Pilbara GP Cara Sheppard shares her experience with Diabetes Connect.
Diabetes Connect was launched by Diabetes WA in 2024 to bring Perth-based endocrinologists to GPs and nurse practitioners working in remote areas. The service allows rural GPs and nurse practitioners to book a phone call with an endocrinologist to talk through a patient’s care plan without them needing to travel to Perth – a journey of 1,177 kilometres – for a hospital appointment. A case conference with an endocrinologist, a credentialled diabetes educator and an Aboriginal health practitioner also present is another option.
For rural patients with diabetes, receiving timely care in their community can make a huge difference to their overall wellbeing – something that healthcare providers in the Pilbara always have in mind as they care for people throughout this vast region.
GP Cara Sheppard, who works one week a month for the Puntukurnu Aboriginal Health Service (PAMS) across five locations in the western desert, has quite a high caseload of diabetes, with around 10% of her patients diagnosed with the condition.
She finds that, on a practical level, scheduling a time to talk to an endocrinologist is more efficient than trying to catch a hospital registrar on the phone. Diabetes Connect, she says, provides time for a more in-depth conversation.
“There’s not always a doctor on the ground here, so I may be getting a phone call from a nurse and making decisions about a patient’s care remotely,” Cara says. “When I book a call, it’s generally to discuss complex patients – someone with an intellectual disability, co-morbidities, poorly controlled diabetes or those who are not engaging with the health services. We can really dig into the complexities, go back over the results and look into the history of a particular patient.”
Diabetes Connect endocrinologist Greg Ong recently visited the Pilbara with diabetes educator Tara Savage. He says that every opportunity counts in a health care setting with significant challenges, because you don’t know how many chances you’ll have to intervene.
“There are more practical issues to consider here, from reliable refrigeration to food security to dealing with extreme weather and the distance to services. These factors can all make it harder to know what the safest option is,” Greg says.
Continuity of care is another issue when an area is dependent on locums. “GPs can call Diabetes Connect and feel empowered to make decisions for patients they don’t know well,” he says. “All of the Diabetes Connect endocrinologists are senior practitioners working in major tertiary hospitals in Perth. We can share our experience with highly complex diabetes care, using the latest scientific evidence, technology and techniques. Users of the service can be confident of receiving friendly, competent and practical advice for any situation.
Cara says it’s helpful that the endocrinologists share a strong understanding of the context of regional medicine, an understanding that will continue to develop as they travel across the state to deliver training and meet with healthcare teams.
“Some of the junior registrars don’t really appreciate the constraints within which we’re working as they haven’t done rural work. The more experienced endos have been in the system long enough to understand the logistical issues, such as how far away we are from services such as X-rays.”
Most importantly, Diabetes Connect offers a sounding board for GPs and nurse practitioners working in more isolated regions.
“While it is obvious on a map, one truly appreciates the scale of distance when visiting the Pilbara and driving between sites”, says Greg. “For many reasons, including the huge distances between major settlements and local health services, a fantastic plan on paper can be impossible in reality. Troubleshooting needs a roundtable discussion, and many eyes on the issues to reach a safe and pragmatic outcome. Diabetes Connect can bring together the locally based practitioners, our endocrinologists and a team of allied health workers with rural experience for case conferences in such situations.”
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