Why become an Aged Care General Practitioner?

Dr Helen Steinke
Dr Helen Steinke

Dr Helen Steinke’s story

As a General Practitioner in private practice with 20 years’ experience of managing patients from cradle to grave, the decision to move from private practice to aged care, dementia and palliative care was relatively straightforward. My skills in geriatrics were being honed while in community practice, and then having gained my Graduate Diploma in Palliative Medicine my client base was heavily skewed towards the ageing, the aged and those nearing the end of life. The misapprehension that this broad range of people required less intensive care, less time, and less skills could not be further from the truth.

The ageing population has chronic and complex medical conditions that require active management on a regular basis. Longevity has increased as advancements in technology and medicine have grown, and consequently we are expecting more sophisticated management of our health for longer. Many of the conditions I see are not only complex but are unique to this generation. I am constantly presented with new conditions, forced to rethink management plans for special circumstances, and intellectually challenged with unusual pathology; in short, I am never bored! I believe strongly that aged care and all it entails should be viewed as a subspecialty within the broader framework of general practice.

Would I encourage young (and not so young) GPs to consider aged care as a career path? Unreservedly YES. It provides the perfect mix of medical challenges, clinical rewards, and personal growth.

HA Medical

Part of the satisfaction of working with aged clientele is knowing that I am part of a small group of doctors who elect to practice in this field. The 2019-2020 Royal Commission has challenged many GPs and possibly forced them to reconsider whether working with the elderly in aged care facilities is for them. I for one believe the current climate has offered more opportunities for scope and change. Increasingly GPs are being viewed as vital parts of the aged care health team and aged care facilities are being upgraded to be equipped with consulting rooms, means for performing minor procedures at the facility and staff who are being constantly upskilled. As a GP working in aged care facilities, I am often asked to advise on clinical governance matters, provide leadership, and meet with the multidisciplinary team.

My daily workday is flexible and ever changing. The routine and structure (i.e. appointment times) of private practice do not apply. I am free to organise my day in a way that suits my patients and my lifestyle. I can think of very few other roles within medicine that are this adaptable.

While all those practical and tangible components of practicing aged care are easily identified and measured, the overwhelming benefit of practicing in this field is the joy I take from feeling as though I have made a difference. Every day as an aged care GP I strive to improve the quality of life of my residents, while acknowledging that their medical conditions are reaching a point where management is changing. The privilege of working with the patient, their family, and the staff of the ACF in providing optimal and appropriate medical care is immeasurable. The emotional and psychological support we GPs offer can be challenging and tiring, so it is worth reflecting on our skills, capabilities and limits as care givers.

Dr Helen Steinke’s biography

Having finished school in rural NSW I was very unsure as to where my aspirations and goals lay so decided to bide my time by moving to Sydney to study nursing as part of the hospital-based training programme.

Three years later with my Registered Nurse qualification I knew this path would not sustain me, so I went on to study psychology in a Behavioural Science degree. Working as a psychologist in a large acute care hospital as part of a multidisciplinary team further whetted my appetite for more knowledge.

I was accepted into Sydney University to study medicine, and after the 6 year degree (which was stretched to 7 years in order for me to produce baby#1 midway through 5th year) I emerged as a (slightly) mature aged intern. I followed the predictable course of internship, residency and thought always general practice would be an ultimately sensible, family-oriented choice.

Two more children and I found myself drawn towards Rehabilitation Medicine. I completed my Physician part one exams but decided this specialty was not for me and returned to the GP career path. I relished being involved in the care of the community and always understood the privileged position the family doctor holds.

The area I practiced had a high proportion of middle-older aged people and my predilection for their management grew. I decided to study palliative medicine and after 2 years of study through Melbourne University I earned my post graduate diploma. Thereafter my focus grew, as did my advocacy for the betterment of care and management of the frail elderly.

GP Story