From Dallas to north Queensland, GP obstetrician Dr Raymond ‘RT’ Lewandowski III is a passionate rural health advocate.
The crisis facing rural maternity units will remain one of the core issues for the Rural Doctors Association of Australia under new president Dr Raymond ‘RT’ Lewandowski III, who took the organisation’s reins at the Rural Medicine Australia conference last week.
Dr Lewandowski, a GP obstetrician practising in the Queensland town of Innisfail, said his predecessor, GP anaesthetist Dr Megan Belot, had left big boots to fill.
“Oftentimes in the past, RDAA have always spoken into things – we’ve always been asking for a seat, trying to get in with government,” he told RMA23 delegates.
“With Megan, now we are now invited to a seat at the table.
“We’re given a place and they really want our input, we’re seen as a source of truth for rural medicine.
“I intend to keep up that momentum.”
While he’s now firmly entrenched in rural Queensland, Dr Lewandowski was born, raised and trained in Dallas, Texas, and spent the first chunk of his career in the Ozarks, a mountainous region spanning Missouri, Arkansas, Oklahoma and Kansas.
He’s also worked short relief stints in Haiti and Mexico, meaning he has a 25-year tenure for rural medicine in four countries.
When Dr Lewandowski first moved to Australia with his wife and two children in 2008, they originally settled in Kingaroy, central Queensland.
After living in Kingaroy, three hours outside of Brisbane, Dr Lewandowski said working in Innisfail – where the drive to Cairns is just 90 minutes – felt like a move to the “big smoke”.
Rural medicine is something of a family endeavour for the Lewandowski clan – Dr Lewandowski’s wife works as an emergency department nurse and his daughter is in her fifth year of medicine at James Cook University, with plans to go on to train as a rural generalist. (His son, who works in IT in Melbourne, is the only exception to the rule.)
Over his two-year term as president, Dr Lewandowski told Health Services Daily’s sister publication The Medical Republic that he hoped to see real change in key areas like maternity, workforce and immigration reform.
Having migrated to Australia as an internationally trained doctor himself, Dr Lewandowski has particular insight into the situation for the thousands of overseas medical graduates who keep rural Australia’s medical system chugging along.
“There’s red tape and weird rules, like you’ve got to practice [in a certain rural area], but you can’t keep your visa unless you’ve finished your training, but you can’t finish your training unless you move [into a city],” he said.
At the end of the day, he said, internationally and domestically trained doctors are all Australian doctors and they need to be supported to work in the bush.
“To [deliver that support] we need to look at things like Medicare, where we know that … especially in very remote settings, it doesn’t work,” Dr Lewandowski said.
“The MBS item numbers don’t fit the complexity and the time involved and the cost.”
There are plenty of situations where rural generalists, for example, are unable to claim the item numbers for the care that they deliver because their additional training is not necessarily recognised.
“We have to provide it for free, and that’s just not fair.”
RMA23 was held at the Hotel Grand Chancellor in Hobart, Tasmania, 19-21 October.