A rural GP in a remote practice
Dr Irene Tjhung is one of the more than 12,000 rural GPs for whom the RACGP’s National Rural Faculty provides vital services and support.
You may not be able to choose where you are born, but you can choose where you live. And while Dr Irene Tjhung, a GP who has worked on the Torres Strait’s Thursday Island, was ‘born and bred in the sandy suburbs of Perth’, she was never quite at home there.
‘I never felt completely settled in Perth, perhaps due to my Chinese-Indonesian heritage, and always seemed to be interested in what was further afield,’ she said.
Tjhung spent her first years as a junior doctor at the Fremantle Hospital before taking time off after her fourth year to travel overseas.
It was during this time that she began to get a feel for the direction in which she wanted her life and career to go.
‘My eyes opened up to the as-yet-unexplored adventures offered in my own backyard in Australia and, unfortunately, the health disadvantage suffered by our own Indigenous people,’ she said.
Tjhung then made the move to Darwin, which she describes as a multicultural melting pot and the place where she ‘finally lost that fish-out-of-water feeling’.‘It was in this environment that my love for Indigenous health was nurtured,’ she said.
After experiencing a number of specialties at the Royal Darwin Hospital, Tjhung was given the opportunity to take up a rural post in a central Australian community called Urupuntja, which helped her see the potential of remote medicine.
‘General practice there was a world away from urban and even rural general practice,’ she said. ‘It made me realise the diversity of skills one needed to be a doctor in a remote setting and gave me a taste of what it would be like to be a true generalist, which was exciting.’
Once she made the decision to move into general practice Tjhung went about obtaining the skills she believed she would need for the specialty, including diplomas in obstetrics and gynaecology, and in children’s health. She then made the move east to the remote Thursday Island to be with her GP anaesthetist husband, Oscar.
‘Working in the Torres Strait provided me the opportunity to do an Advanced Rural Skills Training post in Aboriginal and Torres Strait Islander Health, and enrol in the Fellowship in Advanced Rural General Practice through the NRF [National Rural Faculty],’ she said.
‘Doing the post gave me a greater insight to the culture and history of the region and helped me to improve my communication skills and cultural sensitivity.’
Working in such a remote location, however, is not without its challenges.
‘My first few years were troubled by chronic fatigue from a later-diagnosed spondyloarthropathy,’ Tjhung said. ‘My illness compounded all the other difficulties many find in moving to a remote community, such as loss of social network, culture shock, change in lifestyle, difficulty in accessing quality food, goods and recreation, as well as challenges in the workplace.’
But Tjhung is happy she was able to stick it out on Thursday Island and is proud of the many improvements she saw during her time there, including the advent of an electronic medical record connecting communities and hospitals across the Torres Strait and Northern Peninsula Area, the development of a policy on the management of Papua New Guinea nationals who cross the border for health reasons, and the healthy lifestyle messages she believes are getting through to people in the community.
The 2011 introduction of the electronic medical records has been particularly positive for patient safety, efficiency and communication, but also in terms of doctor retention.
‘I think that’s actually improved the longevity of how the doctors stay,’ Tjhung said. ‘We have been very fortunate in the last few years to have had a relatively stable medical and allied health workforce, which has helped to improve health outcomes,’ she said.
Tjhung recently took her long-service leave from the Torres and Cape Hospital and Health Service (Queensland Health) and will be working at Family Planning Queensland in Cairns. She will also work at a new outreach clinic for women experiencing domestic violence or homelessness and is working to develop a collaborative participatory action research project on Aboriginal and Torres Strait Islander traditional healing and wellbeing practices.