8 DECEMBER 2023

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FOUR IN THIS ISSUE

Surely there is only ever going to be one winner ?

Paul Smith and Heather Saxena LISTENING to Dr Graham Rowlands describe his career would probably give GPs the idea that he is treasured by the community he cares for .

He mentions his years of service in Norseman along with a few references to the on-call hours , the emergency work and his training in obstetrics and anaesthetics .

Like most doctors , he says this with no bombast .

But he is one of those rare doctors working in the middle of nowhere , in a place which to him is the middle of everywhere .

Norseman is tiny , a population of around 700 people , at the gateway of the Nullarbor on the traditional land of the Ngadju about 700km east of Perth .

For the past 17 years , he has been its only full-time GP — at least until recently before he and his wife , Ruth , became embroiled in a bizarre battle with the local council , the Shire of Dundas .

“ I think it started with the perception [ among some within the council ] that a local government body could run a GP practice and turn a profit ,” he says .

“ There was a belief that I was making shitloads of money .”

He says things came to a head last year when he turned to the

‘ There was a belief I was making a lot of money .’

— Dr Graham Rowlands

council for help , asking for more funding for locum cover as he moved to semiretirement .

“ People come in overnight with a heart attack , or there are babies that need delivering , or someone is experiencing respiratory failure — they are urgent cases that arrive at any time .

“ I do the 72 hours on call at the regional centres in emergency and anaesthesia .

“ But you know what ? It is about $ 16 an hour to be on call .”

To mentally survive these pressures , he says he needs around eight weeks of locum cover — he is 61 years old .

Following Dr Rowlands ’ request ,

the council terminated its memorandum of understanding ( MOU ) with him amid concerns that its alleged informality would not withstand auditor scrutiny given the dollars involved .

This meant him losing his existing locum cover along with his shireowned house and car .

PAGE 5

Rachel Fieldhouse YOU would probably expect most doctors to hang up on anyone suggesting they could make 80 % of their diagnoses over the phone .

However , Professor Paul Glasziou , a GP turned professor of evidence-based medicine , thinks it is possible .

He was part of the Department of Health and Aged Care ’ s early review of telehealth at the start of the COVID-19 pandemic and has published multiple reviews comparing telephone , video and face-to-face consultations .

‘ There are a few studies supporting it .’

“ We looked at the controlled trials that were available that compared any form of telehealth to face-to-face , and subsequently did a special review that looked at video versus telehealth ,” he says .

“ The overall conclusion was that it was pretty much equivalent to face-to-face for the management of ongoing conditions … which is a lot of clinical practice .

“ For telephone versus video , it ’ s again pretty similar .” PAGE 8

Copyright © 2023 Merck & Co ., Inc ., Rahway , NJ , USA , and its affiliates . All rights reserved . Merck Sharp & Dohme ( Australia ) Pty Limited . Macquarie Park NSW . MSDA0103 . AU-ANV-00466 . Issued November 2023 .