Lifestyle medicine inspires 2021 RACGP Qld GP of the Year

Maleny-based Medical Educator Dr Sam Manger mentors JCU GP doctors in training, hosts a podcast for health professionals and is an advocate of lifestyle medicine as a powerful way to improve mental health. The RACGP Queensland GP of the Year for 2021 and Equally Well ambassador talks about his passions.

Tell us a little about yourself …

I trained as a rural GP and now work in the Sunshine Coast hinterland. My wife, Anita, is also a GP. We met in Rockhampton – I was doing my final two years of med school and Anita was working as a pharmacist – and moved to the Adelaide Hills while she studied Medicine and I did my junior doctor training. We have two kids aged 3 and 5, one dog, chickens, a few acres and we love living in the country. 

What inspired you to become a GP?

I always wanted to be a GP for as long as I wanted to be a doctor – to be the first point of call, to be “there” for individuals and families, to have broad skills, to have an opportunity to be proactive and involved in the community. 

Your podcast, The GP Show, has a big following in the health professional community. How did the podcast come about?

I started it for a number of reasons. I learn a lot, and I am honoured to share the wisdom and knowledge of my guests with the listeners. I hope it positively influences general practice and health care more broadly. I cover a broad range of topics because GP and health is so broad. I’ve done 135 episodes, each 45 to 60 minutes long, and I have barely scratched the surface of all the things health professionals have to know these days. I try to cover every domain over time, but there is a recurring theme of lifestyle medicine, mental health and health system redesign as these are my interest areas and because chronic physical and mental illness are the most common reasons people present for health care.

Could you share more about your work in mental health and lifestyle medicine, both as a clinician and national advocate?

I have struggled with depression and anxiety myself for many years.  It has been one of the limits to my own career in some ways, but it also strengthens me because it gives me insights that benefit my patients and my listeners. I’ve done training in various mental health skills such as mindfulness, which I also must practise to keep me well.

There is more and more evidence showing lifestyle interventions are powerful treatments for mental illness, leading to genuine wellbeing. Shock horror, exercise makes you feel better! I joined the Australasian Society of Lifestyle Medicine board about five years ago and was elected president three years ago. It is a multidisciplinary society of change makers and innovators in health care whom I am humbled to represent as there are so many inspiring members. Lifestyle medicine is the evidence-based practice of food, movement, sleep, substance reduction, social connection, connection to our natural world combined with behaviour change approaches like health coaching, new technology, public policy and research.

About three years ago I started work as a GPSI (GP Special Interest) in the public mental health services, where we run a raft of lifestyle medicine and wellbeing programs with inspiring outcomes. As a result, I was invited to be an ambassador for Equally Well (a National Mental Health Commission-led initiative to improve the health of people living with mental illness). I give regular talks on the role of lifestyle medicine in mental and physical health, at conferences and events around the world.

Lifestyle interventions, health coaching and new models of care are essential to the healthcare of the future. The public want it, the profession needs it, it has social and economic benefits and is the best path forward for planetary health, which is crucial. I also care very much about the wellbeing of health professionals. Surveys show about 40 per cent of doctors have a mental health condition, and I suspect this is underreported due to stigma. We must care for the carers.

You’ve been a medical educator with JCU GP Training for six years. What has been your experience with training registrars, and what key piece of advice do you give?

I have seen many registrars become GPs and I am proud of them. My advice is that one’s training never ends, the learning never ends, the personal and professional development never ends, and the opportunities never end. I strongly encourage all doctors to get out of their clinic rooms and proactively connect with their community, run projects, deliver talks at schools, give public talks, support existing services. Stronger communities are key to health. I also want to highlight the importance of recognising planetary health, and that lifestyle medicine is also one the best solutions to this.

What are the most valuable lessons you’ve learnt from rural practice?

In Mt Gambier during my registrar years, I worked in the Aboriginal Community Controlled Health Organisation (ACCHO) Pangula Mannamurna, which was one of the best personal and professional experiences I have had. One of the programs the community, Aboriginal health workers, Elders and I initiated was a cultural garden around the entire ACCHO. We planned and planted a 300 square metre garden with native cultural, medicinal and bush tucker plants chosen by the Elders in addition to a 30 square metre vegetable garden, had an open day and the community put their paintings and markings along the walls. It became part of the history and will lead to better health outcomes in many ways. Sometimes health is not about cells, or receptors, or hormones – they  are just the markers or the receivers; rather health is a holistic concept where seemingly irrelevant projects like a garden can have profound benefits by building trust, engagement, connection to culture, connection to each other, enhanced knowledge and first-hand experience of “health”.  

Professionally I learnt to be clinically competent in a wide range of situations, I learnt a lot from the cultural mentors and I learnt about community engagement. Overall I learnt, and continue to learn, how much I love living in the country, connection within community and to the land is so vital to human health in obvious and subtle ways.  

What makes a good GP?

A good GP is one who is clinically competent, safe, sensible, caring, humble, committed and demonstrates leadership. We are fortunate in Australia to have so many brilliant GPs, many of whom have inspired me. I thank them sincerely.

What would you say to someone considering a career in general practice?

General practice is a wonderful but hard job, I am not going to lie. But within that challenge exists enormous value to those we serve. It provides you with incredible opportunity to diversify your career, whether it be in media, academia or community projects. Be creative, have fun, work hard.  

JCU GP Training

Dr Sam Manger’s podcast, The GP Show, is available on all podcast apps and at thegpshow.com.

Dr Manger is academic lead for James Cook University's suite of Lifestyle Medicine postgraduate courses, including a Master of Lifestyle Medicine and a Graduate Certificate of Lifestyle Medicine.