A great all-rounder
Richard Gutch has been an advocate of general practice throughout his medical career. He became a member of the Royal Australian College of General Practitioners in 1961 and has served on many College committees including a term as Chairman of Council. His efforts have resulted in significant changes to the recognition of general practice as a specific discipline within the medical profession. At present he is overseeing the superannuation entitlement of RACGP staff in his role as Chairman of Directors of The RACGP Superannuation Plan Pty Ltd.
“I was born in the Melbourne suburb of Hawthorn in 1925. My father had his own manufacturing business and doubtless, as the only son, it was assumed that I would eventually take over the family business. This was not to be.
"I was educated at Carey Baptist Grammar School but every term holiday I escaped to relatives' properties in the Riverina of NSW where I revelled in the freedom of 'jackarooing', went droving sheep with my uncles and tended the beautiful Clydesdales that made up the teams of working horses in those days.
"These were very important times during my formative years and I believe gave me an early sense of independence and self reliance.
''After completing the Leaving Certificate year, I somewhat impetuously left school. My father declined to employ me on the grounds that I should first attain some outside experience."
The road to a medical career
"I managed to obtain a position at the Royal Melbourne Hospital as a trainee radiographer but abandoned this when I was offered a position as a technical assistant at the Walter and Eliza Hall Institute of Medical Research. It was here that I developed an intense interest and determination to do medicine. It was during the war and under manpower regulations I was unable to leave the position until the war had ended.
"So, on the first day of the school term in 1946 I found myself riding my motor bike up the main drive of the Melbourne Boys' High School. Post war entrance to medicine would be difficult and I knew I would have to achieve matriculation at a sufficient level to gain admission to the medical course.
"I asked to see the headmaster, who, fortunately for me, was the newly appointed Major General Alan Ramsay. He was a man of great generosity and understanding and after due consideration nodded his head and said: 'OK we are running a matric class for some ex service chaps, I don't see why you shouldn't join them', and so I passed matriculation and obtained entrance to the University of Melbourne. I trained at the Royal Melbourne Hospital which at that time had many 'characters' such as Sir Albert Coates and Weary Dunlop. I have recently read Weary Dunlap's biography with great interest and recall with some embarrassment having sold Weary an expensive Daimler car and running out of petrol as he was kindly driving me home after the negotiations."
Entering general practice
"I graduated MBBS, from Melbourne University in 1953 and headed for the bush to take up a position at the Hamilton and District Base Hospital where I obtained the extensive practical experience I was looking for. It was inspiring to work with the late Sam Fitzpatrick, a skilled surgeon famed for his study and treatment of hydatid disease which was so prevalent in the area.
"This experience was followed by locums in far western Victoria. I can still recall the afternoon a women brought in a 6 month old baby from a remote area. The child was obviously very ill and as I unwrapped her on the examination couch I noted very marked opisthotonos, the degree of which I had never seen before. A lumbar puncture and smear at the local hospital confirmed my worst fears that it was meningococcal meningitis. There were no air ambulances in the 1950s, the child too sick for long road transport and so was treated on location at the local hospital with intrathecal penicillin which was very effective in those days. The child made a full recovery without apparent sequelae and I often wonder where that person is today. This was so rewarding that I was sure I would become a rural GP.
"However, not much later I returned to Melbourne to take up an appointment as Senior Demonstrator in Anatomy and Histology at Melbourne University. This was an interesting period and I enjoyed the contact with the students and the opportunity for further study.
"My wife Verna, whom I married in 1951, and I have always been keen on travel so our next move was a trip to England for further experience and study. We had not been there very long when my father died suddenly and as his sole executor, I had no option but to return to Australia.
"Being somewhat impoverished, I was glad to accept an offer of partnership in the Clifton Hill Medical Group which was a multiskilled clinic with a surgeon, obstetrician and physician. The practice was in the centre of the shoe manufacturing and can making industry, both with· a propensity for severe hand injuries. One of my partners at the time, Gordon Trinca, and I set up an Industrial Trauma Clinic as part of the practice which I maintained for the subsequent 30 years of my time in the practice. It was far from the country GP I had envisaged, but I found the many needs of the people I encountered in inner urban practice were both rewarding and demanding."
RACGP involvement
"I joined the RACGP in 1961 because it was directed to the specific needs of general practice, a situation I believe to be even more important today. We always had undergraduates in the practice and I enjoyed being a GP supervisor in the then Family Medicine Programme (FMP) for many years.
"I have been a member of the Victorian Faculty Board since 1982 and a member of a number of committees. I was elected Honorary Treasurer of the faculty in 1986, a position I held for 8 years.
"In 1990 I was elected Victorian Council Representative. This was a period of great change. As a member of the General Practice Consultative Committee, a tripartite negotiating body consisting of the AMA, RACGP and Government, we were able to initiate changes which have resulted in the recognition of general practice as a specific discipline with established standards and qualifications. There is, however, much more to be achieved.
"In 1993, I was greatly honoured by being elected Chairman of Council of the RACGP and this stands out as a highlight of my medical career. The smooth conduct of Council is essential to its function and I saw this as my task. During my chairmanship we had the first overseas meeting of Council in Wellington, New Zealand in 1994 during a joint meeting with the Royal New Zealand College of General Practitioners (RNZCGP).
"It was also of great personal satisfaction to me to conduct the opening ceremony of College House, South Melbourne in 1994 as I was also Chairman of the Property Development Committee for that project."
Family life
"The demands on a busy general practitioner are often not compatible with a growing family. I had been in practice for about 10 years when I realised that my family were suffering from the 'GP's children's syndrome.' My wife and I had three delightful children, a boy and two girls, they were growing up and I was not participating in the process.
"My wife and I decided we should buy a country property not too far from Melbourne where at least on free weekends and holiday s we could relate as a family. With my handicap, it was an easy decision to resign from the golf club and we purchased some broad acres at Healesville in the beautiful Yarra Valley.
It was a great decision, first some cows to eat the grass, then a bull and some breeders and we have been breeding cattle ever since. Our family has grown up with fond memories of horses, calves, motor bikes and the occasional broken limbs.
"I have always been keen on motor sports and it was a great experience to win a class section in the 1990 Grand Prix Rally. This was achieved with my friend and restaurateur Allan Watson in his beautiful 1931 four and a half litre open Bentley. It was quite a thrill to be presented with the trophy by Juan-Manuel Fangio and to have actually beaten Stirling Moss!"
Lighter moments
"A good sense of humour is a great asset for any general practitioner and there was never a shortage of amusing incidents in my practice. I recall one dear old soul shuffling up to the receptionist and inquiring with a loud voice: 'Is Dr Gutch servicing this morning?'
"On another occasion I was called to a factory well after knock off time to find the resident caretaker suffering a heart attack. A MICA Ambulance was called but had difficulty accessing the closed factory. I ran out onto a third floor fire escape stairway to guide them, but slipped on the steel steps, twisting my knee with resultant severe pain. The MICA fellows jumped the fence and almost had the line inserted before I could convince them that the real patient was inside the building!"
Current interests
"Currently I am Chairman of Directors of The RACGP Superannuation Plan Pty Ltd which is an independent corporate entity responsible for overseeing the superannuation entitlements of over 500 RACGP staff. With constantly changing legislation and varying market conditions I find this to be a very challenging and stimulating task and one of great responsibility.
"In 1988 I became the RACGP representative on a public awareness program entitled: 'Could it be asthma?' This was prompted by the rising mortality rate from asthma, particularly among younger people. The program was deemed to have been a success and from it was born the National Asthma Campaign (NAC). I became a founding Director and RACGP representative on that body. I was firmly convinced that general practitioners were the major health care providers for those with asthma.
"It was apparent that many of the deaths from asthma were preventable. This was a challenge to update doctors on the latest information regarding asthma management. A management handbook was published and sent to every general practitioner in 1990. This has been updated twice and the 1996 edition has just been released and is available on request to the NAC.
"The other problem was the public perception of asthma as a 'wimpish' disease leading to denial and under treatment. I believe the NAC media campaigns involving test cricketers and Olympic gold medallists who successfully managed their asthma has changed public attitudes. There has been a decline in asthma mortality since 1990 but the challenge remains. A GP Asthma Group has been established which is a committee of the NAC and which aims to have an Asthma Liaison Person in every Division of General Practice throughout Australia. I have recently retired from the NAC but still retain a keen interest in asthma."
The future
"I still have an interest in my Clifton Hill Practice and hope it will prosper for another 5 years thereby completing a century of continuous service as a general practice from the same location.
"I feel that the diversity of general practice has greatly enriched my life by affording experiences in so many different areas.
"I am currently Provost of the Victoria Faculty RACGP, a member of the College Finance Working Party, the College Personnel Committee and the College Properties Committee. Like many general practitioners I have a concern for the future of general practice. We appear to be dividing our strength and losing public esteem at a time when the quality and standards of general practice have been rising steadily. Differing points of view are healthy but should be resolved by consultative processes if we are not to tear ourselves apart. The leaders of the various GP groups carry great responsibility to find resolutions that will strengthen general practice and reclaim its role as the foundation of health care in Australia.
"I have two more ambitions to achieve. One is to become computer literate under the tutelage of my 5 year old grandson. "The other is to become a vigneron and I am in the process of planting a 5 acre vineyard to achieve this end."
Notable Australian Doctors - First published in: Australian Family Physician Vol. 25, No. 7, July 1996