Dr Nick Carr retires with no regrets FROM PAGE 1 gets the same level of treatment.”
Asked about the finances of bulk-billing marginalised patients, he responds:“ You are not going to get ophthalmologist income, but you will be okay.
“ I am not interested in fast cars. I would much rather say, as I can, that I have never had a bad day at work. How many people can say that?
“ The best thing is mentoring a registrar or student and seeing their eyes light up when they get it. Their excitement about seeing what this job can mean is the best bit for me.”
Firebomb no object
Obviously, nothing is perfect.
“ It was not a great day when we discovered, many years ago, that a practice manager had defrauded us
of tens of thousands of dollars.“ She had forged her police background check. She had previously been in jail for defrauding a different business.”
Dr Carr discovered his superannuation had not been paid and some bill payments had been faked.
“ To my astonishment, she was only
given a small fine when she was prosecuted for defrauding us.”
And she only repaid the practice a few thousand dollars.
Then, in the 1990s, the practice was the victim of a Molotov cocktail attack. The doctors were not the target— that appeared to be a nearby illegal brothel.
“ I arrived at seven, and there was a fire truck, water coming out and the whole place was smoking,” Dr Carr says.
“ Patients started arriving, so I got a desk, stuck it on the footpath, got a prescription pad, a stethoscope and sphygmomanometer, and we got on— this was before we were computerised.
“ We missed only one day of work because we literally operated in the ashes.”
Given his patient demographic, he spent 20 years training
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Then he met Rustie, the‘ worst doctorshopper in Australia’.
GP registrars about doctorshoppers.
Then he met Rustie, the self-described“ worst doctor-shopper in Australia”. She approached Dr Carr after one of his presentations.
“ She told me,‘ This is the first f *** ing sensible thing I have heard at this conference.’”
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Dr Nick Carr at St Kilda Medical Group in 1988. |
At her peak, Rustie had been taking 720mg of oxycodone and 10.5mg of diazepam a day.
“ She was the endorsement of why my approach was right because she had spent 30 years going through doctors around the country, getting drugs.” Rustie joined Dr Carr’ s talks, giving the patient side of the story. When she got lung cancer, she consulted him about voluntary assisted dying before she responded to the immunotherapy.
However, a year later, she died of an infection.
“ I carried on with workshops for a bit, and then COVID-19 happened, and it went online,” Dr Carr says.
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“ I stopped doing them a couple of years later because it was not the same without Rustie.”
Dr Carr’ s retirement began tentatively more than two years ago when he sold his share of the practice.
He gradually moved to 2.5 days a week. As his retirement neared, many patients came to see him one last time.
“ The receptionist said,‘ If anyone else comes out weeping, I’ m going home,’” Dr Carr says.
“ Other patients wondered if I was delivering bad news to everyone, like everyone had got cancer.”
One patient returned who had consulted Dr Carr briefly 15 years earlier.
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“ He said,‘ I heard you are retiring, and there is something I want to tell you.’“ I thought,‘ Oh God, what did I do?’“ But he said,‘ Fifteen years ago, you said things to me that changed my life, and I have told everyone else that, but I have never told you.’
“ You do not realise the impact you might have had.”
Goodbye to all that
Some things Dr Carr will not miss.
“ I struggle hugely with the changes in ADHD diagnosis, the push for medication. The pendulum has swung too far.
“ People do not come in and say,‘ I want an assessment.’ They say,‘ I want a diagnosis because I want the medication.’”
Dr Carr also laments general practice corporatisation, which has forced independent practices to close.
His concern is that doctors rarely stay in a corporate practice for 20-30 years, when evidence shows long-term GP – patient relationships improve health outcomes.
In retirement, Dr Carr, a long-time campaigner for voluntary euthanasia, plans to keep working with Dying with Dignity Victoria, just not as a clinician. He also wants to write more— he has a completed novel in his desk drawer. But do not expect him to pen a medical memoir.
“ I am not sure anyone wants to read it,” he says.“ Maybe I could be persuaded otherwise, but I want to focus on my family. I have a grandson now.”
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