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The stories behind royal recognition for rural GPs


Tim Robertson


8/07/2022 5:07:04 PM

Three GPs recognised for their contribution to medicine speak about their passion for their communities and rural primary care.

Chris HOgan, Sunday Adebiyi, Ewen McPhee.
Associate Professor Chris Hogan, Dr Sunday Adebiyi and Dr Ewen McPhee all received Queen’s Birthday honours last month.

In 2004, Dr Sunday Adebiyi arrived in Dysart, a small mining town in the Isaac Region of Queensland, located around 244 km southwest of Mackay. The town’s population of between 2500–3000 people can swell to 6000–7000 with drive-in-drive-out miners.
 
Dr Adebiyi is the town’s only doctor.
 
‘It was going to be a two-year stint – that “two years” is going on to 18,’ he told newsGP.
 
It may seem like a long way from Nigeria, his country of birth, and South Africa, where he worked prior to migrating to Australia in 2000, but he says these formative years have served him well in Dysart.
 
In South Africa, as well as practicing in small, isolated communities, Dr Adebiyi also headed up the outpatient department at the local provincial hospital.
 
‘I’ve seen places where we have one doctor in a town of about 3000–5000 people, and he has to do everything,’ he said, reflecting on his career in an interview with the Rural Doctors Association of Queensland in 2004.
 
‘The community was 200 km away from the nearest town, there is no proper road and no ambulance, so you have to do it all on your own.
 
‘You have to get the skills to be able to do that and its very interesting.’
 
Prior to moving to Dysart, Dr Adebiyi worked at Charters Towers Medical Centre before opening the Gemfields Medical Centre in Emerald in 2003.
 
He has trouble finding doctors to relieve him and it is difficult to get a locum, which means he often works for long stretches of time without relief.
 
‘I’ve been begging them to give me a registrar for almost 10 years now,’ he told newsGP.
 
‘They tell me it’s because no one wants to come to Dysart. And I say, “It’s because you don’t advertise Dysart.” Some practices are getting four or five registrars and I can’t even get one.’
 
Despite these challenges, the rewards that come with serving the one community for nearly two decades are what sustain him.
 
‘I am very passionate about my job and my patients and the community,’ he said.
 
‘I have promised them that I will not leave them without a doctor and that is what I am trying to fulfill. I’ve known many families for three generations in this town and they get to know you too.’

queens-bday-rural-article.jpgDr Sunday Adebiyi has been working as a GP in Dysart for more than 15 years.
 
The care Dr Adebiyi provides to the people of Dysart is reciprocated.
 
‘When I am [feeling] down, someone comes to me and says, “Thank you, we can’t do without you, we are lucky to have you here”,’ he said.  
 
‘They bring me tea, they come to my house to help me – the community are very helpful, they care about me and my family.’
 
About 130 km south of Dysart, Dr Ewen McPhee is the practice principal, medical educator and rural generalist obstetrician at Emerald Medical Group.
 
With over 30 years’ experience in rural general practice, he is a member of the International advisory committee to the World Organisation of Family Doctors Rural Working Party and clinical lead for the first Rural GP Led Respiratory Clinic in Australia, established in response to the COVID-19 pandemic.
 
Over the years, Dr McPhee has seen a lot of changes in rural medicine.
 
‘Back in the day when I was starting out as clinician, we had a very high workload,’ he told newsGP.
 
‘We had to see a lot of patients, mostly with fairly acute conditions. We didn’t have a lot of time and space for chronic disease management. Things were seemingly simpler then.’
 
The complexity of the cases rural GPs deal with these days has increased significantly, Dr McPhee explains.
 
‘The amount of work a GP has to do and the responsibility a GP has to take for patient care has significantly increased as access to specialist care has declined in regional Australia,’ he said.
 
‘We are looking after some fairly complex comorbidities in reasonably sick patients, whereas probably 10 or 20 years ago we would have had better access to specialist care than we do now. 
 
‘Visiting specialists are in decline. Emerald is fortunate to have an endocrinologist service, which Rockhampton doesn’t have, but that’s individual-specific. There’s no structural program from the [Royal Australian] College of Physicians or anyone else focused on having regional specialists.’
 
The Emerald Medical Group has focused on training and has found that, by providing doctors with a positive experience in a well-supported practice, they are not averse to considering a career in rural medicine.
 
‘It’s about having a strength-based conversation around what’s positive about rural and regional general practice, rather than constantly talking about deficits and how terrible it is,’ Dr McPhee said.
 
‘The most rewarding thing has been just having the opportunity to be part of a community, to have raised my family in that community, to have been part of the medical fabric of that community and to have had a meaningful career. And it’s all been regional.’
 
These same sentiments are echoed by Dr Chris Hogan, a GP from Sunbury, Victoria and Associate Professor at the University of Melbourne.
 
‘When I was a kid, the thing that propelled me into general practice was that I used to hear a family member start to tell a story and, after a few sentences, you knew it was not going to end well,’ he said.
 
‘It was my ambition to interfere and become involved in people’s stories and do a little bit so the story didn’t end quite so badly as it might have otherwise.
 
‘That’s why I became involved in preventive health, early detection and effective management [of disease] and patient empowerment.’
 
Associate Professor Hogan began practising in Sunbury in 1979 and, over that time, there are some families he has treated for four generations and being able to provide this continuity of care has been one of his ‘great joys’.
 
‘One of the things I’ve seen is that people who see the same doctor – and it doesn’t have to be all the time and, in fact, it … can just be the one practice – their health outcomes are 7–10 times better,’ he said.
 
When he arrived in Sunbury it did not yet have an ambulance – that was still years away. It now has three and, over that time as a rural generalist, Associate Professor Hogan has had a varied career spanning emergency work, anaesthetics, obstetrics, aged care and dealing with road trauma, while also sitting on a range of high-level committees and teaching.
 
‘You just do what the community requires,’ he said.
 
Funding for rural general practice has remained a consistent challenge over the years.
 
Associate Professor Hogan explains that the defunding of primary care inevitably results in the healthcare burden being shifted to other parts of the community, whether it be the ambulance service or hospital emergency services. These cuts have far-reaching consequences, he explains
 
‘We know that if we look at societies with a good primary care base…their health outcomes are magnificent,’ he said.

All three of Dr Adebiyi, Dr McPhee and Associate Professor Hogan were recognised for their contributions to medicine on the most recent Queen’s Birthday Honours List.
 
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A.Prof Christopher David Hogan   9/07/2022 9:49:08 PM

Sunbury was very rural when I started & I have lived in the same house for over 40 years. I never moved.
Sadly the city engulfed us & we became a suburb-