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Te Korowai Hauora o Hauraki GP Martin Mikaere was honoured with the Peter Anyon Memorial Award at the The Royal New Zealand College of General Practitioners Conference for General Practice last month.
The Peter Anyon Memorial is given in the memory of Dr Peter Anyon, who is recognised as having made an important and valuable contribution to the vocational education of general practitioners.
Dr Mikaere made the decision to become a GP after taking some rare time out from his then 80-100 hour working weeks in his orthopaedic role at Whangarei Hospital.
He had taken his two young children to the beach and had so much fun with them, he went back the next day to do it all again. That night he turned to his wife and said he was going to become a GP.
“There’s no way I was going to live my life like this anymore,” he said.
“We had such a fantastic couple of days together and it started to dawn on me what was important.
“I had been working hard – and absolutely loving my job – but barely seeing my family.”
“People would say I was making a big sacrifice for my family. But the only thing I was sacrificing was my kids’ time with their dad.”
On his first day back at the hospital Martin resigned. “I went in and spoke to the boss. They were disappointed but understood my decision.
“There were people there that I really looked up to, idolised even, so it wasn’t easy to leave. But I knew it was the right thing to do, and that going back to my home community to start GP training would be a much better option for my wife and kids, and extremely fulfilling for me.”
Now in the third year of General Practice Education programme (GPEP) Martin is thoroughly enjoying work at the Te Korowai practice in Paeroa, which has about 1700 patients, 70% of whom are Māori.
He sees three particular challenges for the future of general practice, the first being the ‘tough sell’ of getting doctors into rural communities.
“In places like Thames and Paeroa, people complain that they never get to see the same GP. There just isn't the continuity of care because we don’t have enough GPs wanting to live here. I’m really not sure how we can solve this.”
Next on Martin’s list is the always-tricky issue faced by GPs around providing care to those close to them.
He understands the Medical Council’s position that this should be avoided in the vast majority of clinical situations but with about 100 whānau living locally, it isn’t straightforward.
He says: “On one hand there's encouragement to work in your own communities and help your people, while on the other there’s an expectation that GPs won’t provide treatment to family members.
“That can be very difficult in small places where there are lots of whānau and not many GPs, and it's really difficult to get locums.
“It’s a tough one - is it OK to do consults with second cousins for example? What about first cousins, aunties and uncles? Where do you draw the line?”
The third big thing on Martin’s mind is how primary care takes advantage of technology, an area he says presents great opportunity but which must be approached with care.
All three issues were included in Martin’s address to the conference, a speech he had about six weeks to prepare himself for after learning of his success in a letter from the College.
“I had no idea that I had even been put forward for this. It was a real shock but I have to say it is pretty cool to be recognised like this.”
Medical Educator Sally Cater, who was Martin’s nominator for the Peter Anyon Medal, says in the award citation: “Martin has returned to his home community to become a GP and is extremely passionate about improving the health of the locals in his community. He advocates very strongly for his patients who need secondary health services.
“His story is inspiring for those who may feel that medicine is an out of reach career for them.”
Source: Royal NZ College of General Practitioners
Amputated limbs, blindness, erectile dysfunction, stroke, kidney and heart disease are just a few complications of a condition suffered by over 200,000 New Zealanders.
Diabetes is a sometimes life-threatening disease that affects three times as many Māori and Pacific Islanders as it does other cultures.
And Ministry of Health figures suggest that another 100,000 New Zealanders could have the condition without realising it.
Te Korowai Hauora o Hauraki dietictian Claire Cannon says once a person gets over the initial shock of a diabetes diagnosis they can focus on implementing positive changes to improve their health.
“I have seen people make a real positive difference to their health by improving their diet, becoming more active and reducing stress,” she says.
Diabetes occurs when the hormone insulin, produced by the pancreas, doesn’t do its job properly. Insulin is needed to balance our blood sugars, which increase when we consume carbohydrates and sugary foods.
There are three types of diabetes.
Type 1 diabetes is an auto-immune condition where the body attacks the cells that produce insulin. Without insulin blood levels in the body remain high resulting in damage to the vessels that supply blood to vital organs. Type 1 Diabetes cannot be prevented but it can be managed through a combination of medication, healthy food choices and exercise. People with Type 1 diabetes need to manage their blood sugar levels with insulin.
Type 2 diabetes is the most common form of diabetes and can be helped by maintaining a healthy weight and through making dietary changes and lifestyle changes.
Gestational Diabetes affects some women during pregnancy when they can’t produce enough insulin to meet the demands of a growing foetus – sometimes up to three times that of normal needs. Gestational diabetes usually disappears after pregnancy, however the woman’s risk of developing risk of developing type 2 diabetes increases by 50-60% in the future, so Diabetes NZ advises yearly blood tests.
The main symptoms of diabetes are frequent urination, excessive thirst, extreme hunger, abnormal weight loss, increased fatigue, irritability, recurrent infections, blurry vision and erectile dysfunction in men.
Claire says some people may not be aware they have diabetes, so if they recognise any or all of the symptoms above, they should see their GP, who can arrange blood tests.
World Diabetes Day is November 14.
Forward-thinking rangatahi leadership group Te Mata Rangatira (TMR), received the national Public Health AssociationTu Rangatira Mo Te Ora Awardon October 11 for exemplary commitment.
A representative group of 21 whānau from Hauraki attended the Parnell, Auckland ceremony as support.
The award is given annually to those who have shown exemplary commitment to making a difference locally, regionally and nationally.
Nominated by TCDC Councillor Sally Christie and Former Green MP Catherine Delahunty, the award was recognition for Te Mata Rangatira’s focus on empowering rangatahi leadership and action.
President of the Public Health Association of New Zealand Lee Tutuki Te Wharau says Te Mata Rangatira’s work was meaningful, successful and unique in challenging rangatahi to be initiators of activities inspiring other young people and the communities around them.
"You have been an instrument of change, and an inspiration or others to continue contributing to the future of rangatahi and their whānau,” she said
She acknowledged and praised TMR’s work, which included developing and sustaining the Hauraki Rangatahi Summit in August this year; bringing whakapapa into the 21st Century and creating whakapapa trails in their local maunga; developing and launching ‘Ko Koe’ - an anti-bullying campaign and working with organisations nationally to change their approach and perspective on rangatahi potential.
Te Korowai Hauora o Hauraki Iwi Health Promoters and TMR co-facilitators Frank Thorne and Carrie Taipari-Thorne say the award and the group’s acknowledgement is evidence of a philosophy they work by, ‘mahia te mahia’ - do what needs to be done, and reap the collective rewards.
“If anything, it has reminded them of their potential and has simply inspired them to think bigger and work harder for their community.”
Every day, two New Zealand tane will lose their lives to prostate cancer. They could be your father, brother, uncle, grandfather, husband or your mate.
Early diagnosis is critical - if detected and treated early, 600 lives a year could be saved.
This month is Blue September and the Prostate Cancer Foundation is raising awareness and funds through initiating ‘Blue Do’ events, where the community can organise fundraisers such as an office morning tea, a baking sale or fishing trip - anything to get a team together to raise vital funds to fight prostate cancer and spread the message for men to look after their health and get checked.
The prostate is a gland located behind a man’s bladder. Part of the reproductive system, it is regulated by the male sex hormone testosterone and is responsible for producing the majority of fluid that makes up semen.
The size of the prostate changes with age, growing rapidly during puberty - fuelled by an increase in hormones - but in an adult it should be the size of a walnut.
Many men begin to have problems with their prostate as they get older. The Prostate Cancer Foundation says most can be caused by simple enlargement of the prostate, but a few are caused by cancer.
Regular prostate PSA tests are recommended for men over the age of 40 if there is a family history of prostate cancer; or who are between the ages of 50 and 70. PSA is a small protein released into the blood by the prostate and if levels in the blood are high it is an indicator that there may be abnormalities in the prostate gland.
Te Korowai Hauora o Hauraki Clinical Services Manager Taima Campbell says prostate cancer may not exhibit symptoms in the early stages so it is important for men to be vigilant in noticing any changes and to have regular check-ups.
“Men having any problems such as pain, fever, swelling, blood and pus in the urine or problems passing urine should consult their doctor without delay,” she says.
For more information, go to www.prostate.org.nz
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