Running a medical practice during a pandemic
Source: Running a medical practice during a pandemic | Dr Dasha Fielder | Medworld - Medical Community
Published: October 18, 2021
Sydney has felt the brunt of Covid-19, both in 2020 and now again as Delta spreads. Last Monday the city only just came out of a hundred day lock-down.
We caught up with Dr Dasha Fielder, who has been running her clinic, Sapphire Medical Practice, in Bondi Junction throughout both Covid-19 outbreaks.
Dr Dasha Fielder immigrated to Australia at the age of fifteen from Moscow where she started her education at a local public school.
“English as a second language was a challenge but my science subjects were very strong so I thought about a career where I could utilise my strong science background and medicine was an obvious choice.”
After deciding upon this calling she worked incredibly hard and got into medicine at UNSW at the age of just sixteen.
“The first few years were incredibly tough for me but by my fourth year, I really started to enjoy my clinical work. My passion is people. I am interested in every single person I meet, what makes them who they are, how they see the world, and I love being able to help them with life’s challenges both physical and psychological.”
Sapphire Medical Practice:
After finishing six years of medical school, Dr Fielder worked in different hospitals as an Intern and Resident, working in various departments.
“I realised my passion was with paediatrics, women’s health, mental health, and emergency medicine, and the only way to combine it all was to specialise in General Practice, which is what I did.”
This inspired her to become a Registrar with Sydney Institute of General Practice, where she spent three years and became a fellow with RACGP in 2009. After working as a Registrar in various practices around the country Dr Fielder quickly realised that she wanted to have her own practice.
“I had a clear vision of having a boutique family practice not far from home, which allowed me to run my own business, be a doctor and at the same time be a present mother to 3 young children.”
Starting the business was challenging, she took on the lease of a new building and had to fit it out from scratch, but this allowed her to purpose-build the practice to meet the needs of doctors and patients.
“We opened our doors in December 2011 and will be celebrating our 10-year anniversary this year. I started on my own with one receptionist and now we have 3-4 doctors, we take on Registrars every 6 months, we have a nurse and a team of 5 administrative staff. We now look after more than 10,000 patients.”
Sapphire Medical Practice is located in Bondi Junction, Sydney. A city that has been in and out of lockdown as Covid-19 cases continue to reoccur.
“The last 2 years have been the most challenging. I had to take on the challenge of looking after my staff, their health, keeping them safe, providing ongoing patient care, and at the same time looking after my own family and children.”
When the first wave of Covid-19 hit in 2020, Dr Fielder and her team faced many challenges.
“During this time several doctors in the practice did not feel safe to work and had to take time off. We went from 4 doctors to 2 (including me). The vaccine was not available, PPE was not provided initially so we had to source our own PPE and work unvaccinated in the centre of Covid Bondi Junction.”
Dr Fielder and her team at Sapphire Medical Clinic practice took all the precautions and had very strict rules while they continued to provide face-to-face care to adults and children, they even set up their own Covid-19 testing in the clinic.
“Every day has been a challenge, coming to work and fearing I would contract the virus and to bring it home to my children was the biggest one of them all. I had considered moving out and renting an apartment however I could not be away from my family.”
In April 2021, they were finally able to arrange covid vaccinations for the staff, “following that we felt safer to work.”
However in June 2021, only a few months later, the Delta strain hit Eastern Sydney again.
“The last few months brought great challenges. Working in strict PPE is very difficult, patients were worried, scared and under pressure, at the same time, we were dealing with vaccine rollout.”
The Vaccine Roll-Out
Initially, AZ was the only vaccine accessible in Sydney and Dr Fielder found patients were wanting Pfizer but they had none to offer.
“We were worked into the ground, very long days…. With very minimal, if any support from anyone."
"Initially, when AZ was available it was good, however, when ATAGI announced changes to age group as cases of TTS became apparent patients stopped wanting to get vaccinated, everyone wanted Pfizer and this was not available. Our Pfizer only arrived 4 weeks ago. It was very challenging and again public messaging was confusing, we were left having to explain risks to every patient in our rooms.”
Many medical practices and businesses In Sydney have been heavily disrupted by Covid-19 and have had to pivot into new forms of service.
“We continued to provide a face-to-face model until July when we had to change to a hybrid model of mixed tele-health and face-to-face to avoid becoming close contact and closing the practice.”
With a strict Covid-19 plan Sapphire Medical Practice has been one of the few that has been able to stay open.
“Lockdown increased demands on our service and made working much harder. Our administrative team had to triage a large number of calls, some demands, and sadly had to deal with abuse from the general public.”
Burnout and taking care of your health and wellbeing:
Dr Fielder’s childhood and all the hard work she has put in to become a doctor have helped her overcome burnout.
“I am very tough. I have had to go through many challenges in my life. Medicine prepares us for working long hours, not taking breaks, and to remain focused and dedicated at all times.“
For her, it’s about remembering your ‘why’ and your commitment to your patients.
“We don’t stop and ask ourselves how we are feeling, we just continue to work and push through that is the grueling training for doctors. In a way it is like army training, survival of the fittest. Those that make it through challenging 6 years of training followed by 4-12 years of additional hospital training, working 16-18 hour days under pressure can survive working in a pandemic.”
3 Tips from Dr Dasha Fielder on looking after your mental health and combatting burnout:
1. Take care of your body
"I try to feed my body well, exercise, I try to read, I would like to say sleep longer but I trained myself to survive on 6 hours most days this allows me to work and finish all my mummy jobs and still be everywhere at all times. I find my fitness training helps, I made sure I kept that up from home, running, circuit training are essential to keep me going."
2. Remember your “why”
"I always remember my husband and my children, being their mum, I have to show up regardless every day. My patients help me remember why I got into the profession. I have had many cards, flowers, and meals dropped off all of that makes a difference. For every aggressive demanding patient, there were 5 grateful supportive patients."
3. Find and utilise your community
"I love to chat with my colleagues. Doctors are great at helping each other, we know what each other is going through so we are always there, chat groups, Facebook groups, quick phone call on the way to the office.
I am privileged to be part of a career where other professionals are amazing like-minded strong caring individuals. I am so lucky to be part of the doctors club. I have friends from various specialties, other GP, other practice owners, surgeons and cardiologists we all relied upon around each other and helped, brainstormed ideas, exchanged information more than ever in the last 2 years during the pandemic."
Dr Dasha Fielder