RACP – Kia ora, Dr Matthews and thanks so much for taking time to chat with us today. Could you tell us a bit about your background and what you do?
Dr Tim Matthews –– Sure, I am a General Physician who has always worked in the smaller, provincial hospitals space-for example hospitals where there are specialists, but small and limited numbers of them, generally across a reasonable range such as surgical services, anesthetics, paediatrics etc. I have been a General Physician, but as a registrar I did geriatric training. I came to NZ from South Africa in 2000, having worked as General Physician in a provincial town where there was a massive burden of HIV and Tuberculosis, so I did a lot of chest work at that time. But coming to NZ and to the Wairarapa, the scope of my work changed, and I started to do a broader range of acute work as it arose, but it relies heavily on support from tertiary specialist colleagues, for example things like coronary angiography, stroke clot retrieval therapy etc.
About two years ago I exited acute on-call general medicine, and I am now working in ambulatory care such as hospital out-patient clinics and geriatric services. This requires a lot of liaison work with GP Practices almost every day of the week, so I have a lot of travel around the region. I thoroughly enjoy my work and feel that my current workload and configuration is at a really sustainable level.
What got you interested in medicine initially, and then into Geriatric Medicine?
I grew up in a farming community in South Africa. My mum was a nurse, but I was inspired by the local GP and thought at an early age that I wanted to be a doctor, so I headed off to Medical School. In South Africa at the time, we had conscription, so I worked as a doctor in the military for two years and this experience made us quite career focused when we got out of the military. I was initially interested in anaesthetics but got pushed into an SHO job in an ICU and from there got interested in internal medicine.
I have always been fascinated by understanding sociology and how humans are part of that across the age trajectory. The community I grew up in was very inter-generational in the way that we related, and we weren’t so intimidated by older folk, so I always found their stories fascinating. Geriatric medicine gave me a nice blend of that human interest side, but with plenty of general medical knowledge required to understand the whole field.
Does living in the Wairarapa feel like your comfort zone, in a rural setting?
Yes, definitely. I live 200m from the hospital, so I have no commute or any such issues. We actually settled in Masterton through a locum agency and have always been happy living here. Masterton Hospital is a wonderful place with dedicated staff, lots of innovation with a strong culture of clinical care excellence.
You mention innovation being essential in small rural hospitals, do you all feel like the Swiss Army Knife of medicine?
You have to have a pretty broad skill set, but we are not shy about reaching out to colleagues in bigger centres to sort out more complex medical issues. In some ways I feel like I am a ‘Health Broker’ working in rural health, and I have always found my colleagues very generous with their help. Overall, dealing with a broad scope of medical conditions is quite exhilarating, but it can wear on you as it can be very demanding.
What does a typical day look like for you?
Well, at the moment quite out-patient based with clinics on Monday and Tuesday, Wednesday and Thursday I am community based outreach, and each of those days I meet with community based GP’s. As a Geriatrician I do a lot of home-based visits, alongside a specialist nurse, and I also have a lot of admin, especially referrals triage. On a Friday, I do procedures, especially with Oncology and Palliative Care. Very clinically oriented week to week.