Introducing Dr Claire Long, Western Health Geriatrician and Clinical Services Director, Aged, Cancer and Continuing Care (ACCC).
Dr Long, who started at the health service as an intern more than two decades ago, shares her fascinating insights.
"I have always driven up to an hour every day to get to Western Health.
Why do I do that? It's because of the culture here. It's because I feel heard. I know that when I have something to say, people will take me seriously and listen. And I genuinely believe that I have the ability to influence the direction of our health service and the care we deliver to patients.
It sounds simplistic, but I feel effective. It keeps me coming back.
I also have to say that I work with the best group of geriatricians in Victoria. We've got such a great culture here, and now people come from all across the city wanting to work here."
A blast from the past: 10:30am coffees, Kath and Kim and a career break
"I did my training at the University of Melbourne and we had the opportunity to work at a couple of hospitals.
I knew instantly that Western Health was where I wanted to work; the feel of the hospital was so different to others- it was a small and homely place.
When I started as an intern (first year doctor) in 1999 all the doctors hung out together.
You felt like you were in it together and you were making a difference. When things got difficult, we all had each other's backs.
When things were quiet clinically, you'd get a message to say: '10:30am coffee'. You'd go across to Western Private and chat.
We had good relationships with the consultants, so there was a lovely cohesion among our team.
We would also travel to Sunshine Hospital to work and I have one funny memory of when we came across a camera crew filming a Kath and Kim episode there!
I completed my resident years in 2000 and 2001. Then I got married and took six months off and we went travelling. I look back on that now and realise it was a pretty incredible opportunity to take some time out after many years of study and training, and to be supported by my workplace and welcomed back afterwards. When I came back, I went straight into preparing for exams."
Pivotal moments that carved out a career in geriatrics
"There are a couple of moments early in my career that I remember distinctly informed my decision to specialise in geriatrics. I was the neurology registrar on a Sunday morning and I remember an elderly woman had a bleed on her brain and we had to make a decision about admitting her to the Intensive Care Unit (ICU), knowing it was likely she would die. In that moment I knew I wanted to practice medicine with a lot of perspective, where the patient's wishes were central to our decision making.
Another defining moment was when I working in the Emergency Department (ED), I would always start with a patient's social history: who they were, how they were functioning and what else was going in their life. I was interested in the whole person, not just what they were presenting with on that particular day.
Geriatrics is the perfect specialty for me because it takes a holistic approach to the patient's care. We don't just focus on a single area; we talk to the patient about memory, continence, falls, driving, and advance care planning.
In the hospital I feel that there isn't a defined geriatrics department, but that we are one of the few medical specialties that are spread everywhere- whether it's in the community through GEM@Home (our rehabilitation in the home service) and residential care in-reach, in Sunshine and Footscray EDs, or on the acute wards, as well as the sub-acute wards. We are involved in everything from hip fractures to rehabilitation, and increasingly we are working in new areas, like older patients having emergency laparotomies.
Secret to success
I think what makes a good geriatrician is someone who is good at listening to the whole story from a patient and their family. We are often also very good at dealing with uncertainty. We can't always provide a definitive diagnosis, or know what will happen next, but we are very practical, so we are always looking at what we can do to help that patient and advocate for them. We also have to be good communicators because we are talking not just to the patient, but often their family members and our colleagues in other specialties as well."
Leading and growing
"My role as Clinical Services Director did not exist when I started as an intern. It was created as an effort to bridge the gap between clinicians and management and executives. It's really important that our clinicians are heard and have the opportunity to contribute to the health service functioning, beyond their individual roles.
One of the things I love about Footscray Hospital is that to me, it still feels the same as it did 20 years ago. It's a very warm, welcoming and friendly place to work.
It's something that we are working hard to maintain, as the service grows and because we are so busy. We used to have four medical registrars and now there are more than 40, so isolation is a big risk, but there is a lot being done, particularly in the staff wellbeing space.
As a leader that's something that I'm always thinking about— what can I do to make life a little easier for our staff? There are simple things that we can do to help. Make sure they are paid on time; ensure they are taking leave and keep an eye on their workload. It's also important to communicate and listen, have an open-door policy and advocate for your staff.
If you treat your staff exceptionally well, at a human level, they will then feel valued and that in turn helps them to look after our patients."
Advice to interns: find your people
"I love working with our Junior Medical Officers (JMOs).
I tell them to find their people. I encourage them to look around the hospital at the different specialties and find the place where people with similar personalities cluster. This is important because they are going to be their colleagues and who you work with will have a direct impact on your career.
I also tell them to learn how to keep their boundaries in terms of maintaining a work/life balance, it's very important."