Have car (and phone) – Will travel. Meet rural locum Penny Kagan
A reliable cell phone and a good car place first and second on the list of ‘must-haves’ for rural locum Penny Kagan. And when you consider the size of her patch, it’s easy to see why.
From a lifestyle block on the Otago Peninsula, Penny has spent the last 16 years treating patients from Waimate in South Canterbury to Tuatapere in Southland. Town to town that’s more than 400 kilometres, most of it pretty remote.
But despite the driving and being away from husband Nigel, the life of a rural locum suits 65-year-old Penny just fine.
“As a rule I’m happy to drive up to an hour and a half for a job, and then drive home afterwards,” she says. “Any longer than that and I’ll stay overnight.
“The travelling part is something you can do at a certain point in your career when your family is no longer dependent on you being around. But working in rural medicine is something I believe all medical graduates should do at some point in their career. If being a GP is not their thing they can work in a rural hospital.
“We need doctors out there. You use all the skills you were ever taught and you really have to be a jack of all trades.”
With such obvious passion for her profession, it’s surprising to hear that medicine was not Penny’s career of choice. Born in London and raised for the most part in Switzerland, Penny grew up wanting to care for animals rather than people.
“I always wanted to be a vet,” she explains. “But it seemed so difficult to get into so I settled for second best!”
Penny’s decision to become a doctor was probably by osmosis: her father, uncle and brother all trained to be doctors at the Westminster Medical School in London where she began her studies in 1969. Her brother Nic works at a rural hospital in Southland.
House surgeon posts in London and Dorset followed before Penny moved north in 1977 to become a Senior House Officer in Glasgow, Scotland. Later that year she became a GP registrar trainee in Manchester before emigrating to New Zealand and taking up a Senior House Officer role at Waikato Hospital.
During her time in Hamilton, Penny built up a varied skill set with three month stints in the Emergency Department; Geriatrics/Dermatology; ENT/Ophthalmology; and Anaesthetics.
She returned to London in 1980 as Senior House Officer Paediatrics at Westminster Children’s Hospital before coming back to New Zealand and starting work in Dunedin where, barring a year in the UK, she has practised ever since.
In between various roles and workplaces, her two sons were born. Aidan is a chef, Felix is a surfboard designer and a builder. Both travelled widely and came back to live in the nearby village of Portobello with their respective families.
Among Penny’s career highlights was opening New Zealand’s first practice of women only doctors - Aurora Health Centre in South Dunedin in 1991. “We were known as the four witches!” she says. It’s something she is very proud of but Penny prefers life as a locum to the world of practice ownership.
“It was very hard work,” she says. “There was consensus decision making and lots of meetings that seemed to last forever.
“For me it’s so much better being a locum. All I need is a good car and cell phone. None of the admin is my problem anymore and that suits me down to the ground.”
It’s a life Penny heartily recommends to others and she’s eager to break misconceptions about being a rural doctor.
“New graduates sometimes think they have to buy into a practice. They’ve got large student debts and the whole thing can be quite intimidating. But there are many practices that have become community health trusts and you can go into those and be a salaried employee.”
For Penny her work represents the best of both worlds – an interesting and challenging job without the pressures and time requirements of practice ownership.
“There’s never a dull moment. I like working in rural communities and exploring their great outdoors, where I can go horse trekking, skiing and tramping.
Horse riding at Broad Bay beach, Otago Harbour: Penny with her son Felix and grandson Koru.
“It’s different than the towns and cities. There’s a lot more trauma to sort out and you are always welcome when you come to relieve GP colleagues who need a break.
“Practising rurally there’s plenty of variety. You work closely with other professionals – prime teams, ambulance teams, search and rescue, pharmacists and vets for example. The vets are crucial for the animal-induced infections you encounter.
“There’s sports medicine, given the increasing number of endurance events, and you can move into occupational health in the likes of farming, fisheries and freezing works.
“And the thing for doctors to remember is they don’t have to commit their whole careers to a rural practice. You can come and experience it, get just as much of a challenge as you would at a large hospital in the city, and then make a call on whether it’s the right thing for you long-term.”
There are undergraduate training choices in 5th year by doing the rural medical immersion programme and postgraduate training in general practice/rural GP network and rural hospital medicine through the RNZCGP.