May 27, 2025 • 50 mins
Who cares for the carers? Discover how one foundation is quietly reshaping rural healthcare.
In this heartfelt episode, we speak with Fran Avon, CEO of the Rural Doctors Foundation, and rural GP Dr. John Buckley. Together, they reveal the hidden struggles faced by rural doctors who serve as the backbone of their communities. From responding to catastrophic floods to managing everyday burnout, we explore why supporting rural doctors is essential to sustaining healthcare in remote Australia.
You’ll hear the inspiring origin story of the Rural Doctors Foundation, born out of crisis and driven by compassion. Their flagship initiative, GPs for Rural Docs, brings confidential medical care directly to rural practitioners, care they often go without due to stigma or isolation. Dr. Buckley shares powerful moments from the field, reminding us just how deeply personal rural medicine can be.
This episode is essential listening for anyone passionate about improving rural healthcare, championing doctor wellbeing, or building stronger, more resilient communities. Fran and John’s mission reminds us that by caring for those who care for others, we ensure a healthier future for all.
It Takes Heart is hosted by cmr CEO Sam Miklos, alongside Head of Talent and Employer Branding, Kate Coomber.
We Care; Music by Waveney Yasso
More about Fran & John's Organisations of Choice, Rural Doctors Foundation
Rural Doctors Foundation is a national rural health charity committed to improving access to life-saving healthcare in Australia’s rural and remote regions. Led by rural doctors and local community members, the foundation supports healthcare where it’s needed most, from the remotest outback towns to vibrant coastal hubs and rural farming districts.
Get to know cmr better!
Follow @ittakesheartpodcast on Instagram, @cmr | Cornerstone Medical Recruitment on Linked In, @cornerstonemedicalrec on TikTok and @CornerstoneMedicalRecruitment on Facebook.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Sam Miklos (00:00):
Welcome to it Takes Heart.
I'm Kate and I'm Sam, and wecan't wait to share more
incredible stories of healthcareprofessionals making an impact
across Australia.
Fran Avon (00:08):
Dad's not just a doctor.
He's the counsellor, he's thelistening ear, he's the person
that people turn to, and sothat's why it's so important
that we support our rural healthpractitioners during crisis.
Kate Coomber (00:22):
Don't forget to hit follow or subscribe if you
want to hear more stories frominspiring healthcare
professionals.
Sam Miklos (00:35):
So with each episode of it Takes Heart, we are
donating to a charity of theguest's choice, and in my
episode in season one, I choseRural Doctors Foundation.
I really felt the foundationaligned with the work that we do
, but we loved the fact thatthey work so hard to improve the
health of rural communities.
The rural communities has beena common theme in many of our
episodes since, and we thoughtit would be great to better
(00:56):
understand the work that theRural Doctors Foundation do.
So today we are joined by theirCEO, fran Aver, as well as Dr
John Buckley, who is one of theincredible GPs participating in
one of their programs, and wereally look forward to learning
more.
Welcome to the both of you toit Takes Heart.
Kate Coomber (01:12):
Thank you, thank you, so tell us a little bit
more about the foundation andthe work that you do so.
Fran Avon (01:27):
The foundation started in 2016, and it was
after the floods that decimateda lot of Queensland and a number
of rural doctors who were verypassionate about the fact that
communities and the doctors wereleft without access to
healthcare, to services, and sothey wanted to do something in
times of crisis, and so that'show we started, and it was very
much a volunteer organisationrun by a number of rural doctors
and with support from the RuralDoctors Association of
(01:49):
Queensland, and the story's beenamazing because it started with
that purpose, but it's grownsince then and it's very much.
We're still doing our emergencywork and, obviously, the recent
floods in Townsville, we've beenhelping out some GPs in the
community there to providesupport, but we're doing a lot
(02:09):
more now.
We're providing grants topeople that are living in rural
communities or are the healthpractitioners in those rural
communities to get healthinitiatives off the ground that
they may not have been able towithout some seed funding or
without a bit of support, andit's really great for us to see,
like you know, five, 10 yearslater, some of those programs
(02:31):
are, you know, really bigprograms now, or you know
they've been able to continuebecause of our initial work with
them and one of them is myinspiration.
It's Heart of Australia andthey.
You know we were one of theirfirst supporters.
And it's Heart of Australia andthey.
You know we were one of theirfirst supporters and I look at
them now and I go.
Sam Miklos (02:49):
Oh, we want to be like them.
Dr John Buckley (02:50):
So it's really great.
Fran Avon (02:52):
We also do research into health issues and really
try and understand what'shappening out there for our
rural health practitioners, andwe also, you know, the program
that John is a part of is verymuch about looking after the
health of our rural healthpractitioners.
So we're going out into ruralcommunities with GPs to provide
(03:17):
GP services for our rural healthpractitioners, who people you
know really need independentsupport.
But obviously John will talkabout that a bit more because he
is.
Kate Coomber (03:28):
Yeah, the program's really interesting.
I'd love to hear so you're ageneral practitioner, Is the
work that you're doing in thisprogram?
Is that the side hustle?
Dr John Buckley (03:38):
No, that's my main clinical work now.
Kate Coomber (03:40):
This is your main clinical work now.
Dr John Buckley (03:41):
If this was video, you'd see my grey hair.
Kate Coomber (03:44):
It is.
Dr John Buckley (03:45):
Yeah, but it's been a passion of mine for a
long time.
I spent most of my medicalcareer working in GP education
and training, and particularlywith a focus on rural training.
So I've watched doctors comeand go, I've watched how hard it
is to recruit, and you guysknow about that.
And I've watched burnout andI've watched people people leave
and I've watched the stressesthey have.
(04:06):
So when this program came upjust as I was leaving the
practice, I was working and Ithought that's a fantastic bit
of work to do.
I still do other work as well,but that's my main clinical work
now is to have this greatprivilege of seeing friends,
colleagues and people I've nevermet and trying to sustain them
in their work in the rural areas.
Sam Miklos (04:27):
So how do you do that?
Yeah, maybe explain the program.
Dr John Buckley (04:31):
What does?
Sam Miklos (04:31):
a day in the life of your role.
Look like I mean yeah, how doesthat program work?
Dr John Buckley (04:34):
So the program is magnificently set up and
that's how I sort of came acrossis when they first announced it
and it's a goal that the ideais that we go to several towns.
It's a pilot program at themoment so I have the privilege
of going to Stanthorpe,gundawindi and St George and my
colleague John Duyere goes tothree other towns and we're
(04:56):
evaluating how that goes.
So on a week of a trip, I'lljust head out to St George on
day one have a nice beautifuldrive.
I love driving out there.
Kate Coomber (05:04):
Are you based in Brisbane?
Dr John Buckley (05:05):
I live on little Coochie Mother Island,
just off from the coast, so Ihead out there and then I'll
stay overnight and in themorning I'll set up, pop into a
generous clinic in St George andspend a fair bit of the day
there seeing whoever wants tosee me, and then I'll bid my car
and drive to Gundawindi.
When you say whoever wants tosee me and then I'll bid my car
(05:25):
and drive to Gundawindi, whenyou say whoever wants to see you
, is that the staff in thepractice?
No it's not really the staff.
It's open to any healthpractitioner in that town or
area who wants to come.
And what I really love aboutthe setup is it's completely
independent.
So I don't work for the RuralDoctors Foundation and I don't
work for the practices.
(05:46):
I am my own self and all of therecords for confidentiality
purpose are kept entirelyseparate.
I don't log into the systems inthe practice.
No one really knows who comesexcept the reception staff, and
even for them I just give them apiece of paper saying here are
the people coming today and theydestroy it at the end of the
day.
Kate Coomber (06:05):
And I guess, why is that important?
Dr John Buckley (06:06):
It's really.
I think for many people it'simportant for their health
anyway that they have privacyconcerns and issues.
But when you're in a small townif you've ever lived there
gossip's a terrible thing andfor most people it's one of the
reasons for the program.
They can probably see acolleague about most things but
not about everything.
And if there's issues of sexualhealth, of domestic violence,
(06:30):
of mental health issues, theyoften don't want friends and
colleagues and others to know.
So that privacy andconfidentiality that we all want
for those areas of health iscritical to maintain and it's
hard to share that with acolleague with whom you work in
the same practice or the sametown.
So having someone come intotown who's separate from all of
that, keeping records separately, and even at the practical
(06:53):
level, if you need a certificatefor time off work, you're
probably not going to ask yourboss for that it's really
difficult.
Sam Miklos (06:59):
You just don't think about that at all.
Dr John Buckley (07:01):
Yeah, People don't.
And what Fran mentioned, theresearch and these are things
we've always known, but theRural Doctors Foundation
research has highlighted thatall of these things we've
suspected are now true andproven and that really helped
guide the setup of the program.
Sam Miklos (07:15):
You know, Fran, you mentioned earlier about when
there's a flood, and again wethink floods about houses and
people, then homelessness.
But we don't actually thinkabout services, or it's probably
not front of mind.
And then you said we go in andwe help out.
What does the foundation?
What does that mean?
What are the foundation?
Are you sending in doctors, areyou?
Fran Avon (07:34):
and it it depends upon the crisis but, in the past
we have flown doctors intorural communities to be able to
provide support and services atthe time.
For some of them it's aboutlike a hardship payment, like a
GP or a health practitioner.
Their home's been totallydestroyed and how do they get
back on their feet?
Kate Coomber (07:53):
very quickly Because you want to make sure
they stay there.
Fran Avon (07:56):
Exactly, and you want to make sure that they're there
for the community, because intimes of crisis, people turn to
people like their GP or theirnurse, because they are trusted.
They are the people that youwant to see.
That it's okay.
You know this crisis, we'regoing to get through it.
And that's probably one thingthat I've learned in my time at
(08:17):
Rural Doctors Foundation therole of those sort of people in
their community.
It has like a real weight.
Those sort of people in theircommunity, it has like a real
weight.
It's a very big burden for someof the rural health
practitioners to carry that theyare always the person that
people look to and one of ourboard directors his father, is a
(08:37):
rural GP, and he said Dad's notjust a doctor, he's the
counsellor.
He's the listening ear.
He's the person that peopleturn to, and so that's why it's
so important that we support ourrural health practitioners
during crisis, and so our youknow appeal is very much about
do we give equipment to get themup and running, you know, do we
(09:01):
send?
Dr John Buckley (09:02):
in medical supplies.
Fran Avon (09:03):
What is it that we need to do so that healthcare
can continue?
In one case, we providedfunding for a GP to work out of
a hotel room for telehealth tobe able to continue serving his
patients in a different way, ofcourse, but at least he was able
to make sure they had theirprescriptions, make sure that
(09:26):
they were able to continue toget healthcare maybe not in the
same way as prior to the crisis,but, yeah, so it does depend on
the circumstances, so it doeslook very different for each
type of crisis that we'reresponding to.
Sam Miklos (09:40):
And is the work that you do Queensland specific?
Fran Avon (09:46):
too?
And is the work that you doQueensland specific, nationwide?
We started as a Queenslandcharity but, you know, very
exciting that we are now anational charity.
And obviously you know, as Johnmentioned, the trial of the GPs
for Rural Docs started inQueensland because that's where
we've got our roots and we'vegot our networks.
But you know we're very excitedthat we've just received some
funding that will enable us totake it outside.
But you know we're very excitedthat we've just received some
funding that will enable us totake it outside of Queensland.
(10:07):
That's wonderful and you knowthat's where we want to get to
that every rural communityacross Australia has access to
the services that we provide.
Kate Coomber (10:17):
Because I guess you're touching a small amount
of rural communities at themoment, presumably Maybe paint a
picture for people listening ofwhat does it typically look
like the communities that don'thave access to this?
Are they avoiding their ownhealth?
Is there wait lists?
Are they having to leavecommunities Like what's the
(10:38):
alternative?
Fran Avon (10:40):
So when we did the research, the alternatives were,
as John mentioned, they wereseeing a colleague.
That may not be I'm sorry, it'squality healthcare, but it may
not be the best healthcare foran individual.
They were travelling, and sothey were travelling, you know,
700 kilometres just to get theirown healthcare, and that's
(11:01):
obviously a burden on the GP orthe health practitioner.
But what it also means is thatcommunity is left without a GP,
and that could be for up to aweek.
And so what that means is, youknow, there's probably 75, 150
people that don't see their GPwhile they're away.
(11:22):
Yeah, and what we're doing withthis program is making sure
that they're in their communityso that they're there for the
community, and thoseappointments are there.
They're available because theGP hasn't had to travel to get
their own health care.
Sam Miklos (11:38):
What other programs do you offer Like?
Is there additional programs tothe one that John's on?
Is there any of those you couldtell us a little about?
Fran Avon (11:46):
Sure.
So we're doing it in othercommunities.
So, as John mentioned, we'vegot Dr John Doyer who's doing
the communities of Charleville,quilpie, cunnamalla.
We're also looking at othercommunities that we can expand
the service to and we've justhad an announcement of some
(12:07):
funding from Western QueenslandPHN which will enable us to
deliver the service to Blackalland Buckholden.
We've had a corporate partnercome on board and they're going
to fund the service in Blackalland Buckholden.
Okay, fantastic, we've had acorporate partner come on board
and they're going to fund theservice in New South Wales.
Not all of New South Wales,yeah, yeah, but some of the
communities in New South Wales.
So really, that's where we'reat and that's why, at the
(12:29):
beginning, when I talked aboutHeart of Australia being the
inspiration, you know Dr Gomes,he mortgaged his house and
started that program.
And now you look at the programand you know, speaking with
Ralph, he sort of talked abouthow, in the early days, you know
, couldn't get anyone to supportthe program or fund the program
(12:52):
and a couple of things happenedthat few people came on board
and then it was a bit like asnowball.
Kate Coomber (12:57):
Yes.
Fran Avon (12:59):
And that's what I kept saying to the team.
We've got a very smallhardworking team and I keep
saying we're still pushing thatsnowball up the hill but, you
know, with these two recentrounds of funding, it's
encouraging and we just hopethat this is the beginning of
other people going.
Yeah, we really do need to lookafter our healthcare
(13:19):
professionals and we really needto make sure that they're
healthy so they can look afterus, and so obviously, we want
other partners to come on boardso that we can offer this
service to every rural andremote community across
Australia.
And, a bit like Ralph, we tooka leap of faith, we invested our
own funding to get the programoff the ground and to
(13:42):
demonstrate its impact.
And you know, I'm sure Johnwill share some stories, I can
share some stories, but itreally is having an impact and
that's so encouraging for us.
Kate Coomber (13:53):
I'd love to hear yeah, John, could you share
something with us that reallyshows and demonstrates that
impact?
Dr John Buckley (14:00):
There's one GP I've seen as a patient who is
one of the most respected GPs Iknow in rural Australia.
He's been there a long time andthat GP was driving a long way
as Fran suggested to gethealthcare and trying to fit it
in with family trips to thecoast and found it just didn't
work.
(14:20):
So they had really beenmanaging care by doing their own
referrals or getting a corridorchat with someone and hadn't
had any coordination of theirown health care for 15 years
which when they think abouttheir own patient.
Of course they would think isterrible.
Sam Miklos (14:36):
I was just about to say that would be so conflicting
for them as well.
It's awful.
Dr John Buckley (14:40):
And so it's not that and it's almost a bit like
the American system.
You know, I'll get myself offto see this specialist and that
specialist, but nobody lookingafter their general health or
their coordination, which iswhat general practice is so
critical.
And they knew it, but theydidn't feel they had an option.
And suddenly this project washappening and they had an option
(15:01):
that they wanted to try andwork, and so that's an obvious
thing.
The other thing that's happenedthe program was initially
conceived to help look afterdoctors and then it changed to
all health professionals, andwhen I looked at that and went
out on a reconnaissance trip andtalked to people, I realised
it's just as hard for a localallied health person or a local
(15:22):
nurse, community nurse orhospital nurse to see the
doctors that they work with in asmall community, and so the
challenge is just as strong forallied health, nursing and other
health practitioners.
And so again, part of thepleasure has been meeting and
having a few patients who arenot doctors, which is not what I
expected when I joined theprogram, and it's actually a
delight to understand theirbarriers and to have them relax
(15:46):
about the confidential nature,and I know medicine's always
supposed to be confidential, butit's hard to trust that in a
really small community, in asmall place.
So that's been an extra bonusto see that those people have
the same barriers and howimportant the program is.
Kate Coomber (16:01):
Because I think as much as there's obviously going
to be confidentiality, but youcan have a conversation in a
clinic room and then see them inthe supermarket 10 minutes
later.
There's still going to be thatfeeling that you have.
I imagine it's awkward yeah.
Dr John Buckley (16:13):
You can manage it and you can both sort of
smile inwardly and think that'sokay, yeah, but it's not the
same.
Or you know your kids are atdaycare together or you play
tennis together yeah, andthere's others there with you
and if you've got a sense of Iknow something about you and
they look at you, it's hard andI lived, you know, a few years
in a very small town.
Sam Miklos (16:38):
And you know you don't get a feeling of privacy
about yourself.
Yeah, A real theme in some ofthe conversations we've had has
been about the impact that thecommunity can have on attracting
healthcare professionals tothese rural communities and the
impact they can have not only inthe attraction but the
retention piece of healthcareprofessionals, doctors and
allied nursing.
What have you seen in somecommunities that they're doing
really well to attract andretain health professionals, or
(16:59):
what would you love to see moreof?
Dr John Buckley (17:03):
I'll just mention first, I view this
program as a retention issuebecause recruitment, you know,
is difficult and very expensiveand long-term and then you keep
losing people and so retainingpeople.
And at some point someone fromresearch said oh, patients are
just saying why don't you justcome out here and see the
patients?
I said well, maybe if I lookafter your health practitioners
(17:25):
they'll stay and they can seeyou much better than if you're
turning them over and gettingnew ones all the time.
The other thing that sort of istriggered by that is, each of
the towns I go to is very, verydifferent.
You know, stanthorpe has a lotof health practitioners,
gundawindi is desperately shortand St George is big in some
(17:47):
areas and not in others.
So the recruitment and retentionvaries depending on what's
going on in town, how far awayit is and involvement of
organisations like localgovernment, who I know the
Foundation has been reallyimportant talking to that.
Those local governments canhelp and support a program like
this, even in small ways.
So what you see is where thereis community support and local
(18:10):
government support and a fewother things to attract people
and help look after theirfamilies, it goes much better.
So when the whole community,government people and other
organisations after theirfamilies, it goes much better.
So when the whole communitygovernment, people and other
organisations are involved, youget better recruitment and
better retention.
Where there are struggles inthe community or a lack of
support from state or localgovernment or a lack of support
or understanding from community,all of those things become far
(18:32):
more difficult.
So it's not so much about thepeople who are trying to recruit
, it's about what's there forthe people they are recruiting
to help them come and stay.
Kate Coomber (18:42):
We've heard that a bit, haven't?
We about the community almosthave a role to play in the
recruitment and retention, Iguess.
What are your thoughts to that?
What can a community do toreally help?
Sam Miklos (18:52):
Yeah, what are some examples of things you see.
Dr John Buckley (18:55):
I had a great story from a friend of mine many
years ago.
She was at a conference inCanada and you know how they
have all these stalls at theconference.
Local remote communities hadstalls and they had signs up and
they were getting doctors ontheir way past and saying why
don't you come to us?
And the community would gettogether and raise funds to own
a clinic building or to provideaccommodation or to do other
(19:18):
things.
So the community as their owninitiatives, putting forward
things to make recruitment andretention easier, and
particularly when you thinkabout families.
So it's one thing to get ahealth professional, their
spouse has to be happy, yeah wealways say that If they haven't
agreed with the offer, there'sno point.
So get a job for the spouse.
Sam Miklos (19:38):
Yes.
Dr John Buckley (19:39):
Or, you know, have a spouse who wants them to
be live-out, and I've certainlygot friends who are only working
rurally because their spouse isfrom a family who's on a
property.
And then there's the differentages of kids.
You know you can have littlepreschoolers anywhere, but once
you reach school, and especiallyonce you reach secondary school
, you get this moment for afamily to decide do we school
(19:59):
locally, do we boarding schoolor do we leave?
And you know family will comefirst.
So thinking about thoseservices, how to support
families and engage families andmake them part of the community
, having sporting clubs andcommunity organisations, whether
it's Lions or whoever else itmight be looking after,
supporting and involving spousesand kids, is really important,
(20:24):
and so the community has toinitiate that.
They have to recognise the needto have the whole family
involved in their community, notjust to have the doctor or the
nurse here and perhaps befriendthem, but isolate their family.
Sam Miklos (20:38):
Do you think most communities are aware of the
importance of having thehealthcare professionals there,
or is it taken for granted?
Fran Avon (20:47):
I think you know, as John said, every community is
different.
And as we've gone out to them.
There's some that you go wow,they totally get this.
You know they understand thatwithout a health practitioner in
their town they're not going toattract other people to the
town.
They're not going to build acommunity.
Because if you're thinking, doI go rural, you know you'll be
(21:08):
looking at what's the education,what's the health you know like
.
So before you make a decisionto live in a rural community,
you look at all of those things.
And there's some communitieslike Quilby, for example, their
council is doing a fabulous job,like they're trying to attract
people to come and work in theircommunity and so, for example,
(21:37):
at the moment they providehousing for their council
workers because they want toattract people to work for
Quilby Council.
So they're looking at ways inwhich they can make sure that
there's support andinfrastructure for the people as
they come into the community.
So you can't underestimate theimpact of having a health
practitioner in the community,what that does for the financial
(21:57):
viability of a community aswell.
Yeah, it keeps it thriving andso yeah, and we are seeing that
there are communities that arereally throwing everything at it
to make sure they can keeptheir health practitioners.
And we're very conscious, evenas a GP, like I'm thinking about
going out to a rural community.
What's the support for me?
(22:18):
And so you know, having aprogram like ours where they can
go, oh okay, that program'sbeing delivered in that
community, I can feel assuredthat if I go and work in that
community, I'm going to have myown health care looked after and
we also do see the familymembers of the GPs, because
probably people think well, you,know a GP can they can, you
(22:39):
know, look after their ownfamily?
and they do, and they can.
But is it the best thing to do?
Probably not, and so us beingable to see family members of
the GPs as well means that youknow it's not mum or dad.
Sam Miklos (22:54):
That's huge actually , especially with kids, yeah, as
they're growing up in teenageyears and things too.
So the communities.
Then you were saying like youwould sit in that community and
see any healthcare professionalif there was like multiple
practices or whatever, or fromthe local hospital or, yes,
practicing independently awayfrom another practice.
Dr John Buckley (23:14):
you know, local physio.
Sam Miklos (23:15):
Yeah, and how do they find you?
Yeah?
Kate Coomber (23:17):
I was going to say .
No, I was thinking the exactsame thing.
Does it take time to drum upbusiness.
Dr John Buckley (23:21):
Yeah, that's where the foundation does a
great job for me, yeah.
Fran Avon (23:31):
We've got an amazing program manager, coral, and she
just hits the phones.
Now, fran, I had a little bitmore money to be able to promote
this, to make sure that peopleare aware that the program is
available.
And that's what's reallyexciting about starting to build
these partnerships, becauseit's not just us on our own, you
know, spreading the word,there'll be people out there
that are going.
You know they're coming nextweek.
(23:53):
You know have you booked yourappointment?
And so that's sort of you knowit is, you know, something that
we hope will, you know, continueto grow and build over time.
And you know, we hope that Johncan have more capacity.
And you know we're not just ina community for the one day.
He's got so many appointmentsthat he has to stay for two, and
(24:13):
you know, it's that sort ofthing that we're hoping for.
Kate Coomber (24:15):
Have you ever had or tried to go into a community
where maybe you know there was abit of protection over this is
we want to do this ourselves, oryou know we don't need outside
help, or a health practitionerwho is so used to flying solo
and almost feels uncomfortable?
Fran Avon (24:36):
Yeah, that was probably something we were very
conscious of and, as Johnmentioned, you know we do a
scoping visit before we go intoa community, so we're not going
to go into a community wherethere is that feeling of you
know what are you doing, whatare you coming into our patch
for?
But we haven't reallyencountered that yet.
Sam Miklos (24:57):
Because do communities seek you out?
Because if someone's listeningto this and you're sending this
out to our client base, can theyring the foundation and say,
come to us.
Kate Coomber (25:06):
If there's an opportunity, this is your
funding moment.
Sam Miklos (25:07):
Can they ring the foundation and say come to us if
there's an opportunity.
Kate Coomber (25:08):
Now you've got funding.
This is your funding moment, oryou know?
Fran Avon (25:14):
And how do you choose ?
We're taking callers.
Dr John Buckley (25:16):
Yes, got a generous sponsor in mind.
Sam Miklos (25:19):
Maybe, I don't know, this is your pitch, right?
Yeah, yeah.
Fran Avon (25:22):
And really that's what it's about.
You know we've got the capacity, We've now built a model that
we can just replicate, and youknow we've got all of the
training in place, We've got allof the governance structures in
place and you've got GPs onboard to yes, we've got you know
, at the moment we've got anumber of GPs on board, but we
have expressions of interestfrom lots of GPs.
(25:43):
That's great.
So it's not like the GPtreating GP is the issue.
It's can we have the funding todeliver this to as many
communities as possible?
So, as you say, if there isanybody out there listening,
that goes wow, this is a programthat we would love to support.
We would love to talk to you,because it's not about what the
(26:05):
foundation's doing.
It's about making sure thatthose healthcare professionals
are looked after and, ultimately, that the rural communities are
looked after.
Kate Coomber (26:15):
So if there's a rural community listening who
think I really need help, wereally need a bit of this type
of support to get them in touchwith you and it may not be
obviously immediate, but just tobe on your radar that this is
an area that maybe we couldfocus on in the future.
Fran Avon (26:30):
And you never know what happens.
Like I was just chatting to atreating GP that's about to join
us.
We started chatting about 18months ago and she said, oh, I
really want to join the program.
And I said, oh, I'd really loveyou to join the program too.
But we don't have any sort offunding at the moment to do that
and obviously with the WesternQueensland PHN funding, we've
(26:52):
now got that.
And I said to her I saidremember we started chatting 18
months ago and now it's happenedand she's so excited about
wanting to get out there in thecommunities and deliver this
service and it's exciting for usto have.
You know, we've now got a realmix.
You know we've got male GPs.
This is our first female GP andso that's really great as well.
Sam Miklos (27:16):
So more funding would mean more of this same
program.
Dr John Buckley (27:21):
More locations.
Sam Miklos (27:22):
Yeah, more locations are covered, obviously, than
more GPs.
Is there other visions that youhave for the foundation?
Like I know, you said, you'restill pushing the snowball.
Yes, but I sort of feel likeyou're not pushing it up a
steeper hill maybe.
Fran Avon (27:37):
And that's sort of the encouraging thing.
There's positive signs.
We're not there yet, but wereally want to build on what
we've got so far.
Sam Miklos (27:49):
And so sorry, just that question you were like is
there, if someone's you knowlistening and thinking, god, I
want to donate, but is there?
Is there other plans for thefoundation?
Dr John Buckley (28:01):
that you've got .
Sam Miklos (28:01):
You've got these programs, but is there a big gap
that maybe you're seeingclinically or that you think?
Gosh, I wish we could fix that.
Fran Avon (28:09):
Yeah, we've got.
There's so many ways in whichthis program can grow and you
know you talked before about,you know, not stepping.
You know, like were there anyresistance or anything like that
, and what this has enabled usto do is to build relationships
with the health practitioners inthe communities.
With the health practitionersin the communities, so if they,
(28:30):
for example, one vision that Iwould love to see is that that
GP could turn around to John andsay, hey look, I want to go and
have a month's leave.
Do you have any capacity tolook after my community while
I'm gone?
Because they now trust John,they know John, yes, and that
enables that person to get thatrest and that recuperation that
they need.
(28:51):
Another way of expanding theprogram is John could be
accompanied by a specialist, youknow, like if John's finding
that there's a real, you know itcould be diabetes it could be
heart disease.
What is it that's showing up inthis community that you know?
John goes as the GP and thenhe's accompanied by a specialist
.
There's the opportunity toexpand the program to the
(29:13):
community as well, but wewouldn't do that without the
support of the local GP.
But the local GP may go.
You know what I'm reallyswamped right now.
John, can you come and hang?
Kate Coomber (29:24):
out with me for a week.
They're looking for a morepermanent person that they can't
get, so this is just additionalhelp.
Yeah.
Fran Avon (29:30):
So, as I said, I just love this program and I just
say there are so many ways.
It's not just about morecommunities, but it's about more
services and it's more supportand that sort of thing.
So that might be the first time.
Sam Miklos (29:45):
John's heard that and he's probably sitting here
going, oh my gosh.
When you see that vision foryou, it's so nice to hear.
Dr John Buckley (29:52):
If I could touch on I think we've already
mentioned that disaster relief,one of the things that I have
nothing to do with that thefoundation does.
It's small enough to be reallynimble and Fran described every
different practice orpractitioner gets help in a way
that's what they need.
So people might have their ownhome destroyed or their practice
destroyed or both, or theymight need particular help with
(30:14):
family, and the foundation issmall and clever enough to help
with that.
And I just wanted to touch alsoon that resistance.
I was lucky that I got to go tomy town scoping visits with
Coral, which was a chance toengage with heaps of practices
in the hospital and just letthem know we're coming.
And one of the points I triedreally hard to make was if you
have an existing healthrelationship that works, I'm not
(30:36):
here to interrupt that.
I'm here if you wantcomprehensive care, because of
course we can have telehealthbetween visits.
I'm here if you are alreadyseeing someone, but there are
some things you want to talkabout, even on a one-off basis.
Or if you've got a greatrelationship and you've got good
care fantastic and you don'twant to see me, that's fine.
(30:57):
So there was no resistance tothe program.
There was a I don't need it,but there was no one saying this
is a bad idea.
In fact, a lot of the peoplesaid I don't need it, but it's
great that you're doing it.
So I didn't sense, on that,scoping, any resistance.
And from the other organisationswe visited, like local councils
, there was a lot of.
I think Coral did a great jobof explaining what it is and why
(31:20):
and the benefit to thoseorganisations of retention
locally.
So they were just starting toget an understanding of what the
foundation's trying to do andthat it wasn't somebody else
coming sort of delivering adrive-in, drive-out service.
That was nothing to do withthem, that we're actually trying
to help them in their community, and they started to get that
as well.
So hopefully we get a lot moresupport from the scoping visit's
(31:43):
really important how often areyou back in a community?
The goal is about every three tofour months and we're building
the schedule depending on theneed and the number of people
who want to come.
So our availability isquarterly but it does depend.
If it's a bit slow on theuptake then we slow the visits
back a little bit.
But in between once I've seensomeone with Medicare and with
(32:06):
the availability of telehealth,now I can catch up with people
in between easily.
The only problem really is ifthey have an acute illness like
a sudden sore abdomen, and ofcourse I'm not in town.
But at the first visit we talkabout what are your options.
If you need to see someone on aday I'm not here.
A lot of the rest of the time Ican be in contact really easily
.
But if you've got to seesomeone and examine them,
(32:28):
they've got to see somebody butthey've got that problem now.
Sam Miklos (32:31):
So that's not a new problem.
That's not new.
John, are you seeing a lot ofburnout in our health
practitioners who are workingrurally.
Dr John Buckley (32:40):
It's lovely to give them a chance to talk about
that, because it's masked andit's hidden and you don't
understand.
And for myself, even when Istopped doing some of my work, I
felt my own brain needed torelax and unload somehow for a
couple of months and I hadn'trealized.
So a lot of people don'trealize until they start talking
.
And they start talking aboutstress and resilience and
(33:06):
struggles and all the pressuresthat are on them and it becomes
evident to them almost before methat they're at a level of
burnout.
And the question then is youknow, what do you do about that?
And sometimes justunderstanding and revealing it
is the first step and thenmaking your own decisions about
what to do.
So, yes, there is.
So there's the obvious burnoutand those who know it.
(33:26):
But I think the more peoplehave good care, the more they
start to understand their ownsteps towards burnout, if not
there already.
Kate Coomber (33:34):
Because they're just not having an opportunity
to talk.
They're not thinking inward.
They're treating other peopleconstantly.
You don't want to burden yourpartner or your family.
Sam Miklos (33:42):
And, as Fran said, if you haven't had a break, and
you've just kept going and goingand going.
You, if you haven't had a?
Dr John Buckley (33:48):
break and you just kept going and going and
going.
You don't notice.
Well, it's like the floods youwere talking about before.
I've got friends who are inLismore and I've got friends who
are in Townsville, and you know, your practice is destroyed,
your house is destroyed, yourfamily's disrupted, but somehow
I'll just keep trying to see thepatients and look after the
community.
I mean, what does that do toone's heart and soul and mind?
It's mind?
(34:10):
It's destructive, and yetthat's that's what they do.
So any support they get there.
But later it's um.
Friends in townsville this lastweek or two were being
triggered just by the rainfall.
Whether they were going to beimpacted this time didn't matter
.
They were feeling anxious andthis says it's almost a bit of
ptsd and burnout sort of kickingin when the clouds gather.
So better prepared butemotionally still struggling and
(34:31):
in some ways more terrified.
Kate Coomber (34:33):
And all the families, as you said.
Yes, all impacted.
You're right, the doctor goesstraight back to work to make
sure that they're there foreverybody else.
Dr John Buckley (34:39):
Yes, who's picking up the pieces and who's
supporting the doctor, who'sprobably tired and grumpy?
Yeah, exhausted.
Fran Avon (34:47):
But it's also what we've seen a lot of is that you
know doctors and healthpractitioners, they're caring
people and so what they often dois they will put the needs of
their patients before their own.
And I had a classic example.
I had a nurse ring me and itwas not this John.
We've got twos as part of theprogram, so another one of our
(35:08):
treating gps, john, was alreadyon the road.
He'd hit the road ready to hitthe skies.
Actually it was a fly-in visitand, um, she rang me and she
said, oh, have you got anyappointments left?
And I said we've got oneappointment left.
And she said, oh, I don't wantto take that appointment if it's
there's only one left.
And I said no, you're exactlythe person that needs this
(35:29):
appointment.
So she said oh, look, you knowwhat?
I'm just next door to whereJohn will be doing the practice,
so I'll wait and see and ifnobody else takes the
appointment, then I'll take it.
And, as it turned out, she gotthe appointment and I spoke to
John afterwards and I said howdid that go?
And he said, oh my gosh.
He said she so needed to see aGP and yet she was willing to
(35:54):
give up her appointment spot forsomebody else, in case somebody
more deserving, more needingcame along, and I thought that's
the sort of people that we'recaring for, people who put
others before themselves, and itis.
You know, part of thischallenge is the education I
think GPs are on the journey of.
(36:15):
We need to look after ourselves, but nurses and allied health
professionals are still notquite there yet.
But your health is moreimportant, because if you're not
healthy, then you're not therefor your patients Completely.
Dr John Buckley (36:29):
So the clinical director of the program is
probably.
Dr Margaret Kaye is probablyour leading doctor in Queensland
about doctors' health andthat's again.
She constantly brings theresearch and the knowledge and
the thoughts about exactly whatFran was just talking about to
the program and to myself andJohn.
And no, having the name Johnwas not a selection question,
(36:50):
that's what you think, it waspure coincidence.
But you know that focus on, youknow, doctor's health and health
practitioner.
Health underpins what we'redoing, but the longer term
outcome really is communitysupport and community services
and by looking after thedoctor's health.
So the doctor's health might bethe action, but the outcome is
(37:11):
community health and communityviability.
Sam Miklos (37:14):
Absolutely.
It's wonderful, Fran.
Is there anything else aboutthe Royal Doctors Foundation
that we haven't covered?
Is there anything else you'redoing or stories you want to
share?
Fran Avon (37:25):
Yeah, there's probably, you know a number of
stories of the things that we'vemade possible, and some of them
are amazing, Like there's onestory of and it's a bit of a sad
story, but there's a doctorthat we were given a grant and
we were able to provide.
(37:46):
They're called sandpiper bags,but they're a bit like an
emergency trauma kit, and sothey're set up in such a way
that a GP that's trained inemergency medicine can grab the
bag and just run and haveeverything that they need.
And it's organised in such away that if it's a snake bite,
all of the snake bite stuff'sthere.
(38:06):
If it's a more critical traumaaccident bite, all of the snake
bite stuff's there.
If it's a more critical umtrauma accident, all of the
stuff's there.
And we had had this beautifulapplication from um, a doctor
based in wa, and I read hisapplication I just loved it.
It was like one of those oneswhere, you know, I just seem to
attract track trouble wherever I.
(38:27):
He said, you know, I was at thefamily holiday and a little kid
got a fishing hook caught intheir lip and had these range of
stories of things that hadhappened to him along the course
.
And he said, and I do have myemergency kit.
And he said, you know, and Iuse it quite often because I
attract this trouble wherever Igo.
(38:48):
And so I thought, oh, he's gotto get one of these bags.
And, as it turned out, he, youknow, not long after he got the
bag, he was travelling out, youknow, sort of Northern Territory
, wa area and came across a caraccident and it totally rolled
the car and he was able tostabilise stabilize the patient,
(39:11):
give them pain relief.
Actually splintered a leg andthe paramedics were obviously a
long way away because they wereout the middle of nowhere, and
so he was able to do this allbefore the paramedics arrived
and they just went.
Oh wow, this is amazing, butthis the that he himself had a
tractor accident and his son waswith him and he said to his son
(39:34):
, can you go and get a mate whohappened to be, you know, a
doctor as well, but grab mysandpiper bag?
And you know he was able tohave his friend use the
sandpiper bag on himself and youknow sort of it was a very,
very serious.
You know accident that he had,but you sort of go wow, and you
know sort of it was a very, veryserious.
You know accident that he had,um, but you sort of go wow, you
(39:55):
know he's.
He was able to save the life orat least alleviate you know
very serious injuries for thesepeople involved in the car
accident, but it ended uphelping himself as well, and
that's that's one of my mostamazing stories.
And probably one of the thingsthat sticks with me most is I
remember one of the GPs.
(40:16):
It was when I was first, youknow, joined the foundation.
I said, you know, tell me, youknow, what does it mean to be a
rural GP?
And he said you know what hesaid.
When you're a doctor in a youknow, a big hospital, in a major
centre, or you're working inyour practice, if there's
something that happens andyou're the treating person in
(40:37):
emergency or wherever it may be,the first question you ask is
what are the injuries?
How far out is the patient?
When you're a rural GP, thefirst question you ask is who is
it?
Because you are very, verylikely to have a personal
relationship with this personand I hadn't really thought
(40:57):
about that before and I thought,oh, imagine the impact of that.
And then another treating GPhad told me about the fact that
he would caught out to a farmaccident and unfortunately he
wasn't able to save the person,and it was his son's best mate.
And you go, how do you, how doyou carry that?
you know how do you cope withthat?
(41:18):
How do you come home and tellyour son his?
Best mate's no longer herefamily, friends, yeah yeah, so I
think there's a lot of, as Imentioned before, there's a lot
of weight that rural GPs carry,rural nurses carry, because it
is so personal.
Absolutely, and that's thestuff that's really stuck with
me.
Kate Coomber (41:40):
But it's also so rewarding and wonderful, and
people living in these ruralcommunities love what they do
clearly, yes, so it's just soimportant that we can support
them so they can remain doingwhat they do, and that's it.
Fran Avon (41:53):
They're so humble, they're so committed so caring
and I remember going to one ofmy first conferences and I
thought these healthpractitioners really know how to
party.
Sam Miklos (42:08):
They're all from the bush.
Fran Avon (42:09):
But somebody said to me at the time this is their
only opportunity because they'rethe stalwart of their community
, so they can't just go down tothe local pub and let loose.
So they really are holdingtheir community in their hearts,
in their hands.
I think it's really and that'swhere I go People look at
(42:30):
doctors and go oh, you know,they're well paid, they can look
after themselves.
What's the problem?
But you go, my gosh.
If you understood the burdenthat they're carrying, you would
have a very, very differentperspective.
Dr John Buckley (42:43):
It's made a lovely point there too, fran
that little bit of distance andisolation within the community.
So, yes, you can go and playtennis and you can go swimming
with the kids or whatever, butif you go to the pub you don't
want to be seen to having moredrinks than you should, or you
maybe shouldn't be laughing outloud so much that people think
you're drunk.
And there's always that littlebit of no matter who I am or
(43:06):
what time of day I am, who I amin this community, and that's
just a little thing.
That makes it just a bit harderto fit in as fully as you might
like, and some GPs are great atdoing that.
But there is always just thislittle barrier and also the
possibility that there's a fewof us in town that if something
big happens, I might have tohelp and be available.
(43:27):
So you, if you're in townunless you're away at a
conference if you're in town,you're kind of always almost on.
So if you're in town, unlessyou're away at a conference.
If you're in town, you're kindof almost on, even if you're not
on.
Kate Coomber (43:36):
Yeah, yeah.
Which is why they do need thatspace, don't they?
Yes, they do those sandpiperbags you mentioned.
Sam Miklos (43:41):
is that an initiative from the foundation
or is that something that exists?
Fran Avon (43:45):
It sounds like every yes, so it was an existing
initiative and that's what wetry and do.
Yes, so it wasn't an existinginitiative and that's what we
try and do.
We try and look for things thatwhat do rural communities need?
And so that was a campaign thatwe really got behind At the
time of COVID.
We really got behind giving allof our rural hospitals and
(44:06):
communities access to COVIDmedihoods, which were a
protective device, so a bit likea boy in the bubble type thing,
but it went over the hospitalbed and it protected the
patients, the nurses, thevisitors, the doctors from
cross-infection and, once thosemedihoods were installed in the
hospital, the relief of actuallythere's something between me
(44:29):
and the patient to make sure I'mnot going to get COVID.
Sam Miklos (44:32):
Especially when they're the only one.
I think in those times we wereprobably seeing more of the
metropolitan areas and theimpact.
But if you actually think aboutthat in a community like you're
, it yeah.
Fran Avon (44:43):
And I just was chatting to a doctor on Monday.
We'd just given them an earloop which is like a device
where you can go in and sort ofsee what's going on in the ear
and actually take out impactedwax.
It doesn't sound like a reallyexciting product, but he said
the difference this has made toour community.
(45:03):
The fact that we have thistechnology means that they don't
have to wait for treatment fromthe specialist coming into the
community and they don't have tobe travelling to the specialist
services to get this treatment.
So it's things like that thatwe go.
(45:23):
What's a piece of equipmentthat we can provide to rural
doctors, rural nurses, that willmake their lives so much easier
, and something like the E-Loop,for example.
It's much less painless, so thepatients get a better
experience as well and theydon't have to wait, they don't
(45:45):
have to go through Doing thingsmore regularly and not having to
wait for build-ups.
Yeah, and if you wait fortreatment, sometimes the
symptoms get a lot worse.
Exactly, and that's what wefind.
A lot, john, isn't it?
Dr John Buckley (45:56):
It's a lovely thing you've just mentioned.
I was chatting with a colleaguethe other day and neither of us
could think of anything else.
There is nothing else we couldthink of where you could provide
immediate and total relief of asymptom than removing any
earwax plug.
Sam Miklos (46:10):
Really.
Dr John Buckley (46:11):
Because you go from I can't hear to I can hear,
painlessly and completely.
I mean, if I get a lot of pusout of an infection, you relieve
the pain, but there's stillsome discomfort.
If you remove earwax, you'vegone from a problem to zero
problem by the time the personleaves the room.
And so, while it sounds simple,impact, it's like you know,
(46:32):
Fred Holloway is fixing people'seyes A dramatic and complete
difference.
And if it's an older person,hearing is so critical, you know
.
And if they're wandering aroundwith this problem and suddenly
they can hear, wow, you know,it's an amazing thing to watch
someone go oh, now I can hear, Ican imagine what's the cost of
that device.
Fran Avon (46:50):
It's only a couple of thousand dollars.
Sam Miklos (46:52):
Wow.
Fran Avon (46:52):
And you know that's the sort of thing that we want
to.
I think that might be our nextproject.
Yeah, you know we're justspeaking with that doctor on
Monday and you know the stuff.
You know that's social, like ifyou can't hear, you can't
socialise.
So isolated in more isolated andhe was a lovely, lovely
gentleman, very humble, but justchatting with him you could
(47:16):
just and it's like with all ofthe doctors that you talk to you
just get that the passion.
You're sort of chatting withhim and he starts off really
quietly and then he startstalking about oh, we did this
with this patient and you canjust hear.
I just love what I do because Iam making a difference in the
lives of people.
So it is really beautiful andI'm blessed to have this
(47:41):
opportunity and to be able toring somebody and say you know
that application that you put in.
I can't imagine we can help youhow great and in some cases it's
a lot of money, in some casesit's not much at all.
Yeah, but it makes a hugedifference.
So they're the sorts of thingsthat we're.
You know, the GPs for RuralDocs is the program that John's
(48:05):
a part of.
That's our main focus at themoment, but you know we will
continue to look foropportunities for how do we
improve the health of peopleliving in our rural and remote
communities?
Kate Coomber (48:17):
look, today cmr are going to make a donation to
the foundation.
Where do people go if peoplelistening also want to
contribute?
Fran Avon (48:26):
so our website is rdforgau, so so fairly simple,
easy to find.
Sam Miklos (48:35):
There's a big button that says donate.
Fran Avon (48:39):
So, you know, we've got, obviously, our crisis
appeal running at the moment andwe have our appeal to support
the GPs for rural docs.
But, you know, if people have aparticular thing that they're
interested in, we'd love to chatto them about it and just say,
yeah, we're, you know, we're thepeople that you know really
want to understand what it isthat a rural community needs and
how can we make that happen.
Kate Coomber (49:00):
I love that.
It's by asking those questionsthat you can have the bigger
impact versus what you thinkmight be impactful.
Fran Avon (49:07):
And, as I said, every community is different.
Sam Miklos (49:09):
So yeah, it's very personalised to that community.
Yeah, thank you so much.
How lucky are our healthcareprofessionals who are getting
access to people like you, john,and your other John
counterparts.
Kate Coomber (49:21):
All the Johns, thank you.
Sam Miklos (49:23):
Just for looking after our healthcare
professionals, and I think it'sjust this whole other layer that
no one, I think, has that greatawareness of and that impact of
the work that you're doing andthe whole work that the
foundation's doing when there'scrises that happen.
Dr John Buckley (49:38):
thank you both so much, it's been lovely
hearing Fran talking about thefoundation, because I knew it at
the beginning when it was smalland single purpose, and what
it's become in its breadth ofthinking about community, and
what it's become in becoming anational organisation now.
Even that surprised me.
In that short time when I sawthis program starting, I thought
(49:59):
, wow, look at all this stuffthey've been doing from a very
small beginning with still avery small team.
But I know the members many ofthe members of the board and
they're such dedicated peopleand there's great innovation and
good leadership.
So I've been excited listeningto Fran's responses today.
Sam Miklos (50:15):
Yeah.
I think the foundation's ingood hands.
You're doing an incredible job,fran like what a what a great
few years, and I really hopethat people lean in and support
the foundation, because there'sso much good that that you're
doing and that you can continueto do so.
Dr John Buckley (50:28):
Thank you for your time.
Thanks so much.
Real pleasure.
You can continue to do so.
Sam Miklos (50:31):
Thank you for your time.
Thanks so much Real pleasure,thank you.
Kate Coomber (50:36):
We acknowledge the traditional custodians of the
land of which we meet who, forcenturies, have shared ancient
methods of healing and cared fortheir communities.
We pay our respects to elders,past and present.
Welcome to it Takes Heart.
I'm Kate and I'm Sam, and wecan't wait to share more
incredible stories of healthcareprofessionals making an impact
across Australia.
Fran Avon (00:08):
Dad's not just a doctor.
He's the counsellor, he's thelistening ear, he's the person
that people turn to, and sothat's why it's so important
that we support our rural healthpractitioners during crisis.
Kate Coomber (00:22):
Don't forget to hit follow or subscribe if you
want to hear more stories frominspiring healthcare
professionals.
Sam Miklos (00:35):
So with each episode of it Takes Heart, we are
donating to a charity of theguest's choice, and in my
episode in season one, I choseRural Doctors Foundation.
I really felt the foundationaligned with the work that we do
, but we loved the fact thatthey work so hard to improve the
health of rural communities.
The rural communities has beena common theme in many of our
episodes since, and we thoughtit would be great to better
(00:56):
understand the work that theRural Doctors Foundation do.
So today we are joined by theirCEO, fran Aver, as well as Dr
John Buckley, who is one of theincredible GPs participating in
one of their programs, and wereally look forward to learning
more.
Welcome to the both of you toit Takes Heart.
Kate Coomber (01:12):
Thank you, thank you, so tell us a little bit
more about the foundation andthe work that you do so.
Fran Avon (01:27):
The foundation started in 2016, and it was
after the floods that decimateda lot of Queensland and a number
of rural doctors who were verypassionate about the fact that
communities and the doctors wereleft without access to
healthcare, to services, and sothey wanted to do something in
times of crisis, and so that'show we started, and it was very
much a volunteer organisationrun by a number of rural doctors
and with support from the RuralDoctors Association of
(01:49):
Queensland, and the story's beenamazing because it started with
that purpose, but it's grownsince then and it's very much.
We're still doing our emergencywork and, obviously, the recent
floods in Townsville, we've beenhelping out some GPs in the
community there to providesupport, but we're doing a lot
(02:09):
more now.
We're providing grants topeople that are living in rural
communities or are the healthpractitioners in those rural
communities to get healthinitiatives off the ground that
they may not have been able towithout some seed funding or
without a bit of support, andit's really great for us to see,
like you know, five, 10 yearslater, some of those programs
(02:31):
are, you know, really bigprograms now, or you know
they've been able to continuebecause of our initial work with
them and one of them is myinspiration.
It's Heart of Australia andthey.
You know we were one of theirfirst supporters.
And it's Heart of Australia andthey.
You know we were one of theirfirst supporters and I look at
them now and I go.
Sam Miklos (02:49):
Oh, we want to be like them.
Dr John Buckley (02:50):
So it's really great.
Fran Avon (02:52):
We also do research into health issues and really
try and understand what'shappening out there for our
rural health practitioners, andwe also, you know, the program
that John is a part of is verymuch about looking after the
health of our rural healthpractitioners.
So we're going out into ruralcommunities with GPs to provide
(03:17):
GP services for our rural healthpractitioners, who people you
know really need independentsupport.
But obviously John will talkabout that a bit more because he
is.
Kate Coomber (03:28):
Yeah, the program's really interesting.
I'd love to hear so you're ageneral practitioner, Is the
work that you're doing in thisprogram?
Is that the side hustle?
Dr John Buckley (03:38):
No, that's my main clinical work now.
Kate Coomber (03:40):
This is your main clinical work now.
Dr John Buckley (03:41):
If this was video, you'd see my grey hair.
Kate Coomber (03:44):
It is.
Dr John Buckley (03:45):
Yeah, but it's been a passion of mine for a
long time.
I spent most of my medicalcareer working in GP education
and training, and particularlywith a focus on rural training.
So I've watched doctors comeand go, I've watched how hard it
is to recruit, and you guysknow about that.
And I've watched burnout andI've watched people people leave
and I've watched the stressesthey have.
(04:06):
So when this program came upjust as I was leaving the
practice, I was working and Ithought that's a fantastic bit
of work to do.
I still do other work as well,but that's my main clinical work
now is to have this greatprivilege of seeing friends,
colleagues and people I've nevermet and trying to sustain them
in their work in the rural areas.
Sam Miklos (04:27):
So how do you do that?
Yeah, maybe explain the program.
Dr John Buckley (04:31):
What does?
Sam Miklos (04:31):
a day in the life of your role.
Look like I mean yeah, how doesthat program work?
Dr John Buckley (04:34):
So the program is magnificently set up and
that's how I sort of came acrossis when they first announced it
and it's a goal that the ideais that we go to several towns.
It's a pilot program at themoment so I have the privilege
of going to Stanthorpe,gundawindi and St George and my
colleague John Duyere goes tothree other towns and we're
(04:56):
evaluating how that goes.
So on a week of a trip, I'lljust head out to St George on
day one have a nice beautifuldrive.
I love driving out there.
Kate Coomber (05:04):
Are you based in Brisbane?
Dr John Buckley (05:05):
I live on little Coochie Mother Island,
just off from the coast, so Ihead out there and then I'll
stay overnight and in themorning I'll set up, pop into a
generous clinic in St George andspend a fair bit of the day
there seeing whoever wants tosee me, and then I'll bid my car
and drive to Gundawindi.
When you say whoever wants tosee me and then I'll bid my car
(05:25):
and drive to Gundawindi, whenyou say whoever wants to see you
, is that the staff in thepractice?
No it's not really the staff.
It's open to any healthpractitioner in that town or
area who wants to come.
And what I really love aboutthe setup is it's completely
independent.
So I don't work for the RuralDoctors Foundation and I don't
work for the practices.
(05:46):
I am my own self and all of therecords for confidentiality
purpose are kept entirelyseparate.
I don't log into the systems inthe practice.
No one really knows who comesexcept the reception staff, and
even for them I just give them apiece of paper saying here are
the people coming today and theydestroy it at the end of the
day.
Kate Coomber (06:05):
And I guess, why is that important?
Dr John Buckley (06:06):
It's really.
I think for many people it'simportant for their health
anyway that they have privacyconcerns and issues.
But when you're in a small townif you've ever lived there
gossip's a terrible thing andfor most people it's one of the
reasons for the program.
They can probably see acolleague about most things but
not about everything.
And if there's issues of sexualhealth, of domestic violence,
(06:30):
of mental health issues, theyoften don't want friends and
colleagues and others to know.
So that privacy andconfidentiality that we all want
for those areas of health iscritical to maintain and it's
hard to share that with acolleague with whom you work in
the same practice or the sametown.
So having someone come intotown who's separate from all of
that, keeping records separately, and even at the practical
(06:53):
level, if you need a certificatefor time off work, you're
probably not going to ask yourboss for that it's really
difficult.
Sam Miklos (06:59):
You just don't think about that at all.
Dr John Buckley (07:01):
Yeah, People don't.
And what Fran mentioned, theresearch and these are things
we've always known, but theRural Doctors Foundation
research has highlighted thatall of these things we've
suspected are now true andproven and that really helped
guide the setup of the program.
Sam Miklos (07:15):
You know, Fran, you mentioned earlier about when
there's a flood, and again wethink floods about houses and
people, then homelessness.
But we don't actually thinkabout services, or it's probably
not front of mind.
And then you said we go in andwe help out.
What does the foundation?
What does that mean?
What are the foundation?
Are you sending in doctors, areyou?
Fran Avon (07:34):
and it it depends upon the crisis but, in the past
we have flown doctors intorural communities to be able to
provide support and services atthe time.
For some of them it's aboutlike a hardship payment, like a
GP or a health practitioner.
Their home's been totallydestroyed and how do they get
back on their feet?
Kate Coomber (07:53):
very quickly Because you want to make sure
they stay there.
Fran Avon (07:56):
Exactly, and you want to make sure that they're there
for the community, because intimes of crisis, people turn to
people like their GP or theirnurse, because they are trusted.
They are the people that youwant to see.
That it's okay.
You know this crisis, we'regoing to get through it.
And that's probably one thingthat I've learned in my time at
(08:17):
Rural Doctors Foundation therole of those sort of people in
their community.
It has like a real weight.
Those sort of people in theircommunity, it has like a real
weight.
It's a very big burden for someof the rural health
practitioners to carry that theyare always the person that
people look to and one of ourboard directors his father, is a
(08:37):
rural GP, and he said Dad's notjust a doctor, he's the
counsellor.
He's the listening ear.
He's the person that peopleturn to, and so that's why it's
so important that we support ourrural health practitioners
during crisis, and so our youknow appeal is very much about
do we give equipment to get themup and running, you know, do we
(09:01):
send?
Dr John Buckley (09:02):
in medical supplies.
Fran Avon (09:03):
What is it that we need to do so that healthcare
can continue?
In one case, we providedfunding for a GP to work out of
a hotel room for telehealth tobe able to continue serving his
patients in a different way, ofcourse, but at least he was able
to make sure they had theirprescriptions, make sure that
(09:26):
they were able to continue toget healthcare maybe not in the
same way as prior to the crisis,but, yeah, so it does depend on
the circumstances, so it doeslook very different for each
type of crisis that we'reresponding to.
Sam Miklos (09:40):
And is the work that you do Queensland specific?
Fran Avon (09:46):
too?
And is the work that you doQueensland specific, nationwide?
We started as a Queenslandcharity but, you know, very
exciting that we are now anational charity.
And obviously you know, as Johnmentioned, the trial of the GPs
for Rural Docs started inQueensland because that's where
we've got our roots and we'vegot our networks.
But you know we're very excitedthat we've just received some
funding that will enable us totake it outside.
But you know we're very excitedthat we've just received some
funding that will enable us totake it outside of Queensland.
(10:07):
That's wonderful and you knowthat's where we want to get to
that every rural communityacross Australia has access to
the services that we provide.
Kate Coomber (10:17):
Because I guess you're touching a small amount
of rural communities at themoment, presumably Maybe paint a
picture for people listening ofwhat does it typically look
like the communities that don'thave access to this?
Are they avoiding their ownhealth?
Is there wait lists?
Are they having to leavecommunities Like what's the
(10:38):
alternative?
Fran Avon (10:40):
So when we did the research, the alternatives were,
as John mentioned, they wereseeing a colleague.
That may not be I'm sorry, it'squality healthcare, but it may
not be the best healthcare foran individual.
They were travelling, and sothey were travelling, you know,
700 kilometres just to get theirown healthcare, and that's
(11:01):
obviously a burden on the GP orthe health practitioner.
But what it also means is thatcommunity is left without a GP,
and that could be for up to aweek.
And so what that means is, youknow, there's probably 75, 150
people that don't see their GPwhile they're away.
(11:22):
Yeah, and what we're doing withthis program is making sure
that they're in their communityso that they're there for the
community, and thoseappointments are there.
They're available because theGP hasn't had to travel to get
their own health care.
Sam Miklos (11:38):
What other programs do you offer Like?
Is there additional programs tothe one that John's on?
Is there any of those you couldtell us a little about?
Fran Avon (11:46):
Sure.
So we're doing it in othercommunities.
So, as John mentioned, we'vegot Dr John Doyer who's doing
the communities of Charleville,quilpie, cunnamalla.
We're also looking at othercommunities that we can expand
the service to and we've justhad an announcement of some
(12:07):
funding from Western QueenslandPHN which will enable us to
deliver the service to Blackalland Buckholden.
We've had a corporate partnercome on board and they're going
to fund the service in Blackalland Buckholden.
Okay, fantastic, we've had acorporate partner come on board
and they're going to fund theservice in New South Wales.
Not all of New South Wales,yeah, yeah, but some of the
communities in New South Wales.
So really, that's where we'reat and that's why, at the
(12:29):
beginning, when I talked aboutHeart of Australia being the
inspiration, you know Dr Gomes,he mortgaged his house and
started that program.
And now you look at the programand you know, speaking with
Ralph, he sort of talked abouthow, in the early days, you know
, couldn't get anyone to supportthe program or fund the program
(12:52):
and a couple of things happenedthat few people came on board
and then it was a bit like asnowball.
Kate Coomber (12:57):
Yes.
Fran Avon (12:59):
And that's what I kept saying to the team.
We've got a very smallhardworking team and I keep
saying we're still pushing thatsnowball up the hill but, you
know, with these two recentrounds of funding, it's
encouraging and we just hopethat this is the beginning of
other people going.
Yeah, we really do need to lookafter our healthcare
(13:19):
professionals and we really needto make sure that they're
healthy so they can look afterus, and so obviously, we want
other partners to come on boardso that we can offer this
service to every rural andremote community across
Australia.
And, a bit like Ralph, we tooka leap of faith, we invested our
own funding to get the programoff the ground and to
(13:42):
demonstrate its impact.
And you know, I'm sure Johnwill share some stories, I can
share some stories, but itreally is having an impact and
that's so encouraging for us.
Kate Coomber (13:53):
I'd love to hear yeah, John, could you share
something with us that reallyshows and demonstrates that
impact?
Dr John Buckley (14:00):
There's one GP I've seen as a patient who is
one of the most respected GPs Iknow in rural Australia.
He's been there a long time andthat GP was driving a long way
as Fran suggested to gethealthcare and trying to fit it
in with family trips to thecoast and found it just didn't
work.
(14:20):
So they had really beenmanaging care by doing their own
referrals or getting a corridorchat with someone and hadn't
had any coordination of theirown health care for 15 years
which when they think abouttheir own patient.
Of course they would think isterrible.
Sam Miklos (14:36):
I was just about to say that would be so conflicting
for them as well.
It's awful.
Dr John Buckley (14:40):
And so it's not that and it's almost a bit like
the American system.
You know, I'll get myself offto see this specialist and that
specialist, but nobody lookingafter their general health or
their coordination, which iswhat general practice is so
critical.
And they knew it, but theydidn't feel they had an option.
And suddenly this project washappening and they had an option
(15:01):
that they wanted to try andwork, and so that's an obvious
thing.
The other thing that's happenedthe program was initially
conceived to help look afterdoctors and then it changed to
all health professionals, andwhen I looked at that and went
out on a reconnaissance trip andtalked to people, I realised
it's just as hard for a localallied health person or a local
(15:22):
nurse, community nurse orhospital nurse to see the
doctors that they work with in asmall community, and so the
challenge is just as strong forallied health, nursing and other
health practitioners.
And so again, part of thepleasure has been meeting and
having a few patients who arenot doctors, which is not what I
expected when I joined theprogram, and it's actually a
delight to understand theirbarriers and to have them relax
(15:46):
about the confidential nature,and I know medicine's always
supposed to be confidential, butit's hard to trust that in a
really small community, in asmall place.
So that's been an extra bonusto see that those people have
the same barriers and howimportant the program is.
Kate Coomber (16:01):
Because I think as much as there's obviously going
to be confidentiality, but youcan have a conversation in a
clinic room and then see them inthe supermarket 10 minutes
later.
There's still going to be thatfeeling that you have.
I imagine it's awkward yeah.
Dr John Buckley (16:13):
You can manage it and you can both sort of
smile inwardly and think that'sokay, yeah, but it's not the
same.
Or you know your kids are atdaycare together or you play
tennis together yeah, andthere's others there with you
and if you've got a sense of Iknow something about you and
they look at you, it's hard andI lived, you know, a few years
in a very small town.
Sam Miklos (16:38):
And you know you don't get a feeling of privacy
about yourself.
Yeah, A real theme in some ofthe conversations we've had has
been about the impact that thecommunity can have on attracting
healthcare professionals tothese rural communities and the
impact they can have not only inthe attraction but the
retention piece of healthcareprofessionals, doctors and
allied nursing.
What have you seen in somecommunities that they're doing
really well to attract andretain health professionals, or
(16:59):
what would you love to see moreof?
Dr John Buckley (17:03):
I'll just mention first, I view this
program as a retention issuebecause recruitment, you know,
is difficult and very expensiveand long-term and then you keep
losing people and so retainingpeople.
And at some point someone fromresearch said oh, patients are
just saying why don't you justcome out here and see the
patients?
I said well, maybe if I lookafter your health practitioners
(17:25):
they'll stay and they can seeyou much better than if you're
turning them over and gettingnew ones all the time.
The other thing that sort of istriggered by that is, each of
the towns I go to is very, verydifferent.
You know, stanthorpe has a lotof health practitioners,
gundawindi is desperately shortand St George is big in some
(17:47):
areas and not in others.
So the recruitment and retentionvaries depending on what's
going on in town, how far awayit is and involvement of
organisations like localgovernment, who I know the
Foundation has been reallyimportant talking to that.
Those local governments canhelp and support a program like
this, even in small ways.
So what you see is where thereis community support and local
(18:10):
government support and a fewother things to attract people
and help look after theirfamilies, it goes much better.
So when the whole community,government people and other
organisations after theirfamilies, it goes much better.
So when the whole communitygovernment, people and other
organisations are involved, youget better recruitment and
better retention.
Where there are struggles inthe community or a lack of
support from state or localgovernment or a lack of support
or understanding from community,all of those things become far
(18:32):
more difficult.
So it's not so much about thepeople who are trying to recruit
, it's about what's there forthe people they are recruiting
to help them come and stay.
Kate Coomber (18:42):
We've heard that a bit, haven't?
We about the community almosthave a role to play in the
recruitment and retention, Iguess.
What are your thoughts to that?
What can a community do toreally help?
Sam Miklos (18:52):
Yeah, what are some examples of things you see.
Dr John Buckley (18:55):
I had a great story from a friend of mine many
years ago.
She was at a conference inCanada and you know how they
have all these stalls at theconference.
Local remote communities hadstalls and they had signs up and
they were getting doctors ontheir way past and saying why
don't you come to us?
And the community would gettogether and raise funds to own
a clinic building or to provideaccommodation or to do other
(19:18):
things.
So the community as their owninitiatives, putting forward
things to make recruitment andretention easier, and
particularly when you thinkabout families.
So it's one thing to get ahealth professional, their
spouse has to be happy, yeah wealways say that If they haven't
agreed with the offer, there'sno point.
So get a job for the spouse.
Sam Miklos (19:38):
Yes.
Dr John Buckley (19:39):
Or, you know, have a spouse who wants them to
be live-out, and I've certainlygot friends who are only working
rurally because their spouse isfrom a family who's on a
property.
And then there's the differentages of kids.
You know you can have littlepreschoolers anywhere, but once
you reach school, and especiallyonce you reach secondary school
, you get this moment for afamily to decide do we school
(19:59):
locally, do we boarding schoolor do we leave?
And you know family will comefirst.
So thinking about thoseservices, how to support
families and engage families andmake them part of the community
, having sporting clubs andcommunity organisations, whether
it's Lions or whoever else itmight be looking after,
supporting and involving spousesand kids, is really important,
(20:24):
and so the community has toinitiate that.
They have to recognise the needto have the whole family
involved in their community, notjust to have the doctor or the
nurse here and perhaps befriendthem, but isolate their family.
Sam Miklos (20:38):
Do you think most communities are aware of the
importance of having thehealthcare professionals there,
or is it taken for granted?
Fran Avon (20:47):
I think you know, as John said, every community is
different.
And as we've gone out to them.
There's some that you go wow,they totally get this.
You know they understand thatwithout a health practitioner in
their town they're not going toattract other people to the
town.
They're not going to build acommunity.
Because if you're thinking, doI go rural, you know you'll be
(21:08):
looking at what's the education,what's the health you know like
.
So before you make a decisionto live in a rural community,
you look at all of those things.
And there's some communitieslike Quilby, for example, their
council is doing a fabulous job,like they're trying to attract
people to come and work in theircommunity and so, for example,
(21:37):
at the moment they providehousing for their council
workers because they want toattract people to work for
Quilby Council.
So they're looking at ways inwhich they can make sure that
there's support andinfrastructure for the people as
they come into the community.
So you can't underestimate theimpact of having a health
practitioner in the community,what that does for the financial
(21:57):
viability of a community aswell.
Yeah, it keeps it thriving andso yeah, and we are seeing that
there are communities that arereally throwing everything at it
to make sure they can keeptheir health practitioners.
And we're very conscious, evenas a GP, like I'm thinking about
going out to a rural community.
What's the support for me?
(22:18):
And so you know, having aprogram like ours where they can
go, oh okay, that program'sbeing delivered in that
community, I can feel assuredthat if I go and work in that
community, I'm going to have myown health care looked after and
we also do see the familymembers of the GPs, because
probably people think well, you,know a GP can they can, you
(22:39):
know, look after their ownfamily?
and they do, and they can.
But is it the best thing to do?
Probably not, and so us beingable to see family members of
the GPs as well means that youknow it's not mum or dad.
Sam Miklos (22:54):
That's huge actually , especially with kids, yeah, as
they're growing up in teenageyears and things too.
So the communities.
Then you were saying like youwould sit in that community and
see any healthcare professionalif there was like multiple
practices or whatever, or fromthe local hospital or, yes,
practicing independently awayfrom another practice.
Dr John Buckley (23:14):
you know, local physio.
Sam Miklos (23:15):
Yeah, and how do they find you?
Yeah?
Kate Coomber (23:17):
I was going to say .
No, I was thinking the exactsame thing.
Does it take time to drum upbusiness.
Dr John Buckley (23:21):
Yeah, that's where the foundation does a
great job for me, yeah.
Fran Avon (23:31):
We've got an amazing program manager, coral, and she
just hits the phones.
Now, fran, I had a little bitmore money to be able to promote
this, to make sure that peopleare aware that the program is
available.
And that's what's reallyexciting about starting to build
these partnerships, becauseit's not just us on our own, you
know, spreading the word,there'll be people out there
that are going.
You know they're coming nextweek.
(23:53):
You know have you booked yourappointment?
And so that's sort of you knowit is, you know, something that
we hope will, you know, continueto grow and build over time.
And you know, we hope that Johncan have more capacity.
And you know we're not just ina community for the one day.
He's got so many appointmentsthat he has to stay for two, and
(24:13):
you know, it's that sort ofthing that we're hoping for.
Kate Coomber (24:15):
Have you ever had or tried to go into a community
where maybe you know there was abit of protection over this is
we want to do this ourselves, oryou know we don't need outside
help, or a health practitionerwho is so used to flying solo
and almost feels uncomfortable?
Fran Avon (24:36):
Yeah, that was probably something we were very
conscious of and, as Johnmentioned, you know we do a
scoping visit before we go intoa community, so we're not going
to go into a community wherethere is that feeling of you
know what are you doing, whatare you coming into our patch
for?
But we haven't reallyencountered that yet.
Sam Miklos (24:57):
Because do communities seek you out?
Because if someone's listeningto this and you're sending this
out to our client base, can theyring the foundation and say,
come to us.
Kate Coomber (25:06):
If there's an opportunity, this is your
funding moment.
Sam Miklos (25:07):
Can they ring the foundation and say come to us if
there's an opportunity.
Kate Coomber (25:08):
Now you've got funding.
This is your funding moment, oryou know?
Fran Avon (25:14):
And how do you choose ?
We're taking callers.
Dr John Buckley (25:16):
Yes, got a generous sponsor in mind.
Sam Miklos (25:19):
Maybe, I don't know, this is your pitch, right?
Yeah, yeah.
Fran Avon (25:22):
And really that's what it's about.
You know we've got the capacity, We've now built a model that
we can just replicate, and youknow we've got all of the
training in place, We've got allof the governance structures in
place and you've got GPs onboard to yes, we've got you know
, at the moment we've got anumber of GPs on board, but we
have expressions of interestfrom lots of GPs.
(25:43):
That's great.
So it's not like the GPtreating GP is the issue.
It's can we have the funding todeliver this to as many
communities as possible?
So, as you say, if there isanybody out there listening,
that goes wow, this is a programthat we would love to support.
We would love to talk to you,because it's not about what the
(26:05):
foundation's doing.
It's about making sure thatthose healthcare professionals
are looked after and, ultimately, that the rural communities are
looked after.
Kate Coomber (26:15):
So if there's a rural community listening who
think I really need help, wereally need a bit of this type
of support to get them in touchwith you and it may not be
obviously immediate, but just tobe on your radar that this is
an area that maybe we couldfocus on in the future.
Fran Avon (26:30):
And you never know what happens.
Like I was just chatting to atreating GP that's about to join
us.
We started chatting about 18months ago and she said, oh, I
really want to join the program.
And I said, oh, I'd really loveyou to join the program too.
But we don't have any sort offunding at the moment to do that
and obviously with the WesternQueensland PHN funding, we've
(26:52):
now got that.
And I said to her I saidremember we started chatting 18
months ago and now it's happenedand she's so excited about
wanting to get out there in thecommunities and deliver this
service and it's exciting for usto have.
You know, we've now got a realmix.
You know we've got male GPs.
This is our first female GP andso that's really great as well.
Sam Miklos (27:16):
So more funding would mean more of this same
program.
Dr John Buckley (27:21):
More locations.
Sam Miklos (27:22):
Yeah, more locations are covered, obviously, than
more GPs.
Is there other visions that youhave for the foundation?
Like I know, you said, you'restill pushing the snowball.
Yes, but I sort of feel likeyou're not pushing it up a
steeper hill maybe.
Fran Avon (27:37):
And that's sort of the encouraging thing.
There's positive signs.
We're not there yet, but wereally want to build on what
we've got so far.
Sam Miklos (27:49):
And so sorry, just that question you were like is
there, if someone's you knowlistening and thinking, god, I
want to donate, but is there?
Is there other plans for thefoundation?
Dr John Buckley (28:01):
that you've got .
Sam Miklos (28:01):
You've got these programs, but is there a big gap
that maybe you're seeingclinically or that you think?
Gosh, I wish we could fix that.
Fran Avon (28:09):
Yeah, we've got.
There's so many ways in whichthis program can grow and you
know you talked before about,you know, not stepping.
You know, like were there anyresistance or anything like that
, and what this has enabled usto do is to build relationships
with the health practitioners inthe communities.
With the health practitionersin the communities, so if they,
(28:30):
for example, one vision that Iwould love to see is that that
GP could turn around to John andsay, hey look, I want to go and
have a month's leave.
Do you have any capacity tolook after my community while
I'm gone?
Because they now trust John,they know John, yes, and that
enables that person to get thatrest and that recuperation that
they need.
(28:51):
Another way of expanding theprogram is John could be
accompanied by a specialist, youknow, like if John's finding
that there's a real, you know itcould be diabetes it could be
heart disease.
What is it that's showing up inthis community that you know?
John goes as the GP and thenhe's accompanied by a specialist
.
There's the opportunity toexpand the program to the
(29:13):
community as well, but wewouldn't do that without the
support of the local GP.
But the local GP may go.
You know what I'm reallyswamped right now.
John, can you come and hang?
Kate Coomber (29:24):
out with me for a week.
They're looking for a morepermanent person that they can't
get, so this is just additionalhelp.
Yeah.
Fran Avon (29:30):
So, as I said, I just love this program and I just
say there are so many ways.
It's not just about morecommunities, but it's about more
services and it's more supportand that sort of thing.
So that might be the first time.
Sam Miklos (29:45):
John's heard that and he's probably sitting here
going, oh my gosh.
When you see that vision foryou, it's so nice to hear.
Dr John Buckley (29:52):
If I could touch on I think we've already
mentioned that disaster relief,one of the things that I have
nothing to do with that thefoundation does.
It's small enough to be reallynimble and Fran described every
different practice orpractitioner gets help in a way
that's what they need.
So people might have their ownhome destroyed or their practice
destroyed or both, or theymight need particular help with
(30:14):
family, and the foundation issmall and clever enough to help
with that.
And I just wanted to touch alsoon that resistance.
I was lucky that I got to go tomy town scoping visits with
Coral, which was a chance toengage with heaps of practices
in the hospital and just letthem know we're coming.
And one of the points I triedreally hard to make was if you
have an existing healthrelationship that works, I'm not
(30:36):
here to interrupt that.
I'm here if you wantcomprehensive care, because of
course we can have telehealthbetween visits.
I'm here if you are alreadyseeing someone, but there are
some things you want to talkabout, even on a one-off basis.
Or if you've got a greatrelationship and you've got good
care fantastic and you don'twant to see me, that's fine.
(30:57):
So there was no resistance tothe program.
There was a I don't need it,but there was no one saying this
is a bad idea.
In fact, a lot of the peoplesaid I don't need it, but it's
great that you're doing it.
So I didn't sense, on that,scoping, any resistance.
And from the other organisationswe visited, like local councils
, there was a lot of.
I think Coral did a great jobof explaining what it is and why
(31:20):
and the benefit to thoseorganisations of retention
locally.
So they were just starting toget an understanding of what the
foundation's trying to do andthat it wasn't somebody else
coming sort of delivering adrive-in, drive-out service.
That was nothing to do withthem, that we're actually trying
to help them in their community, and they started to get that
as well.
So hopefully we get a lot moresupport from the scoping visit's
(31:43):
really important how often areyou back in a community?
The goal is about every three tofour months and we're building
the schedule depending on theneed and the number of people
who want to come.
So our availability isquarterly but it does depend.
If it's a bit slow on theuptake then we slow the visits
back a little bit.
But in between once I've seensomeone with Medicare and with
(32:06):
the availability of telehealth,now I can catch up with people
in between easily.
The only problem really is ifthey have an acute illness like
a sudden sore abdomen, and ofcourse I'm not in town.
But at the first visit we talkabout what are your options.
If you need to see someone on aday I'm not here.
A lot of the rest of the time Ican be in contact really easily
.
But if you've got to seesomeone and examine them,
(32:28):
they've got to see somebody butthey've got that problem now.
Sam Miklos (32:31):
So that's not a new problem.
That's not new.
John, are you seeing a lot ofburnout in our health
practitioners who are workingrurally.
Dr John Buckley (32:40):
It's lovely to give them a chance to talk about
that, because it's masked andit's hidden and you don't
understand.
And for myself, even when Istopped doing some of my work, I
felt my own brain needed torelax and unload somehow for a
couple of months and I hadn'trealized.
So a lot of people don'trealize until they start talking
.
And they start talking aboutstress and resilience and
(33:06):
struggles and all the pressuresthat are on them and it becomes
evident to them almost before methat they're at a level of
burnout.
And the question then is youknow, what do you do about that?
And sometimes justunderstanding and revealing it
is the first step and thenmaking your own decisions about
what to do.
So, yes, there is.
So there's the obvious burnoutand those who know it.
(33:26):
But I think the more peoplehave good care, the more they
start to understand their ownsteps towards burnout, if not
there already.
Kate Coomber (33:34):
Because they're just not having an opportunity
to talk.
They're not thinking inward.
They're treating other peopleconstantly.
You don't want to burden yourpartner or your family.
Sam Miklos (33:42):
And, as Fran said, if you haven't had a break, and
you've just kept going and goingand going.
You, if you haven't had a?
Dr John Buckley (33:48):
break and you just kept going and going and
going.
You don't notice.
Well, it's like the floods youwere talking about before.
I've got friends who are inLismore and I've got friends who
are in Townsville, and you know, your practice is destroyed,
your house is destroyed, yourfamily's disrupted, but somehow
I'll just keep trying to see thepatients and look after the
community.
I mean, what does that do toone's heart and soul and mind?
It's mind?
(34:10):
It's destructive, and yetthat's that's what they do.
So any support they get there.
But later it's um.
Friends in townsville this lastweek or two were being
triggered just by the rainfall.
Whether they were going to beimpacted this time didn't matter
.
They were feeling anxious andthis says it's almost a bit of
ptsd and burnout sort of kickingin when the clouds gather.
So better prepared butemotionally still struggling and
(34:31):
in some ways more terrified.
Kate Coomber (34:33):
And all the families, as you said.
Yes, all impacted.
You're right, the doctor goesstraight back to work to make
sure that they're there foreverybody else.
Dr John Buckley (34:39):
Yes, who's picking up the pieces and who's
supporting the doctor, who'sprobably tired and grumpy?
Yeah, exhausted.
Fran Avon (34:47):
But it's also what we've seen a lot of is that you
know doctors and healthpractitioners, they're caring
people and so what they often dois they will put the needs of
their patients before their own.
And I had a classic example.
I had a nurse ring me and itwas not this John.
We've got twos as part of theprogram, so another one of our
(35:08):
treating gps, john, was alreadyon the road.
He'd hit the road ready to hitthe skies.
Actually it was a fly-in visitand, um, she rang me and she
said, oh, have you got anyappointments left?
And I said we've got oneappointment left.
And she said, oh, I don't wantto take that appointment if it's
there's only one left.
And I said no, you're exactlythe person that needs this
(35:29):
appointment.
So she said oh, look, you knowwhat?
I'm just next door to whereJohn will be doing the practice,
so I'll wait and see and ifnobody else takes the
appointment, then I'll take it.
And, as it turned out, she gotthe appointment and I spoke to
John afterwards and I said howdid that go?
And he said, oh my gosh.
He said she so needed to see aGP and yet she was willing to
(35:54):
give up her appointment spot forsomebody else, in case somebody
more deserving, more needingcame along, and I thought that's
the sort of people that we'recaring for, people who put
others before themselves, and itis.
You know, part of thischallenge is the education I
think GPs are on the journey of.
(36:15):
We need to look after ourselves, but nurses and allied health
professionals are still notquite there yet.
But your health is moreimportant, because if you're not
healthy, then you're not therefor your patients Completely.
Dr John Buckley (36:29):
So the clinical director of the program is
probably.
Dr Margaret Kaye is probablyour leading doctor in Queensland
about doctors' health andthat's again.
She constantly brings theresearch and the knowledge and
the thoughts about exactly whatFran was just talking about to
the program and to myself andJohn.
And no, having the name Johnwas not a selection question,
(36:50):
that's what you think, it waspure coincidence.
But you know that focus on, youknow, doctor's health and health
practitioner.
Health underpins what we'redoing, but the longer term
outcome really is communitysupport and community services
and by looking after thedoctor's health.
So the doctor's health might bethe action, but the outcome is
(37:11):
community health and communityviability.
Sam Miklos (37:14):
Absolutely.
It's wonderful, Fran.
Is there anything else aboutthe Royal Doctors Foundation
that we haven't covered?
Is there anything else you'redoing or stories you want to
share?
Fran Avon (37:25):
Yeah, there's probably, you know a number of
stories of the things that we'vemade possible, and some of them
are amazing, Like there's onestory of and it's a bit of a sad
story, but there's a doctorthat we were given a grant and
we were able to provide.
(37:46):
They're called sandpiper bags,but they're a bit like an
emergency trauma kit, and sothey're set up in such a way
that a GP that's trained inemergency medicine can grab the
bag and just run and haveeverything that they need.
And it's organised in such away that if it's a snake bite,
all of the snake bite stuff'sthere.
(38:06):
If it's a more critical traumaaccident bite, all of the snake
bite stuff's there.
If it's a more critical umtrauma accident, all of the
stuff's there.
And we had had this beautifulapplication from um, a doctor
based in wa, and I read hisapplication I just loved it.
It was like one of those oneswhere, you know, I just seem to
attract track trouble wherever I.
(38:27):
He said, you know, I was at thefamily holiday and a little kid
got a fishing hook caught intheir lip and had these range of
stories of things that hadhappened to him along the course
.
And he said, and I do have myemergency kit.
And he said, you know, and Iuse it quite often because I
attract this trouble wherever Igo.
(38:48):
And so I thought, oh, he's gotto get one of these bags.
And, as it turned out, he, youknow, not long after he got the
bag, he was travelling out, youknow, sort of Northern Territory
, wa area and came across a caraccident and it totally rolled
the car and he was able tostabilise stabilize the patient,
(39:11):
give them pain relief.
Actually splintered a leg andthe paramedics were obviously a
long way away because they wereout the middle of nowhere, and
so he was able to do this allbefore the paramedics arrived
and they just went.
Oh wow, this is amazing, butthis the that he himself had a
tractor accident and his son waswith him and he said to his son
(39:34):
, can you go and get a mate whohappened to be, you know, a
doctor as well, but grab mysandpiper bag?
And you know he was able tohave his friend use the
sandpiper bag on himself and youknow sort of it was a very,
very serious.
You know accident that he had,but you sort of go wow, and you
know sort of it was a very, veryserious.
You know accident that he had,um, but you sort of go wow, you
(39:55):
know he's.
He was able to save the life orat least alleviate you know
very serious injuries for thesepeople involved in the car
accident, but it ended uphelping himself as well, and
that's that's one of my mostamazing stories.
And probably one of the thingsthat sticks with me most is I
remember one of the GPs.
(40:16):
It was when I was first, youknow, joined the foundation.
I said, you know, tell me, youknow, what does it mean to be a
rural GP?
And he said you know what hesaid.
When you're a doctor in a youknow, a big hospital, in a major
centre, or you're working inyour practice, if there's
something that happens andyou're the treating person in
(40:37):
emergency or wherever it may be,the first question you ask is
what are the injuries?
How far out is the patient?
When you're a rural GP, thefirst question you ask is who is
it?
Because you are very, verylikely to have a personal
relationship with this personand I hadn't really thought
(40:57):
about that before and I thought,oh, imagine the impact of that.
And then another treating GPhad told me about the fact that
he would caught out to a farmaccident and unfortunately he
wasn't able to save the person,and it was his son's best mate.
And you go, how do you, how doyou carry that?
you know how do you cope withthat?
(41:18):
How do you come home and tellyour son his?
Best mate's no longer herefamily, friends, yeah yeah, so I
think there's a lot of, as Imentioned before, there's a lot
of weight that rural GPs carry,rural nurses carry, because it
is so personal.
Absolutely, and that's thestuff that's really stuck with
me.
Kate Coomber (41:40):
But it's also so rewarding and wonderful, and
people living in these ruralcommunities love what they do
clearly, yes, so it's just soimportant that we can support
them so they can remain doingwhat they do, and that's it.
Fran Avon (41:53):
They're so humble, they're so committed so caring
and I remember going to one ofmy first conferences and I
thought these healthpractitioners really know how to
party.
Sam Miklos (42:08):
They're all from the bush.
Fran Avon (42:09):
But somebody said to me at the time this is their
only opportunity because they'rethe stalwart of their community
, so they can't just go down tothe local pub and let loose.
So they really are holdingtheir community in their hearts,
in their hands.
I think it's really and that'swhere I go People look at
(42:30):
doctors and go oh, you know,they're well paid, they can look
after themselves.
What's the problem?
But you go, my gosh.
If you understood the burdenthat they're carrying, you would
have a very, very differentperspective.
Dr John Buckley (42:43):
It's made a lovely point there too, fran
that little bit of distance andisolation within the community.
So, yes, you can go and playtennis and you can go swimming
with the kids or whatever, butif you go to the pub you don't
want to be seen to having moredrinks than you should, or you
maybe shouldn't be laughing outloud so much that people think
you're drunk.
And there's always that littlebit of no matter who I am or
(43:06):
what time of day I am, who I amin this community, and that's
just a little thing.
That makes it just a bit harderto fit in as fully as you might
like, and some GPs are great atdoing that.
But there is always just thislittle barrier and also the
possibility that there's a fewof us in town that if something
big happens, I might have tohelp and be available.
(43:27):
So you, if you're in townunless you're away at a
conference if you're in town,you're kind of always almost on.
So if you're in town, unlessyou're away at a conference.
If you're in town, you're kindof almost on, even if you're not
on.
Kate Coomber (43:36):
Yeah, yeah.
Which is why they do need thatspace, don't they?
Yes, they do those sandpiperbags you mentioned.
Sam Miklos (43:41):
is that an initiative from the foundation
or is that something that exists?
Fran Avon (43:45):
It sounds like every yes, so it was an existing
initiative and that's what wetry and do.
Yes, so it wasn't an existinginitiative and that's what we
try and do.
We try and look for things thatwhat do rural communities need?
And so that was a campaign thatwe really got behind At the
time of COVID.
We really got behind giving allof our rural hospitals and
(44:06):
communities access to COVIDmedihoods, which were a
protective device, so a bit likea boy in the bubble type thing,
but it went over the hospitalbed and it protected the
patients, the nurses, thevisitors, the doctors from
cross-infection and, once thosemedihoods were installed in the
hospital, the relief of actuallythere's something between me
(44:29):
and the patient to make sure I'mnot going to get COVID.
Sam Miklos (44:32):
Especially when they're the only one.
I think in those times we wereprobably seeing more of the
metropolitan areas and theimpact.
But if you actually think aboutthat in a community like you're
, it yeah.
Fran Avon (44:43):
And I just was chatting to a doctor on Monday.
We'd just given them an earloop which is like a device
where you can go in and sort ofsee what's going on in the ear
and actually take out impactedwax.
It doesn't sound like a reallyexciting product, but he said
the difference this has made toour community.
(45:03):
The fact that we have thistechnology means that they don't
have to wait for treatment fromthe specialist coming into the
community and they don't have tobe travelling to the specialist
services to get this treatment.
So it's things like that thatwe go.
(45:23):
What's a piece of equipmentthat we can provide to rural
doctors, rural nurses, that willmake their lives so much easier
, and something like the E-Loop,for example.
It's much less painless, so thepatients get a better
experience as well and theydon't have to wait, they don't
(45:45):
have to go through Doing thingsmore regularly and not having to
wait for build-ups.
Yeah, and if you wait fortreatment, sometimes the
symptoms get a lot worse.
Exactly, and that's what wefind.
A lot, john, isn't it?
Dr John Buckley (45:56):
It's a lovely thing you've just mentioned.
I was chatting with a colleaguethe other day and neither of us
could think of anything else.
There is nothing else we couldthink of where you could provide
immediate and total relief of asymptom than removing any
earwax plug.
Sam Miklos (46:10):
Really.
Dr John Buckley (46:11):
Because you go from I can't hear to I can hear,
painlessly and completely.
I mean, if I get a lot of pusout of an infection, you relieve
the pain, but there's stillsome discomfort.
If you remove earwax, you'vegone from a problem to zero
problem by the time the personleaves the room.
And so, while it sounds simple,impact, it's like you know,
(46:32):
Fred Holloway is fixing people'seyes A dramatic and complete
difference.
And if it's an older person,hearing is so critical, you know
.
And if they're wandering aroundwith this problem and suddenly
they can hear, wow, you know,it's an amazing thing to watch
someone go oh, now I can hear, Ican imagine what's the cost of
that device.
Fran Avon (46:50):
It's only a couple of thousand dollars.
Sam Miklos (46:52):
Wow.
Fran Avon (46:52):
And you know that's the sort of thing that we want
to.
I think that might be our nextproject.
Yeah, you know we're justspeaking with that doctor on
Monday and you know the stuff.
You know that's social, like ifyou can't hear, you can't
socialise.
So isolated in more isolated andhe was a lovely, lovely
gentleman, very humble, but justchatting with him you could
(47:16):
just and it's like with all ofthe doctors that you talk to you
just get that the passion.
You're sort of chatting withhim and he starts off really
quietly and then he startstalking about oh, we did this
with this patient and you canjust hear.
I just love what I do because Iam making a difference in the
lives of people.
So it is really beautiful andI'm blessed to have this
(47:41):
opportunity and to be able toring somebody and say you know
that application that you put in.
I can't imagine we can help youhow great and in some cases it's
a lot of money, in some casesit's not much at all.
Yeah, but it makes a hugedifference.
So they're the sorts of thingsthat we're.
You know, the GPs for RuralDocs is the program that John's
(48:05):
a part of.
That's our main focus at themoment, but you know we will
continue to look foropportunities for how do we
improve the health of peopleliving in our rural and remote
communities?
Kate Coomber (48:17):
look, today cmr are going to make a donation to
the foundation.
Where do people go if peoplelistening also want to
contribute?
Fran Avon (48:26):
so our website is rdforgau, so so fairly simple,
easy to find.
Sam Miklos (48:35):
There's a big button that says donate.
Fran Avon (48:39):
So, you know, we've got, obviously, our crisis
appeal running at the moment andwe have our appeal to support
the GPs for rural docs.
But, you know, if people have aparticular thing that they're
interested in, we'd love to chatto them about it and just say,
yeah, we're, you know, we're thepeople that you know really
want to understand what it isthat a rural community needs and
how can we make that happen.
Kate Coomber (49:00):
I love that.
It's by asking those questionsthat you can have the bigger
impact versus what you thinkmight be impactful.
Fran Avon (49:07):
And, as I said, every community is different.
Sam Miklos (49:09):
So yeah, it's very personalised to that community.
Yeah, thank you so much.
How lucky are our healthcareprofessionals who are getting
access to people like you, john,and your other John
counterparts.
Kate Coomber (49:21):
All the Johns, thank you.
Sam Miklos (49:23):
Just for looking after our healthcare
professionals, and I think it'sjust this whole other layer that
no one, I think, has that greatawareness of and that impact of
the work that you're doing andthe whole work that the
foundation's doing when there'scrises that happen.
Dr John Buckley (49:38):
thank you both so much, it's been lovely
hearing Fran talking about thefoundation, because I knew it at
the beginning when it was smalland single purpose, and what
it's become in its breadth ofthinking about community, and
what it's become in becoming anational organisation now.
Even that surprised me.
In that short time when I sawthis program starting, I thought
(49:59):
, wow, look at all this stuffthey've been doing from a very
small beginning with still avery small team.
But I know the members many ofthe members of the board and
they're such dedicated peopleand there's great innovation and
good leadership.
So I've been excited listeningto Fran's responses today.
Sam Miklos (50:15):
Yeah.
I think the foundation's ingood hands.
You're doing an incredible job,fran like what a what a great
few years, and I really hopethat people lean in and support
the foundation, because there'sso much good that that you're
doing and that you can continueto do so.
Dr John Buckley (50:28):
Thank you for your time.
Thanks so much.
Real pleasure.
You can continue to do so.
Sam Miklos (50:31):
Thank you for your time.
Thanks so much Real pleasure,thank you.
Kate Coomber (50:36):
We acknowledge the traditional custodians of the
land of which we meet who, forcenturies, have shared ancient
methods of healing and cared fortheir communities.
We pay our respects to elders,past and present.
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