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>>>Faces of Rural Generalism | Dr Renee Cremen

Faces of Rural Generalism | Dr Renee Cremen

Director of Medical Services, Babinda and Yarrabah

Dr Renee Cremen is the Director of Medical Services for Babinda and Yarrabah Hospitals in Queensland. As a medical student, Renee enjoyed the unique and complex challenges of her rural and remote placements and was drawn to the tropical and Indigenous health elements of medicine of the far north. Her final rural experience in Atherton confirmed that the mix of primary care and emergency work unique to Rural Generalism was the career for her.

After joining the Generalist Pathway, Renee and her young family moved to Babinda. This occurred during her third year of training in response to a workforce need for twelve months. Her original plan was to return to Cairns and undertake Advanced Skills Training (AST) in obstetrics and gynaecology. When it came time to plan the move back to Cairns, Renee realised that she wanted to stay to ensure continuity of care for her patients.

“I changed my AST to population health because I didn’t want to cause the same problem I was trying to help solve and could complete that AST in my community. After Nathan and I completed our family with three active children, I was able to apply for credit from my local emergency experience toward an AST in emergency medicine, supplemented with time in Cairns.

During that time, Babinda grew and separated from being under the management of Innisfail. Renee was interested in giving leadership a go and was successful in securing the Director of Medical Services position.

“I was looking at how I could gain some knowledge and apply it quickly in my new role, so I undertook leadership programs on offer from Queensland Health. I also ensured I had a good working relationship with my line management and other Directors of Medical Services and made a point to get to know business managers and other support staff.”

Renee undertook a few Queensland Health supported short courses such as the Clinician and Medical Managers Orientation Program, Manage4Improvement Program and the Cairns and Hinterland Hospital and Health Service (CHHHS) Manager Development Program. These courses gave her skills to write a business case, manage finances, build networks, create an elevator pitch, and manage stakeholders and partners. In 2020, she was nominated by the Cairns Hospital and Hinterland Health Service to undertake the Queensland Health Executive Leadership Program.

Renee was also sponsored by the QRGP to undertake the Associate Fellowship of the Royal Australasian College of Medical Administrators (AFRACMA) and is finishing her qualification while backfilling the Executive Director of Medical Services (EDMS) and Executive Director of Rural and Remote Services (EDRRS) roles and supporting rural facilities in the Cairns and Hinterland region.

“At times during these Executive roles I find that I miss my clinical work, but it’s interesting to see how things are done at that next level, and I’m starting to think about how I would negotiate an ongoing clinical component to any leadership role that I move into in the future.”

For Rural Generalists looking to navigate the shift to a leadership position, Renee has a few suggestions about how to get started based on her experience.

“Get some leadership training!  Even the short-day courses will open your eyes to aspects that are not clearly visible when stepping up from a clinical role. Being able to check in, reflect and discuss any challenging aspects you’re facing with a line manager or senior support is helpful, with people outside of your own HHS or workspace as well, and this is where these courses are so helpful; networking with likeminded people who experience the same challenges. From a functional aspect, I still have a piece of paper with the tasks I need to do each day to keep things ticking. Keeping a to do list when juggling clinical work and continuously re-prioritising your list has worked well for me.”

Consciously dividing her time between clinical and non-clinical work has also been a great strategy for Renee to keep things moving.

“Instead of doing the clinical work and Medical Superintendent work on the side, I found it more effective to dedicate a whole uninterrupted day for non-clinical work to plan, think strategically and have important conversations.”

Managing the change from colleague to manager can be a difficult transition to navigate and is different for everybody.

“I’m quite fortunate to have a good team that works well together. As a manager, you still work with your team the same way as before in some circumstances, such as when performance issues need to be addressed it’s not appropriate to consult with your team that you lead and manage. Then there are decisions that need to be made independent of your team but with your leadership group.  That aspect of the role can be isolating, so having a good working relationship with your manager and fellow Directors of Medical Services in the District is important for feeling well supported and being able to work through challenges to move the health service forward.”

Renee ensures there’s plenty of opportunity to maintain an open and positive culture in the team.

“We have a dinner every so often with everyone from medical students to Senior Medical Officers. We start each day in our facility with a Huddle; this is a great way to ensure that to the team is up to date and what is happening now. On Wednesdays we have Multi-Disciplinary Meetings and regular SMO meetings to involve them in decision making, planning, group discussion and feedback that is required as a team. AFRACMA also highlighted how having a meeting time with each individual on a regular basis (fortnightly or monthly) ensures that your team members know they are important, that you are prioritising them and allows you to be aware of any issues that may be occurring or great ideas that they have to improve our service. They know they’ve got protected time with me. For the broader multidisciplinary team, ward rounds and group emails are the main way I bring everyone together. Even a surprise coffee round and shouting each other is a nice thing we do for each other. All these ways ensure that there’s good open dialogue, fosters trust, respect and transparency, which helps us connect as a team.”

The Babinda health workforce team has expanded recently with a new General Practice (GP) Registrar on deck.  This was achieved through ensuring the outpatients clinic was accredited with The Royal Australian College of General Practice (RACGP) Standards, enabling all training time within the clinic to count toward GP training time. This further complemented the hospital and emergency department as a training location as well as Babinda being approved as a population health AST location. Babinda is the only facility so far in the CHHHS that offers GP training. They also enjoy having the Rural Generalist (RG) Primary Care Rotation intern with the team, gaining experience in rural primary care in our community.

Being the Director of Medical Services for Yarrabah and working clinical shifts in the facility means Renee has a lot of variety in her Rural Generalist career.

“Between Indigenous Health, aged care, general practice, sub-acute care, student and registrar supervision, management and leadership…  I get to keep my foot in the door clinically and be part of the positive progression in our region alongside other Directors of Medical Services.”

In a role where her priority is supporting the workforce and service provision for her community, Renee highlights the importance of taking time to care for yourself.

“You’ve got to take care of yourself as a whole person. Exercise is great for mind and body health. Four years ago I got back into dancing jazz and tap.  My daughter and I dance together at the same dance school. End of year concerts have become a wonderful week where I take the few days off and really enjoy mummy-daughter time sharing the experience that comes with rehearsals, performances, costumes and makeup with other like-minded dancers.”

Renee enjoys the breadth of practice within her Rural Generalist career and will continue to work with her team toward progressive positive change in her community.

Dec 22nd 2021| Faces of RG, |