Rachel Fieldhouse DR Tanvir Kapoor was first diagnosed as obese at the age of 12 .

“ I remember a paediatrician encouraging my mum to give me more fruits and vegetables ,” he wrote in The Medical Journal of Australia last month . “ This was when my immigrant parents had just arrived in the US and were working at 7-Eleven . We slept on the floor because we could not afford mattresses .

“ Highly processed carbohydrates were tasty , cheap and in abundance .”

Now a GP registrar and senior medical officer at Jandowae , 250km west of Brisbane , he still deals with obesity .

But his own lived experiences have an upside .

“ For the first year I was there , it was hard to get stable accommodation for myself , and I ate at the local supermarket while I was on call at the hospital , it was hard to get fresh food ,” he says .

“ There was no defined space for exercise , no walking paths , no gyms — things we take for granted in the city .

“ My health suffered terribly : I gained weight , and my mood plummeted .

“ In the second year , I moved into a new flat , had more access to food , was able to get stuff from out of town and I started to feel a lot better .

“ What I realised in that year was that I had lived like my patients and suffered because of it .”

“ I find that I can gain trust from my patients as I tell them that this is something I struggle with as well ,” he tells Australian Doctor .

FROM PAGE 1 The council ’ s next step was to put out a tender for GP services .

As anyone who has ever googled ‘ Australia ’ s rural workforce crisis ’ would expect , only one bid was made — by Dr Rowlands himself .

He says the council reviewed it and declared it “ uncompliant ” with its procurement processes .

So it seems the thought process was why not dispense with the services of Dr Rowlands altogether and find someone else .

This is what it did , and in his place a new clinic was launched in Norseman run by a company called I-Medical Australia .

At this point , things started to go wrong .

The ‘ super clinic ’

Although I-Medical was only registered

as a business back in March this year , its Norseman clinic was billed as the region ’ s first super clinic .

It sounded good : an upgrade from a solo GP .

But the doctors recruited by I-Medical were fly-in fly-out . On their arrival this year , the first two recruited to work at the Norseman clinic quickly began to wonder if they had made a mistake in coming .

“ When we got there , they had not even done the painting , so the clinic had to be shut for two days ,” says Dr Ashley Sood .

“ The skirting boards were not done for the whole time I was there . There was no treatment bed for the first two-and-a-half weeks , so you had to examine patients standing up .

“ Half the equipment was missing . There was no nurse .”

Also missing were vaccines and emergency drugs , such as adrenaline , she claims .

Dr Sood and the other GP she worked with only saw a handful of patients a day — no doubt because Dr Rowlands was around the corner still seeing his own patients .

It made them nervous about the cash flow .

The I-Medical model was also universal bulk-billing , but the GPs could see the Medicare billings they were generating were nowhere near enough to cover the salaries they were promised .

“ It would have to be extremely busy even with us doing health assessments ,” Dr Sood says .

“ But there was no equipment , and we were not doing health assessments ; we could never have survived .”

Although Dr Sood says her contract with I-Medical stipulated that she be paid weekly , by the end of the third week of her four-week locum stint , she says she had not received a cent .

Chasing payment

So when she and the locum agency

that had recruited her could not get hold of I-Medical ’ s owner — an audiologist called Ashley Yong — by phone , Dr Sood drove two hours to Kalgoorlie to see him in person .

Mr Yong gave a convoluted excuse involving computer software , Dr Sood says .

“ To cut a long story short , I did not follow what he was saying . He said not to worry and that the accountant was all over it . I would get my money . “ I said , not in a raised voice , ‘ It is unacceptable . We have been here for three weeks . I have come from Queensland and left my friends and family to come to do this locum job

and help out .’

“ To which he replied , ‘ Well , you are raising your voice to me , so I am calling the police .’

Dr Sood says the police never arrived .

She said she eventually received two payments totalling about $ 17,000 , which did not match the invoices she submitted .

She says she is still owed about $ 14,000 .

In Kalgoorlie itself , it seems there were similar issues at the I-Medical clinic , which had also opened for business in the town .

Dr Sally Partington , who was brought in for an 11-day shift in mid-August along with another GP , says she was stunned when she arrived .

She says they were given consulting rooms in Mr Yong ’ s audiology clinic .

‘ The owner replied , ‘ Well , you are raising your voice to me , so I am calling the police .’ The police never arrived .’

— Dr Ashley Sood

There was no signage to indicate a GP clinic was available .

“ The problem was that the other GP did not have an examination couch in his room ,” Dr Partington tells Australian Doctor .

“ There was no treatment room , so if there was an emergency , what were we going to do ?

“ We were told we would have nursing support . There was a nurse for three hours on one Saturday .

Laurene Bonza .

WESTPIX / CARWYN MONCK

“ There was no light , so I had to use my phone light to insert a speculum . “ Luckily , the patient thought it was a joke , but you can see the standard of what we were offering . It was very poor general practice — it just was not set up for it .”

Dr Partington and the other GP also had misgivings about the financial viability of the clinic .

“ We were seeing five patients a day max , so we were hardly seeing any patients .”

“ We spoke to Ashley Yong , and he said , ‘ Do not worry . The council is paying ; it is sponsoring this clinic .’ “ We thought that was a relief because there was no way we were earning enough for $ 2000 a day bulk-billing .”

Five weeks after she finished the locum , Dr Partington was still waiting for her agreed salary — $ 2000 a day — to come through .

She was eventually paid $ 11,000 — half what she was owed .

Both I-Medical and Mr Yong have been contacted for full right of reply . They have not responded .

Dr Sood says the company has offered a payment plan to the GPs involved .

“ At this stage , I am not really hopeful anyone will get their money back ,” she says .

The council responds

Last month , the council ’ s president ,

Laurene Bonza told the ABC that I-Medical still had the council ’ s support .

“ There have been a few teething problems , as expected . It is a brand new undertaking .

“[ There have ] been a couple of hiccups along the way .”

Dr Rowlands says the whole thing has been a pantomime . But he is also angry .

He says following his request for more support for locum cover , he felt he was suddenly being portrayed in the media as greedy . There were statements declaring he was asking for a “$ 250,000 pay rise ”.

“ It was being implied that I was holding the community for ransom . For the past 17 years , I have had a house and a car ; it is the sort of arrangement offered to almost every rural doctor .”

Last week there was hope that the council would see the light .

With the I-Medical clinics now floating in troubled waters , it met to discuss whether to renew the MOU with Dr Rowlands .

But the meeting went nowhere . The council was concerned about the budget implications of extending financial support to Dr Rowlands ’ practice given it was now invested with I-Medical .

It complained that Dr Rowlands had been reluctant to engage . “ The council acknowledges Dr Rowland ’ s longstanding service to the community and regrets that the doctor ’ s behaviour has led to a sour note in the relationship ,” the minutes of the meeting state .

They go on to say it was “ committed to ensuring long-term provision of essential medical care to the Norseman community ”.

No doubt the Norseman community will be asking the question asked by rural communities across Australia : ‘ Yes , commitment is great , but what are you actually going to do to find us a doctor ?’

For now there is no clue as to the answer .