A general practice clinic in South Australia's west is a model for how a supportive working environment and commitment to medical training contribute to sustainable community care.
Pictured above: Dr Emmy Hennell, Dr Christopher Roeger and practice manager Jennifer Moss
A general practice clinic in coastal Tumby Bay is demonstrating how a small team of dedicated, innovative, patient-focused doctors and their co-workers can attract and retain talented clinical staff and provide consistent care for its community.
Dr Chris Roeger, one of three rural generalists at the Tumby Bay Medical Clinic, says he and his colleagues have made a determined effort to build a practice that offers its staff a safe working culture, opportunities for professional development - and fun.
'Our clinic, like many others, must attract more long-term GPs to handle ever-increasing demand,' Dr Roeger says. 'We are always looking for and testing creative and flexible ways to attract GPs who will come to Tumby Bay and stay here.
'Ongoing recruitment and retention are huge priorities in a small country town. We work hard to make sure all staff know they have joined not just our team but our work family.'
The practice comprises three long-time rural generalists, three GP registrars, an RMO employed by the Tumby Bay Hospital, three nurses, a practice manager, an office manager and three admin staff members. There are also often two medical students fulfilling their placement obligations.
Together they serve the small coastal community of Tumby Bay, with 2,000 people in the town, another 1,000 in the wider district and countless more in peak holiday season.
Inspiring the next generation
The clinic's bright, colourful website clearly defines the clinic's mission and values - 'Excellence in care, community and training'.
'Teaching and training are part of each day in our clinic and the staff help to make protected time when it is required,' Dr Roeger says. 'At other times we are proactive in taking opportunities to include medical students and registrars in important moments of teaching with certain presentations or procedures.
'All of our senior doctors are passionate about teaching, knowing we have an important role in training the next generation of rural GPs.'
Dr Roeger says all three GPs - he, Dr Sara Georg and Dr Emmy Hennell - completed their registrar training in the region, demonstrating the impact of exposing junior doctors to rural medicine to influence their later career decisions.
'We have had 16 registrars train at Tumby Bay Medical and three have stayed,' he says. 'However, we know the other 13 are out there across South Australia and Australia doing great things and drawing on the important formative lessons they have learned while practising as rural doctors.'
He says the clinic's GPs understand the importance of medical student and GP training, and their passion has inspired their colleagues to support and nurture the students in their midst. 'It naturally became a shared focus,' he says. 'It continues to push our skills and knowledge, it refreshes us when we become a bit stale, and it is truly satisfying when we manage to inspire the next generation.
'And in line with our culture, we aim to give them a good time and a good laugh, not just help them learn how to be good doctors.'
Dr Roeger says the Tumby Bay community recognises the contribution of international medical graduates in providing a sustainable health service. While all of the clinic's current doctors are graduates of Australian medical schools, many GPs in nearby Port Lincoln are IMGs and Tumby Bay's own ongoing recruitment efforts involve engaging with IMGs.
'Unfortunately, there are often barriers to them successfully moving to Australia and transitioning to practising medicine locally, but we continue to explore these options,' he says.
Consistent, trusted community care
Dr Roeger says a contract with the Eyre and Far North Local Health Network (EFNLHN) to provide medical services to the co-located Tumby Bay Hospital means it provides 24/7 cover to the hospital every day of the year. One of the GPs is on call at all times, and registrars also fill the roster while supervised by GPs.
The RMO is employed by the LHN but works under the GPs' supervision at the hospital and in the clinic, and two nurses have RN roles at the hospital in addition to their general practice responsibilities.
Weekday mornings begin with a combined ward round with all medical staff and the lead RN and hospital Nurse Unit Manager (NUM) or Director of Nursing (DON) if available. Nursing students and allied health or palliative care staff often join them.
Access to Sunrise EMR allows the doctors to view the records of local patients, many with long histories of complex conditions.
'Having our own computers and practice software located alongside this in the ED helps us provide much more nuanced and tailored care for patients and ensure excellent continuity of care,' he says.
He says the philosophy and values shared by the current staff have been a part of the clinic for decades. 'We have had the privilege of being handed this challenge by the GPs before us, Dr Dennis Eaton and Dr Graham Fleming, who each gave over 30 years of dedicated service to this town and its people,' he says.
'Medicine is so much more fun, satisfying, interesting and manageable when you are working in teams with trusted colleagues. This was the tradition of the long-term partnership of Dr Fleming and Dr Eaton before us, and we have continued to honour that.
'The community has put their trust in us 100%. We are humbled by the huge weight of responsibility but equally we are strengthened by the work we do and the joy and satisfaction it brings.'
