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March 6, 2025 • 14 mins

She's been a GP in the Shoalhaven for decades, but not many know, Dr Manderson's has a specialised side hustle as CASA's go-to doc to ensure our pilots are fit to fly!  

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Episode Transcript

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Speaker 1 (00:00):
I heartshoal Haven.

Speaker 2 (00:03):
Hello, Peter Andrea with you And as International Women's Day
crops up on our calendars, this episode is dedicated to
every single woman in the shoal Haven whose contributions make
this part of the world a safe, thriving place to live.
Women who are Mum's sisters, daughters, grandmas and great mates.
And our guest for this episode is doctor Kate Manderson.

(00:26):
It's tough to bring all of her credentials into a
concise few lines. Twenty years as a GP in the
shoal Haven. Doctor Manderson is a byproduct of accomplishing her
registrar years in the Australian Navy. These days, she's the
Chief Medical Officer of Australia's Aviation Regulator CASSA. No, she
doesn't fly herself, but is passionate about those who do.

(00:50):
But it's also declining frontline local health options that gets
her fired up.

Speaker 3 (00:55):
So I trained as a medical student down in Tasmania,
which means that my of my training time was actually
in rural community in Lonchester and on the West coast
of Tasmania as well, which really planted the seed for
me that I wanted to be able to work in
the community and work closely with people not in a
sort of major center. So from there, very much the

(01:18):
seed was planned. From medical school. I was lucky enough
to be sponsored through my medical training by the Royal
Asharian Navy, which means that I streamed into the general
practice world through the Navy, and my first posting was
to HMAS Albatross down here in Naura, which is where
I put down rotes eventually, so started here and then

(01:40):
and then stayed here.

Speaker 2 (01:41):
Now we're heading into a federal election and the medical
system Medicare is a very big issue. This is something
our pollies have got to get right.

Speaker 3 (01:51):
It certainly is, absolutely and it's a really complex issue
to unpack, and which is why simple solutions don't always
work and unintended consequences or role on effects of what
seemed to be fairly simple solutions often don't work out.
What we do know is that Australia has got one
of the strongest primary health care systems in the world

(02:13):
and our population is one of the healthiest in the
world because of that. But that is built on what
we call habitual or continuous relationships with a doctor with
a family doctor that learns about you knows about you
and works with you through your life to look after
whatever can happen to you. And that focus on continuity
of care in your community over a long time is

(02:36):
what keeps us healthier, prevents diseases from happening in the
first place, rather than wait for you to get sick
and then have to deal with it further down the tracks.
The problem, of course, is that the Medicare system and
the way that the government ensures the population is in
the Medicare rebate, doesn't reinforce that model where you need
to spend time with patients with people, and you need

(03:01):
to spend time not just reacting to disease, but going
through the things that can cause you to become unwell
and to prevent those things from happening. So time and
complexity are expensive and they're not funded by our Medicare
model at the moment, which is the challenge that the
government needs to be able to respond to. Well, wait
and see if they can come up with something that
will actually deal with the real issue like that.

Speaker 2 (03:22):
So turnstile consultations pumping them through isn't conducive to good
regional health.

Speaker 3 (03:29):
People in regional communities do end up with more diseases,
more chronic diseases, and more severe diseases. We have lower
access to health care in general, and we tend to
put things off more so. For example, down in mischell Haven,
if you're having an acute heart issue, we don't have
the option to take you into a capital lab and

(03:50):
to unlock your culinary arteries. It's just it's not available
down here. So people down in michell Haven have worse
outcomes to the cardiovascular disease than someone in urban center where
they can get you into the cash lab and sort
that out really quickly. So what we need to do
is focus on stopping people from becoming unwell again. The
social determinants of getting sick are about having less access

(04:13):
to education, less access to good food and exercise activities,
that kind of thing. We are older, more likely to
smoke and drink alcohol in the shoal Haven, more likely
to have chronic diseases, and yet we have less access
to quality healthcare overall because we don't have the doctors.
We don't have the money to pay for those doctors,

(04:34):
so we end up with the short and sweet, I
feel sick today kind of consult but not hey, doc,
how can I stop from becoming unwell. We don't have
access to those consults.

Speaker 2 (04:46):
Doctor Kate Manderson has more than one string to herbo.
You're very much involved in the Civil Aviation Safety Authority.
Can tell me what position you hold there.

Speaker 3 (04:57):
For almost four years now, I've been the principal medical
of the Civil Aviation Safety Authority. I lead the team
of doctors and other assessors that look at whether or
not people are fit to fly as pilots and fit
to operate as air traffic controllers. So if they have
any diseases that could stop them from safewood, being able
to operate the aircraft or control the aircraft, our team

(05:20):
is responsible for looking at that disease, Is it a
problem or not? What can we do to keep it safe?
So we make sure as best we can that a
person is not going to be in tired or incapacitated
so you lose consciousness or have a heart attack or
a kidney stone or something like that while they're flying.
But even within that, we still rely on pilots for

(05:41):
self affess So when they walk out to the aircraft
to jump in the cockpit, be thinking to themselves, how
am I feeling today? Am I feeling well, did I
get good sleep? Have I eaten? Am I taking any
tablets today? That a problem? Did I have a headache
this morning? So the pilots and the air traffic controllers
are self assessing every time they show up for work
call work outs of the aircraft. We also have safety

(06:02):
systems inside the aircraft as well and in the setting
that they're working in. So they have like currency checks,
stimulator checks, They've got people who watch what they do.
They've got multi crew sometimes another person in the cockpit
to keep an eye on them and make sure that
they're making good decisions. So within the safety management system,
aerospace medicine has an important role. But we're certainly not

(06:26):
the only thing that stands between a pilot and safe aviation,
that's for sure.

Speaker 2 (06:30):
More soon of our conversation with doctor Kate Manderson, shoal
Haven GP and one of the key architects of the
rules that ensure our pilots are fit to fly.

Speaker 1 (06:41):
I heart shoal Haven. I heard shoal Haven.

Speaker 2 (06:48):
Peter Andrea back with you, and we haven't had to
look too far to find a fabulous case study of
a shoal Haven woman worthy of a little acknowledgment ahead
of International Women's Day. Doctor Kate Manderson takes many boxes
for success. She is community focused, straight talking, at doer
and a major advocate of preventative medicine. She operates several

(07:10):
GP practices on the coast, but it's her impressive side
hustle as the Chief Medical Officer for the Civil Aviation
Safety Authority where Doctor Manderson is flying high. She's done
a hell of a lot already reducing the amount of
process pilots encounter to prove their fit to fly.

Speaker 3 (07:30):
We're one of the only aviation authorities in the world
that still has most of the medical applications coming centrally
to the main office. We're based in Canberra, and what
we're looking to do is to take it out of
that sort of central bureaucratic process that a lot of
pilots and air traffic controllers don't like, and make it
so that the aviation medical examiner that they see, they're

(07:53):
usually a GP looking after them regularly, is the one
that knows them best and is the one that knows
they're health best, and therefore might be a better place
to make those regular decisions. And it's only then the
more complicated or challenging decisions for complex medical diseases and
things that would need to come to CANRA. That's a

(08:13):
massive reform for Australia to be able to do that,
but we're working towards that so that the pilots and
controllers they can see their regular usual doctor, the one
that they trust, the one that they know, and hopefully
that'll make it easier for the pilot or the controllers
to look after themselves better because they're under the care
of that doctor rather than being having their file reviews

(08:35):
by a doctor they don't know in CANBRA.

Speaker 2 (08:38):
But that's a very fine line that you walk between
making it easier and having a system that ensures pilots
are safe to.

Speaker 3 (08:45):
Fly absolutely and that's one of the reasons that we
consider it is safe.

Speaker 1 (08:50):
Well.

Speaker 3 (08:50):
First of all, it is the way that major jurisdictions
around the world do business. So if we look at
the United States, Canada, New Zealand and the UK and
the Europe the aviation medical examiner that looks after the
pilot is the controller is the one that issues the
medical certificates most of the time, so certainly not an outlier.
There were actually quite different in not doing it that way,

(09:12):
but our aviation medical examiners are very highly trained. They
do a course of training that it's at least two
weeks and in some cases up to six months at
master's level to learn how to understand fitness to fly
and how the aviation environment affects the human body and
how it can be kept safe. So aviation medical examiners,

(09:32):
there's just under a thousand of those around Australia and
they are particularly well trained to make these decisions, and
they're trained at a level that's compliant with the international
obligations that we have to keep everybody at the same standard.
So I'm very confident that our aviation medical examiners are
very very good at making these decisions.

Speaker 2 (09:50):
Are the eyes of the aviation world looking at this
in Australia and maybe looking to adopt it?

Speaker 3 (09:57):
Do you know, As I've said, many of the author
around the world already have the local their coal phase
aviation medical examiners doing their medical certificates. One of the
things that we are leading the world on is approach
to mental health for pilots and their traffic controllers. So
going back about thirty years, Australia is one of the
very first jurisdictions in the world. That allowed pilots and

(10:18):
controllers who need treatment for depression and anxiety to continue
to work as pilots controllers while they're being treated. So
we allowed pilots to be taking antidepressant medication thirty years
ago before much of the rest of the world did
do that. What that means is instead of flying under
the radar, so to speak, what those pilots and controllers

(10:39):
are able to do is to confidently go and see
their doctor, seek help when they need it. They don't
need to hide their symptoms or their illness, and they
can be really effectively treated for that. Building on the
background of that pioneering mental health work from about thirty
years ago, again, we're pushing forward with trying to find
ways to make further our pilot controllers are not afraid

(11:01):
to seek help, that they're not hiding their symptoms and
their diseases, that they can trust the people who are
making decisions about their medical certificates, and in particular in
the mental health space. There's been a lot of work
done around the world in the last few years, particularly
falling out of the mental health impact of COVID on
the aviation industry. But what we're doing in Australia is

(11:23):
we're trying to build in the safety management system, working
with the pilot or controller, with a peer worker, with
their psychologists, with their medical examiner, with their usual doctor
to make really good, informed, risk assessed decisions and help
those people keep working in the aviation industry rather than

(11:43):
grounding them. And we are very much at the front
of the global stage for that one.

Speaker 2 (11:49):
Yes, during the COVID period we had a lot of
pilots and people involved in the aviation industry laid off
because of a lack of their travel. Are we seeing
the COVID hangover still today from that?

Speaker 1 (12:02):
Oh?

Speaker 3 (12:02):
Yeah, most definitely. We're still seeing the fallout of that,
and you know, things are around abouts. I suppose we
have seen an absolute uplift in willingness to talk about
the problem, which is fantastic. So people are willing to
talk about the mental health impact of COVID. People were
absolutely thinking help and telling us that they needed to
seek help, and it's really shone a light on mental

(12:25):
health and well being as a really critical function of
safe performance in the aviation industry. But we are absolutely
still seeing people who are struggling after the effects of it.
Are having become unwell during COVID during lockdown, the aviation
industry was much more effected than many other industries were
if you look at the amount of isolation that pilots

(12:47):
had to do when they flew in and out of
the country rescuing people from overseas, but then rather than
being able to go home to their family, they had
to stay at a hotel for two weeks before they
got back into aircraft and did it all again, really
really debilitating stuff. And we're working on understanding how much
that affected them and how we can keep them safe

(13:07):
while they continue to work through their mental health challenges.

Speaker 2 (13:11):
And we're broadcasting this podcast to coincide with International Women's Day.
This is a great opportunity to let ladies know that
you've done it, they can do it too.

Speaker 3 (13:24):
Absolutely, and you know, the Women in Aviation Australia organization
is absolutely fabulous to support women who want to be pilots,
who want to be a traffic controllers. It is absolutely
a male dominated industry, no question about that. And there's
only a small percentage of our commercial pilots are women
and a slightly larger but still small percentage of private

(13:45):
pilots are women. It's a challenging environment to tap into.
The gender biases are real, there's no doubt about it.
But one of the things that we're focusing on this week,
in particular, I'm doing a webinar on Wednesday night for
all comers to talk about how women's health can affect
fitness to fly, and in particular how just because you

(14:07):
are going through menopause or needing more monal treatment doesn't
mean that you're not fit to fly. So yeah, really
raising the profile of women's well being and being able
to fly safely while while looking after.

Speaker 2 (14:20):
Their health well, Doctor Kate Manderson, many of our female
pilots have the fortune of an advocate such as yourself.

Speaker 3 (14:30):
Thank you very much. That's very kind.

Speaker 2 (14:33):
Many thanks to doctor Kate Manderson for taking time out
of her busy life to join us on iheartshoal Haven.
I'm Pete Andrea. Catch you next time.

Speaker 1 (14:46):
I heartshoal Haven.
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