Feature: GP Obstetrics Continued from Page 8 The eight GP obstetricians form the core of the service, with three covering a mix of public and private cases and the rest only on call for public patients. The specialist obstetricians have recently decreased from three to two with the retirement of Dr ‘Bert’ Hellmuth after 25 years (having helped Gary enormously over the years). The midwives employed by the public hospital complete the team picture. Maud Bellas Maternity is a busy unit, with more than 1200 deliveries a year. “The GPs run a publicly billed antenatal clinic at the hospital. It’s meant to be a costfree way of getting good care and it operates in tandem with a hospital-based antenatal midwifery service,” Gary explained, adding that the former is Commonwealth funded and the latter funded by State. The doctors review the mothers with uncomplicated pregnancies at 20, 28 and 36 weeks. Complicated pregnancies are reviewed as required, with the specialists. Weekend private on-call is mercifully rotated between two obstetricians and the three GP-obstetricians who do private work, which means Gary gets a break and can plan other activities. When the government took over. Armadale Hospital from Galliers in 2005, the private obstetrics was maintained, and from December last year, private and public patients have been delivering in a common ward with single-suite rooms provided for private patients. The single rooms are slightly bigger and husbands can room-in if need be. “It’s pretty important to have privacy and quiet for the new parents. I wouldn’t be
I firmly believe in supporting the public system but I get more satisfaction and less harassment from the private system. practising there if there wasn’t a mix of private and public care. I firmly believe in supporting the public system but I get more satisfaction and less harassment from the private system, like my coffee and a bit of a break in my private rooms. It allows me to maintain general practice, really.” Gary works closely with two other GP obstetricians, Dr Adrian Jameson (Kelvale Medical Group) and Dr Nafeesa Moolla (Byford Family Practice). Adrian does anaesthetics as well, and Nafeesa originally hails from South Africa and came to WA from South Australia 18 months ago. Gary’s interest in musculoskeletal medicine includes manipulative and acupuncture skills. He has two children studying medicine, and sees himself still doing
n Dr Gary White, of Armadale Hospital, above, with one of his babies.
obstetrics in five years. He said the arrival of two new advanced diploma registrars from King Edward (GP-obstetricians with C-section skills), will be good for the group, and he praises the specialist support for this initiative. Hopefully, word will get around and two more obstetrician-gynaecologists will materialise to provide both obstetrics backup and non-acute gynaecology and fertility services at Armadale Kelmscott Hospital. l
By Dr Rob McEvoy
What GPs with Advanced Diplomas do There are 261 GPs diplomates in Western Australia – 43 with the previous DipRACOG and 29 with the new advanced diploma. The advanced diploma trains GPs to do caesarians, after performing a minimum of 15 elective and 15 emergency LUSCS while in training. They are also trained to provide a variety of advanced GP obstetrical and gynaecological services. (See below) The Royal Australian New Zealand College of Obstetrics and Gynaecology are in the process of compiling a national database of the practice profiles of its diplomates – with only a 38% response so far. The DRANZCOG training offers training for GP obstetricians/doctors who wish to: • Provide shared ante and postnatal
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care with specialist obstetricians, GP obstetricians or a specialist hospital • Provide office gynaecology • Provide family planning • Manage the antenatal care of low to moderate risk patients • Perform normal deliveries and assisted deliveries • Perform basic gynaecological procedures The DRANZCOG Advanced training is for those who wish to provide all of the above plus: • Manage complicated labours • Perform LUSCS (Elective and Emergency) safely and confidently • Provide support for GP obstetricians when specialist obstetricians are unavailable
• Perform laparotomies in emergency gynaecological situations • In special circumstances, be able to perform laparoscopies and/or colposcopies Albany Hospital, Joondalup Health Care Campus, Bunbury Regional Hospital, Kalgoorlie Hospital, King Edward Memorial Hospital for Women, Osborne Park Hospital, Rockingham General Hospital and Swan District Hospital are all accredited for DRANZCOG training. All except Bunbury are accredited for Advanced Training. The latest statistics from the Department of Health show there was a total of 14,071 babies born in public hospitals in WA – 12,085 born in the metro hospitals and 1986 in regional hospitals. l
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