After 34 years of practicing medicine I have been reflecting on the changes over this time. I have had an exciting career, having trained in South Africa at a time of great political upheaval and change and had the privilege of very good teaching in a first world environment, but also the experience of pathology and disease in a third world nation.
Twenty five years in primary care in New Zealand has been interesting with the changes in the health system, the closure of smaller peripheral hospitals and the move towards ‘bigger and better’.
There is no doubt that there are benefits in bigger groups of doctors working together, but certainly in the Auckland region we have largely seen the demise of the small family doctor practice where your doctor knew you personally and you were able to pick up each consultation without needing to repeat what you had said at the previous one.
Even 15 years ago, GPs on the Coast provided all after hours services, doing house visits even on weekends, but these services were really only available for emergencies. Now we have the advent of the A&M where you can walk in and be seen between 8am and 8pm and even later hours if you travel 20 minutes down the motorway to Smales Farm, which operates a 24 hour service. However, if you live in Sandspit or Leigh you have a good 30 to 50 minute drive to Red Beach and after 8pm another 20 minutes to Smales Farm and that is before you join the queue to be seen. On the plus side there are other facilities available at these sites such as x-rays and pharmacies, so pretty much a one-stop shop.
Now I am exchanging the pleasures of living close to Auckland city and all it has to offer (including the convenience of excellent medical facilities close by) for the different pleasures of rural general practice in Central Otago.
I will be the only GP in a small town with a large rural practice population, about an hour away from Dunedin. I am looking forward to living in a small community where I will know everyone and everyone will know me! Patients will have less access to facilities like x rays, and the pharmacy is 40 minutes away, but the medications come by bus to a local depot on a daily basis and the practice has a good supply of emergency drugs. I will be challenged with being on call 24 hours a day to assist the ambulance officers with major trauma and may have to brush up on my obstetric skills after 13 years of leaving that to the midwives!
I am hoping that I can contribute another 10 years to making a difference in rural New Zealand and my family are looking forward to living in Otago – close to tramping, skiing and all the outdoor pursuits the South island has to offer.
As she is moving on, this is Dr Ruth’s final column for Hibiscus Matters. We thank her for her contributions to the paper and look forward to welcoming a new GP to our Health column in our February 3 issue.
