Sydney GP Dr Dasha Fielder has been able to maintain her love of family medicine while enjoying the diversity of general practice.
Dr Dasha Fielder didn’t always envision a career in general practice. She initially had a more specifi c speciality in mind.
‘When I was doing my training I actually was very keen to be an obstetrician and gynaecologist,’ she told Good Practice. ‘When I realised that would require many more years in hospital and might not be good with my family life, I thought that general practice would be a really good choice.’
Regardless of how she came to the decision, Fielder has never regretted moving into general practice.
‘I feel like it is much more suited to me because not only is it allowing me to practice the obstetrics and gynaecology skills, but it also keeps me on top of my game in other areas,’ she said.
‘It is probably the only speciality that allows you to have this much variety on a daily basis.’
Fielder trained as an intern and resident at the Prince of Wales Hospital and Sydney Children’s Hospital after her 2003 graduation from the University of New South Wales. Following stints as a rural GP in regional NSW, she completed her general practice training at the Sydney Institute of General Practice and became a Fellow of the RACGP in 2009.
Fielder opened the Sapphire Family Medical Practice in Bondi Junction in 2011 after working in a variety of clinics in Sydney. As its name suggests, the clinic has a strong interest in family medicine and women’s health, which mirrors Fielder’s own career-long medical pursuits.
‘My interests are in paediatrics and women’s health, so a lot of patients do travel to come and see me because they know that is where my expertise lies,’ she said. ‘Where the practice is located, in eastern Sydney, there are a lot of families who live around here, a lot of young families with children, and they are the main demographic by default.’
Despite the local demographics and her own medical interests, Fielder does not exclude anyone from becoming a patient at Sapphire and ensures the practice is inclusive of anyone in need of a GP.
‘I have made big efforts in trying to include other members of the community, particularly men,’ she said. ‘They are the group that very rarely present to doctors for quite a few reasons; either they are working and can’t come or they are simply too embarrassed … while having the same health needs as others.
‘I do have a particular interest in men’s health and do try to encourage them to come along, as well as elderly people who live in the area. We try to accommodate them.
‘There is no one that we exclude. The practice just falls in a demographic with a lot of families.’
Fielder’s role at Sapphire means she is able to regularly offer care to multiple members of the same family, which is one of the things she most cherishes about life in general practice.
life in general practice. ‘It is the only discipline that allows the continuity of care. To see your patients from when they are born, or even before that, and as they grow up then seeing their parents and grandparents at the same time,’ she said.
‘It is about understanding that the family dynamic is the key in general practice. That is the part that I enjoy the most, to be honest.’
Family medicine is not the only service available to patients at Sapphire. The practice employs a paediatric nurse and a psychologist, and offers a number of other services, including chronic and complex disease management, skin checks, immunisation clinics, travel advice and immunisations, corporate health checks, mental health consultations, minor surgical procedures and more.
‘I do not have any other specialists who come and consult at this stage. It is nice to have a general practice domain and outsource all of the specialist [consultations] elsewhere,’ Fielder said.
Fielder said. ‘We also have pathology adjacent to us and we are able to do a lot of investigation, like ECG [electrocardiogram].’
Fielder’s desire to continue developing her skills and keep up with the demands of her patients also saw her recently add another string to her medical bow and take up cosmetic medicine, which she offers at Sapphire.
Sapphire. ‘It is an interest that I have developed on request from my long-term patients,’ she said.
‘That stems from my interest in dermatology, where I do a lot of skin checks, so it complements that.’
Outside the clinical setting
Fielder’s love of family medicine extends beyond the rooms of Sapphire and she regularly volunteers her time outside of her own practice.
‘Because of my interest in women’s health and obstetrics and gynaecology, I am a VMO – visiting medical offi cer – at the Royal Hospital for Women,’ she said. ‘I participate in the antenatal shared care program, which is a program that cares for women before and during their pregnancy. I do training every year, I do lectures.
‘What we are trying to achieve is take a little bit of the burden off of the public hospitals by looking after the community.’
Fielder is also heavily involved with the RACGP, where she has been a Fellowship examiner since 2009. She said this position has allowed her to continue learning while indulging in another of her favourite aspects of medicine.
‘After I completed my Fellowship [in 2009] I was invited by the RACGP to become an examiner,’ she said.
‘One of my other passions is education, so I really enjoy that. I feel it enables me to be able to stay in touch with information and able to participate in the fi nal step of their accreditation before [exam candidates] are a fully fl edged GP.
‘It allows me to meet with my other colleagues and talk about clinical cases and, of course, to examine on the day, which is interesting and enjoyable.’
Sapphire is also an accredited training provider and Fielder accepts registrars at the practice to work and learn alongside her every six months.
Regardless of how she came to be a GP, Fielder loves all areas of the specialty that still allows her to practise the medicine she has always wanted to, while also providing her with the type of diversity she likely wouldn’t see anywhere else.
‘Women’s health, paediatrics were always my interest. I suppose I would have to give one of those up if I just chose one speciality. General practice allowed me to do both, as well as other things that I have grown to love,’ she said.
‘If I had to choose now, I couldn’t see myself doing anything else.’
First published in Good Practice July 2014:10-11