Learned author and loyal GP
Dr Ian Rowe has served medicine in a number of important fields. He has been a general practitioner in one community for more than 40 years, he has gained wide recognition for his research writings and he has been deeply committed to the Royal Australian College of General Practitioners. And he has found time to pass on his knowledge to young doctors involved in the RACGP Training Program.
Ian Rowe has been in the same practice in Yarraville, a Melbourne suburb, for 43 years. Now he practises half-time, but he recalls when he worked 80 hours a week in the 1950s.
The long hours were taken up travelling to city hospitals for deliveries before Western General Hospital was opened in 1953, visiting homes before antibiotic and diuretic tablets could replace injections of penicillin and mersalyl (5600 home yisits in 1952, compared with 1400 in 1956), answering the door day and night in an era when telephones were scarce, and performing operations such as reduction and plaster of a Colle's fracture under open ether anaesthetic on the kitchen table in a patient's home.
Patients were generally considerate with after-hours demands, although one night a patient knocked on the door at midnight and said he had a sore throat When Ian asked, "How long have you had your sore throat?" "A week!" replied the patient.
Ian thinks he said something about 'emergency' and 'midnight', whereupon the patient removed the scarf around his neck and revealed a gaping infected cutthroat wound from ear to ear. "I didn't have the guts to finish the job", he said.
He was a boarder in a woman's home. With a scarf around his neck, he had eaten his meals with her for a week without raising any suspicions. Ian decided it could be classed as an 'emergency' after all.
Especially in the early days Ian's wife, Patricia, has been involved in the provision of the services of the practice, and many were the times when she coped with emergencies while Ian was out on calls or at the hospitals.
One such episode proved an outstanding public relations exercise. An anxious mother arrived carrying a febrile convulsing infant. Patricia took them into the family home and successfully treated the baby in the bath with mustard and tepid water. The mother never tired of telling her story to other patients.
Beginnings
Ian was born in Hawthorn, a suburb of Melbourne, on 19 June 1924, with help from the skilled and experienced hands of well-known general practitioner and orthopaedic surgeon, Dr Cecil Colville. His mother, Ellen Ann Strickland Rowe (nee Wilson), was a school teacher, and his father, Walter Leonard Rowe, a bank officer. Ian was the eldest of three sons and the family lived in East Malvern. He attended Lloyd Street State School and Wesley College before embarking on the medical course at the University of Melbourne, where he graduated in 1947.
Commencing practice
Ian married Patricia Orr in 1949 and after an appropriate broad training at Geelong and District Hospital, began his medical career in a country general practice in New Norfolk, Tasmania. Then at the end of 1950 they moved into a general practice at Yarraville, a western suburb of Melbourne. "It was a good area to practise medicine - there were few doctors in the locality.
It was a closely-knit community in an industrial area and many of the locals were highly skilled workers," Ian recalls.
They resided at the practice for 13 years, during which time they became involved in community affairs, especially Western General Hospital, Rotary International, Yarraville Football Club and the Guide movement. They had four children. One of the children died at home at the age of 14 months due to fulminating virus pneumonia, and Ian says this was a devastating episode in his family's life.
Football hero
Although he was not a player, Ian Rowe was a key figure in Yarraville's grand final win in the 1961 Victorian Football Association 12-team competition.
The game was played in enervating heat" 80° F" as Ian recalls, and the medical officer used his secret weapon to boost the players energy levels. He had rigged up an oxygen cylinder with a special attachment that could deliver a puff to eight players at a time.
"It worked wonders," Ian says, "the team kicked 13 goals in the third quarter to set up an unbeatable lead.
"When the captain came off the ground he said 'the team thought they were floating on air"'.
Dr Rowe's ingenuity rated a few headlines in the papers - 'The oxygen "trick"', 'Full marks to Doc Ian Rowe', 'Yarraville started something' - but he acknowledges now that administering oxygen in that way could be considered on a par with drug use.
Academic results
The first RACGP examination was conducted in 1967 in Melbourne and Ian passed that examination.
He is a great advocate of the College examination, not only as a test of competence and excellence, but also as an educational experience.
In 1990 he was awarded his Doctorate of Medicine (MD) Monash University for his thesis 'Medical Workforce Changes in Victoria: Implications for General Practice'. The thesis was based on 13 research projects carried out under a parttime Research Fellowship in the Monash University Department of Community Medicine, directed by Professor Neil Carson, and reported in 31 published articles and monographs over 12 years.
In 1986 he shared the Francis Hardey Faulding Memorial Award with Leon Pitterman. Ian's thesis was 'Doctor and Patient Evaluation of Automated Health Testing at the Shepherd Foundation'.
In 1990 Ian won the same award with his Medical Workforce thesis.
An inquiring mind
His interest in GP research began when he joined the first Research Committee of Victoria Faculty and investigated postpartum haemorrhage and the management of the third stage of labour. The findings were presented to the First GP Convention in Melbourne 1959, and subsequently published in the Medical Journal of Australia.
Sixty subsequent research publications indicate his involvement in the organisation of and participation in many projects, especially the morbidity and prescribing survey, therapeutic trials, evaluation of medical education, and community health surveys, as well as his award winning evaluations of automated health testing at the Shepherd Foundation and his MD thesis on medical workforce studies at Monash University.
He was Chairman of the Faculty Research Committee 1961 to 1966 and Chairman of Research Committee of Council 1966 to 1971. In 1979 he retired from RCC after 18 years of continuous membership.
He recalls the diligent groundwork of early members of Research Committee of Council, especially John Radford, Bill Breinl, John Bamford, Paul Clarke, Neville Andersen, Max Dunstone, Alan Chancellor, Charles Bridges-Webb, David Watson, Bruce Roberts and Martin Hutchinson. By 1972, 150 research articles by Australian GPs had been published and many projects were in progress or near completion. The enormous output of research was detailed in Research Digest, Volumes 1 and 2, produced by Ian in 1968 and 1972.
Ian is quick to acknowledge the encouragement and assistance of others in his research projects, especially Neil Carson, Lief Larsen and Royce Baxter.
His interest in medico-political matters was manifested in his membership of the Faculty Medical Organisation Committee for 20 years.
A budding politician
While at Melbourne university, Ian became involved in left-wing politics. He was a member of the Labor Club and in 1942 campaigned on behalf of the Labor Party led by John Curtin, who became the nation's wartime leader. He thought he might later enter Parliament, but his views mellowed during the 1950s, especially after the Hungarian revolution was suppressed by the Soviet Army in 1956. His abundant enthusiasm was then directed to his medical practice, the local community and the Royal Australian College of General Practitioners.
Involvement in RACGP
He has been a member of the College since the foundation of a Victoria Faculty of the Royal College of General Practitioners in 1956, at which time he was the youngest member of the Faculty Board. In 1958 a separate Australian College was founded and he continued as a member of the Faculty Board until 1990. He was Chairman 1968 to 1970 and Provost 1976 to 1977.
He was a member of College Council from 1966 to 1971 and 1980 and 1982.
The Yarraville practice is affiliated with the Monash University Department of Community Medicine and regularly takes students for training.
The dramatic increase of GP numbers has caused a reduced patient load for the average GP, and Ian considers that in order to retain a good practice many GPs should be more mindful of changing patient requirements. The programs of College Standing Committees offer tremendous opportunities for GPs to enhance their competence in practice organisation, stress counselling, preventive care, lifestyle modification, personal health education, early diagnosis of dis ease and identification of health hazards, and to enlarge the scope of their procedural work and to develop special interests, for example, sports medicine and hypnosis.
FMP
He has been involved with the Family Medicine Programme (now the RACGP Training Program) both as Area Co-ordinator and GP Supervisor. Before the days of FMP he was the first Chairman (1964 to 1966) of the General Practice Attachment Committee, which supervised the GP attachments within the Rotating Internship Scheme and the College Vocational Training Program until the establishment of FMP in 1973. It was through the Vocational Training Program that Ian's partner, John Lamont, first came to his practice in 1970.
More recently, Dr Christine Longman came to the practice as an FMP trainee and became a partner in 1987. Ian's manpower studies have extended to several papers on female doctors and he has promoted the concept of group practice by association, with flexible financial arrangements.
Shepherd Foundation
When the Shepherd Foundation was established in 1970, Ian was one of the Trustees nominated by the RACGP and thus was involved in planning and management. He was disappointed in 1987 when the government withdrew the medical benefit for referrals for automated testing at the Foundation and thereby forced the closure of the centre. Even so, he considers that the Foundation effectively encouraged the increased emphasis by GPs on selective screening for early diagnosis, identifying risk factors, the use of mammography and other preventive activities.
On the road - again and again
Ian and Patricia are familiar figures at RACGP conferences throughout Australia. Since first travelling as a Nuffield Fellow in 1968, when Ian was Chairman of the College Research Committee, to selected GP research centres in North America and the United Kingdom, and writing a comprehensive report 'General Practice Research Abroad: Observations and Ideas', Ian and Patricia have enjoyed the friendship and stimulation of many overseas meetings, such as WONCA conferences, and the pleasures of travel with groups of colleagues to interesting places.
Recent medical tours have included Japan, Russia, Alaska, India and Tanzania.
Leisure
Some leisure has always been essential, so Ian and Patricia in early days joined the Melbourne Theatre Company, the Australian Elizabethan Theatre Trust, the Australia Opera, the National Trust, the Alkira Ski Club and Mount Martha Yacht Club. A beach house at Mount Martha on the Mornington Peninsula, about 50 km from the city, was a boon for the whole family, who particularly enjoyed water-skiing behind a runabout, sailing a Heron and later a 420, and the camaraderie of a large circle of friends, young and old, on the beach.
Office pathology tests
Ian believes that one of the reasons why his enthusiasm for general practice has been maintained is the addition to the practice of special interests such as office pathology. He has encouraged many GPs to provide common tests, for example, haemoglobulin and blood film, urine micro and culture, and desktop analyser testing for lipids, glucose, and uric acid, and is convinced that they can be provided economically, especially in a practice of two or more doctors.
In 1984 Ian was appointed to the Pathology Services Accreditation Board of Victoria and he is Chairman of the College Office Pathology Committee. At present he is conducting a strong campaign for a reduction of Commonwealth Accreditation fees for Category 5 laboratories.
Special interests
Nowadays, walking and swimming are the main regular activities which Ian pursues for fitness.
Other special interests include history, especially Australian history and Australia's involvement in the two great wars, and Banjo Paterson, Frederick McCubbin, Charles Dickens, stamps, photography, reading, and theatre.
Patricia has recently completed a long term project, an autobiography with family history and genealogy, entitled 'Never a dull moment'.
In 1936 to 1937 Ian was able to see the great Donald Bradman and other great Test cricketers, including Stan McCabe, Jack Fingleton, Bill Oldfield, Bill O'Reilly and Clarrie Grimmett in two Test matches at the Melbourne Cricket Ground. This excitement launched an absorbing interest in international cricket and Ian has seen nearly all the great world players in the past 55 years. For him the most exciting player since Bradman was Dennis Lillee - "a likeable larrikin and wonderful fast bowler".
A final reflection
"I'm glad I became a GP. I still enjoy my work in the practice. There was more drama in my early days but I never cease to be fascinated by the variety of problems to be managed and the close and confidential nature of the doctor-patient relationship."
First published in: Australian Family Physician Vol. 22, No. 12, December 1993