WA News Trailblazers Fighting for Country Folk and their Doctors
Fighting for Country Folk and their Doctors
Written by Shannon McKenzie
Wednesday, 01 April 2015

 

A love of rural general practice and a desire to contribute has seen Dr Felicity Jefferies step into many roles during her career. From practice rooms to board rooms, she has been a long-standing advocate for the profession she loves.

Jefferies-Felicity-Dr 2000.-170Dr Felicity Jeffries circa 2000Though she was born and raised in Perth, Felicity has always had strong ties to the country – her mother was from Broome, her father from the Wheatbelt.Growing up, there were plenty of holidays in the country visiting family and friends.

So when a career in medicine beckoned, so too did the country. Felicity spent her GP rotation in Northampton supervised by Dr Ron Hutchison, a rural GP who ran a solo practice.

"Dr Hutchinson worked across the spectrum – anaesthetics, obstetrics, surgery and even acupuncture and hypnosis. It made me think about what I wanted to do when I finished training and general practice – rural general practice – really appealed," she said.

After completing her training, which included one hairy day as a junior doctor staffing the local emergency department after a cyclone, Felicity followed her heart into rural general practice.

She spent 15 years working as a GP in Geraldton and raising a young family. It was during this time that Felicity also became a passionate advocate for rural general practice.

A quick glance at her CV shows there is barely a rural GP body that she hasn't been associated with.

Changing policy at the source
The Rural Doctors Association of WA, the Mid-West Division of General Practice, the WA Centre of Rural and Remote Medicine (WACRRM) and later Rural Health West – her name is a common denominator.

What motivated her to step into policy making and advocacy?

"In the early 90s, country areas were really short of doctors. In Geraldton and other places we tried to recruit but we were just not getting any doctors coming to our towns. I worked a lot with patients with breast cancer and I would see these women, in such poor health, having to travel all the way to Perth to get the necessary treatment. You couldn't help but see the raw deal that people from the country got."

"A lot of the thinking from other doctors was 'Well you just need to pay doctors more money to go out there'. But that just wasn't true. Someone had to start saying these things, correcting the misconceptions. Someone needed to start speaking up about it. I thought I could be one of those people."

Throughout the 1990s and early 2000s, Felicity worked on a number of projects aimed to boost and support the rural GP workforce yet she also knew there was still much more that needed to be done.

A move to government – to the centre of decision-making – came next.

"I came to realise that the levers that needed to be pulled were with the State Government. [It] alone had the funds and the capacity to make a real difference and in the end I decided I needed to go there and be a driver from the inside," she said.

Dr-Felicity-Jefferies-Mr-Kim-Snowball170Dr Felicity Jeffries and
Mr Kim Snowball
Royalties for Regions zeitgeist

She spent five years as the Executive Director of Clinical Reform at WACHS, overseeing a number of projects including the Southern Inland Health Initiative, which is often touted as something of her baby,

The SIHI aimed to transform health services in the State's south by tipping more than $560m into GP services, primary health care, hospital upgrades and telehealth services.

For Felicity, the key was to preserve and support the models of health care that worked for rural areas, not replace them.

"SIHI was about getting more resources to support the GPs already working there and helping them to achieve a better lifestyle, so that they would stay in the communities where they were needed."

Other initiatives included the Rural Practice Pathway (which now puts an extra 30 junior doctors in country areas each year) and the Emergency Telehealth Service (which last year won the Premier’s Award) were key.

What did she bring to the table to see these services come to fruition?

Sharing the doctor experience

"What it meant to be a rural doctor and how they perceived WACHS. This changed behaviours and attitudes," she said.

But she is quick to add that she had two big advantages. Her timing was impeccable – the Royalties for Regions funding had just been announced and she was able to access funds for projects. And there was her team, a group of people who "were prepared to work through the bureaucracy to get things done".

While she admits that at times the bureaucracy drove her mad – the business case for funding more junior doctor positions had to be rewritten three times – she remembers WACHS as a place where "people really seemed to care about the work they were doing".

Why, then, did she leave?

As she tells it, both she and her husband, Mr Kim Snowball, the then Director General of the WA Health, had both stepped into the government system with the idea that they would work there for three to five years.

Both held roles with "24/7 demands" and after five years, both were looking for challenges that allowed for a better work-life balance. There was also emotional investment her role demanded.

"You feel like you are responsible for all of the clinical services in the entire State, and you want to make sure every single one of them is responsive and is supported," she said.

Jefferies-Felicity-Dr Mar15.170Dr Felicity Jeffries

A new era of advocacy
Today she and Kim head up HealthFix Consulting. As a Director, Felicity now lends her expertise to organisations across a variety of fields, from policy development to education and training.

She has been involved in a review of the national registration and accreditation scheme and a review of the WA telehealth services. She is currently working on projects involving the WA General Practice Education and Training and Silver Chain.

In regards to telehealth, Felicity has researched governance and business models for WA Health to ensure better access for rural patients to both private and public health services, while for Silver Chain she is helping to guide it through an expansion of its junior doctor placement program.

"The work with WAGPET has included an assessment of the community residency program and its potential to expose more junior doctors to the rewards and challenges of general practice through early placements. I recently completed a review on the PGPPP in WA, which is highly regarded by supervisors, junior doctors and communities alike."

"At HealthFix I am choosing which issues to take on," she says. "It's hard sometimes because I am very conscious that there are still problems out in the country, but this time I am not the one charged with fixing them."

Rural general practice, and getting the right workforce for the country, remains a pet subject. Just over a year ago she was commissioned to produce a report for Curtin University on the feasibility of a third WA medical school.

The report, titled Western Australia: A Sorry State for Medical Education and Training, estimated the State has a shortage of 950 doctors. It again highlighted that this shortage is more acute in rural and regional areas.

Any new medical school, she argued in the report, must commit to producing graduates predisposed to take up general practice in these areas – otherwise the investment would not be worthwhile.

"While increasing the number of medical school graduates will help, what we also must do is make sure that they are going into the specialties and communities that need them the most. We need to make sure we are creating the workforce that the community needs, rather than leaving it to chance. We want to be able to get medical students into areas like general practice, because we know there is a need."

While she admits to missing the cradle-to-grave medicine of general practice, particularly telling a woman who has been trying to start a family that she’s pregnant, policy is her future.

"I really do feel that I can make the bigger difference by doing what I am doing now."