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Reaping benefits as a rural GP
James Cook University medicine graduate, Dr Bryce Nicol, has just been appointed Director of Medical Services at Winton Hospital – at the ripe old age of 28.
“Having only just finished my years as a registrar and awaiting fellowship, this is an opportunity that would never have come my way, if I hadn’t joined the hospital through the JCU General Practice (GP) training program,” he said.
Dr Nicol initially fell in love with the remote town in central west Queensland in 2013 when he undertook a rural relieving rotation in Winton. At the time, he was working as a Resident Medical Officer at Caboolture Hospital, near Brisbane.
“I had a fantastic experience in Winton,” he said. “There was this lovely town with a beautiful little (16 bed) hospital with wonderful nursing staff. I got to meet the senior doctors in the district. They had an excellent teaching culture and an excellent collegiate culture. It just seemed like the perfect place for me to be a GP registrar.”
The young doctor applied for the post of Senior Medical Officer at the Winton Hospital and Winton Medical Practice, as soon as he had finished his Advanced Skills Training in emergency medicine at Bundaberg Base Hospital.
He returned to Winton in 2016 and held the fort as the only doctor in town until another JCU trainee GP joined him last year.
Becoming a two-doctor town has already significantly improved the health outlook for chronic disease sufferers in Winton and the wider catchment area – a total population of around 2200 people.
“When I first came here as a registrar in 2016, I was frequently seeing people who were critically unwell,” Dr Nicol said. “Now there are two doctors in town, there are appointments for people to receive chronic care. We have the ability to better manage people’s chronic diseases. That's one of the many things that general practice in remote areas is really good at.”
However, the stoicism of rural folk still inhibits many from seeking timely medical attention, despite the fact that the aging population is beset by health issues, according to the doctor.
“Often people get quite sick here before they go to a doctor,” he said. “And you just certainly very rarely see minor ailments.
“There is this great myth of rural Australia; all these tough men and tough women out here. And that's true to an extent. But due to injuries, the aging workforce, troubles with the price of cattle and wool, and the drought, we actually have these very strong people who have – through years of adversity – been made into very frail people, who are more unwell than people in cities.”
Managing the care of acute patients in a remote area poses challenges that a young city doctor never encounters, he has found.
“There’s the challenge of arranging fly outs, as well as arranging and supervising specialist care,” Dr Nicol said.
“My day may start with 30 patients booked in a clinic, but then a cardiac arrest comes in at 9 am and none of my patients will get seen that day, because I'll be in the hospital all day taking care of this patient, waiting for the Royal Flying Doctor Service to arrive.”
As a doctor who trained in emergency medicine, Dr Nicol thought he would most enjoy that aspect of his work in Winton, but he now places greater value on the ongoing relationships that he has had the opportunity to forge with patients through general practice.
“I get to participate in and oversee their care and know that I am really making a difference in their lives,” he said. “As one of only two doctors in town, you become very important to both patients and their families. It's a very privileged position.”
His patients also play an important role in his life, outside working hours.
“My patients are the people who make my coffee and the people who serve me beer,” he said. “They're the people I drink with and the people I celebrate with at the races and the people I commiserate with – often also at the races! It's a wonderful environment.”
Apart from attending the races, Dr Nicol devotes his spare time to camping, sport and a thriving social life.
“We have a modern gym and a football club,” he said. “And I have an enjoyable social life in town with the medical students and the nurses. We’re a very tight knit group. There are so many social opportunities and so much town spirit.”
He is very content with his decision to combine emergency medicine with GP training in a remote area.
“You get more challenging clinical situations, with more appreciative patients, with more supportive colleagues in a remote area of Australia that very few people are fortunate enough to visit,” he said. “There's probably nowhere better to be a GP registrar.”