Work-life balance the medicine for rural GPs

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Living and working in a small rural community many miles from city life isn’t for everyone – but it’s just what the doctor ordered for two young GPs.

Fiona Neal and Johnny Emery-Barker, who are both in their 30s, are the sole doctors at the medical practice in Dunbeath, a small village on the east Caithness coast.

And though they are both from Scotland’s central belt, they’ve completely embraced rural living.

“This is a perfect place for me,” said fitness fanatic Fiona, 34, who spends her spare time surfing, cycling, running, ski-ing, climbing, hillwalking and anything else she can think of to keep on the go.

Johnny Emery-Barker

It wasn’t just the scenery and the leisure opportunities that attracted Fiona and keen walker, camper and cyclist Johnny, 33, to Caithness. It was the opportunity to live, and just as importantly to practise as a GP, in such a remote and rural community.

And it was largely their experience of a national initiative designed to give newly-qualified doctors a chance to work in some of Scotland’s more far-flung places that persuaded them that country life was for them.

Both doctors signed up for NHS Education for Scotland’s (NES) Rural Fellowship scheme, which offers fledgling GPs an opportunity to get a taste of work for one year in rural general practice. The fellowships, which are run as a co-operative venture between NES and health boards, provide contracted posts in which the GP are allocated a base practice, and are expected to work around half a year there, and have 13 weeks of protected time and a financial allowance to support educational work.

Given long-standing challenges in recruiting and retaining doctors in remote and rural communities, it’s a scheme NHS Highland embraces wholeheartedly, and it was through NHS Highland that Drs Neal and Emery-Barker came to work in Caithness.

They both spent their fellowship years working in small communities throughout the north of Scotland, and Fiona enjoyed the experience so much that she took over the Dunbeath practice not long after it finished. She subsequently recruited Johnny, who had spent part of his fellowship year there.

They both say they’ve been happy to swap the attractions of the central belt for what Fiona described as the “amazing lifestyle” they now enjoy. And both are grateful for the opportunity that the Rural Fellowship scheme gave them.

The Dunbeath docs agree that the big plus of working in a rural practice is that it’s easier to build up a relationship with their patients and the community at large.

Fiona Neal

“We have 520 patients and I like the fact that we can get to know them, build up a rapport with them and spend a good amount of time with them,” said Fiona. “We have an ageing population here, many of them with multiple health issues, and I think I actually see quite a high percentage of our population.”

Johnny added: “There is a lot of stress associated with being in general practice these days, associated with GP shortages, increasing patient demand, the focus on trying to ensure that patients are kept at home, where they are more comfortable, rather than be admitted to hospital. In city areas, the stress can be constant, but here it comes in peaks and troughs, which makes it more manageable.

“And I love the fact that patients can call us for an appointment and, more often or not, be seen the same day.”

While the Dunbeath GPs have a good working relationship with neighbouring practices, and with medics at Caithness General Hospital in nearby Wick and Raigmore Hospital in Inverness, a two-hour drive away, they say that a particular attraction – and challenge – of rural practice is the range of work it offers.

“As GPs, we see more medical emergencies here than we would in the city,” said Johnny, who works for the Dunbeath practice two days a week and also does locum shifts in Brora and Helmsdale. “It may be quieter here but we’re kept on our toes!

“And I think we both have the kind of work-life balance we were looking for.”

Fiona added: “I love my job, and I can honestly say that I look forward to coming to work every day. But I also love my time off. In a place like this, why wouldn’t I?”

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