A tale of two towns
Author: Morgan Liotta
Scottish GPs Dr Derek Wooff and Dr Jane Gall have adapted well to Australian healthcare at their practice in Shepparton in rural Victoria.
Migrating to Australia in 2010, leaving behind their general practice in the small town of Stranraer in the south-west of Scotland, signalled a refreshing change for husband and wife GPs Dr Derek Wooff and Dr Jane Gall.
‘We had reached the stage where our kids had moved off to university and we thought it might be fun to use our experience somewhere else,’ Dr Wooff told Good Practice.
The temptation to move abroad was also influenced by others, as Dr Gall told Good Practice.
‘We have GP friends who moved to New Zealand and showed us it was possible to work elsewhere,’ she said. ‘Australia had always been on our “to do” list and to be able to live and work here is much better than visiting.’
Coming from regional Scotland to Shepparton, a town of close to 50,000 people in northern Victoria, helped the couple transition to Australian life and establish a sense of belonging within a community.
It was in their newly-adopted home town that the couple helped set up and design University of Melbourne Shepparton Medical Centre.
‘University of Melbourne Shepparton Medical Centre was primarily set up for teaching students, and partly to encourage them to have an experience of country general practice with the hope that would inspire them to stay rural,’ Dr Gall said. ‘[It is about] trying to practise a high standard of care and hope that the students get exposed to that and understand it, and then adopt it for themselves.
‘Teaching is something that we both really enjoy and is a huge part of the work that we’re doing here. It has been a way for us to connect with the next generation and gain an understanding of Australian life.’
Dr Wooff and Dr Gall found the local Shepparton community to be friendly and welcoming, especially given the demand for doctors in rural areas of Australia.
Having experienced a similar situation in Scotland, the couple was familiar with the challenges of providing and retaining quality healthcare professionals outside of urban locations.
‘We’d been working as GPs in a Scottish practice for 25 years, so we’re very comfortable in a rural situation and dealing with rural people and the challenges of that kind of medicine,’ Dr Wooff said. ‘So that made it familiar in that sense, but it’s also the kind of work we enjoy doing.’
One of the most immediate differences that came with the move to the Southern Hemisphere was between two healthcare systems – the National Health Service (NHS) in the United Kingdom and Medicare in Australia. The two Scottish GPs embraced these differences and took them on as a learning experience.
‘We both had a little bit of burnout in the system we were in [in Scotland],’ Dr Gall said. ‘And, for me, it was like pressing the refresh button.’
The two GPs found they were able to inject fresh energy into a new practice.
‘We had more time to concentrate on the patient and the consultation and enjoy more of that relationship-building that perhaps we had lost a bit of back home,’ Dr Wooff said.
‘It was actually very refreshing because we were taking on a completely new medical system in Medicare, and patients that we’d never met before. As experienced, senior GPs, to have a completely fresh field to work in was challenging, but also stimulating.’
Now having experienced the NHS and Medicare, both GPs have unearthed some noticeable differences between their patients in Australia and Scotland.
‘Patients tend to be a little more independent here,’ Dr Wooff said. ‘I find that patients [in Australia] are willing to take on responsibility and seek out solutions for themselves with your help and guidance.’
Dr Gall believes that a tailored approach to healthcare, based on where a doctor practises, is vital to better health outcomes.
‘Back in the UK, there is a list of patients who are registered with one practice. Although they may move, it is assumed that they will be with you for all of their care. Whereas patients in Australia move around and may go to other places for care,’ she said. ‘So that is a very different feel and that does lead to you having to be very mindful of that.’
Gaining an understanding of such disparities between patients and their individual needs has been something the doctors consider an educational part of their time working in Australia. This patient autonomy, however, does not divert them from providing holistic care.
‘Part of the essence and the art of [being] a GP is getting an understanding of that person as an individual and providing appropriate care with the right pacing and the right understanding,’ Dr Gall said. ‘You get to know your patients and provide more than just treatment of a disease.’
Both agree there is always much to learn from patients.
‘One of the things that we emphasise is that if you listen to patients and just give them really good attention and care, hopefully with a skilful background, then you really stand to deliver good general practice care,’ Dr Wooff said.
A bit of Scotland in Shepparton
Dr Wooff and Dr Gall believe that bringing certain elements of the Scottish system to their practice in Shepparton can help to achieve some beneficial outcomes for patients. Dr Gall has fostered a number of close connections since the move.
‘I think we probably brought out some of the NHS values, and I’d like to think some of them have actually formed the foundations for this practice,’ she said. ‘And it’s been adapting over the years as we’ve learned how it moulds within the context of Shepparton.
‘Initially, we didn’t quite appreciate just how instrumental we’d be in that process but, actually, it has allowed us to be proactive, having that experience. That was probably a good use for it.
‘Four years ago we had two good friends from Scotland who came out and joined University of Melbourne Shepparton Medical Centre, which has added a huge amount to our experience. It does feel like we’ve got something sustainable that’s got a vibrant future. We have been fortunate to have this opportunity.’