Purpose from grief

Dr Luke McIntosh’s path to general practice started as a first-year medical student grieving the loss of his mum, Leanne, to breast cancer. Throughout the illness, it was a supportive GP in their Geelong hometown who made all the difference to Mrs McIntosh and her family in the last years of her life.

“Dr Ward really did inspire me because he displayed all the characteristics of an absolutely fantastic GP,” says Dr McIntosh, who was in Year 12 when the diagnosis was made. “All the way to the very end when Mum passed away, he provided so much support, not only to Mum as the patient but to the family. It just made a very difficult situation a lot more tolerable. From that day I aspired to become a GP and to live up to the example that he set. That’s what’s driving me still to this day.”

A community mindset

Dr McIntosh threw himself wholeheartedly into community life after arriving in Mundubbera as a GP registrar in February 2020. Mundubbera is a town of about 1,200 people in the North Burnett region of Wide Bay. “Everyone has been so welcoming and have been encouraging me to get involved in the community. Before I arrived, I was already signed up to the local touch football team and the squash competition,” he says.

Whether it’s providing first aid at touch footy, helping the local retirement home association or speaking at events such as Australia’s Biggest Morning Tea, Dr McIntosh is active in community life. He’s also taken a proactive role in community mental health, working with the local suicide prevention group, and teaming up with the local school principal and school nurses to plan sessions on resilience and mental health for students.

“Mental health in rural communities is quite a challenging topic,” he says. “It is something that for a long time has been overlooked, but we are seeing a lot more focus on it and a lot more funding from the state and federal governments, which is really exciting. Still, we’re having issues with accessing face-to-face services, so I’m very happy to be able to use my background in mental health training to provide some of that support in my role as a GP. We’ve been able to use telehealth psychology services, and that’s been helpful for our community. Thankfully, our town has a local Suicide Prevention Network and they’re doing good things on the ground and providing support to families affected by suicide or providing support to people who have issues with mental health and are contemplating suicide.”

Dr McIntosh discovered his passion for mental health while doing his junior doctor training in Bundaberg. He was loving the regional lifestyle and the rural towns he visited as a registrar completing his Advanced Skills Training in mental health. “I got to visit all the local communities, including Mundubbera, and I thoroughly enjoyed that work and meeting the people out in these towns, seeing the small hospitals and working with the GP,” he says. “When the end of the year came up and there was a job option in Mundubbera, I jumped straight on it.”

Broad experience

He works at the private general practice and the small rural hospital, which includes an emergency department, a general medical ward and a nursing home. He’s completing his RACGP Fellowship along with a Fellowship in Advanced Rural General Practice (FARGP). “Being here as a registrar, I get such a broad exposure to a number of clinical scenarios,” he says of working in a rural town. That has really prepared me well for not only the exams, but just in general it builds my confidence in becoming a good GP.

“It’s not always easy to get certain imaging scans or access to specialists so you really do have to break down the medical presentations to their basic features and go back to solid clinical reasoning and medical judgment to try to help the patients as best you can. You can’t always have access to instantaneous results with a CT scan or MRI. Even blood tests take a lot longer to come back. Although that has its challenges at times, it’s really enjoyable and it allows you to think through the presentations. I think a good GP is someone who can sit down with a patient, listen to their story and work with the patient to achieve the best possible health outcomes. I would like to think that my experience in mental health and the skills I have learned in effective communication are helping me achieve this goal and is helping the patients in my community.”

Supportive network

Dr McIntosh says JCU GP Training’s Wide Bay office is a source of support for the area’s rural registrars, helping to build a professional network. “Early on in COVID when everyone was worried, they were calling to check in and make sure everything was all right,” he says. “We’re really lucky that we have a good telehealth model for the rural registrars so even though I’m at least a few hours away from the nearest registrar, each week we can still catch up on Zoom. You do feel like you’ve got a bit of a community of registrars that you can bounce ideas off and learn things from. That’s really important because it can become a bit isolating out in the rural communities. Having that regular catch-up facilitated by JCU really helps smooth the process and transition into the rural town. We learned a lot through those workshops and half-day releases, and it really did prepare me well for the exam. They constantly got you thinking about clinical presentations and rational use of medications and pathology and imaging.”

Rewarding work

“Working and living in a smaller community, getting to meet everyone and feel like you’re a more valued part of the community was a big drawcard for me,” he says. “It becomes a lot easier to develop that rapport with patients when they see you down at the local show and they see you at the local Anzac Day Parade and things like that. You still do get to go away for weekends and get to enjoy some of the highlights of the big cities but coming back to live and work in a town like this is so rewarding and it’s something that I’ve really valued.”