IWD: The fight for better breast care

She may not have been born and raised in the Apple Isle, but after moving to Hobart from Sydney 17 years ago, Dr Virginia ‘Ginny’ Baird and her family now consider Tasmania home.
 
‘Love it. No regrets moving down here,’ she told newsGP.
 
The mainland’s loss has become Hobart healthcare’s gain, as Dr Baird has established herself as a women’s health GP and is now training to become a breast physician.
 
The Newcastle-born Dr Baird’s busy schedule includes working in the Breast Clinic at the Royal Hobart Hospital, as well as for BreastScreen Tasmania, and as a surgical assistant.
 
Until July, Dr Baird also worked with Family Planning Tasmania, until her other commitments took over. ‘I actually don’t have time’, she said as she spoke to newsGP between reading mammograms.
 
Dr Baird said it was a comment from a lecturer at medical school that prompted her to go into general practice.
 
‘They said “medicine is so compartmentalised, it’s good to be covering all things”,’ she recalled.
 
‘I’m not really doing that now because I’m sub-specialising, but I think that’s one of the great things about general practice – that there’s opportunity to do some sort of speciality training in terms of upskilling in areas, so you don’t have to do everything all the time.’
 
Dr Baird said she initially chose women’s health after seeing the opportunity ‘to do a bit more than what was just then known as pap smears’.
 
‘I generated this half-hour appointment at a practice I was working at where I’d cover mostly women who were coming for cervical screening, but I was also asking “are you up to date with your mammograms? What about osteoporosis prevention and management?”,’ she said
 
‘I started doing that, and then when I was in Townsville for part of this training, I got the opportunity to be funded to do the Family Planning training in the National Certificate of Sexual Reproductive Health.
 
‘I thought “oh this is a good idea”. Then I had to come back to Hobart and do a clinical post as part of that training, and I really enjoyed it.’
 
Dr Baird ended up spending several years working part-time in adolescent contraceptive management at the youth health service in Glenorchy.
 
‘I like to do things really well,’ she said. ‘Just cutting down on what you actually cover with health presentations, I think it improves your confidence, and I think it’s a better outcome for the patient as well.’
 
Her interest in women’s health led Dr Baird to become even more specialised, as she became increasingly involved in breast health and, in turn, a passionate advocate for better access to free screening.
 
Dr Baird said in Tasmania – unlike most Australian states and territories – only a small number of women have access to public diagnostic breast imaging.
 
Through BreastScreen Tasmania, eligible women can get free breast screening using 2D digital mammography. However, in addition to 2D mammography, diagnostic breast imaging can require 3D mammography, ultrasound and, in some cases, MRI and/or contrast enhanced mammography.
 
A range of factors can impact the cost of an MRI, such as whether the patient has a concession card or has had a recent cancer diagnosis, but it can range from $105 to $800 – cost-prohibitive for many women.
 
‘There are women who are advised to go and get [imaging], but they can’t afford it, so they don’t go because they can’t afford the out-of-pocket costs,’ Dr Baird said.
 
Those women that do get imaging are not only met with high costs, but often long wait times – a situation that has gained increasing attention.
 
‘We’ve had lots of newspaper articles in the past couple of years; one woman was told it was a three-month wait, so she went to Melbourne and got [breast imaging] straight away,’ Dr Baird said. ‘And there was a cancer there.
 
‘We really need more access down here in Tassie. I know that other countries don’t even have screening, but where we have got the finances available, then we shouldn’t be without when there’s good evidence for timely investigation and management’.
 
Dr Baird also devotes time to women’s health education and, four times a year, gives a lecture on vaginal health at the University of Tasmania.
 
‘I try to make it less didactic and get a bit of audience participation, which is slightly awkward with the 20-year-olds,’ she laughs.
 
‘It’s really important, because the main point I make in the lecture that I give is that it’s the only time in their training they’ll hear about one of these particular conditions – lichen sclerosis – which can be absolutely devastating to women if it’s not diagnosed.
 
‘So, I’ve got lots of pictures, just trying to help people think about it, and talking them through how you manage it, and when you refer.’

Along with fellow GP Dr Miranda Hann and neuroscientist Dr Lila Landowski, Dr Baird will be part of a special International Women’s Day event at RACGP Tasmania on Friday, 7 March, as they lead a discussion on how women are driving change and achieving equality.  
 
It is part of a broader week of online and in-person events the RACGP is presenting nationally in the lead-up to International Women’s Day, which is observed globally every year on 8 March.
 
For the Hobart event, Dr Baird said she hoped to speak about the outpatient breast clinic at the Royal Hobart Hospital and the new Breast Care Centre planned for the floor below, which will co-locate BreastScreen Tasmania and a new public Diagnostic Breast Imaging Service.
 
‘The idea is that, hopefully at the end of this year, the diagnostic and screening clinics will be in the same place … so, we’ll have it all centralised,’ she said.
 
The diagnostic breast clinic began operating within the hospital about four months ago but is not yet available to GPs outside the hospital. That will eventually change, said Dr Baird.
 
‘I can refer from our breast clinic at the Royal, and specialists can refer to it, but the plan is to open that up to all GPs for referrals,’ she said.
 
Tasmania is likely to keep Dr Baird for quite a while to come, with the doctor and her family now enamoured with the charm of Hobart.
 
‘Everybody’s so friendly and relaxed,’ she said. ‘Because the lifestyle is better, the area is clean, and you’re so close to the beautiful wilderness.’
 
The theme of this year’s International Women’s Day is ‘March Forward’, and RACGP events are taking place across Australia and online from 5–11 March, proudly supported by Major Partners, Gedeon Richter and Bayer.
 
Find out more about the speakers in your state and secure your spot now.
 
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breast health breast imaging breast physician International Women’s Day mammograms women’s health