Gday and welcome back to the podcast after a short hiatus as I checked out the fish in Fiji… Ahhh.
Today’s podcast is a conversation I had with my former colleague and mentor Dr Airell Hodgkinson. Airell is a rural GP Anesthetist based in Albany – the southern end of WA.
He is a real thinker and has similar interests in trying to ensure our rural patients get the best quality care which they deserve. Airell has recently concluded an audit of the local Albany cohort of “fractured NOF” patients. He has collected the data to see how this group of high risk patients fare in Albany and compared it to those whom were transferred to a metropolitan hospital for surgery / anaesthesia etc.
The data is quite interesting – but not yet published… so watch this space.
Although it is an audit of older people with NOFs – there is a lot we can learn from this review – particualry when it comes to the decsion-making around transferring rural patients to tertiary care for serious illness. Although it seems like a good idea on first thought – one has to consider a lot of factors when making these decisions with our patients. As there are a lot of problems associated with transfer – especially for conditions with a time-critical course and where the rate of bad outcomes can be high.
From the outset – the Broome Docs motto has been: “delivering great care, out there!” And it is something that I think about a lot – are we doing the best thing by this patient by keeping them in a small rural cetre – or could they get better care in the city? This is a really tough call – especially when the patient wants to stay in the bush and for you to do “your best”.
In Broome, our capacity to provide great care has increased in recent years for conditions like sepsis, mental health clients, trauma and other medical emergencies. As such the lines have moved in terms of who we keep or whom we send “south” (or east!) Most of my practice is shaped by anecdote and receny bias – so it is really nice to see Airell has managed to collect some hard data around a group of patients where there is no good answer often. This is a dynamic and wicked problem – one where there are many unknowns. BUt now we have a bit of data to have htat important discussion with our patients before deciding on the best place for their care.
I am a GP working in Broome, NW of Western Australia. I work as a hospital DMO (District Med Officer) doing Emergency, Anaesthestics, some Obstetrics and a lot of miscellaneous primary care. Also on the web as @broomedocs | + Casey Parker | Contact