Sorry all! Have been a little slack with this so far this year. Uni started almost five weeks ago, so I'm well and truly in the thick of it at the moment.
My first term this year is GP and I have been placed in a lovely clinic near my home. There are only three doctors at the clinic and, for the first time, I have been placed in a predominately private-billing clinic. The differences between the way medicine is practiced in bulk-billing clinics (where I have been before) and private-billing clinics is quite stark. This would appear not to be due only to the differences in billing, but also the differences in the demographics of the patients we see. At this clinic, they are far more affluent than my previous practices. Though "health inequalities" are a topic that we're confronted with quite early on, I didn't expect the difference to be this stark. Simply put, patients at this practice come in a hell of a lot healthier. Even those with serious medical conditions appear to be less serious. For instance, in five weeks I've only seen one patient with poorly controlled diabetes and only one overall with COPD. I'd reach these numbers in one session at the other clinics!
Some might feel a little resentful about this; that people's health is so strongly connected to their level of wealth. I think this is fair enough and is symptomatic of a system that doesn't work for those of a low SES background. Personally, though, I'm choosing to be optimistic, as well. That the patients we're seeing are so much healthier is a ringing endorsement of the capacity of health care and, more importantly, preventative medicine to deliver. The big challenge then is to find a way to achieve the same level of good health in people from low SES backgrounds.
Policy discussion aside, the clinic itself is wonderful. There are three doctors there, all of whom are lovely to me. The practice staff are also great and have been very warm and welcoming. I even managed to score myself a spot on their website, which was a bit of a laugh! I think the patients who attend the clinic are particularly fortunate. All of the doctors appear to practice good medicine and are extremely thorough. Perhaps as importantly, if not more so, the clinic has in place a lot of really sensible procedures to ensure that patients are followed up appropriately and to ensure that the doctors are performing lots of preventative medicine, not just dealing with people's presenting complaints. As a model for good practice, I think this practice really works. Their recall system is excellent, and you tend to find that issues are followed up really well and rarely fall through the cracks. It's one thing to be a good doctor, but without systems like these in place patients far too often fall through the cracks.
Aside from placement, I've been really busy! I'm working for SWOT again, this year as their Human Resources officer. We've managed this year to overhaul the human resources policy, such that it is fairer. Without going into the details, we've put in place a strategy to blind all of our applications, so that all of our applicants are assessed on merit and not their personal relationship with the people selecting them. This has been a huge task and the technical challenge of distributing blinded applications has been fairly taxing, but with one minor fix to come I think it should hopefully pay dividends.
Beyond SWOT, I've also assumed the role of Global Health co-chair for my med soc. This role involves a lot of different things, but is basically split into events and advocacy. We run various events to get a good vibe happening around global health and to get people engaged in global health issues. On the advocacy side of things, we're peripherally involved in curriculum development and, in particular, feedback to the school re global health teaching. More critically, my co-chair and I are joint AMSA global health reps for the University, meaning that we represent our student body at national meetings of the Australian Medical Student Association's Global Health Council. I haven't been to one of these yet, but the meeting effectively exists to determine AMSA's policies around Global Health, which inform its activities (mainly advocacy and education) in this space. AMSA global health is surprisingly big, forming the most sizeable sub-committee of AMSA itself, so the fact that we're in this position is fairly exciting!