Obstetrics and Gynaecology AST

Since that time, a lot has happened. Dr Baker has received an Order of Australia Medal (OAM), she became the Director for the NSW Rural Generalist Training Program, and she has also fought the good fight for Cowra during the COVID-19 pandemic.

 

The College recently caught up with Dr Baker to find out all about what she has been up to, and learn about her life as a RG.

 

I grew up in rural NSW in Cooma and as a school student was given a “baby sitting job” answering the phone for one of our local GPs who delivered babies. It was before mobile phones and answering machines and when the hospital rang to say the doctor was required at the hospital, I told them the phone number to ring to contact him. Wow! How exciting was that; that he was going to bring a new person into the world?

 

From then, I always had a fascination about being an obstetrician and then at high school I met my “husband-to-be” who was a farmer near Cowra. He came to Sydney for three years during my junior doctor years, including my advanced skills year in obstetrics. We then moved back to Cowra. In the first year I was in Cowra, I delivered over 150 babies with the support of experienced rural doctors – such an amazing experience that inspired me to become a Rural Generalist obstetrician. 

 

You need to be able to work as part of a team and have a passion for being a rural doctor. You need to have good communication skills with your patients and colleagues. You need to have good procedural skills and support from other proceduralists, mentors and colleagues, and be willing to ask for and provide assistance if needed. You also need to be flexible! For example, as a mother, taking the kids to pony club could also mean being the pony club doctor when called upon. I also occasionally help on the farm in obstetric services.

 

Being a Rural Generalist is vital for communities with small rural hospitals as you can provide advanced skills not otherwise available on a full-time basis to the community. Without RG obstetricians, maternity services close. Without RG anaesthetists, maternity services also close. Likewise, elective surgical lists can’t be attended to without a visiting anaesthetist, emergency surgery also can’t occur, and it decreases the backup for emergency services (especially for patients with airway compromise). This has a flow-on effect to the community, in that families often move away if they can’t have their babies locally or feel their local hospital can’t provide the services locally that they want or need.

 

Having worked in Cowra for a long time, I have had the privilege of delivering a lot of babies here, for whom I've then continued to see as their GP, and watched them grow up. I've watched their early development, I've provided their immunisations, and I've followed them through to their adolescent years, where I've given contraception and STI consultations. And then there's the joy of confirming their pregnancy and delivering their babies.

 

I have also had the privilege of providing end-of-life care for my elderly and palliative care patients, while also supporting their families. True continuity of care from birth to death. This makes you feel like you are making a genuine difference, as a doctor.

 

The interesting thing I have recently noticed is many of my Aboriginal patients who I have cared for over the years are now starting to call me “Dr Baker”, not Louise. I asked a few of them recently, because it was so odd, and the response was “It is a sign of respect for one of our Elders!”. A true compliment but also made me feel kind of old! 

 

I have been so proud of our community with their willingness to wear masks, get vaccinated and “follow the rules”. It took a long time for our first case in Cowra which wasn’t until September 2021, and then, unfortunately, it affected many families with primary school aged children.

 

Given our practice provides the majority of GP services and also hospital services, the practice has had to be incredibly vigilant with screening patients, providing swabbing and vaccination services and ensuring all of our doctors and staff wear Personal Protective Equipment in case of exposure, to minimise the impact on medical services in Cowra. Our practice manager, nurses, administration staff and medical team have stepped up and provided an incredible service. That's all while dealing with the additional workload of being a Commonwealth Respiratory Centre with an offsite vaccination centre, to limit risks to patients. Last year, we set up a Drive-Flu Clinic to enable large numbers of patients to receive their fluvax without the risk of exposure in the practice. The practice has been very proactive in setting up new approaches approaches to providing medical services. 

 

Receiving the ACRRM-RDAA Cohuna award in 2018 was one of the most special experiences of my life. It gave me the opportunity to thank everyone who has allowed me the privilege of providing medical services in my rural community, especially my husband and family but also my medical colleagues, practice and hospital staff and the community itself. It also led to recognition in other fields - 2019 NSW Regional Woman of the Year and opportunities to talk with NSW Ministers and the NSW Premier about the importance of RGs and rural medicine.

 

Then, in 2021, I was awarded an OAM for services to rural and remote medicine which gave an even greater opportunity to be interviewed by national and local media about the important work of rural doctors and how vital they are to rural communities.

 

Having been acknowledged by ACRRM also very likely provided me greater respect as a NSW Rural Generalist and provided the recognition to become the State-wide Director of the NSW Rural Generalist Training Program.

 

For a long time, I’ve had a strong interest in rural medical education and the rural workforce. I put this to action as a GP Supervisor and medical student mentor, and then I was involved in setting up the NSW Central West Division of general practice, CentWest RTP, and was the National Medical Advisor for ACRRM. I completed my Masters of Clinical Education at UNSW and have now been a Senior Lecturer for the ANU Rural Clinical School and Academic Coordinator for third year ANU students in Cowra for over 10 years. This provides medical students and junior doctors the opportunity to see what being a RG is all about, and how important the role is. The doctors I work with in Cowra have a passion for rural medicine that is infectious, and they role model what is required to deliver excellence to the community.

 

Since March 2020, I have been the State-wide Director for the NSW Rural Generalist Training Program (NSWRGTP). This last 18 months has been an incredibly busy time, accompanied by a huge workload. Continuing as a RG obstetrician, dealing with introducing new initiatives in our local community with COVID-19, and the huge responsibility for directing such an important program as the NSWRGTP and the NSW GP Procedural Program has been challenging.

 

Despite COVID-19, the NSWRGTP has larger numbers of RG trainees both in Foundation Year and undertaking their AST training. We have managed to run three face to face orientation workshops in Anaesthetics and Obstetrics and webinars for the rest of the cohorts in 2021. We are having regular meetings with Local Health District Directors of Medical Services, Heads of Departments and Supervisors of Training. We have a team of Rural Directors of Training (who are all practicing NSW RGs) who are also providing career planning to all NSW RGs.

 

This work, I hope, will make a difference for future RGs in NSW and help out current RGs with succession planning.

 

A career in rural generalism is a fantastic job, however it has been living in and raising a family in rural Australia that has provided the greatest joy.

 

My family are the light of my life and I am so proud they were born and schooled in rural NSW and have the same passion for living and working in rural regions as I do.

 

To anyone contemplating being a RG, I say - don't contemplate - JUST DO IT!

 

Good luck for a wonderful career and lifestyle for prospective RRGs and thanks to all the existing RGs for the wonderful job you do for your communities.