have found that the support from strong female mentors has been invaluable.’
 
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disaster medicine female leadership general practice career International Women’s Day IWD