Interview with Hayley Lindsay – Invercargill, New Zealand

At the southern tip of Aotearoa, Hayley Lindsay delivers vital ultrasound services to the Southland community, from Invercargill to Te Anau, Gore, and even Stewart Island. Born and raised in the region, Hayley combines local insight with specialist expertise in obstetrics and gynaecology, playing a crucial role in early detection and patient care for those far from tertiary hospitals. She reflects on the privilege of caring for familiar faces, and the deep satisfaction that comes from ensuring her community has access to high quality imaging close to home.

Invercargill is New Zealand’s southernmost city. What is it like delivering ultrasound services in such a unique location?

I feel incredibly lucky that I get to provide ultrasound services to Invercargill and the wider Southland community. No day is ever the same. I can start the day with antenatal or general ultrasound, knowing an acute scan can come in at any time. As Invercargill is so far away geographically from a tertiary centre, ultrasound imaging is relied on heavily by both our local referrers and out-of-town specialists.

Being a sonographer in Southland really broadened my skills due to the wide range of cases.

I feel privileged that there is a huge variety of work. As a general sonographer, who trained in a large city with tertiary centres, I have always had a strong interest and subspecialised in obstetrics and gynaecology. I am fortunate since working rurally to have a broad clinical exposure. This has allowed me to step out and not only develop my skills in obstetrics and gynaecology, but to find new passions within other avenues of sonography, such as MSK imaging. Learning MSK ultrasound was imperative to save patients having to go elsewhere to get MSK scans.

We have closer professional relationships with referrers and specialists, which builds up a good continuity of care.

Are there particular health conditions or patient needs in Southland that shape the kind of work you do most often?

High level obstetric ultrasound is critical, given the large distance to higher level maternal care. Our closest maternal fetal medicine is roughly a 7-hour drive from Invercargill. Early detection of fetal abnormalities or pregnancy complications allows early referral to Dunedin or Christchurch. Some fetal abnormalities require the mothers to give birth in Auckland (a 2-hour flight away). Picking up these fetal abnormalities antenatally can be lifesaving.

Acute/emergency work is also important in Southland, since definitive surgical or specialist interventions may require patient transfer out of the region.

How do you think geography influences access to imaging for people living in your region?

Invercargill has a very large and wide catchment area. We service not only the Invercargill population, from Te Anau, Gore, the bottom of the South Island and Stewart Island. On any one day, it is not uncommon to have a few patients drive 150 km+ to arrive for their ultrasound examination. Patients from farming communities and remote areas rely heavily on accessible imaging. This means that while we have the patients in the department, we adjust our bookings so that most anatomy scans are completed on the day, rather than having to get the patients back for completion.

If the patient has to travel to Invercargill for a specialist appointment, we facilitate same-day appointments to lessen the burden of travel on our patients. We also try to extend examinations if needed to limit out-of-town travel.

The nearest tertiary hospital is Dunedin Hospital; this is over 2.5 hours away by road. This means imaging services in Invercargill play a crucial role in providing timely diagnostics without patients having to travel long distances.

In Southland, the climate is often cold, wet, windy or snowy. This heavily affects patients’ travel from out of town or flights in from Stewart Island.

What do you enjoy most about working in Invercargill and serving this community?

I am originally from Invercargill, so it is nice to be back in my hometown serving the community, as Invercargill is a smaller, close-knit community.

I get to build a rapport with patients. I am privileged to scan patients throughout their multiple pregnancies, so you end up getting to know the patients personally, making care more connected and tailored.

We have closer professional relationships with referrers and specialists, which builds up a good continuity of care. I also love that we have monthly multidisciplinary meetings discussing abnormalities with our specialists; the discussions are great as we get some feedback on scans and answers to clinical questions.

Have there been any moments in your work that really highlight the importance of having sonographers based locally?

There are so many, but honestly, on the days when an abnormality or pathology is identified, this can avoid dangerous delays, sparing patients stressful and costly travel for an examination that we can do locally. This is rewarding as it allows clinicians to act immediately.

Looking ahead, what changes or improvements would make the biggest difference for sonographers working in Invercargill or in the Southland region?

Honestly, just having more sonographers down here would be the dream. Maybe having one or two sonographers Te Anau or Gore-based, would make a huge difference in the amount of travel our patients would have to do. I would also love to be involved in multiregional CPD so that I am always learning and my skills are always developing.