Rural generalism makes a splash

There are a pair of ducks that I often spy out of my kitchen window, shortly after rising for the day. Frequently, I catch them splashing about in a puddle they seem to thoroughly enjoy; and more recently I’ve met these rather pretty multi-coloured quackers looking in through my back door, or hunting for loot in the front lawn. Perhaps eating the snails who occasionally attack my mail?

They seem to be very contented ducks. I often bid farewell to them as I set off on my journey to work in the morning, and this has led me to reflect on my own contentedness.

In recent days, Rural Generalism became a specialty in Australia. As much as it will amuse me to see the self-contradictory words “Specialist Rural Generalist” under colleagues’ names, and one day my own, I recognise the consequence of the recognition.

One of the delights of working and living in a small rural town as a Rural Generalist registrar is that my journey to work is a 20-minute walk, not a long drive. A walk that’s about enough for some quiet, absent-minded contemplation; a stop for coffee along the way; and a brief hello with somebody, a friendly dog, or perhaps the cat that purrs at passers-by through the window of the farm supply store.

I’ll inevitably pass by the local hospital, where I work a day or so each fortnight – tending to both the ward and the emergency department. I can probably guess which patient is behind each window, eating their breakfast. If there’s an ambulance in the bay, I’ll probably recognise the St John crew as well. Having the hospital across the road from the practice means, in a pinch, you can make it from consult room to emergency room with a patient in a wheelchair. Or nip across to use the better coffee machine during a break in the ward round.

Arriving at the medical centre, my workplace for 2.75 (or thereabouts) days a week, I go about my little ritual – lights, air-con, bag, jacket, favourite pen – as I settle in for the day; not yet sure what to anticipate. Having my own room – a relative luxury even in general practice – and one where everything works, does feel such an indulgence after years in the hospital playing daily roulette with simple things like, “Will I get a computer that has a mouse attached?” It’s nice to work somewhere that understands the preconditions for getting work done.

Shortly I’ll fetch my first patient from the waiting room. What will they need from me? Who knows! Some I’ve met before; some have come to see the doctor for the first time; or perhaps the only time this decade. I might start the day with a procedure, a mental health care plan, or spend an hour with the practice nurse getting our flock immunised. In a town this size, you feel you can actually make a difference to public health statistics in a couple of hours.

Later in the day, wandering home, I listen to the birds sing and look out over the local park and, in the distance, the mountain ranges. It’s pretty quiet up this end of town late afternoon, and often my strolling is uninterrupted until I get to the main town drag. I turn my thoughts to tomorrow, an academic session that I work from home; something I enjoy even more for the contrast it affords me from the clinical sessions as I alternate through the week.

There is now a specialty for those of us who seek to tend to our pond, who seek a variety of practice and the associated delights, and who take pleasure in making a difference to a community. It’s a specialty that deserves to be recognised in Australia, and one that I heartily recommend to other doctors in training as worthy of their consideration.