Dr Kean-Seng Lim
Following two years in the hospital system, Sydney’s Dr Kean-Seng Lim, the recipient of the RACGP’s 2015 GP of the Year Award, came to the conclusion that the patient and healthcare diversity of general practice made it the specialty for him.
‘After doing a variety of hospital rotations, including paediatrics, psychiatry, general medicine and surgery, I decided that general practice was where I really wanted to be,’ he told Good Practice.
‘I found hospitals to be very “partialist” environments that didn’t always take a holistic view of patients and their health or their social nature. The focus was on the single illness that the patient came in with.
‘General practice is where you have the greatest capacity to make a difference to someone’s life. We are seeing patients not just for a single episode, but on multiple occasions throughout their life.’
Dr Lim received his medical degree from the University of Sydney in 1991 before undertaking his residency in the Hunter Region of New South Wales. He has worked at the Mt Druitt Medical Centre in the western suburbs of Sydney for the past 20 years, where he is able to offer the holistic, collaborative care that has appealed to him since his days as an intern.
‘I have a keen interest in the evolution of the general practice model and our practice has been strongly infl uenced by the RACGP’s 2012 paper on the general practice of the future [A quality general practice of the future],’ he said. ‘I am supported in my day-to-day work by our practice team of doctors, admin staff, practice nurse, pharmacist, dietitian, exercise physiologist and psychologist, who all play an integral role in helping me provide what I like to think of as more comprehensive care for our patients.
‘A good team allows us to be better doctors and adds to the joy of the work we do.’
Dr Lim’s primary special interests are nutrition and lifestyle, subjects that have driven signifi cant areas of his work outside of the consulting room.
‘That interest is what has led to my involvement with the SALSA [Students As Lifestyle Activists] program, which was established about 11 years ago,’ he said. ‘The SALSA program is a peer-led education program where we train Year 10 students to be peer leaders, to take on the role of educating Year 8 students in the context of having lessons embedded into their PDHPE [Personal Development, Health and Physical Education] curriculum.
‘The purpose of the program is to encourage behavioural change in the way of improvement in diet, improvement in lifestyle and reduction in poor health behaviour, such as screen time, junk food, consumption of juices and soft drinks.’
SALSA has now grown from a single participating school to more than 20. The idea for the program came about after Dr Lim and other GPs in Mount Druitt, following several years of treating overweight and obesity in general practice, came to understand the relative limitations of short sessions with patients.
‘We realised that managing obesity and other lifestyle problems was very difficult in the context of day-to-day consultation, and we have much difficulty addressing wider issue of the obesogenic environment,’ he said.
‘The SALSA program gives us the opportunity to intervene at a wider cultural level, and by this I’m referring to actual school culture. Having a peer-led education model, you not only influence the leaders and each peer group, but as those peer leaders in Year 10 go on to become Year 11 and Year 12 students they actually start to influence the whole school culture.
‘Culture in any organisation, in my mind, is paramount when it comes to sustaining any sort of change. So we really have the ambition of nothing less than changing society.’
Dr Lim sees the model presented by the SALSA program as a more organic way of getting a positive nutrition and lifestyle message across.
‘The model of healthcare is very interesting and works in a whole lot of subtle ways, including the fact that a lot of the teachings do not have to be made directly through the lessons themselves, but can actually be a change of influence by role-modelling by the students, who are peer leaders, and the influences they have on their peers and their family.
‘The next stage from here is to move on to influencing the broader school community by going to the parents, the grandparents and others who are part of that extended community.’
Future of general practice
Training the next generation of GPs through medical education plays a signifi cant role in Dr Lim’s career. He is a general practice supervisor with the Western Sydney GP training organisation WentWest, and a guest lecturer at the University of Western Sydney School of Medicine.
‘I have been training general practice registrars and medical students for many years now. It is part of what I see as an important role for GPs,’ he said.
‘Part of my belief is that GPs have a responsibility to leave the system better than when we entered it and part of that involves training the new generation of doctors, from medical students through to registrars.’
Beyond the people who will populate it, Dr Lim believes much of the future of the general practice profession lies in the digital world.
‘eHealth has certainly been one of my other big interests, pretty much right from the beginning of my general practice career,’ he said. ‘Information management and information technology is a real game changer when it comes to what we can do in general practice.’
Dr Lim feels the availability of these new tools will allow GPs to better serve an ever-growing patient population.
‘More and more of the work we do in general practice is chronic disease management, and more of the patients we see are suffering from more complex diseases and the interactions of those conditions,’ he said.
‘In the general practice of the future we will be doing more proactive population-based care, which is the sort of work that’s very difficult to do without having very good data on your patient population and management.
‘So information management and technology – eHealth technology and health informatics – is vital for what we will need to be doing in general practice now and into the future.’
When reflecting on his present position in the industry, namely the RACGP’s GP of the Year, Dr Lim shies away from individual praise, preferring to see the award as the culmination of the work he has done with many GPs and healthcare professionals in what is a very collaborative profession.
‘I’m going to steal from Michael Crampton – the GP of the Year Award winner from last year – in that I see it as accepting an award on behalf of all of the good work done by so many others that doesn’t get recognised,’ he said. ‘It is very nice to be recognised and I am very grateful to the RACGP.
‘I hope that it will make me a better doctor.’
By Paul Hayes - originally published in Good Practice October 2015