Dr Charlotte Hespe – The Face of Primary Health Care
Dr Charlotte Hespe was the founding Director of the Central Sydney Division of General Practice (CSGPN) and Sydney Institute of General Practice Education and Training (GPSynergy). She is currently Chair of the Inner West Sydney Medicare Local and GP Synergy and Deputy Chair, NSW/ACT RACGP Faculty. Charlotte is Head of GP research and conjoint Head of General Practice at University of Notre Dame, Australia, School of Medicine Sydney.
CAN YOU TELL US A BIT ABOUT YOUR WORK AS A GP?
I work in a group practice in inner city Glebe. I love working in Glebe as there is a real diversity among our patients. We have several half way houses, drug rehab centres, and supported housing communities, which include a reasonably large Aboriginal population. There are also very wealthy retirees and empty nesters living on the harbour, and a lot of students coming in from the three Universities and large TAFE in the area. As a GP I like to do everything, but I seem to have gathered some expertise in working with people who are Transgender, particularly those needing medical assistance in transition procedures. I also undertake a lot of antenatal care and women’s health, diabetes and travel medicine, not to mention lots of counselling. What I really love about our practice is that we really work as a team. We meet twice a week for a group Doctors meeting and for a clinical supervision meeting, where we debrief about how to manage the Dr/patient relationship for the best outcomes.
WHAT FIRST SPARKED YOUR INTEREST IN RESEARCH?
I have always been interested in understanding why we do what we do, and wanting to understand the principles of best practice. I have also felt that primary care is poorly researched, and that this is why a lot of GPs seem to disregard guidelines, as they feel they are written by academics in hospitals with no understanding of what happens at the coal face.
WHAT ARE YOU WORKING ON AT THE MOMENT?
I have several small projects on the go, but the basis of my PhD is: Reducing CV Disease: Translating an evidence-based quality improvement tool into “real-world” general practice. This project specifically seeks to help GPs use their existing medical software to translate evidence-based guidelines into everyday clinical practice. It will provide GPs with an integrated desk top tool to help identify patients with high CVD risk and also support General Practices in a “whole of practice” method of monitoring and improving prevention strategies for these patients.
CAN YOU TELL US SOME OF THE HIGHLIGHTS OF YOUR CAREER?
Working with my local Division of General Practice and Medicare Local over the last 14 years has been really rewarding. It’s been great to see how our work is starting to improve health outcomes for our local communities. In addition to this, working as Clinical Chair for the Improvement Foundation over the last five years has been a real highlight. It has been humbling to see the great ideas and innovative projects that practices have come up with to solve health problems.
HAVE YOU HAD ANY MENTORS THROUGHOUT YOUR CAREER? WHAT IS THE BEST ADVICE YOU RECEIVED?
Before I had even considered general practice as a career Di O’Halloran told me that I would be a great GP—it turned out to be excellent advice, as it has ended up being the best career choice I could have made! Another mentor, Michael Kidd, encouraged me to always say ‘yes’ when asked to do something. This attitude has led me into health governance, quality improvement work and research—all of which have guided me into my current role and PhD project.
HOW DO YOU ENSURE YOUR RESEARCH IS USED IN PRACTICE AND POLICY SETTINGS?
As a clinician I am very clinically focussed and have always looked for practical ways to translate research into practice. I really feel that all the projects I am involved in are focussed on improving what we can do, and are doing, in the clinic.
WHERE DO YOU SEE PRIMARY HEALTH CARE IN THE FUTURE?
I dream of having a really patient centred medical home model of primary health care. A model where the patients’ needs are the focus at all times with a central accessible medical ‘home’ that oversees and coordinates the best and most appropriate care as needed. This means that our current model of health care will need to adapt and morph, with changes to funding and how we interact in teams rather than in silos.
WHAT ARE YOUR RESEARCH GOALS FOR THE FUTURE?
I dream of being able to understand how to assist practices in becoming better at everything that they do, without it being onerous or too regimental. I am hoping that by understanding what makes practices work really well, as well as what doesn’t work so well, that I can help to inform the ways we develop models of care and medical practice.