Artist, Doctor, President.
Dr Karen Flegg is a general practitioner, medical educator and President of WONCA, the World Organisation of Family Doctors. She also attended Art School.
Karen has practiced mostly in rural and very remote areas and is an Associate Professor in the Rural Clinical School, of the Australian National University. She has a strong interest in Aboriginal Health, women’s health and has been actively involved in both undergraduate and postgraduate specialty training for general practice for over 20 years.
She is President of the World Organisation of Family Doctors, taking office in October 2023 and previously served as editor of the WONCA journal (2010-20). She has been on the boards of directors of numerous medical / general practice organisations, including the Royal Australian College of GPs, and Australian General Practice Network, often taking on roles relating to finance, audit or governance and bylaws. She has obtained the Fellowship of three Colleges of General Practice – the Royal Australian College of GPs, the Royal New Zealand College of GPs and the Australian College of Rural and Remote Medicine.
She also has a passion for art, having taken two years out of medicine to study at art school, majoring in printmaking and painting, preferring life drawing and large abstract works. She does yoga, meditation and dog walking to relax.
“I’m hoping that this WONCA conference will be like all the WONCA World conferences I’ve been to. Great places to see old friends, meet new friends, exchange ideas with people from your own country in my case, but also all those International people who are coming here to tell us about Family Medicine in their countries. I’ve made some great friends in WONCA over the years.”
Karen has had a fascinating international career trajectory taking her to Australia, from New Zealand and Iran.
Karen Flegg: I worked in New Zealand, 25 years ago. I was the Chief Executive Officer of the Royal New Zealand College of GPs, one of the WONCA member organizations, but I did do some clinical practice at the same time so I didn’t quite give that up. And the Iranian trip that you referred to was actually a mission with Médecins Sans Frontières in 2005. I enrolled with MSF and they told me I’d be very difficult to place because of, perhaps, age and preferences and I thought I’d get sent to Indonesia because the Tsunami had just hit Banda Aceh. And two days later I’m being offered a place in Iran, and had an enjoyable time doing that MSF mission.
DMacA: That experience both in New Zealand and in Iran equips you very well for your incoming Presidency. The WONCA conference is coming to Australia, tell me what your hopes are for the conference.
KF: I’m hoping that this WONCA conference will be like all the WONCA World conferences I’ve been to. Great places to see old friends, meet new friends, exchange ideas with people from your own country in my case, but also all those International people who are coming here to tell us about Family Medicine in their countries. I’ve made some great friends in WONCA over the years. My first WONCA conference was actually held somewhere fairly close to you in Dublin, with the council meetings in Killarney before that, and there are people that I met at that conference who I’m still friends with today.
DMacA: That WONCA conference in Dublin was a really remarkable event. I greatly enjoyed it, I found it inspiring and indeed Michael Boland who was the President of WONCA ran a terrific conference. But while WONCA is an inspiring organization, it’s got many challenges because you’re trying to bring together Primary Care from very many different backgrounds. How does that work?
“In Australia many of us GPs are concerned about the sustainability of general practice and I’m really talking about financial sustainability, workforce sustainability and, of course, workforce is a fairly big International issue for all of us.”
KF: It is challenging at times as WONCA is a member-based organization and the members are the member organizations in the country, the colleges and academies of general practice or family medicine, so it’s bringing people together to work on problems on a global level. And I guess some of those problems are things that may be in your health system or my health system that we may be able to help others with and at times others can help us with them. So, there’s a knowledge exchange and a richness based on having people from such a wide variety of countries. WONCA has, at this point I think, something like 133 member organizations and that represents 111 countries in the world, which is quite a large number- about half a million family doctors and perhaps 90 per cent of the world’s population.
DMacA: One of the things you talked about with WONCA is the exchange of ideas and communication and, of course, you’ve had a role within WONCA in communications because you’ve been editor of WONCA News. Tell me about that.
KF: I was the WONCA editor for 10 years and for much of that time I also managed the website. That presented an opportunity to meet so many colleagues and find out about what family medicine was like in their countries, by doing interviews with them for a ‘Featured Doctor’ column, by having them write articles which I had to read, so I learned an awful lot about what happens and what people’s challenges are through that role. I also learned how to look at the back end of a website which was a skill I never really expected to have. I did have the advantage of spending much of that time working with Garth Manning as CEO and, before him, some time with Alfred Loh, and with several different Presidents in Rich Roberts (US) , Michael Kidd (Aus), and Amanda Howe (UK). It was a very rewarding 10 years but, at times it was quite a lot of work.
DMacA: You have name checked some fairly significant figures in the world of WONCA, very different and very interesting people each bringing their own angle to WONCA. But let me ask you about something else because, when we talk about Family Medicine we do have a problem at the moment in terms of getting our message across. As an editor, how do you feel we’re doing in communicating the role of Family Medicine, in Australia for example where there are great difficulties, but also around the world.
“… we’re hoping that, whatever the outcome in the referendum, we will get some change particularly in places like remote Australia where a lot of change is needed to bring health outcomes and health equity in line with other places in the country.”
KF: In Australia many of us GPs are concerned about the sustainability of general practice and I’m really talking about financial sustainability, workforce sustainability and, of course, workforce is a fairly big International issue for all of us. There are issues locally. I do have colleagues who talk about sustainability from a much broader perspective, including environmental issues which I’m quite passionate about and interested in, but also those other issues of workforce, burnout which was fairly common as well in Covid, in multiple places and multiple systems. But yes, we are struggling with the system.
DMacA: You’ve worked both in rural practice and in urban practice but you have an interest also in the Indigenous Community, and this is an issue that’s coming up in the headlines in Australia at the moment. That seems very difficult. Where are things at present with the referendum.
KF: There is a referendum coming up in two and a half weeks on whether the Aboriginal, Torres Strait Islander people, will have a voice in our Parliament and there’s a lot of debate internally. There are people on both sides. I have worked a lot in the last half a dozen years in central Australia in remote Aboriginal communities, or in Alice Springs which is that dot fairly well in the center of the country. Conditions are not good. The workforce of GPs themselves is rather low. The system tends to be a nurse-led system because they are the ones in those communities all the time, along with Aboriginal health workers, and doctors tend to visit. We have a workforce problem in our urban areas but we have a fairly big one in our remote areas as well. I guess we’re hoping that, whatever the outcome in the referendum, we will get some change particularly in places like remote Australia where a lot of change is needed to bring health outcomes and health equity in line with other places in the country.
“the advantages of a group practice are that you have colleagues on site, it’s not as isolated, you’ve got people to talk to, people to show the most difficult rash to, and there’s always difficult rashes!”
DMacA: We’ve talked about workforce, and sustainability earlier, and you’ve worked both in single-handed practice and in group practice. What model do you think we’re looking at for the future of general practice?
KF: I think we’re looking at group practice. I worked in a one doctor town as the only doctor when I was a still in the training program for general practice. It’s fairly well unheard of today. Yes, practices are joining together. In Australia we have private practices not government clinics, except if you go remote, and they are becoming often corporatized. It’s not just one group practice, it‘s groups of group practices. But I think the advantages of a group practice are that you have colleagues on site, it’s not as isolated, you’ve got people to talk to, people to show the most difficult rash to, and there’s always difficult rashes! So I think the future for us is group practice. It’ll be interesting to see how long it takes before we all become government employees in this country which the GPs are, of course, in many countries.
DMacA: We’ve talked earlier about administration and about WONCA. People might get the impression that you’re a very serious administrator and a backroom worker. But I know you have another string to your bow and I’d like to ask a little bit about that, because you have an interest in Fine Art. Tell us about that.
KF: Art wasn’t a terribly approved of thing in high school and, when I was in my 30s, I was doing some forensic work in a sexual assault service. So, I went to art school for two years and survived doing highly paid forensic work after hours. I enjoy life drawing and I quite like doing abstract paintings as well, two extremes of reality.
DMacA: You’ve gone from single-handed practice to group practice, CEO in New Zealand, President of WONCA, but you also have this vocation in art. So, when you’re talking to young doctors, what do you say to them. Is it to follow your vocation or get a job?
KF: That’s a difficult one isn’t it, and I do talk to young doctors. I think everybody really has to do what they have a passion for, and find the thing with passion in medicine. But, everybody also needs other interests and other outlets. I’m not sure that art mixes that well with medicine, although people will disagree because we’ve certainly taught artist therapy in our medical school. I find a little difficult to do that but it’s good to have passions inside and outside medicine.
DMacA: Thank you very much for chatting to us this morning, and your evening. Following your passion that’s a lovely message.
