Showing posts with label mentoring. Show all posts
Showing posts with label mentoring. Show all posts

Saturday, January 9, 2016

Beating the Drum for the Country Docs

It can be lonely out there





Rural Health - the real challenge.




As you may know, I took a few years off from clinical medicine as the emotional strain from caring for patients was hard enough, but running a practice was even harder! Now I've chosen to return to Family Medicine, but this time as a Locum GP, and I've chosen to help patients in the rural community. And it's been great!

Firstly, country people are different and have different problems. They're different in that they're more 'forgiving' and they're more thankful:  I had four 'Thank You' cards from one practice after just one three week Locum! But they face their own challenges too. Obesity is a big issue - excuse the pun - and is only compounded by the sense of inertia that occurs in small country towns. With the obesity of course comes Type II Diabetes with all it's insidious complications. 

Then there's a big issue with Chronic Pain Syndromes and the use of powerful analgesics that are being used to control them. It's a real challenge in such a short period of time to educate such patients on pain modulation, alternative treatments and the ancillary lifestyle modifications availabe. The resources needed are limited - professionals such as myself, clinical Psychologists and dieticians are nearly all FIFOs which makes continuity of care a real challenge.

And that leads to the one constant gripe of so many rural patients - with the inevitable question being asked "How long are you here for?" They feel that they are constantly having to repeat their stories to new faces (and despite computerised medical records, getting up to speed in 15 minutes in a complicated history is a tough gig even for someone with years of experience)  and many patients have literally given up trying merely limiting their consultations to requests for 'a new script'!

Our full time GP colleagues are bearing an enormous load in very isolating circumstances. I can fully understand why a female GP graduate with a young family would find it daunting to embark on a career in a remote rural practice. She would face so many professional and domestic stresses for which there are few practical answers. One may be to utilise the skills, knowledge and experience of those retired GPs who are looking for that something extra in life rather than playing bowls or embarking on another cruise, and developing an efficient, effective mentoring service!

Another would be to support groups such as the Australian Doctors Spouse Network that's been established to support Fellowship spouses in their un-ending merry-go-round of moving from hospital to hospital over their 6 to 10 year training. This group are aware of the challenges their partners face - perhaps Rural GPs Spouses can work with them to build support for their craft too.

Because at the end of the day, we're there to supply Health and Wellness information to our patients. We're there to support our patients when they're struggling. We're there to be their advocate when they have nowhere else to turn and to constantly remind them how special they are and why health is such a valuable commodity. 

At the end of the day it's all about our patients, and we can't do that properly unless we look after our Rural Doctors too.




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Saturday, October 5, 2013

Family meal times - more than just nutrition.



CLICK THE LINK TO DOWNLOAD THE PODCAST OF THIS ARTICLE.

Recently I read an article heralding the return of family TV viewing time! Apparently we’ve been through an era where seemingly “everyone in the family” had a TV in their own room and consequently family viewing time had gone the way of the dinosaur: but not so apparently! Now we have to thank the ever present tablets - not those of the pharmaceutical variety but rather the electronic ones - that allow each family member to watch the family wide screen whilst following friends on Facebook or, miracle of miracles, actually reading a book ...on their iPad that is.

You may gather by the tone in my voice that I am perhaps a tad cynical about such amazing advances in human interactions, but just call me old fashioned, but when it comes to spending time with family, watching TV together doesn’t come very high up my list of things to do together. Don’t get me wrong, I am a total convert to the electronic age because it’s opened up so many new horizons and spaces, but the downside is that so many of those spaces have been filled with total and absolute ... well .. rubbish.

But even the suggestion that families congregating to view a common TV is important news, and tells me that family still has a huge part to play in our society. Family is not just a group of people living together, it’s also the time when we create so many templates for our children’s future in health, education and value systems and once that period of time has passed, unfortunately we cannot go back and easily fix up the mistakes we made. And realizing that family life has such a big impact on future health is why I’m a big advocate of family meal times.

There is no doubt that we live in a frenetic era far different from earlier generations, and that’s perhaps a reflection of the far higher living standards and expectations that we now enjoy. But with the need to have a nice home and a nice car - in order to provide the best education we can for our little people, this also means that we need the cash to pay for these things and as a result, where there are two parents, both often have to work, and where there is only one the pressures are even greater - and creating the time for a daily family meal together can turn out to be a major juggling act between all the demands that young parents face. But when it is done, then the benefits are huge.

Where families frequently sit down to eat together,  the children tend to eat more vegetables and are less likely to be obese, and if obesity can be avoided then so too can all the health complications that come with it. But physical health is not the whole story. Family meals are not just about the food that we eat, there is a process that has to occur in order to prepare the food and prepare the table - and by involving the children in these activities they start to “own” and be involved in the process of service as well of being recipients of the good deeds of others.

Family meal times are an occasion where that unit of people - whatever the composition by gender, race or religion - sit and share their daily activities within the boundaries of that particularly family unit’s “family rules”. These rules are often unspoken - such as telling the truth, being kind, no bad language and not fighting or shouting at each other - whilst others may base their family rules on the Judeo-Christian ethic that has survived over 2000 years and of which GK Chesterton famously once said “Christianity has not been tried and found wanting, it has been found difficult and largely left untried” - which I suspect also applies to most other major world religions too!  By having such a set of family rules each person is then subject to them .. including the parents. And this can have unexpected and yet positive benefits for everyone: for example, when one of the parents has bent the rules - it might be when a child is unjustly shouted at by a parent - then at the family meal time, if the innocent party feels secure enough to point out the injustice, this can provide the occasion for the parent to apologize for getting it wrong and asking their son or daughter for forgiveness. This is a crucial lesson for a child to learn at an early age and helps them understand and accept personal responsibility for their actions - and how sorrow and forgiveness can heal an emotional injury at source and not allow it to fester into chronic guilt or resentment.

All parents of teenagers know that the teenage years are the years of chaos - and it really is not surprising as the teenage brain is continuing to make new connections during a time when their bodies are physically changing, and at the same time surging with adolescent hormones - a guaranteed recipe for long sullen pauses or inexplicable explosive reactions. If all parents were to realize that teenage development equates with chaos not entirely of their own making, then life for both parents and teenagers could be more serene. Which brings me back to family meal times.
One of the great joys of family life is that just about everyone there is of a different age group, whilst at school for 12 years of their lives, our young people are put in classes where everyone is of the same age and at the same level of life experience. Whilst preparing for, eating and cleaning up after the family meal, the group has to cooperate with people of different ages and life experience. So when the teenager says to the parent “You don’t get it do you?” ... well perhaps they do actually get it better than the teenager thinks! The important thing is to allow the youngsters to express their thoughts in a loving secure atmosphere, within the family rules, and not get a long lecture on why they are wrong, and how they should get their act together.
Family meal times allow for parents to hear whats happened to their children during that day or week and try to understand what outside influences they’ve been under when away from home. It also calls on each member to learn how to listen, as well as to have the confidence to speak out to. And it’s also that important time when issues can be completed and not carried on as hurts for weeks, months or even years. Unfortunately, children still grow up in dysfunctional families where parents continue to pass on the negative ideas and habits they learned from their parents and which still stunt their own children’s emotional development for life.
All of this is so important for the mental health of our young people as about 1 in 3 of the whole population will experience some form of mood disorder during the course of their lives, but if they have experienced the benefits of life in a stable, happy family unit, they will be better prepared to deal with such challenges if and when they arise.
Family meals are not easy to organize in these so called modern times, but they are an essential part of a healthy society - both physically and mentally - so the effort to make it happen as often as possible will be more than rewarded with happy memories and a healthier future generation.

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Monday, March 25, 2013

Young Moms - the key to a healthier future

There are a group of people whom I believe to be the most important people in this world, and they're our young Moms: but to use an Australian colloquial expression, I also think that they're getting the wrong end of the pineapple! They're doing it tough and we need to work out how best to help them during those challenging first 5 years as parents.

The challenge to effect positive change is that "one size" will not fit all: what may work for the affluent parts of San Franciso or Perth, will not work in rural areas of say Africa or India, but the basic principals are the same: education, health and effective mentoring.


I want to start a conversation that leads us to better ways to support our "jeunes Mamans"*, especially those who are single or living in distressed areas, and the internet gives us an opportunity to provide that support.

There are some great educators in cyberspace who can provide culturally appropriate resources for their communities so that literacy and numeracy for young Mums can be improved - and better skilled mothers offers hope for smarter, healthier kids. There is a wealth of information about health issues too - the paradox being that so many in the affluent "west" need information on how to lose weight and yet millions of less affluent "others" needs information on how to provide basic nutrition for themselves and their children: wouldn't it be good for the "Health" of us all if one group could be connected to the other - ? As for mentoring, there must be literally millions of baby boomers with some time on their hands who can provide mentoring for young women in their communities or even those in other communities. Many "grey nomads" already are committed to providing new homes and schools for less well off cultures, perhaps this could be extended to exchanging emails as well?

Another challenge is to have some level of ethics for such an enterprise and here I am impressed by the 12 steps of AA where it's "success" is based on the fact that members need to recognize a "Higher Power", and I believe that for a great number of people this has resonance. There is no doubt that one program will not appeal to everyone, but every woman who is helped to improve their own health and education will have a huge impact on their children and their future life which has great significance for the whole world over time.

I want to start a conversation whereby we can develop a Web Based resource that can be adapted to local needs of each community. What do you think? How can we make a difference? What can we establish that can easily be handed on to the next generation so that we protect the most valuable members in our Communities - our "Madres jovenes"* and their precious children.

*young Moms

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