Livingston Medical

#1000#Pfizer#rollupforwaWe hit our 1000th Vaccine in Jerramungup giving it to none other than Martin the Shire CEO.So far we have stepped above >1100 now giving out a combination of #Pfizer and #AstraZeneca COVID19 vaccinations in Ravensthorpe, Hopetoun, Jerramungup, Bremer Bay and even Varley.Today in our clinic alone we are handing out 104 Pfizer vaccines in Ravensthorpe as Dr Paget runs a parallel clinic in Bremer Bay.This is a great response for us in the great southern and well done to those who stepped up.Well done everyone, great community effort.Shire of JerramungupShire of RavensthorpePeter Rundle MLARick WilsonThe Nationals WALiberals WAABC Great SouthernWAFarmersAustralian College of Rural and Remote Medicine (ACRRM) ... See MoreSee Less

#Emergency#RuralGeneralistRight. Following the many enquires about this article I thought it prudent to adjust or correct certain elements and areas of misinformation this article has raised and also highlight my initial reasoning for broaching this subject which ironically I raised on this very page some years ago.I am not looking for permission to speed 🏎 I have had since 2016 an Australian Medical Association Emergency Pass. This is a formal identification card between the AMA and the Western Australia Police Force that in certain instances of excess speed in a confirmed emergency I not only have identification but speeding fines can be addressed and appealed. This is endorsed by the AMA and WA Police.The issue is no other road users know my intention. How would they? It’s a card inside a car.The card works irrespective of the vehicle driven. That has led to less than courteous behaviour by other roads users to me when I have been responding to an emergency involving you or a loved one.Yep.I have had the vehicle damaged by driving between road trains who have ‘dusted’ me a process by which wheels are put in the dirt thereby forcing stones onto the vehicle to ‘teach me a lesson’ causing damage to the front of the vehicle. This as they clearly communicate and laugh about the plan over the radio.I have had drivers check brake me - Sudden sharp braking to force me into evasive action.I have drivers think it’s a race and accelerate when I attempt to take over.The list goes one. Hence the lights and sirens🚨 ? Seems almost too logical now.That was the intention behind this which to me made logical sense but has been misconstrued into me wanting things I don’t actually need and aspersions and denigration of General Practice further with people weighing in and giving their opinions of #JustaGP and commenting from afar about my job, me and my presumed lack of skills.I work as a Rural Generalist (RG)It’s a real title with a real job and will be endorsed by the Australian Medical Council in the next 12 months.waruralgeneralist.com.au/I even shot their promo videovimeo.com/439886113This comes with a fellowship (FACRRM) from the Australian College of Rural and Remote Medicine (ACRRM) which includes my advanced skills in Emergency Medicine. The Advanced Speciality Training (AST) had a pass rate at the time I sat it of just 10%. I hold ASTs in both Emergency and Surgery with a Medicare exemption for Ultrasound.I am not a ‘GP’ having a go at emergency care.I have continually worked in this sphere at a senior level for 14 years and attend ongoing and regular upskilling like this weekend coming.I am also in regular discussions with other RGs Tim Leeuwenburg and Scott Lewis around the Rural Emergency Responders Network (RERN) that successfully operates in South Australia and how like similar programmes in the UK (BASICS) and NZ (PRIME) it uses local RGs in exactly these locations to narrow the trauma gap and improve survival. Apart from WA.Your survival in these locations is intrinsically linked to the platinum 30 minutes/golden hour delivered locally and not solely retrieval by RFDS. You have to be alive to be retrieved and the life saving interventions to stop your bleed, keep you breathing or restart your heart happen locally not at 22 000 feet.sandpiperaustralia.org/index.php/rural-responder-network/Some commentators have said well what emergency kit can a car like this carry? With a >300L boot quite a bit. Sandpiper Australia is a charity for pre-hospital care, they provide and use the same pre-hospital bags used by doctors in remote areas of the UK. sandpiperaustralia.org/index.php/the-sandpiper-bag/I have been in discussion around obtaining a bag for a while and had initial agreement from a local mine who agreed to purchase one. Tim Leeuwenburg is the president of Sandpiper and along with Scott Lewis have been working their socks of to improve rural care across Australia. We even have our own prehospital courses - Pre Hospital Emergency Care (PHEC).www.acrrm.org.au/courses/face-to-face/pre-hospital-emergency-care-phecsandpiperaustralia.org/A cobbled together plan by a have a go doctor this is not. In any other state I would be and I am recognised as a consultant rural generalist. Here for example is a current job advert by Royal Flying Doctor Service of Australia looking for someone exactly like me.www.flyingdoctor.org.au/careers/job/consultant-rural-generalist/The term ‘GP’ should be long gone in this role but as per the comments this appears to bring out inaccurate statements and a very stay in your box opinion either by other healthcare professionals not educated enough or cognisant of our role.When we break down the numbers to show this isn’t just something that happens infrequently, since being in Ravensthorpe’s over 5.5 years I have responded to 5252 emergency cases. That’s over >80 calls, call outs and presentations a month - day or night, 24 hours a day. On top of my regular job which is 5 days a week and over 150 patients. Unlike other healthcare providers I haveNo lone worker protection. No one checks in or out if I make it to my destination alive. No paid days off. If staff are with me out of hours it’s double pay and the next day is paid off. My time with patient taps out at 5 hours of contact and even if I have been up all night my time taken off the next day is at my own expense both health and financially.No sick pay.No annual leave pay.No super.There is also no such thing as an ‘Oncall’. This mythical and archaic term gets thrown at me quite a bit and is outdated. I have a close proximity fee which is 4 days a week. $16 an hour. It states within 30 minutes of the hospital.Anyone else want the stress or burden to role out of bed for this?Didn’t think so.When I respond to most of these life threatening cases they are on my weekends/nights off, when I am home with my family and not to be called at all.But I do. Because as the case in this article highlights. There is no other option. Telehealth has peaked at what it can offer, the drugs have been given, RFDS is too far away and the system is at its absolute melting point. Now what?We accept that it’s ok to flog one doctor and that whatever happens to them is ok. It’s endemic is a system that treats us like a doormat and there is a belief that if one goes up pops another one. As I highlighted previously and in a recent talk to WAFarmers.There are now more than 5000 MORE non-gp specialists than there are GPs. That’s right, earning on average 2-3x our annual income and doing anything like this? Nope.Ask yourself this:A never ending work cycle A system with no rest. I have no allotted quiet time by WACHs for breakfast/lunch or dinner. I am phoned whenever. Trying to be a father to my daughter? Or husband to my wife? Forget it.Social isolation. No professional network.Public perception of a bumbling doctor outside his scope of practice wanting to race fast in his car.Decisions made about rural and remote made by metro centric policy makers and people from the comfort of their own armchair.Everyone line up and throw your rock as he’s #justaGPThis article has shown the public perception about the role I and others do. The widening margin between what we do and what people think we should or can do.This needs to change, we are human beings but the system treats us with a robotic automaticity and somehow it’s ok to do this? How does it change? Speak to your local member. I have, they were copied into every single email I had with Transport WA and the decision to actually reject my application was done by a panel with a veto from both WA Police and St. John’s Ambulance.The feedback I have had is they will never approve the car as they don’t want to start a precedent. A precedent for what? There aren’t enough rural doctors as it is and what approving one GTR will suddenly start a mass rush to the country? If that did happen that would be the cheapest and most effective rural health policy ever.I was given statistics about male drivers of emergency drivers being involved in accidents more yet I notice this doesn’t same rejection criteria doesn’t apply to any other emergency service. I was told that the vehicles low road height yet I notice that the police here until recently had a Holden SS and the police officer at Lake Grace still does. It also doesn’t apply to the Highway Police car that drives between Hopetoun to Ravensthorpe, Albany, Esperance and surrounds and is a Kia Stingerwww.kia.com/au/cars/kia-stinger/specification.htmlI paid for and did the driving under operation conditions course in Perth. This covers the law, driving, maintenance and use of lights and sirens and a driving test.I am led to believe other emergency services are exempt from this course.So there you have it. What really happened and the innocent reason to apply for this in the first instance. Yet the discriminatory decision by Transport WA. One rule for one service and another because they don’t ‘like’ the car. I have heard this firsthand from police officers directly and also colleagues who have attempted to represent me to senior officers.I said in my final reply that history will judge their decision. One day I will be held up, one day I won’t make it as I will be stuck in traffic. Then the root cause analysis and post case analysis will look at the why and how it could have been prevented. Now we know.Yes it’s not the total solution much more is need, this is a flare being fired about the state of rural and remote healthcare however change has to start somewhere or what is the point of this?Peter Rundle MLARick WilsonMark McGowanRoger CookScott Morrison (ScoMo)The Nationals WALiberals WAABC Great SouthernABC AustraliaGWN7 NewsWhat Car?Drive.com.auThe Australian ... See MoreSee Less

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