Senior Medical Officer, St George
Dr Tom Gleeson is a Rural Generalist poised to celebrate his 10-year anniversary at St George in South West Queensland. Reflecting on a decade of Rural Generalist medicine developments, the best thing about rural practice has stayed the same for Tom; getting to know your patients and providing continuity of care in his community.
“The first patient I delivered out here goes to school with my daughter. I see them running around the school playground together. [Rural practice] is really good that way. You get to know your patients, their families, what they do and where they come from.”
There have been major progressive changes to Rural Generalist medicine and services in St George over the last decade. “When I first came here we had three Rural Generalists and internally relieved. It was intense with on-call, although that’s changed dramatically now. We now have seven Rural Generalists which is heaven.”
Tom credits having junior doctors and Principal House Officers (PHO) on staff for making a big difference to workload and after hours. Providing an exceptional learning environment for students and junior doctors contributes to continuous improvement efforts as a health service. “Supervising upcoming Rural Generalists has been really rewarding. They tend to enjoy the rural terms because they get a lot more autonomy and hands-on procedural experiences.”
Tom was one of the first Rural Generalist trainees through the QRGP. He has observed the structure and support around Rural Generalist training and practice become more embedded as the Pathway matured in Queensland. The integration of primary care with hospital practice in St George has provided many benefits to both Rural Generalists and patients.
“What I love most about my job is it has a lot of variety. We do primary care in the General Practice as well as hospital-based care. We have a great arrangement where we work in the private practice and can follow our patients through to the hospital. This helps with the continuity [of care].”
One of the most recent health service initiatives in St George is the provision of endoscopy services. “It all came about with a visiting endoscopy service that was intermittent and sometimes unavailable. We had patients who had to travel 800km round trip to Toowoomba to get a gastroscopy that takes five minutes.”
St George already had the medical equipment, someone to do the anaesthetics and nursing staff. The missing link was someone to do the procedure. In true Rural Generalist style, Tom decided to go and get the skills needed to deliver the service. “It involved getting gastroenterologists onside and agreeing to train me. With the support of the QRGP and South West HHS, I travelled to Princess Alexandra Hospital over two years and completed my Gastroenterological Society of Australia qualification.”
Since integrating the new service, the endoscopy waiting list in St George is now non-existent. “You can get a public colonoscopy here as a category 6 within three to four weeks. I think we have the shortest waiting list in the state for endoscopy.” The community has welcomed the new service with open arms. “I often have people say how great it is that they can access these services locally and eliminate the need to travel”.
St George continues to thrive with the support of a strong, dedicated rural health workforce and commitment to meeting the needs of the local community.