Creating positive health outcomes
Strong relationships have helped Dr Sam Gubicak have a positive impact on the health outcomes of his rural and remote patients.
Dr Sam Gubicak’s love for remote and rural medicine has seen him train in various rural hospitals and clinics in south-eastern New South Wales and the Northern Territory.
‘At the moment I am working at the Aboriginal Medical Service in Anyinginyi in Tennant Creek [NT], where we are the major medical service provider for the Barkly Region and Tennant Creek,’ Gubicak said.
‘I always knew that I wanted to work in remote and rural areas because it is there that you can make the biggest impact on your community.’
It is this passion for rural and remote health, as well his work with Aboriginal and Torres Strait Islander populations, that played a significant role in Gubicak receiving the RACGP’s 2014 Rural Registrar of the Year Award.
Aboriginal and Torres Strait Islander health
Gubicak graduated from the Australian National University in 2009 before completing his intern year at Canberra Hospital. While he enjoyed all areas of medicine during his hospital placement, the relationships GPs are able to form with patients was a major factor in Gubicak deciding to pursue a career in general practice.
‘The main reason that I wanted to be a GP is because of the fact that you get to forge closer links with the patients and you can follow them up,’ he said. ‘In the hospital you might only see the patient once and that’s it, but in general practice you have an ongoing interaction and that is what I really like about being a GP.’
Gubicak began his education in rural and remote medicine after his intern year and has continued to train in some of the most remote locations of Australia. He feels this experience has helped him learn skills he may not have had a chance to develop in a more urban context.
‘I really do enjoy working in remote medicine and Indigenous health,’ he said. ‘That is the main interest that I am really passionate about, working with Aboriginal and Torres Strait Islander peoples.
‘It is a really challenging area to work in and it is really a sub-specialty in itself, not only because of cultural considerations, but because of the medicine you see in this population compared to other populations.
‘I knew that if I trained in remote places around the country, it would allow me to get more skills in working with Aboriginal and Torres Strait Islander peoples.
‘The other reason that I really wanted to work in remote locations is that you really need to be confident with your clinical skills. Compare this to working in an urban sitting; you rely on tests like medical imaging, whereas a lot of the diagnoses in rural and remote settings are made clinically.’
The vast majority of people Gubicak sees at his practice in Tennant Creek identify as Aboriginal and/or Torres Strait Islander.
‘They make up about 90% of the patients that we see on a daily basis,’ he said. ‘The clinic here is an Aboriginal Community Controlled Organisation, so it means the way it functions is culturally appropriate and more sensitive of people. It just means that we don’t have those barriers stopping people who need primary healthcare from coming in because their needs were not met elsewhere.’
While a medical education can provide students with many clinical skills, Gubicak believes areas like cultural sensitivity cannot be learnt from a textbook.
‘A lot of lessons you learn from a community are things that you pick up from working in the places and talking to other people who work there or have experience in this sort of environment,’ Gubicak said.
‘Your mentors, supervisors and local Indigenous staff are probably the best people to talk to about these things because, usually, they have been there for so many years and have that kind of experience you cannot get from studying alone.’
Gubicak understands the important role a GP plays in rural and remote communities and appreciates the fact he has been able to form strong bonds with local people.
‘I enjoy the community aspects of it because, if you look at it, other aspects of medicine are based on hospitals and big facilities,’ he said. ‘In general practice, on the other hand, there is a lot of outreach-type work in the community. That is one of the things I do now and I really enjoy that.’
Gubicak’s advice to medical students and future remote and rural GPs is to make an effort to become involved with the local people outside of the consulting room.
‘You might be working in a community, but you are also a part of the community,’ he said. ‘It is a very isolated environment and you might have a couple of hundred people that live in the community and so you are really a part of the community.
‘That kind of mentality isn’t just for a rural or remote community. Whether you are in an urban community or a city community, it is important wherever if you are living.’
Much of Gubicak’s success in remote medicine can be credited to this commitment to local people, which he believes helps his patients feel as though they can trust him.
‘Yes, you work in a location, but you also need to remember that you live in that location,’ he said. ‘When people see and you are actually part of the community and getting involved, they really appreciate it a lot more.
‘Even if you are there for a couple of weeks or for a couple of months, really make the effort to know your community and get involved.’
Gubicak has been a part of several community-based campaigns, including Healthy Lifestyle Days and Men’s Wellbeing Bush Trips, which were aimed at improving the health needs of his patients.
‘A lot of the time work in these remote communities, or Indigenous communities, is not just focused on health. Health outcomes are, in fact, intertwined with cultural factors and broader social determinants of health,’ Gubicak said. ‘These points are important as well if you consider the health and wellbeing of an individual because it is all about taking the opportunity to help in primary preventative care for the community.
‘You might not be seeing people in a clinical setting, but you are working in a broader health sense and helping to care for people before they fall off the tracks sometime later.’