Hard to retire from a career of helping people

Dr Janne Bills is ready to hang up her stethoscope and move into retirement. PHOTO: GREGOR...
Dr Janne Bills is ready to hang up her stethoscope and move into retirement. PHOTO: GREGOR RICHARDSON
Dr Janne Bills has packed plenty into her medical career since starting out in Chistchurch in 1971.She has called time on it but one gets the feeling she may never really retire. Steve Hepburn catches up with her and gets the rundown on what has been a real trip around the world of medicine.

She has retired three times, maybe four — she is not quite sure. Then again she still has a job to do, one which she has much passion for.

Dr Janne Bills (75) has worked all over the world.

Her last stop perhaps, on an eventful and what she says is an engaging and fun career, is Waikouaiti.

But it was a long and lively road to get to the East Otago coast.

The doctor, who has just retired from East Otago Health, was born in Australia.

She grew up in Tasmania and went to medical school in Hobart. She was one of three women in her class and, like all medical students, dallied in different fields of medicine.

But it was general practice which she took a shine to — rural general practice at that.

She moved to Christchurch to do some training, including her surgery training.

She arrived in the garden city on December 31, 1971 and began work the very next day.

"I got to Christchurch and I had one baby six weeks later and then 14 months later my second daughter came along. So it was going to be tough. It was a hard era for women.

"As a hospital, Christchurch had a good reputation but it was not easy for women. Then they had a quota for so many overseas doctors, 20% of their doctors had to be foreign graduates," she said.

"I arrived and a pen pal I had been writing to had just left the country the day before so I never got to meet her. But I was looking for an adventure.

"There were some distant relations of my dad there so I hooked up with them. I didn’t feel anxious. It felt exciting."

She got some work part-time as a general practitioner but as the main bread winner — her husband was an engineer, in and out of work — she needed to find something steady.

She worked in the emergency department for a period but wanted to get into general practice, preferably in a rural area.

Running a rural practice with small children — her daughters Holly and Jessie were still young — just did not seem feasible at the time.

"But a head ED nurse rang me and said ‘what about a rural practice in North Canterbury?’. They had not had a doctor for 15 years. It was a big area but they welcomed me with open arms. It was really nice farming country."

So she became the doctor for the Amuri community, a large area in North Canterbury which included towns such as Culverden, Rotherham and Waiau. She ran branch clinics, all piling into a Kombi van twice a week to travel to Culverden and Waiau.

She started there in 1979 and stayed until 2004.

"It was not easy, and there was lots of times it got too hard. Then I took on Hanmer practice, seven years before I left. I had 19 staff at one stage — nurses, office staff, practice manager, receptionists, district nurses. We took on Hanmer by default because the hospital board pulled out. It was a free service but I turned it into a paid service. I was not popular but in reality we were subsidising the Hanmer service from Amuri.

Dr Janne Bills on her way to a branch clinic by small plane from Kalkarindji, 600km south of...
Dr Janne Bills on her way to a branch clinic by small plane from Kalkarindji, 600km south of Katherine, Australia. PHOTO: SUPPLIED
"I went to the community and said something had to be done. They called a community meeting and a quarter of the community came along. It was going to fall over as I was not prepared to run the service any more.

"I had to hold a lot of responsibility for 25 years. A group from the community came forward and I showed them the books. They came in and then they almost pushed their chairs back as they saw what was happening.

"But then a great team came forward and got involved. I said to them I will mentor the doctor and will stay for two years until they got everything right."

At the same time she was lecturing in rural health at the Christchurch campus of the University of Otago medical school, helping graduates receive a rural health diploma.

By 2004 it was time to move on and perhaps put the feet up.

She decided it was time to head overseas. She had never had a real foreign jaunt and it was time to get rid of the itchy feet.

Dr Bills wanted to work in the Scottish Highlands and the outer Scottish Islands. She had previously worked on the Chatham Islands in 1992, and also spent time in the Australian outback.

She got through the bureaucracy and ended up working at a hospital in Grantown-on-Spey, a small town in the south of the Highlands.

"I wrote a poem to apply. It was something different, I suppose. Within 24 hours I had heard from the manager. I went to the best place."

"I did blocks of work and in between times I got to travel. Went to Spain, France, Greece, went up to Norway for my 60th birthday."

Dr Bills worked at a hospital on Orkney Island and experienced island life in the very north of the United Kingdom.

"It was different — with dark days in the winter but light in the summer. Rained a fair bit but never too cold. You had to really manage the patients and work hard to get them well," she said.

By now her daughters had children. She was coming back to New Zealand every year before she got homesick and, after four years, decided to head home permanently.

She returned to perhaps retire but went to North Canterbury and offered to help out at the Hanmer practice.

"I said I would be there for one month. It was four and a half years. But I enjoy working with a team, with good nurses and doctors."

Then an opportunity came along to do something completely different. She was at retirement age but decided it was not the time to stop.

That involved heading to Christmas Island to help treat the boat people who were coming in to land. For years asylum seekers had been attempting to get to the Australian territory, just south of Java, part of their passage of fleeing their homeland.

But the boat people had met resistance from Australian governments, who were pushing back on accepting them, many from places far beyond Indonesia.

"It was a beautiful island but was tragic for those people. The politics of it were against all my ethics. People were dehumanised, having to call them their boat numbers, not their names. I worked in those migrant communities and it was very sad ... a lot of the young doctors who were working there when the boats came in were hospital based ... but there was a real need for people with primary care experience.

"There were so many sad stories, so many people you could have helped.

"But my daughter said to me, ‘you can help these people and support these people but you cannot support the system that is not right’."

She talks of seeing pregnant women sent to Darwin to have babies, all alone and scared; about trying to help people who have rotten feet because of their footwear.

Sometimes it was not always humans which turned up at the medical clinic in outback Australia....
Sometimes it was not always humans which turned up at the medical clinic in outback Australia. PHOTO: SUPPLIED
She returned home and in 2016 moved to Waikouaiti with her new partner Trevor Walker, a former GP from Te Anau.

The plan was to see out retirement. But like before, it did not happen.

"I went to a meeting about rural mail post — I had come down to retire — and one of the local nurses said to me at the meeting, ‘are you a GP? would you come and help?’. Then a bit later the manager from the practice rang me and asked me to come and have a chat."

That chat led to her being a doctor at East Otago Health for the best part of six years.

She said she wanted to help out the marvellous staff and the locals who were so glad to have a doctor. She had stayed on board this year to help a practising nurse get some more qualifications and mentor others.

Now though, the meetings with patients are over.

But unsurprisingly, she is not fully putting her feet up.

Her passion is rural general practice and she is keenly aware of how hard it is to attract GPs to the country.

"Rural practice has been a wonderful career to me but I feel really sad we are struggling to find people to fill the gaps.

"These people are coming out with big loans and GPs are just under-valued. I do not think we have selection [of future doctors] right.

"The University of Otago has set up a committee to look into it and I am part of that — giving my rural voice. I was the first chair of the Rural GP network.

"Many young doctors want to work in hospitals and work as specialists. They do not want to be GPs."

She was helping with work to get better evidence on how to select medical students.

She felt strongly it should not all come down to marks in exams in the final years of school. Humanities and the ability to talk to patients were much more important.

Primary care and GPs were so vital to the overall health system.

"I remember in Amuri the ambulance service said to me something was wrong — they were not getting the same amount of calls. But that is because of what we were doing.

"There is really good evidence, a really good primary care team can lead to reduced hospital admissions and ambulance call-outs."

She was really disappointed primary care nurse salaries were not being matched to hospital nurse salaries, and they were simply not valued.

Because of the skills gained in the career of rural medicine doctors were very much in demand overseas, she said.

After more than 50 years in New Zealand Dr Bills has applied for citizenship.

"It has been a great career. A lot of fun and met some great people.

"Health is a great career to be in and I have enjoyed every moment of it. Sure there are some tough times and it can be hard but what you get back cannot be bettered."