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Providing Patience with Patients

For nearly two decades, Dr Allan Moffitt ran a successful medical practice in the East Auckland suburb of Howick. But an increasing awareness of the growing health problems among struggling communities in the Counties Manukau region saw him appointed as the DHB’s Clinical Advisor and Director of Primary Care Development in 2004 and later the Clinical Director of Procare in 2014. He now practices one day a week at The Fono in Manurewa.

In comparison to the majority of fellow suburbs in the Counties Manukau District Health Board region, the residents living in Howick are not only well-to-do, they’re generally well.

“The practice I ran was a nice, friendly place with good staff and patients,” he recalls.

“But, to be honest, I was dealing with a lot of people who didn’t really need my help. Sure, you can ‘help’ them, but I’d classify them as ‘Worried Well’ people. They really didn’t need help.

“Whereas working at practices in Otara and here at The Fono in Manurewa, we’re dealing with people who really do need our help. And helping here is far more satisfying.”

Allan describes himself as “a bit of an all-rounder”, capable of performing minor surgery procedures and helping patients overcome rashes and pathology, which relates to diseases such as diabetes.

While he was at Counties Manukau, the DHB ran a Let’s Beat Diabetes programme from 2005-2010.

“It was hard work,” Allan admits.

“We did a lot of work with Pacific communities. But there was a huge problem in getting them to recognise obesity and being overweight, and how that affects them. I realised then that people didn’t get it explained to them in a way they could understand. I try to do so and just this morning a patient said to me, ‘This is the first time someone’s explained this to me properly’.”

A sense of fatalism, however, still exists among Pacific communities, as Allan admits having recommended lifestyle changes, including improving diet and increasing exercise, to patients.

“Some will say to me, ‘It’s God’s will and I’ll leave it up to him’. Their Mum may have died at 50 and they’ll believe it’s normal,” says Allan.

“But when New Zealanders on average are living well up into their 80s, it’s not right for Pacific people to die well before that. I understand, however, that many have the challenge of simply trying to put food on the table and managing a multitude of issues, including money. When they’re really struggling to make ends meet, many don’t think their own health is as important … even though it is.”

As Clinical Director of Procare, The Fono’s PHO (Primary Health Organisation), Allan came across The Fono, recognising that it is equipped to assist with the number of wrap-around services also on offer such as Whanau Ora and the ARI (At Risk Individuals) Programme.

And amid the struggles, Allan sees a number of positive changes, including the rise of positive health messages among the younger Pacific generation taught at schools.

Experience has also taught Allan not to become too paternalistic with patients.

“What’s important for us doctors is to remember we’re here to help people,” he says.

“Give them the right guidance and advice. Build your relationship and understanding with the patient. I admit some, particularly the older ones, will nod and smile politely before going onto do what they’ve always done. But more want to know how they can become healthier, so the opportunity is there for them to develop a trust in you and open up, so you can really help them.” 

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