A Country Practice
As the only full-time specialist dermatologist in the northern rivers, Dr Ken Gudmundsen plays An important role within his local community – and his passion for photography taKes him further afield.
There has been a considerable increase in the number of medical graduates in Australia in recent years, but according to the AMA’s Position Statement – Rural Workforce Initiatives, published January 2018, more than three-quarters of locally trained graduates live in capital cities.
The divide between metropolitan and rural access to medical care continues to grow. Australians who live in regional and remote areas typically wait longer to see GPs and specialists, and a higher proportion of people in the major cities report better patient experiences compared to people outside major cities.
Various government initiatives have since sought to address the health crisis in rural Australia, the latest of which is the Department of Health’s $550 million investment to support improved rural health services.
Dr Ken Gudmundsen is a specialist dermatologist running a busy practice in Lismore – the Lismore Skin Clinic – on the far north coast of NSW, an area known as the ‘Northern Rivers’. He is the only specialist dermatologist providing a full-time service between Tweed Heads/Gold Coast in the north, Co s Harbour to the south, and Tenterfield, Moree and Glen Innes in the west.
In addition to full-time practice, he is a visiting doctor at Lismore Base Hospital, the local tertiary referral hospital, and St Vincent’s Private Hospital in Lismore.
‘It’s a relatively unique position to provide medical services to patients in rural Australia,’ he says. ‘There’s a scarcity of medical manpower in regional areas.
Rural Australia is generally under-serviced by specialists, and it is the same in our area. There are very few dermatologists, usually solo practitioners, and finding locums can be very di cult. That being said, there is a large demand from patients with severe and serious acute and chronic skin diseases, and constant requests from GPs for patients to be seen urgently. There are simply not enough specialists in rural areas.’
As one solution to this situation, Dr Gudmundsen says up-skilling nurses to give practical help to dermatologists is immensely beneficial.
‘The nursing staff at Lismore Skin Clinic are highly trained to provide support for the dermatologists. They are able to take histories from patients, give local anaesthetic and perform biopsies,’ he explains. ‘Nurses are provided with specific templates on the computer relating to the presenting condition, from which they take a history and examine the patient before being seen formally by the dermatologist.’
Lismore Skin Clinic has a total of four nurses, with two nurses on each day. In this role, nurses can be considered as ‘doctor extenders’, saving the doctor time and allowing more patients to be seen each day. ‘Our nurses work as a trained network around the doctor and I try to support the education of our nurses by subsidising attendance at conferences and training days,’ says Dr Gudmundsen.
The Lismore Skin Clinic itself is a private specialist dermatology practice, owned and operated by Dr Gudmundsen since 2000, housed in a late-Art Deco two-storey building in the CBD of Lismore, appropriately named Molesworth House.
Branching out Lismore Skin Clinic works in cooperation with North Coast Medispa, which has its main clinic in Molesworth House, and now has two other branches in Ballina and Byron Bay.
Prior to becoming North Coast Medispa, the business originally started as the ‘aesthetics department’ of Dr Gudmundsen’s Lismore Skin Clinic. While working as a dermatology nurse there, Kerry Lynch (RN), Ken’s wife of ve years, saw the ever-growing need to o er a more aesthetic approach to skin care, with the evolution of cosmeceuticals, anti-wrinkle and dermal filler technologies.
In late 2014, the ‘aesthetics department’ was renamed North Coast Medispa and Kerry’s son Shaun left a career in engineering to invest in the expansion of the clinic. Taking on the role of General Manager, he developed the business strategy and oversaw the expansion of the business to include the full-time Ballina clinic.
With continued growth in 2017, the partnership structure evolved to become a company – Australian Dermatology Group Pty Ltd – which still trades as North Coast Medispa and continues to offer superior service and the highest quality treatments in the region.
The North Coast Medispa operates independently of Lismore Skin Clinic; however both clinics support each other and work synergistically to o er broad services in medical, surgical and aesthetic dermatology.
Between the rainforest and the sea
While the shortage of doctors in rural Australia has garnered significant press over recent years, what doesn’t get a lot of publicity are the unique opportunities and lifestyles offered to doctors practicing outside the ‘big smoke’. ‘Lismore is in a vibrant, beautiful part of Australia, between the rainforest and the sea, and it’s only 35 minutes to Byron Bay,’ says Dr Gudmundsen. ‘More people are now choosing to venture out of the cities and live in our area.
‘Being the main dermatologist in a rural area means that working takes up a large part of one’s life, and it isn’t easy getting the proverbial work-life balance. We do try to have one main family holiday abroad each year, but living in paradise usually means we don’t need to go far,’ he says.
‘Over the past few years we have been slowly and intermittently renovating parts of our home, which I have been supervising, and has occupied much of my spare time. As a creative outlet, I enjoy photography, singing karaoke and occasionally, when the weather is good, I go for an early-morning surf on my boogie board.’
Through the lens
Dr Gudmundsen leads a large part of his life through the ‘visual’; both through his chosen career in dermatology, as well as through the lens of his camera. ‘I am always consciously or unconsiously looking at my surrounds to spot the unusual or the special things,’ he says.
‘Photography holds a special place in my life,’ he shares. ‘My first job after leaving school was in a camera shop in Crow’s Nest, Sydney, where the owner was a well-respected photographer held in high esteem in Sydney camera clubs. I saw his ne photos printed with care in his darkroom, and avidly viewed and read many photography books. Gradually the practical camera skills and techniques became part of my psyche.
‘I must say I learnt from my mistakes, taking far more bad photos than good photos. That is still true today. One principle to follow: the more photos you take, the more chances you have of getting a good one. It’s a bit like closing time at the pub (or so I’m told).
‘Many people ask what is the best camera in the world? My answer is one you have with you. I feel incomplete without a camera with me, and usually it is just a point-and-shoot one that is easiest to carry.
‘I take photos as a creative outlet. It seems to ful ll an artistic side; a balance to medicine which can seem quite regimented at times. It is an escape. It is another search for that successful achievement.’
Dr Gudmundsen typically incorporates his love of taking photos into outings and vacations rather than going on speci c photographic expeditions. ‘It is a bit of a love-hate thing for my family who have to be ‘delayed’ sometimes while I stop for that special photo,’ he says.
He says the trick to that one special photo is usually a combination of noticing something: good lighting; technique; composition; focussing; timing; patience; and luck – and often all these things have to come together in a split second. He personally prefers early morning or late afternoon for special lighting and likes silhouettes. He also usually takes shots with manual exposure and focus, rather than automatic, for better control over the outcome.
‘To me, photography is special because it often records a moment in time that will never come again,’ he says. ‘It is unique in time and space.’
And his approach to capturing a moment? ‘I tend to stick to the original trade I learnt. This includes trying to ll the frame with the shot, ie move in, get the main ‘action’ and try to exclude any non-contributory aspects. I also don’t do any post- shooting tinkering. Usually what is taken is what you get!’
The photos shown are a small collection of Dr Gudmundsen’s work. The majority was taken with a digital camera. The photos from South America were shot for the last time on film (2007). AMP
For enquiries call Ross Andrews on 0488 767 722 or Hannah Smith on 0467 667 555 or visit www.prolending.com.au
*article sponsored by ProLENDING
Working with ProLending
With the significant investments made to the clinics, Dr Gudmundsen has relied on ProLending, a medical nancing company offering unique and tailored solutions for professionals.
‘ProLending have been instrumental in the expansion and upgrades of our clinic,’ he says. ‘Ross Andrews and his team have helped with re-financing the initial costs of the t-out of the main clinic (Art Deco/Art Nouveau style in the reception and consult rooms and state-of- the-art clinical in the procedure rooms). ProLending has also helped with the purchase of new computer hardware, medical equipment and even the fit-out of my home office.’
‘At the end of March 2017, Lismore had a devastating flood which affected our practice and put us out of work for about three months. The fast financial assistance from ProLending was helpful for the clean-up and repairs and ongoing post-flood issues.’
‘There can be so much red tape dealing with banks, and loans are typically strictly secured,’ says Dr Gudmundsen. ‘With Prolending, you can get access to funds quickly and e ciently. Ross has always been easy to approach and helpful with our needs. He likes to take a personal interest and visits us when he can.’
‘ProLending offers easier access to business nance without the need to waste time at banks. Ross’s advice on several business matters has been instrumental in the expansion and success of our practice,’ he concludes.