GP – working with the whole person

Dr Ramya Raman is a GP who loves connecting with her patients to nurture trust for their ongoing care and a lot of people are taking notice. Ara Jansen reports.

Dr Ramya Raman regularly feels humbled to care for people and to care for generations of the same family. As a GP at Skye Medical in Armadale, Ramya has embraced specialising in general practice because she loves the variety of the work and the connection to the community it creates. 

“People bring their kids to see you and you become part of their family story, and that’s a special relationship and a level of trust they give you,” she says.

Ramya and husband Surakshan.

As an only child born to Indian parents who were posted around the world because of her father’s work in academia, Ramya considers herself a country girl after moving to Dubbo in New South Wales and spending her high school years in the town of Orange. She completed her undergraduate Bachelor of Social Science at Charles Sturt University before moving to Perth to complete her medical studies at the University of Notre Dame.

Ramya’s mother is an alcohol and drug counsellor, which is what piqued her interest in the health field. 

Childhood inspirations

“My interest in medicine was also triggered by going to a country school where not a lot of students showed interest in the area at the time. My dad noticed this interest and gave me the biography on Dr Ida Skudder. It was an inspirational story – an American missionary, she was the first female practitioner who built a medical college for women in India,” she said.

“Skudder worked against a lot of gender resistance in the mid to late-1800s. Her having an Indian heritage was a real role model for me and showed me that medicine was a possibility. She has been my inspiration and fire for doing medicine. I have to thank my dad for that book.” 

Curious about biology and how the body works as much as she is about the human condition, Ramya considers medicine a profession which offers both stimulation and the chance to build relationships with people. 

“That’s what I’m really interested in. It’s probably why I’ve chosen general practice, so I can build those long-term relationships with people, which is a privilege. A GP in primary care helps build continuity and allows you to engage with people before a health issue becomes a problem.”

She recalls working with a GP in rural New South Wales who looked after a community of about 3000 people and had been doing so for nigh on 40 years. 

“I thought that was amazing and nice to have that continuity of care at a family level, seeing someone through from birth to later in life.”

That level of comfort and assurance has gone a long way, especially at the start of COVID, when numerous patients came in to discuss issues such as whether to send their kids to school. She says it puts GPs in a challenging situation to try and answer these types of questions beyond playing the role of providing medical advice. 

Personal touch
The Skye Medical team.

“As GPs you are a trusted source of information to parents and their families. During COVID, with some of my elderly patients, they just needed to come and see someone, and connect with a real human. They told me they felt like they could just come in and say hello, which is wonderful.”

Ramya joined the Armadale practice 18 months ago and many of her patients have moved with her. She’s enjoyed being able to have that continuity of care alongside meeting new patients. 

“In terms of connection, it’s an extremely rewarding profession and my biggest driver as a GP is to be able to make a difference to people’s lives and to do that at a grassroots level in the community, treating kids through to adults. 

“I enjoy the variety of having the opportunity to see patients of various ages and cultural backgrounds. No two days are the same.”

The use of telehealth consultations has understandably risen greatly over the past year for Ramya and her colleagues. It has been a huge learning curve in terms of diagnosing as well virtual and online communication and connection.

“It’s going to have a huge impact on the way the GP system works. It has been a long time coming and has its drawbacks as there are certain things you need to do in person, but there’s still a lot of work we can do this way. Hopefully, it also makes doctors more accessible to more people.” 

Ramya has a special interest in women’s health and her patients come from diverse cultural backgrounds, something which she can relate to. Particularly for women, who for various reasons, culturally or otherwise, feel uncomfortable with a male doctor. 

Hard questions

“I’ve also done extra work in the area of family and domestic violence, trying to make women and men aware of it and being available to approach it. The numbers have gone up, particularly in the past year, and people still don’t know how to talk about it,”
she said.

“That’s where relationships with patients is particularly important. When you know a family, it gives insight into certain things going on. It makes it a little easier to navigate through and break the ice with a patient. It gives women the opportunity to come and talk about it and for me to ask the right questions. 

“I teach and supervise medical students from Notre Dame and these clinical encounters are the best way to show students how we approach delicate topics such as domestic violence in clinical practice.” 

She suggests using opportunities like postnatal checks as a chance to gently find out how things are going at home. Who is home with the patient? Who is helping?

As part of last year’s postponed World Organisation of Family Doctors (WONCA) conference in Sydney, Ramya had planned to present a workshop on how doctors deal with the fourth trimester (a newly minted phrase for the three months after the baby is born). Hopefully, they can resubmit it to the WONCA World Conference slated for November. 

“Women at this time can present with mental health concerns and physical issues but they can be physical, verbal, emotional or even financial. A GP’s role is really important at this time. When you’ve built up a trusting relationship, they may be able to see things as they are, and you can explore and work through them together.

Next gen

“These issues don’t necessarily present in a standard way. I’m hoping the workshop will be able to generate some insightful discussion to bring back to use here. I hope to use these in teaching sessions for my GP registrars in training at WAGPET and my students at Notre Dame.” 

When she’s not hard at work, Ramya is slightly obsessed with recreational cycling, either out on the paths or enjoying her favourite television shows while pedaling a stationary bike. She also loves to dance and is a trained Barathanatyam dancer, though it has been a while since she danced. Barathanatyam is a major form of Indian classical dance hailing from the country’s south and is one of its oldest. 

She also enjoys flying with her husband, Surakshan, a product manager and private pilot. Together they also indulge their love of food by eating out around Perth. If it’s outdoors, even better. 

In September, Ramya received the City of Fremantle Aspire Award, which offers a $5000 scholarship for personal and professional development towards an overseas conference. Thanks to nominations from her colleagues at Skye Medical, she was also named 2020 Western Australian GP of the Year by the Royal Australian College of General Practitioners. 

“It’s a huge honour and I’m grateful to my colleagues and the patients who nominated me. I’ve been incredibly lucky to have such a supportive family and colleagues, all of whom support my passion as a GP and in medical education. 

“The way primary care is rapidly evolving thanks to technology – which has been particularly accelerated through COVID – there’s lot of space to contribute and participate in the journey. 

“Teaching really helps with clinical practice. Teaching, writing and learning keeps you up to speed with new things, which I can use in my practice and as examples for my registrars and students. Using clinical cases is immensely powerful and much more engaging than ‘death by PowerPoint’. It also forces students to work through something and figure out all the things that can happen.”