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Episode 3

Disaster recovery

Show notes

Welcome to Generally Speaking, the conversation for all GPs sponsored by CommBank.

Join GPs Dr Gill Singleton and Dr Billy Stoupas as they discuss some of the most pressing topics and challenges in healthcare for Australian GPs to stay informed, connected and inspired.

This episode, our hosts Gill and Billy discuss disaster recovery with Dr Michael Clements, who prior to joining Fairfield Central Medical Practice, served under the Royal Australian Air Force Graduate Medical Scheme, serving in Australia, the Middle East and in the UK. There’s no question this topic is vital with the global COVID-19 pandemic, following the disastrous summer that many communities in Australia experienced as a result of the bushfires and floods.

22 April 2020 - 02:49 PM | 27 min 35 sec

(00:27) Gill and Billy recognise the impact pandemics and natural disasters have on the people in the community, the public and GPs themselves. During these periods of loss and devastation, these GPs are an essential point of contact, a reliable and trustworthy voice that understands their circumstances and histories, especially within rural communities.

(02:05) How do you think GPs fit into the community and into the recovery process?

Gill believes that GPs are instrumental in the recovery process of these communities faced with disaster as they are a part of the fabric of that community. Rural and remote GPs specifically are living and working in their areas for long periods of time, building relationships and care for their patients. For these GPs, the disaster doesn’t just happen for a few days and then it’s over. The recovery process takes an incredibly long time.

(02:45) As you specialise in refugee health, Gill, do you see and reflect on the situations where people are removed from their original area/community? 

Working primarily with asylum seekers who have experienced trauma from migration or separation, Gill understands that while these situations are different, they share similar aspects. Primarily, Gill recognises the long-term effect, moreover, once the experience of the ‘disaster’ is over, they have to heal, psychologically, and this is something she observes as a constant struggle for people who have lost a sense of belonging and community.

Introduction of Dr Michael Clements

(04:47) Having experienced the personal and professional effects of a natural disaster (flood), can you provide us with a little bit of insight into how this has impacted you?

When Michael’s residence in Townville was hit by floods, he initially focused his efforts on assisting in evacuation centres, providing healthcare and scripts were necessary. He then quickly realised his own home was being affected, so he returned to ensure the safety of his family. This holistic effect on Michael’s town also spread to the livelihood of his practice and employees, financially damaging his infrastructure as a business. However, he posits that ‘the response to the general practice right in the middle of the disaster zone was both overwhelming and challenging, but also remarkably rewarding, which was a bit of a surprise.’

(08:59) Trying to attend to the needs of the town during this period, how did you attend to yourself?

In the early stages of the disaster’s development Michael focused solely on the town’s needs, with all attention and resources going towards the evacuation and rescue centres. However, once Michael’s personal life began to become affected, he quickly shifted his focus. While he was focusing on his family and home at this point, he still hadn’t let him himself take a breath. Formerly in the Air Force, Michael had been trained to cope with these dramatic situations, however, he says for those 3­–6 months, he was constantly overloaded and burnt out, forced to face hundreds of tough decisions and challenges a day that would often feel insurmountable.

(11:45) A year on from the floods, what effects has the disaster had on your community and patients?

Michael notes that he saw a lot of people dealing with their loss and grieve by downplaying their situation by comparing their loss to others that have lost more. While Michael believes there was no real increase in psychological disorders or depression, he did see a communal stress, brought on by displacement and dysfunction.

(15:53) As a GP in a regional area, how should you approach that consult with someone who has been through a disaster?

Michael believes that being a GP in a rural and tight-knit community means you understand their reactions to all types of stimulus, the context of their visit and generally a deep background knowledge. These tools and resources allow Michael to dig deeper, so when a patient is suffering from loss as a result of a disaster, he can truly identify the issues and best equip the patient with the care and information they need. Michael also posits that he benefited deeply from Rural Focused Psychological Skills Training, something he participated in to better equip himself during the floods last year.

(17:54) What is your thoughts on the recent crackdown on the billing of multiple item numbers dealing with mental health and other MBS items?

Michael believes that within communities, particularly rural ones, patients rely heavily on bulk billing, and the constant interruption by the Federal Government in making this process harder creates a significant disconnect between the service delivered and the successful health of the Australian people.

(24:31) Disaster recovery adds another layer of complexity in really caring for our older and more ageing population. What resources do we have as GPs to help navigate through this?

The RACGP Curriculum for Australian General Practice offers a disaster management contextual unit and there’s also a range of resources available on the college website to help us all plan for and recover from the effects of floods, fires and pandemics.

  • In disaster-prone areas, it’s about the continuity of care.
  • For a GP, particularly one working in a rural area prone to disasters, self-care is extremely important.
  • Intimately living and working in these communities, GPs have the permission and knowledge to dig deeper and enable patients to recognise their pain and loss during times of stress.
  • As a GP, it’s important to have trust. Made up of friends, colleagues and contemporaries, this informal board of directors will assist you in times of important decision making, especially when under duress. 

‘As GPs, we know that everybody has their own reaction to any kind of external stimulus.’ 

‘As GPs … we’re very good at identifying risk in others – risk of burnout or even seeing symptoms of burnout in our patients – but we’re not so good at looking at ourselves.’

‘As GPs, we’ve got both the permission and the knowledge to be able to dig a bit deeper into what’s going on to actually let [patients] acknowledge their feelings.’

– Dr Michael Clements

Generally Speaking is an RACGP podcast, sponsored by CommBank and hosted by GPs.

Resources referred to in the podcast and on the webpage are not necessarily endorsed by RACGP and views of the presenters are their own.

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