Rachel’s rural connection

Growing up in Perth, studying in Adelaide, and practising abroad early in her career, Dr Rachel James never imagined taking up practice in regional New South Wales.

But for a little over two years now, Rachel and her husband Ben have been the new doctors at a family-run practice in Deniliquin, where they have forged strong ties with the community and found a place they’re happy to call home.

“I always wanted an exciting career and I always wanted a bit of an adventure. When I was growing up, I thought that had to be outside of Australia but by doing med school and getting the chance to do lots of rural rotations, I realised it could be within Australia. There's just so many different lifestyles that you can have when you work in the country.”

While it wasn’t part of the original plan, the perfect combination of a great career and a rural lifestyle made Rachel’s decision to move to Deniliquin in 2018 an easy one.

“When you move to the country, it's not just choosing a job. You're choosing a lifestyle.

“I had lots of experiences as a junior doctor in rural South Australia. Then I went to Wagga and did two-and-a half years there. It was a beautiful hospital and it really supported me in getting that scope of practice that I needed to work as a rural generalist.  I worked in emergency, anaesthetics, obstetrics and gynaecology, and paediatrics. From our time there, we decided we really liked the Murrumbidgee region and wanted stay. We wanted to do the rural GP job and loved the idea of living in a smaller town.

“Then Deniliquin Clinic came up as an option. My husband had a few family ties here. We had been here for holidays and just loved the river and the people in the town We had a think about what type of life we wanted and thought maybe this could be our new home.

“So, we came down and met the doctors here and they were just all so supportive.

Custodians of care

For Deniliquin Clinic Practice Manager, Sarah Campbell, bringing in Rachel and Ben was about securing the future of the practice.

“This clinic was set up by a doctor who had been here for many years and established himself as a trusted advisor to the local community. When my father came along as a registrar, the Clinic and the connection with the community was passed on as a custodian arrangement, and now we have gotten to a point where we need to pass on that community knowledge to the next generation.

“We were really particular about who we were going to pick. We’re a tight knit community and the role of a GP in a place like Deniliquin is vital. We rely on them quite heavily not just for the health and wellbeing of patients, but relationships and knowledge beyond the practice. And people want to know their doctor is going to stay around and be a stable part of our community here.”

Building strong connections with her patients is part of the appeal for Rachel.

“I think rural GP is a job like no other. The continuity of care is amazing. You really get to know your patients. It’s rare these days that I have to say hello to my patient and not know who they are. I get to manage them here in the Clinic, but I can also take care of them over in ED and on the ward. The continuity is second to none.

“Out here you get that entire scope of that patient’s care and it means you can get better healthcare outcomes. I enjoy being able to take care of patients in every stage of their health.”

Supporting the rural choice

Since moving out of the capital cities, Rachel has become increasingly invested in the plight for quality regional and rural health care. Such is her passion for living and practising in a rural setting that in 2019 she created an award-winning short video that highlighted its many benefits.

“I really wish we had more doctors here. There's such need. And the truth is, if every GP in Deniliquin worked every day and consulted for 15 hours each day, there would still be people needing doctors. I just don't think that's good enough for the populations that live in rural communities.

“Everybody deserves to be able to see a GP when they need to see a GP. I think part of doing that video was not only showing what the positives are, but also saying that this is where we're needed. This is where you can make a difference. This is where your career can really flourish.”

Focus on mental health and wellbeing

For Rachel mental health and wellbeing is a critical part of rural practice.

“Mental health affects every interaction with healthcare and there is a portion of every one of my consults that's about mental health, even though it might not be the direct reason that somebody comes in.

“At the moment with COVID-19 it's starting to get really tough. It was already tough here in Deniliquin beforehand, with the drought and the reduction in our rice mill – we’ve been having a few battles on multiple fronts – but now more than ever it’s about making sure that people are okay. Some people don't actually voice that they're going through a hard time until they're asked about it and being a GP is the perfect opportunity to do that.”

Rachel’s top tips for maintaining mental wellbeing:

• Focus on the things you can change: At the moment there's so much happening in the world, and there's very little that we can control. But thinking about all of that can feel overwhelming. If we can just focus on the things we can do to make somebody else’s life a bit better, that’s achievable and it creates a really good community environment.

• Always reach out for help: Whether that's to a friend, a family member or your doctor, go and have a chat with somebody. You'd be amazed at what a talk can do and how much better you feel once you've expressed what you're going through.

• There are other sources of help: If you don't feel like you can open up to the people around you, there's always Access Line Lifeline and other supports available. The important thing is that you just to put your hand up and say, “I need a bit of a hand here.”

To access local support services please call our Central Access and Navigation team on 1800 931 603 or email can@mphn.org.au. This is not an emergency or crisis service and is available during the business hours of Monday to Friday between 9am and 5pm. For more information on local services click here.

The Australian Government resource Head to Health has digital mental health and wellbeing resources, for you or someone you care about – visit headtohealth.gov.au.

Anyone who is experiencing a mental health emergency (themselves or others) should call Mental Health Line 1800 011 511, Lifeline 13 11 14 or call 000.