Tena koutou on Dec. 1, 2019,
I promised to talk about the medical system here in New Zealand, or at least the perspective I have in a rural farming town in mid-south North Island. Going back to May 2019, I had a description of the the Taihape Health clinic in front of me on my computer to consider as a locum tenens physician, and then an interview by phone. I had my misgivings. Why not the coast, or the South Island? Why a place I couldn't even find in Fodor's Guide to New Zealand? And the interview was not reassuring.
I told them I didn't really have experience reducing fractures and casting them. All ok. I said I hadn't really treated cuts with stitches for awhile. O.K. Another locum physician came on the phone and told me how she reduced a shoulder dislocation when she first arrived. I signed on. There was the catch that on call was shared among the doctors and nurses. This consisted of a Saturday clinic from 9am-12pm with only the receptionist and provider there. If patients called in on Sunday by 9 a.m., they could be seen between 10-12. After I started at the clinic, got acclimated and knew everyone's names, and met John, a wonderful locum physician from Australia, and Antonia, my supervisor, and physician there for some years, I settled in. The Great Anxiety persisted about my call weekend, which was due to occur over the New Zealand Labor Day weekend. Stories about farm accidents:
the farmer who showed up with a knife in his arm at the clinic, the beekeeper who fell over with a cardiac arrest, farmers charged by bulls who had broken sternums and ribs and collapsed lungs.
I showed up at a couple of Saturday clinics to familiarize myself with emergency equipment, including the EKG machine, which doctors typically leave to nurses, but I would be by myself (with receptionist). Asthma attacks and chest pain are common. It didn't help that the first day I was at the clinic, several patients went off in ambulance or helicopter for various emergencies.
On my weekend, one of the nurses volunteered to come in to support me, and I was relieved and grateful. Nothing horrendous happened, but I have done some suturing and treatment of cardiac chest pain since then. We are an hour+ away from the closest hospital, and so much has to be done here. The nurses are so competent, and can cast uncomplicated fractures and do some suturing as well.
They are very underpaid, but extremely bright, funny, and light-hearted. Everyone is a farmer or married to a farmer. Tea time is built into the appointment schedule--morning tea and afternoon tea, and nurses will leave patients in the waiting room to take time out for this. I have had a difficult time doing this, but will occasionally join them. It is, really, a very civilized custom.
On patients' charts, it will be designated if the patient is Maori, or Pakeha (European descent), even though many folks are of mixed race/culture. Life seems to be more easy-going between Maori and non-Maori here compared to what I hear about regions farther north, and closer to Auckland.
A common medical problem here is bad teeth, because dental care is so expensive, and dental hygiene not so commonplace. Many people come in with tooth abscesses, and need antibiotics, and it is not uncommon for even people in their 20's, early 30's to be missing teeth, or no teeth. Medical care, including hospital care, is universally covered by socialized medicine, but if one requires a hip replacement, or example, there may be a long wait if it is considered non-urgent. About a quarter of the population has access to private insurance. Specialists are in short supply. There is a mobile operating room, which goes throughout New Zealand to rural sites, and makes the tour every 5 weeks. It is amazing--simple general or orthopedic surgeries done in the town where a patient lives, and then they move on
to treat the next patients.
Until later,
Adrianna
I promised to talk about the medical system here in New Zealand, or at least the perspective I have in a rural farming town in mid-south North Island. Going back to May 2019, I had a description of the the Taihape Health clinic in front of me on my computer to consider as a locum tenens physician, and then an interview by phone. I had my misgivings. Why not the coast, or the South Island? Why a place I couldn't even find in Fodor's Guide to New Zealand? And the interview was not reassuring.
I told them I didn't really have experience reducing fractures and casting them. All ok. I said I hadn't really treated cuts with stitches for awhile. O.K. Another locum physician came on the phone and told me how she reduced a shoulder dislocation when she first arrived. I signed on. There was the catch that on call was shared among the doctors and nurses. This consisted of a Saturday clinic from 9am-12pm with only the receptionist and provider there. If patients called in on Sunday by 9 a.m., they could be seen between 10-12. After I started at the clinic, got acclimated and knew everyone's names, and met John, a wonderful locum physician from Australia, and Antonia, my supervisor, and physician there for some years, I settled in. The Great Anxiety persisted about my call weekend, which was due to occur over the New Zealand Labor Day weekend. Stories about farm accidents:
the farmer who showed up with a knife in his arm at the clinic, the beekeeper who fell over with a cardiac arrest, farmers charged by bulls who had broken sternums and ribs and collapsed lungs.
I showed up at a couple of Saturday clinics to familiarize myself with emergency equipment, including the EKG machine, which doctors typically leave to nurses, but I would be by myself (with receptionist). Asthma attacks and chest pain are common. It didn't help that the first day I was at the clinic, several patients went off in ambulance or helicopter for various emergencies.
On my weekend, one of the nurses volunteered to come in to support me, and I was relieved and grateful. Nothing horrendous happened, but I have done some suturing and treatment of cardiac chest pain since then. We are an hour+ away from the closest hospital, and so much has to be done here. The nurses are so competent, and can cast uncomplicated fractures and do some suturing as well.
They are very underpaid, but extremely bright, funny, and light-hearted. Everyone is a farmer or married to a farmer. Tea time is built into the appointment schedule--morning tea and afternoon tea, and nurses will leave patients in the waiting room to take time out for this. I have had a difficult time doing this, but will occasionally join them. It is, really, a very civilized custom.
On patients' charts, it will be designated if the patient is Maori, or Pakeha (European descent), even though many folks are of mixed race/culture. Life seems to be more easy-going between Maori and non-Maori here compared to what I hear about regions farther north, and closer to Auckland.
A common medical problem here is bad teeth, because dental care is so expensive, and dental hygiene not so commonplace. Many people come in with tooth abscesses, and need antibiotics, and it is not uncommon for even people in their 20's, early 30's to be missing teeth, or no teeth. Medical care, including hospital care, is universally covered by socialized medicine, but if one requires a hip replacement, or example, there may be a long wait if it is considered non-urgent. About a quarter of the population has access to private insurance. Specialists are in short supply. There is a mobile operating room, which goes throughout New Zealand to rural sites, and makes the tour every 5 weeks. It is amazing--simple general or orthopedic surgeries done in the town where a patient lives, and then they move on
to treat the next patients.Adrianna
Fascinating! But hey dental in rural America is almost next to non-existent that is what we observed in our tour of the Deep South and in Appalachia. Thanks for the medical report about the job.
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