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Meet GPTQ medical educator, Dr Gillian Eastgate

Dr John Buckley (featured image)

Dr Gillian Eastgate has enjoyed the diversity of general practice, having worked in Indigenous health, addiction medicine and family planning, as well as supporting patients with intellectual disabilities.

“General practice appealed to me as I didn’t like the episodic nature of hospital care. I wanted ongoing relationships with patients and to look after them in their real life, not their hospital life.”

Young love planted the seed of practising medicine

Dr Gillian Eastgate travelled from England to Australia with her family in 1967 at age eight. Her family initially settled in Sydney but after just six months, her father’s job fell through. They then made the move to Brisbane, where she still currently lives.

During high school, Gillian pondered studying English and other languages as most of the women in her family had been teachers. Medicine didn’t cross her mind until an early romantic relationship got her thinking.

“I had a boyfriend whose long held childhood dream was to become a plastic surgeon. He wanted to go to Bangladesh and perform reconstructive surgery for leprosy patients, and that inspired me to contemplate studying medicine,” she explains.

“He did go on to become a plastic surgeon, but leprosy surgery was out of date by the time he qualified, though he did volunteer with Interplast Australia. Of course the romance fizzled out as we were only sixteen, but we’re still friends at age 60!”

A further conversation with a guidance counsellor, who told her that her school performance warranted her considering medicine, cemented her decision.

Deciding on general practice

After high school, Gillian studied for her medical degree at The University of Queensland. She then spent some time getting a small taste of rural medicine.

“I went to Townsville for my intern year, and then spent a year in Mount Isa with short stints at Cloncurry, Richmond and Normanton. I had another year in Mackay and really liked my time in North Queensland,” she says.

“I would have considered practising in a larger rural centre, but I ended up settling in Brisbane because my parents were here. Being from England, I’d grown up without grandparents and I didn’t want my children to experience that too.”

As for her decision to become a GP, she felt it was quite an easy one as she didn’t enjoy working in the hospital environment.

“I really couldn’t see myself spending a lifetime working in the hospital system. General practice is more suitable as I enjoy the autonomy. I also really enjoy establishing ongoing relationships with my patients, and never quite knowing what is going to come through the door,” she smiles.

Practising diversely

Gillian currently practises five days per fortnight at Inala Community Health Centre in the Alcohol and Drug Service, along with a half day of medical education work with GPTQ, plus teaching medical students at The University of Queensland.

“I have a second fellowship in addiction medicine. Much of what I do is ongoing management of opioid dependent patients. The care is similar to what I’d give in standard general practice, but the main difference is I’m focusing on their addiction issues,” she explains.

“They’re very interesting patients because they have a whole range of medical and psychiatric issues, and we have to do quite a lot of liaison with our local GPs when it comes to their care.”

Gillian also spent 16 years working at the Queensland Centre for Intellectual and Developmental Disability at The University of Queensland.

“My role was to provide in-depth health assessments for adults with an intellectual disability. I wasn’t seeing them for their acute complaints; they would visit their regular GP for those. I’d instead see them for a series of hour long appointments, and basically pull apart all of their health conditions and health care, and make recommendations to their usual GP. Practising there, I got to experience a huge range of medical issues,” she says.

A long history of medical education

While Gillian began her medical educator role with GPTQ in October 2019, she has long been involved in medical education, whether that’s as an RACGP examiner or teaching medical students and Registrars.

“I began teaching first year Social and Preventive Medicine when I was in fourth year myself. Later when I was raising my two children, I did quite a bit of teaching at the university. It was good as the university and school terms aligned, so that allowed me to have a bit more time with my kids when they were on holidays,” she says.

“I have always enjoyed teaching and picked up whatever was available in my clinical work. When the opportunity to do ECT visits came up several years ago, I happily took it up. And it grew from ECT visiting to taking on my medical educator role with GPTQ.”

Practising diversely

Gillian currently practises five days per fortnight at Inala Community Health Centre in the Alcohol and Drug Service, along with a half day of medical education work with GPTQ, plus teaching medical students at The University of Queensland.

“I have a second fellowship in addiction medicine. Much of what I do is ongoing management of opioid dependent patients. The care is similar to what I’d give in standard general practice, but the main difference is I’m focusing on their addiction issues,” she explains.

“They’re very interesting patients because they have a whole range of medical and psychiatric issues, and we have to do quite a lot of liaison with our local GPs when it comes to their care.”

Gillian also spent 16 years working at the Queensland Centre for Intellectual and Developmental Disability at The University of Queensland.

“My role was to provide in-depth health assessments for adults with an intellectual disability. I wasn’t seeing them for their acute complaints; they would visit their regular GP for those. I’d instead see them for a series of hour long appointments, and basically pull apart all of their health conditions and health care, and make recommendations to their usual GP. Practising there, I got to experience a huge range of medical issues,” she says.

A long history of medical education

While Gillian began her medical educator role with GPTQ in October 2019, she has long been involved in medical education, whether that’s as an RACGP examiner or teaching medical students and Registrars.

“I began teaching first year Social and Preventive Medicine when I was in fourth year myself. Later when I was raising my two children, I did quite a bit of teaching at the university. It was good as the university and school terms aligned, so that allowed me to have a bit more time with my kids when they were on holidays,” she says.

“I have always enjoyed teaching and picked up whatever was available in my clinical work. When the opportunity to do ECT visits came up several years ago, I happily took it up. And it grew from ECT visiting to taking on my medical educator role with GPTQ.”

Learning from Registrars

With a broad range of specialty experience, it’s no surprise Gillian particularly enjoys teaching those subjects.

“I gravitate to teaching topics about drugs, alcohol and pain management. It’s an area I hope Registrars find engaging. I’ve also worked as a family planning doctor, so anything to do with women’s health excites me. Of course the other one is disability due to my experience in that field,” she says.

However, Gillian says she does find it challenging to teach some mainstream GP topics as she has worked in her special interest areas for so long.

“I have to re-educate myself on the topics I’m not so familiar with anymore, which is actually a fantastic thing to do. An example this year was teaching the diabetes unit. The Registrars and I were collectively bamboozled by the sheer range of new medications, and the enormous amount of information about which ones might suit which patients. It was very interesting to go through that with the Registrars because it was as new for me, as it was for them.”

On being a compassionate GP

When it comes to advice for Registrars training towards their fellowship, Gillian discusses both the practical and the inspirational sides of general practice.

“I’ve had many discussions with Registrars about billing. Many bulk bill their patients and don’t see large numbers so ultimately, they’re practising in a way that may not be financially viable in the future. It’s important for you as a Registrar to work out what you’re going to do about your billings, so you can actually make a living out of it,” she says.

“On the more inspirational side, I encourage you to think about what kind of GP you want to be. Think in terms of how much of a valued resource you can be for your patients, as you’re there with them for the long term, and through many life changes.”

At the end of the day, Gillian feels much of being a great GP comes down to being compassionate.

“I teach medical students a unit called Vulnerability in Medicine, looking at the human side of the patient experience. Recently, one of my students asked, ‘What if I have an obnoxious patient or someone I don’t like? How can I feel compassion for them?’” she says.

“In the end, I don’t think we have to feel positive towards a patient to behave in a compassionate manner. Compassion is about treating that patient with respect, despite how they’re behaving, and doing what you think is the best and safest thing in that circumstance. And I suppose that’s what we’re called to do in general practice all the time.”