WA News Trailblazers A Passion for General Practice
A Passion for General Practice
Written by Ms Shannon McKenzie
Monday, 01 June 2015


Perlen-Nadine-Dr 195Dr Nadine PerlenMention nutritional medicine to a group of GPs and the responses will more than likely vary from genuine interest to a polite raised eyebrow. Lockridge GP Dr Nadine Perlen, however, is passionate about the field, and a proud advocate of the benefits it can have for patients as part of integrated care.

What began as a passing interest in her early years as a GP is now a part of her everyday practice, thanks to a long and personal journey with her own sick child.

“When my second son was 10 or 11, he became quite ill. He had gastrointestinal problems initially but then multi-system problems. We took him to a lot of specialists, but none of them could explain his complex symptoms or how they were related. No one thing explained the skin rashes, the head aches, the vomiting, the fatigue. No one could put the whole thing together,” she said.

Nadine wrote a piece for Australian Doctor on her son’s illness and being a ‘medical parent’. That piece was read by a NSW doctor, who pointed her to a nutritional medicine specialist in Brisbane, with whom the family eventually ended up working.

“He took into account things like my son’s nutritional status, gut flora and enzyme deficiencies, food allergies and genetic polymorphisms. It took some time but we did have success. My son is 15 now and he is much healthier. Through his illness I learned so much about nutrition and the body, and I am still learning.”

Seeking answers in different places
Nadine, who studied at the Australasian College of Nutritional and Environmental Medicine, defines nutritional medicine as taking existing and ongoing knowledge of biochemistry and physiology and using this in safe, effective and evidence-based therapy to improve patients’ health. This applies to diet, nutritional supplements and even herbal medicine where it is effective and supported by evidence.

“On the base level, many of our patients have an inadequate diet. Even just working with people to cut sugar or to identify certain food groups with which they have a problem can help,” she said.

“Some of the people I treat have chronic conditions and in some cases – for example fibromyalgia – modern medicine doesn’t have a whole lot to offer them. Nutritional medicine gives doctors another approach, another way to look at these problems which also involves the patient. People like to be involved in treatments that do not necessarily mean more pills.”

Are medical colleagues as receptive to such an approach?

“I get varied responses. Some are fascinated; they’re open-minded and want to know more, others are less so,” she said.

A nod from the College
Now the RACGP has the Faculty of Special Interests with an integrative medicine working group, more doctors may be encouraged to take a second look at the field, but Nadine concedes it will take years before this approach is widely accepted.

“That is because [medical therapies] must be based on evidence, which is there for nutritional medicine but it is still growing. One thing this field does have on its side is that it is very scientifically based. Plus nutritional medicine is using new technologies many people will be unfamiliar with.”

Twenty years into her career her passion for general practice has not dimmed. For Nadine it is all about holistic patient care and the personal connection to patients.

She has spent her entire career at the Lockridge Medical Centre, caring for a diverse patient population that includes vulnerable patients such as refugees, immigrants and Indigenous people.

Medical-teaching-supervisor190Lockridge’s diverse demographics
“You see everything here, that’s what makes it a great place to work. We have always seen more chronic diseases which are typically associated with poverty and lifestyle, including mental health problems,” she said.

She has also managed to get herself out of the Perth metro area courtesy of the Royal Flying Doctor Service.

For the past 13 years she has regularly travelled to Pingelly where she offers a female GP service to women residents. Previously funded as part of a Federal Government push to offer gender choices in regional and remote areas, Nadine’s monthly visits have proven hugely popular.

As of July 1, Rural Health West has taken over the administration of the program offering a lifeline to those women who use the service]

Importance of mentoring
Nadine was inspired to take on this role by GP academics at Monash University, where she attended.  

She said they went beyond the clinical and taught her about the practical elements of becoming a doctor, such as attitudes toward patients and strong communication skills.

When Nadine moved to Perth after she finished her training, she actively sought out a teaching practice. She was directed to the Lockridge Medical Centre, which was started as a teaching practice in the 1970s by GP academics from the University of Western Australia.

Her teaching role is obviously a good fit. In 2009 she won the Royal Australian College of General Practice’s GP Supervisor of the Year Award.

“The phone call from Dr Chris Mitchell (then RACGP president) came through about two months after my father had passed away. It was a bit sad that he wasn’t able to see or be a part of it. But it was really nice to be acknowledged for what I enjoy and love doing.”

“I have always enjoyed sharing what I know with others. I found that the more teaching I did, the more I got out of it. There is something really nice about mentoring and passing on what you know with others who come after you. I really get a kick out of that.”