Escape to the Country: Practising in Rural & Regional Areas

Optometrist Melissa Zhu couldn’t wait to escape the rat race when the opportunity arose mid-2018. Having just completed her final optometry exams, she’d tackled Auckland’s rush hour traffic for the “1,000th time” and felt a desperate urge to leave. Understandably so – a new report reveals Auckland city is the most congested in Australasia.¹

A job offer with OPSM was her “sink or swim” moment.

“I spoke to Jonathan, OPSM’s Professional Services Manager – I looked him in the eyes and asked for a job anywhere but in a major city,” she said.

“Anywhere” turned out to be New Plymouth, on the west coast of New Zealand’s North Island, population c74,000.

“Quiet, coastal, less cars… New Plymouth is much like my hometown of Tauranga… and it had an iconic mountain to climb,” said Ms Zhu.

I’m a big believer in change being the vessel for growth

For Adelaide born Anna Richter, it was a job offer with an EyeQ practice in Nowra on the south coast of New South Wales (population c30,000), that provided the opportunity for a change.

“I wanted to move away from home for my first job but regional South Australia was too small. I wanted to live closer to my sister in Canberra but there was no way I wanted to live in the city.

“Nowra suited me well. It’s coastal, surrounded by mountains, and close to Sydney and Canberra. I knew it would also offer a variety of professional experiences. In short, Nowra ticked all the boxes,” she said.

For similar reasons, Sophie Woodburn chose to move from her home town of Auckland to work with Specsavers Taupo in New Zealand’s southern Waikato Region (population c25,000) and later on to Hastings (population c80,000) on the east coast of New Zealand’s North Island.

“I knew I’d be seeing a more diverse demographic, and be exposed to a wider range of pathologies. Living away from Auckland also made sense personally. The cost of living is lower, plus no traffic!

Similarly, Tom Bennett wanted to get away from the city. He grew up in Brisbane and studied optometry at Queensland University of Technology, where he met his wife, Ali. They lived and practised optometry in Kingaroy, Queensland (population c.10,000) for three years before moving back to Brisbane.

“Having lived in Kingaroy, we realised we didn’t want to live in Brisbane – it was too big and too crowded, so we moved to Townsville (population c180,000), then soon after brought a practice in Charters Towers,” he said.

For seasoned optometrist Tony Lord, co-owner of Lord and Wells Optometry in West Wyalong NSW, the decision was all about going home. However, he graduated and spent nine months in Sydney, then a couple of years in London first.

Rural practise is much more about medical practise as opposed to product practise

Mr Lord believes early career optometrists who move to regional and rural Australia will positively impact their professional skills as well as their lifestyle.

“If you’re young or you have a young family, you can easily get into the housing market in regional Australia. You’ve got a five minute commute to work with no traffic, and even if you need to travel to a second or third place of practice, it’s only on occasion. Most regional practices don’t open on Saturdays, so you’re left with plenty of time to spend with family and friends.”

This is something that Mr Bennett has experienced.

“Practice owners in regional and rural Australia often find it difficult to find optometrists, however as a couple, we were comfortable that between us, we had the necessary resources. Additionally, purchasing a practice outside the city was an affordable proposition.

“The practice we bought in Charters Towers (population c.8,000) had been owned by a woman who was retiring and selling her three practices. There was no transition – she handed us the keys and that was it.

“At that time, back in 2009, the practice was only operating one to two days a week. We immediately opened up two regular days a week and then, in 2016, transitioned to full-time. The local community really supported our practice and made the growth possible.”

TOTAL IMMERSION

Mr Lord said the key to settling into a regional or rural town is getting involved in the local community.

“In Sydney you don’t need to be involved in the community, but rural communities are communities not economies. The way to become known and build friendships is to involve yourself.

“Music groups, bands, cultural groups, tennis and football clubs… there are plenty of groups to get involved in. There is also bird watching, camping, movies, the theatre, and art.”

Anna Richter agrees that community involvement is key.

“I settled into Nowra pretty quickly. I started work, and going to the local church, and all of a sudden I had a community.

“The biggest thing I have learnt about myself, having moved away from home, is that although I’m an introvert, I thrive off being with people and being involved. I play music in church, and help out with various church groups, and I’m also involved with a local theatre company playing in the orchestra… I like that balance between work, social activities, my music outlet, and running.”

Sophie Woodburn also made an effort to create a social and professional network when she moved to Taupo.

“I still remember how daunting it was to attend the first Young Professionals meeting at our only local bar. It was challenging trying to make friends with people who had lived there for years and were not necessarily in need of new ones. I learnt quickly the merit of attending every event and reaching out to people. Over time I met a new group of people who I now consider to be lifelong friends. And, little did I know that within a year of moving to Taupo, I’d be asked to be a committee member for the Young Professionals Council,” said Ms Woodburn.

I couldn’t replicate the life I’ve created here – I won’t be going anywhere for quite some time

“Work wise, I had great support from the Specsavers Graduate Program and I started attending a monthly meeting for business professionals in town. Attending these meetings allowed me to meet other professionals and get to know other businesses. It took a while to warm to a demographic of people I hadn’t spent much time around, but slowly conversation became easier and mutual interests became obvious. I was even asked to present information about our optometry clinic to the group.

“Having genuine conversations with patients also gave me the opportunity to make connections with local teachers and workplace nurses. This led to businesses sending their patients to us, and me being asked to present to school kids about leadership and science,” she added.

While it was hard to say goodbye to her Taupo community, Ms Woodburn said she felt more prepared when it came to moving to Hastings because she knew the challenges ahead and that, with time, she could adapt and thrive.

IT TAKES CONFIDENCE

Mr Lord says as well as overcoming the fear of leaving home and settling into a new community, optometrists who have been trained with state of the art equipment can find it challenging to adapt to practising with less equipment and less professional support.

“Rural practise is much more about medical practise as opposed to product practise,” he told mivision. “Working in areas with limited equipment hones your diagnostic skills and your ability to make clinical judgements. You have to have the confidence to make a call.

“My nearest ophthalmologist is 160km up the road, so I don’t send patients up there unless I really need to. But we have a good relationship. I can pick up the phone anytime, I can send through optical coherence tomography (OCT) images and digital images for review… It works.”

Ms Richter’s EyeQ Optometrists practice in Nowra has the necessary equipment and immediate access to ophthalmologists in the area. However, her work with EyeQ also takes her further south to Vincentia, where ophthalmologists are not on tap.

“I co-manage a lot of my Nowra patients with local ophthalmologists and when necessary the patients are happy to travel to Sydney. In Vincentia, I often find patients don’t even want to travel to Nowra to see an ophthalmologist. This gives me the opportunity to have a bigger role in managing some more complex cases, which I love.”

Similarly Melissa Zhu’s experience working in regional New Zealand has exposed her to a variety of ocular conditions.

if I were to do it all again, I would still look Jonathan in the eyes, leave the big smoke behind and take the challenge on – the crazier, the better

Ms Zhu inadvertently found herself moving several times before settling into her new job with OPSM New Plymouth, due to renovations underway at the practice. She said while daunting at first, the experience turned out to be “a luxury” that provided a true insight into regional optometry.

“Over the span of six weeks, I moved from Palmerston North to New Plymouth to Wellington to Masterton and back to New Plymouth again. Apart from two weeks with my mentor, Ammar, in Palmerston North to start with, I did it all alone. Jumping week to week from these vastly different populations armed with a handful of helpful phone numbers and Kanski, I answer all my own questions about regional versus urban optometry.

“In Masterton, New Plymouth and Palmerston North, any mixture of nonverbal, non-mobile, very young or even non-seeing patients could be booked in for any day. Patients and their families looked at me, as ‘the specialist’, for answers to all their problems – and not only vision problems – one patient asked me how to convince their child to attend Chinese lessons. By the end of 45 minutes, I had become part of the family. In stark contrast, patients in Wellington would drop in on their lunch break fixated on achieving 6/3 vision by the end of their appointment.”

She said this unusual start to work yielded unexpected rewards.

“A patient in New Plymouth mentioned that she had made a booking on the advice of her sister, who lived in Wellington. Three weeks prior, I had given her sister a trial contact lens with adjusted toric axis to counteract its rotation. The trials were a success, and the patient had referred me, by name, to her whole family in New Plymouth because I mentioned I would be based there.

“According to the patient, I ‘unblinded’ her. I do not think 15 degrees of rotation deserves such praise, but that instant feeling of pride in my job will stay with me forever.

“The satisfaction of knowing for sure that I could handle new places, and use my training to solve problems in the real world, gave me the much-needed confidence boost to face more difficult cases and keep learning. Regional optometry does come with a terrifying amount of responsibility, but we grads can and will shoulder it – as long as we give ourselves the chance.”

THE CRAZIER, THE BETTER

Having finally settled in at her newly refurbished OPSM New Plymouth practice, Ms Zhu says the journey to get there was absolutely worth her while.

“Landing in all those different locations was not something I signed up for, but it was, for lack of a better word, a luxury – it has made me a more adaptable person and better prepared for all the different patients who walk through my door. I cannot tell where optometry will take me in the future, but I can say with absolute certainty that if I were to do it all again, I would still look Jonathan in the eyes, leave the big smoke behind and take the challenge on – the crazier, the better.”

Ms Richter too, has been surprised at how settled she has become. “When I thought about moving away for my first job, I told myself it would be for three years, but I didn’t realise that in three years you make lots of friends and community connections.”

Ms Woodburn feels the same.

“It is really tough to say where I might end up in the future, but I know for sure I’d love to stay practising provincially. Working in rural communities has allowed me more room to professionally grow, and I love the relaxed, nature-based lifestyle. I couldn’t imagine going back to a big city.”

Now with three young children, Mr Bennett says he and Ali are really noticing the benefits of living and working outside the city.

“Townsville is a great place to bring up children, there is plenty of space, it’s safe and more relaxed. We have great access to education here, with a choice of excellent high schools.

“Owning our country practice is both financially and professionally rewarding. I have a diverse patient demographic that ranges from schoolkids through to young miners and retirees, and they all really appreciate having an optometrist in town. Being 130km from ophthalmologists in Townsville, I really get to see a lot of pathology and put my skills to great use.”

TAKE THE OPPORTUNITY

Tony Lord is at the other end of his career. He and his business partner Phil Wells are ready to sell their practices, and slowly ease into retirement. However, despite the rewards of living in rural Australia, they’re finding a buyer hard to attract.

“The lifestyle has been wonderful, but rural practices are difficult to sell.

“We have two rural practices – as well as rooms in more remote areas like Condobolin that are equipped for our monthly visits. Our patient base is exceptionally loyal. Those in the more remote areas are happy to wait for our visits and to travel to our fully equipped practices when they need services like OCT imaging.

“Unfortunately for Phil and I, regional practices out here are not in high demand. But that makes it a great opportunity for a young optometrist to buy in to an established business, with a full book of appointments for a very reasonable price.”

He said the real opportunities for regional work come for couples who both have skills that are in demand. Mining engineers and those who are medically trained will do well in West Wyalong, for instance.

In a world in which attitudes about where and how we work are rapidly changing, many more opportunities for workers with a variety of skills will be available to those who wish to enjoy the fruits of regional and rural Australia. Will you be an early adapter?

Reference 

1. www.stuff.co.nz/auckland/local-news/manukaucourier/ 111272672/auckland-is-australasias-mostcongested- city–more-dynamic-traffic-lanes-planned-to-help

Why Make the Move?

1. A more affordable path to practice and home ownership,
2. A greater variety of clinical challenges and more autonomy,
3. A more relaxed lifestyle; great for bringing up children,
4. A stronger sense of community, and
5. Less travel, or at least, less traffic.