‘The best career’: 40 years as a GP in country Australia

Dr Kate Davey makes time for her interview with newsGP in between patients and while on call.
 
Despite entering the twilight of her 40-year career as a GP in country Victoria, she isn’t slowing down just yet.
 
‘I’m on call and it’s always busy. We run a 24-hour service,’ she said.
 
‘The on-call person sees anyone that needs acute care. We have our own respiratory room as well, so with COVID you could be in PPE for the whole day.’
 
When on-call, Dr Davey takes calls and comes into the clinic if necessary overnight. She also performs home visits, tends to four residential aged care facilities in town and trains registrars.
 
And while that all sounds difficult to manage, Dr Davey extolls a genuine verve and passion, particularly when she talks about rural general practice.
 
Originally from Melbourne, she chose to live rurally and has based herself in and around Wangaratta in rural Victoria.
 
‘Once I decided that general practice was the career pathway for me, it seemed more inviting to live and practice in the rural environment,’ she said.
 
‘Fortunately, by a series of helpful coincidences I met and married my husband Ken who just happened to be a winemaker from northeast Victoria, and rural practice became my chosen path.’
 
Dr Davey wishes her story was more commonplace and that it was possible to encourage more GPs into rural and remote areas. Recent media reports regarding ongoing GP shortages around Australia only reinforce that the current downtrend has proved difficult to break.
 
She says a recent pilot program aimed at attracting GPs to diverse locations – Practice to Practice – showed promise, but unfortunately was impacted by COVID.
 
‘Despite the inspiring vision of the pilot program, sadly it collided with the pandemic,’ she said.
 
‘Given the strains that were put on general practice as a whole, I found that it was difficult to concentrate on recruitment when simple survival in a very unstable clinical environment took priority.
 
‘Maybe relaunching and reinvigorating the program as a creative and more interesting option now that life in urban Australia may have lost some of its attractiveness, should be considered.’
 
While COVID has exacerbated workforce issues, there have long been challenges recruiting GPs into regional areas – and Dr Davey has thoughts as to why.
 
‘I suspect that the answer to this question is far more complex than can be captured by a few sentences,’ she said.
 
‘Graduates from the current medical schools are older and frequently already have significant financial and relationship commitments which can make moving to the country very challenging.
 
‘The issues of jobs for partners and availability of childcare have been consistent and unchanging barriers for the last 40 years.
 
‘[Also] the hospital environment appears to stream young doctors into making career choices very early in their postgraduate years with the battle to enter all specialist training programs beginning very early, maybe prematurely.’
 
Dr Davey says it was not until her third postgraduate year, when she had had an opportunity to sample working across a wide range of medical disciplines, that she chose general practice.
 
‘I think this process enabled a wiser and better-informed decision on my behalf,’ she said.
 
‘There are many urban myths revolving around isolation, both academic and geographical, [the] skills required to function in a rural environment and available support from specialist colleagues, [all of] which complicate people’s choices.’


Dr Kate Davey’s husband, Ken, is a winemaker from northeast Victoria which helped her settle on the path towards rural practice.

However, for her, working as a rural GP is filled with satisfying challenges and fascinating experiences.
 
‘Being a country GP is the best career I could have ended up in,’ she said.
 
‘Becoming embedded with the community is a privilege, in terms of what you get to do and the engagement with families.
 
‘One of my most challenging jobs was working with five generations of one family, and that’s a privilege to do that. When you educate one generation and you see that health literacy passed on to subsequent generations, that’s a highlight.’
 
Dr Davey says she never once considered leaving general practice – although the challenges brought about by the pandemic did make her wonder how it might feel not to be responsible for providing patient care.
 
Overall, she says general practice has afforded her privileges she may not have had in other specialties.
 
‘When I started out in my hospital career, I really enjoyed working in single disciplines but soon came to realise that I needed a wider challenge,’ she said.
 
‘I have really enjoyed being involved in the care of patients of all ages with all conditions.’
 
Rather than be concerned with the challenges of general practice, Dr Davey brims with pride as she describes training future GPs. Which leads to the next question – does she recommend general practice to medical students?
 
‘Absolutely,’ she said. ‘I have found general practice an intellectually challenging career that has kept me interested every day of my working life.
 
‘You just never know what is going to happen next.
 
In fact, Dr Davey believes no other specialist pathway can offer the variety and satisfaction of general practice.
 
‘I can say sincerely that I have never seen the same disease present in exactly the same way twice,’ she said.
 
‘Our patients keep us alert and ensure that we maintain our diagnostic and therapeutic skills.
 
‘It is [also] possible to shape your general practice career to reflect your interests and situations. Fortunately, nowadays part-time hours are accepted as part of the fabric of general practice and support for this pathway is not limited to gender.’
 
And while 40 years is a long time to spend in any career, Dr Davey says the core of general practice has remained the same – albeit with a more rigorous understanding of effective consultations and evolution into ‘masters of uncertainty’ who provide high-quality, efficient and cost-effective care.
 
There are currently three GPs in training at her clinic, Ovens Medical Group. But even though she is retiring, Dr Davey is not ready to give up teaching and mentoring the next generation just yet.
 
‘Our general practice training programs have harnessed the wisdom of years of general practice to ensure new graduates emerge with a far greater range of skills than I did all those years ago,’ she said.
 
‘I don’t think I’ll stop being an educator. It’s one of my passions.’
 
Other than continuing teaching, she also intends to travel.
 
‘I am a very keen trekker and I have planned several walks to occupy myself, at least initially. I have already completed large parts of the Australian Alpine track but need to fill in some of the missed bits,’ she said.
 
‘Then if the European situation seems safe enough, I would like to complete the European Peace Walk from Austria to Slovenia.’
 
But at the end of every journey, Dr Davey says she will return to her country Victorian home – and potentially even some form of clinical practice.
 
‘I might come back and do some occasional work,’ she said
 
Perhaps the life of a country GP is too rewarding to ever fully retire from.
 
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