Giving back
Dr John Kramer believes in giving back to his community and those who have taught him in his career.
Long-time GP and former RACGP Corlis Travelling Fellow Dr John Kramer has been teaching and practising medicine on the NSW mid-north coast for more than three decades.
'I have been at my general practice in Woolgoolga since I graduated [medical school] in 1981,’ he told Good Practice. 'To date, we have had 50 GP registrars come through the practice and also a lot of medical students coming through from various universities.'
Practice makes perfect
Kramer wanted to be a doctor from an early age and the diversity offered in general practice saw him gravitate towards the speciality while in medical school.
'When you are a student, you work in hospitals and you see a wide range of things,' he said. 'That is what drove me to take up general practice, because I was not willing to just look into one aspect of health. I wanted to be there for everything.
'I had a good family doctor and I have always been exposed to good models, and they were very positive.
'General practice is the keystone in primary healthcare and it is also the most efficient way to deliver healthcare. GPs can manage both acute and chronic conditions cost-effectively.'
Kramer's love of general practice, as is often the case for GPs, stems largely from the fact it allows him to make a genuine and lasting impact on people's lives, and even on multiple generations of the same family.
'I love being a GP because of the continuity that you get when you are caring for your patients,' he said. 'I am at a stage where I am seeing people across four generations, and applying the knowledge that you have about other generations within a person's context is great.
'That can help you to map what to expect when you look at the family history, especially in cases of asthma or CVD [cardiovascular disease].'
Kramer has been heavily involved with the RACGP for several years as a member of both the National Rural Faculty and the National Archives Committee. He was also named the Corlis Travelling Fellow for NSW and ACT in 2009, a position he embraced before stepping down in 2013.
'I decided that I would move on from the role [of Corlis Travelling Fellow] because all roles within the College need some turnover and I think there is always a risk of becoming set in the ways when people stay indefinitely,' Kramer said.
Broad horizons
Kramer's interests extend beyond general practice and he has been actively involved in Aboriginal and Torres Strait Islander health since he was a medical student.
'Indigenous health is such an important thing both for me and my community and, as a GP, you should do what you can to help some of Australia's most disadvantaged,' he said. 'I do an outreach clinic every fortnight to a nearby community for the Aboriginal people because it is incredibly important.'
Kramer also works extensively with children with learning and behavioural disorders. Professional healthcare in Woolgoolga, which has a population of around 5000, can occasionally be hard to access and Kramer believes he has a responsibility to provide medical services to people in need.
'Being a GP in a small country town, dealing with some of these children with behavioural issues and seeing that the local services are lacking, you have to find out more for your patients so that you can help them,' Kramer said. 'I see a large number of children with ADHD [attention deficit hyperactivity disorder], autism and related conditions all the time in my practice.'
Giving and receiving
Kramer also spends one day of each week as a lecturer at the University of New South Wales' Rural Clinical School in Coffs Harbour.
'Medical education is incredibly important because it is one of our key roles as doctors and GPs,' he explained. 'All of us [doctors] need to think about succession planning, if nothing else. But, ultimately, it is a core responsibility.
'When we were younger, we were taught by more experienced colleagues and there is an inherent obligation to then give back and teach.'
Kramer believes that, as well as passing on his knowledge and experience, teaching gives him the opportunity to continue learning and developing along with his students.
'My passion for medicine is reignited when I see students who are so enthusiastic and that reminds me of what I was like all those years ago,' he said. 'It is easy to do things from habit, but when you have students around, asking you why you are doing it in certain ways, it does make you think and you research it to get them the right answers.'
Kramer's inspiration to teach came from his early exposure to quality medical educators who motivated him to enter general practice.
'Being exposed to good teachers definitely opened my eyes to the apprenticeship model of GP training,' he explained. 'GP registrars are able to get the training and see patients, but have the backup of an experienced supervisor nearby. If the patient comes in with something that is troubling them we have these experienced GPs who can step in and help if required.'
The future
Kramer believes general practice has evolved significantly since he first began medical school all those years ago, and one of the most significant changes in that time has been the increase in female GPs.
'It is good to see that the gender ratio of GPs has shifted a lot since I was a graduate,' Kramer said. 'It is always good to see this type of positive change and to encourage more students to get into general practice.
'That is just one of the many things that has evolved from general practice and one can only hope that it continues to evolve to serve the community.'
Kramer challenges current and future students who may be considering a career in general practice to aim high in their ambitions.
'To those who want to be the next generation of GPs, be a pastoralist and try to be a good GP, the best GP you can be. Someone who is skilful and understands their community,' he said.
First published in Good Practice Issue 6 June 2014 pp10-11 – Written by Bevan Wang