Active Health – Portland
Active Health Portland opened in March 2012 and services the wider Portland community of around 12,000 people.
It is a general practice within a multidisciplinary health service. The range of health practitioners and services available at the clinic is extensive. Additionally, the building is a hub for community groups and has facilities and rooms available for group activities, meetings, conferences and activities.
General practice education and training is an important component of the clinic which hosts AGPT registrars, medical, nursing and allied health students.
Portland’s historic past has left a legacy of more than 200 historic buildings, many dating back to the 1800’s. A short drive will take you to National Parks, or for true historians, set your sights north-east, on Lake Condah Aboriginal Mission, and learn about the history of Victoria’s indigenous people. Or if in pursuit of a good drop of red or white, once again, head north-east to the Coonawarra Wine District.
Heading east take in a coastal journey and the intrigue of the Shipwreck Coast towards the famous Great Ocean Road….discovering little seaside hamlets along the way. If the lure of the city is your thing, Geelong, or Melbourne could be your ultimate destination for a weekend away.
Active Health Portland recognises the need to have well-developed systems and referral pathways in place to meet the healthcare needs of its community. The clinic’s patients have access to a gym, physiotherapist, podiatrist, exercise physiologist, dietitian and diabetic educator on-site, as well as the practice nurses, a mental health nurse and a visiting speech pathologist.
The scope of practice spans management of acute, chronic and complex conditions across all age groups. Clinical Director, Dr Marg Garde, is passionate about preventative care, health promotion and early intervention. She appreciates the opportunities provided by being a GP and the long-term relationships she has been able to develop with her patients.
The clinic’s diversity makes Active Health Portland a comprehensive training environment for registrars. A visiting plastic surgeon enables registrars to build skin cancer management knowledge, placements are available in Aboriginal Health at Winda-Mara Aboriginal Corporation and involvement in community programs and activities, such as the Doctors in Secondary Schools program, Breast Feeding Association and local Men’s Shed build further skills. The supervisors at Active Health Portland also have varied special interests to support and consolidate registrar learning.
Portland District Health comprises acute, primary health and aged care services.
Portland hospital has a 24/7 Urgent Care Centre and has 69 inpatient beds. A resident general surgeon and obstetrician / gynaecologist are available. The hospital has two theatre suites, an eight-bed day procedure unit plus a visiting specialists centre. A 30 bed residential aged care facility, Harbourside Lodge is located within the grounds (see Programs and services).
General practitioners have opportunities for procedural work in emergency, surgery, obstetrics and anaesthetics. GPs have the option to take up VMO admitting rights to the hospital and are supported by medical and surgical specialists. A specialist anaesthetist or GP anaesthetist is available.
Portland is part of the South West Alliance of Rural Health, which represents public health agencies across south west Victoria, from west of Melbourne to the South Australian border. The main referral centre is Warrnambool.
Dr Marg Garde
Dr Marg Garde is senior GP and Clinical Director of the clinic. She enjoys many aspects of the practice, particularly working in a multi-disciplinary team providing integrated patient care. Dr Garde explained the clinic has a whole of life focus on preventative care, health promotion and early intervention.
“Chronic disease is an enormous burden and you need a multi-disciplinary practice to address patient’s needs. ….the patients really do see this as a one stop shop. Everyone knows them and someone will be able to help them get what they need.” said Dr Garde.
Dr Garde always wanted to be a general practitioner. She grew up in Melbourne, graduated from Monash University in 1981 then completed hospital rotations in Melbourne and Geelong. While in Geelong she met her husband, a Portland local, ‘made a leap of faith’ and moved to Portland, commencing practice in 1984.
In a career spanning three decades of medical practice, Dr Garde has contributed significantly to the fabric of health care provision in her community. She appreciates the opportunities that have resulted in her being able to develop long term relationships with her patients, colleagues and the community in general.
Dr Garde has practiced in various health services, worked as a solo practitioner, worked in Aboriginal health and established general practices and specific services to meet community need. Dr Garde reflected on how her particular interests and type of practice changed depending on the type of patients who presented to her. For example, while her children were little babies, Dr Garde describes setting up her consulting rooms at home, an unusual and impossible idea by today’s standards.
“We had gold fish bowls and the kids pet mouse – all really exciting. Those sort of things that accreditation would frown upon today. I did all my on call from home, did plasters and suturing and the whole thing. It was great… but would not be possible now.” she said.
Dr Garde has been instrumental in the establishment of a family planning clinic, adolescent health drop in centre and involvement with the local Aboriginal health service, Winda-Mara Aboriginal Corporation working with that organisation for seven years. Having a special interest in mental health Dr Garde completed a post graduate Diploma in Hypnosis at Melbourne University. Currently her focus is more on older women’s health issues and menopause.
Dr Garde described the newest project, Doctors in Secondary Schools Program as innovative, targeting youth in their own environment. This Victorian State Government project, rolled out through Primary Health Networks, places adolescent health trained GPs in 100 secondary schools across the state.
In 2000, Dr Garde was awarded fellowship with RACGP explaining that she had worked for many years without any involvement with the RACGP.
“I wanted to prove to myself that I could pass. ….. in those days, I was the only female GP with nobody to bench mark against really. I sat the fellowship exam without a training provider, I passed thank God. It is one of the reasons that I am passionate about supporting people through the exam.” said Dr Garde
Dr Garde explained she enjoys general practice in Portland for many reasons. The scope of practice is diverse, spanning management of acute, chronic and complex conditions across all age groups.
She explained the service has well developed systems in place to meet the needs of people with chronic disease. In this multi-disciplinary clinic, patients have access to a gym, physiotherapist, podiatrist and exercise physiologist, a dietitian and diabetic educator. The practice nurses, a mental health nurse and a visiting speech pathologist are also available for patients at the clinic.
“We have a lot of services here – the patients really do see it as a one stop shop…. everyone knows them and someone will be able to help them get what they need.”
Dr Garde has had a long term, personal commitment to medical education. She completed a Graduate Certificate in Health Professional Education with Monash University and holds the position of Regional Head of Medical Education with MCCC GP Training for the South West region.
As part of her role as Clinical Director, Dr Garde is responsible for coordinating the continuing education program across the service. As a teaching clinic, Active Health Portland trains AGPT registrars, hosts medical students from Deakin University and John Flynn Medical Scholars and trains nursing and allied health students. The clinic allocates dedicated time for teaching with programs in place to meet the RACGP curriculum through all stages of the AGPT training program.
“It is about training. We have dedicated time for teaching. We have got a vertically integrated model of training in this practice. We have elderly GP’s like me, GP registrars then medical students. We have registrars at different levels so that they all support one another through their training.” said Dr Garde.
Dr Garde explained the practice divides the year into various subject matter and works to relate the teaching to patients that the registrars have seen. The teaching program also supports the registrars as they get closer to their exams providing specific training and OSCE exam practice.
The registrar experience
The clinic provides a comprehensive training environment for registrars. In addition to general practice training, the clinic is happy to facilitate registrar involvement in various experiences and special interests. There are multiple opportunities to be involved with various health services across the community.
- Aboriginal health: practice diversity placement at Winda-Mara Aboriginal Corporation
- Skin cancer management: training around the management of skin cancers and removal of skin lesions through attending the clinic of the visiting plastic surgeon
- Emergency medicine: work opportunities are available with the local hospital
- GP Obstetrics: training can be undertaken in conjunction with local hospital
- Industrial medicine: clinics at the Port of Portland and the Alcoa Portland Aluminium Smelter providing medicals, preventative health education, immunisation for Q fever, pre-employment checks, periodical medical checks for lung function, hearing and skin checks
- Adolescent health: the Doctors in Secondary Schools Program and various youth programs
- Community health: registrars attend sessions with Breast Feeding Association and the local Men’s Shed.
Dr Marg Garde, said General Practice is about many things: clinical skills, team work, education and training, but for Dr Garde, mostly it is about the relationships.
“The most valuable thing is just taking a patient’s hands along their journey of getting better, or of learning to live with whatever illness they have.
“Every single patient gives you something or another that makes you feel that is it worthwhile sitting in the chair. It might not be every consultation every day that they do that, but every patient – somewhere along the line – just makes you feel glad that you do what you do. You can’t beat that.” said Dr Garde.
Dr Marg GARDE
Clinical Director Active Health Portland and
MCCC Regional Head of Medical Education – South West
MBBS, Monash Melbourne, 1981
Post Graduate Diploma in Hypnoses – Melbourne University
Grad Certificate in Health Professional Education – Monash University
Special Interests in adolescent health, women’s health, family planning, menopause.