Image from https://www.gplivinglibrary.org/human-book-catalogue-1/dr-elizabeth-liz-sturgiss-1
“But I’ve always been drawn to prevention…”
Prof Liz Sturgiss is a clinical general practitioner and primary care researcher in the Faculty of Health Sciences and Medicine at Bond University, Queensland.
Liz leads an emerging research program on complex and chronic disease management in primary care that focuses on the translation of guidelines into real-world practice and the implementation of innovative interventions. Her research is based on theoretical principles from behaviour change and implementation science.
Watch the video of the interview below or on Youtube or listen to the podcast on Spotify and all the major platforms
Hello, I’m Domhnall MacAuley and welcome to MedicsVoices.com, where we talk to the key opinion leaders in health and medicine around the world. Today we are in the Australian Gold Coast and I’m talking to Liz Sturgis.
Liz, let’s take you back to the very beginning, to your school days, what interested you in medicine?
Liz Sturgiss: I grew up not really interested in medicine. I’m the first doctor in my family. Dad was an accountant, and a managing director of a television company, and mum was a science school teacher. I actually grew up wanting to do law. As a high school student in Australia you can spend time in different workplaces to see what it’s like. I did work experience in the Supreme Court in Canberra and got to sit with the law clerks at the front of the court. I found that really intimidating and actually a little bit boring. And then I did some work experience with one of dad’s friends who was a lawyer. It was more interesting work, which was with pharmaceuticals. Then I spent time with a physiotherapist in a hospital and really enjoyed that environment.
So, that work experience as a high school student changed my direction, and I went on to do medicine. After medical school, I did start in the hospital environment but I found it really frustrating as a very young doctor, seeing people come in with a heart attack and thinking, if someone had looked after their blood pressure for the last ten years, would this be this person’s story? I started doing public health very early on, studying for a Masters in Public Health, and I had quite a long journey before I started to be a GP. But I’ve always been drawn to prevention and less of the ‘ bells and whistles’ side of medicine, and where we ask what we can do to stop something in the future for this person?
DMacA: Before you did general practice, you had a number of different roles and, as part of that career path, you did a Master’s in Forensic Medicine. Was that bringing you back to your interest in law?
LS: Maybe! That’s interesting. I kind of fell into a sexual health and forensic medicine job. At the time, I was traveling overseas. Indeed, we actually lived in Ireland for six months and I worked in the emergency department at Cork University Hospital, which was very enjoyable- there were lots of night shifts but we had a good time. I had been traveling with my now husband, through South America when I found out what job I’d been allocated back at the hospital and I thought, I don’t know if I can do more of that. So, I ended up having a phone interview from Peru with Professor Vanita Parekh, who was the head of sexual health at the time, and I came back to do a job in sexual health.
What I really loved was that it was the first time I got to look after patients in their own clothes, which I know sounds really strange, but in hospital you see people in a hospital gown. Everyone looks the same in a little hospital bed but the same people come into sexual health as their own person. And hearing the story of what it brought them in- I really enjoyed that. For ten years I did sexual health and forensic medicine and looked after people after sexual assault, domestic violence, and people who’d been charged and were in custody during the night, to ensure their health and safety. That’s when I did forensic medicine and I was part of the first cohort of forensic physicians in Australia as Fellows of the College of Pathologists. I really did love that work, loved the community, loved seeing people as a person, but it was a little bit narrow. I wanted to know more and, when a person came in, I didn’t want to just look after their sexual health, I wondering about all the other parts of them. And that’s why, after ten years, I ended up in general practice.
“I really wanted to know everything about my patient. I wanted to look after their heart, and their lungs, and their women’s health, and their everything, and that’s what I really love about general practice.”
DMacA: Tell me about that transition…
LS: It was tricky. I think some of my hospital colleagues were disappointed that I decided not to pursue a hospital career. I think that in Australia there is definitely still the thought that general practice is the poor cousin of our hospital specialties, and if you choose to do that, you’re probably not as committed to being a doctor, and that you just want a flexible lifestyle. But that really wasn’t what drew me. I really wanted to know everything about my patient. I wanted to look after their heart, and their lungs, and their women’s health, and their everything, and that’s what I really love about general practice.
I remember the very first workshop I ever went to as a GP trainee and Doctor Katrina Anderson, who was the director of clinical training at that time, said, “Welcome to your first workshop as a GP trainee. And in this space, there are no silly questions. We’re all learning together.” And I just really remember feeling like this was the right space for me- when you can be curious and wonder, and it’s okay to be uncertain, and you can change your mind if the story or the situation changes, and working like a bit of detective looking at what’s happening for this person in their life, and this person who’s living with this condition.
DMacA: You transitioned again into the academic world…
LS: In Australia we’re very lucky. As part of your GP training you can choose to do an academic stream. Again, it was Katrina Anderson. I didn’t really know this was an option but Katrina tapped me on the shoulder and said, “Hey, have you thought of doing this academic post? I think you’d really enjoy it.” You spend half the time in the university doing teaching and research, and half the time in clinical practice, and I really did enjoy it. Ever since that very early stage of my GP training, I’ve spent time in universities and I’ve never been a full time clinical GP. I’ve always had some time in university and some time in clinical practice. After I’d finished my GP training I did a PhD. It was my supervisor, Professor Kirsty Douglas , who said that, if you want to stay in the university sector and if you want to progress your career, you’ve got to do a PhD because that’s what makes sense to other people in universities. And I think that was really good advice. I did my PhD quite early compared to other GP’s in Australia, but it was sage advice from Kirsty because it has opened up lots of doors and different opportunities.
DMacA: You were way ahead of the game with the topic of your PhD, which was in obesity management, and which has now really come to the fore.
LS: It’s funny thinking back at that PhD. I came to obesity with a very biomedical model and I thought that what I needed to do was to help patients to eat better and move more. But, I learned a lot during the PhD about the biology of obesity and the drivers of hunger and satiety. All of these things were known for a very long time in biomedicine but it just hasn’t trickled down into our training of doctors. I now give workshops to GP trainees and when I talk about the biology of satiety and the biology of hunger, there are a few more people saying- oh yeah, I know that, but it’s still very new for a lot of GP trainees. We’ve got a long way to go with obesity in terms of understanding it properly as a chronic condition. And in Australia, access to treatment is based on having money to pay because there’s very little effective treatment available in our public sector.
DMacA: There seems to be a big law magnet throughout your career, because I see you’re due to give a talk to a medical law conference on obesity, what are you going to tell them?
LS: There does seem to be a bit of a thread. Maybe it goes back to my high school self, thinking that I might be a lawyer. They want an update on obesity and what’s happening in the obesity space. I was drawn that particular alliance because their mission is around equity and social justice and that aligns very strongly with my own views as a GP. It’ll be interesting but I hope I won’t be put too much of a grilling.
” …and what I love about the primary care research community, in both Australia and New Zealand, and anywhere I’ve been, is that it is more about that nurturing, that curiosity, that learning together, and valuing other people’s perspectives.”
Liz, Prof Michelle Guppy and Dr Pallavi Prathivadi in front of an Indigenous artwork at Bond University – we are celebrating Michelle’s PhD in February 2025
DMacA: While we are talking about health promotion, you did a lot of work on alcohol reduction and the REACH project.
LS: That was a fantastic project. In 2019, I moved to Melbourne with my family to work at Monash University and the team. Vic Health is part of the Victorian Government and they work in health promotion. They had these fantastic health impact grants where they gave you the topic and you told them how you’d answer the question. They were really interested in getting more brief interventions for alcohol into the community so we worked with GP’s looking at a toolkit and working with the local primary health network who could then feed information back to the practice on how many alcohol histories they were taking. That was a really challenging time because, if you remember back to 2019, and 2020, there was Covid in Melbourne and the city of Melbourne had the most days of lockdown throughout the world. We had our intervention all set out when the first lockdown started happening so it was a very tough time to do research and we had to change to online. But, what surprised us and made proud about the intervention was when our fantastic biostatistician at Monash, Cathy Martin, brought back the final analysis. It was a time series analysis which showed that we had made a quantitative difference to the alcohol histories, which under the circumstances of what was happening in Melbourne at the time, was amazing. And, if we can make that change in processes around preventive health in general practice during the Covid lockdown in Melbourne, that gives me great hope for what we can achieve with the right processes and the right support for general practice in terms of prevention, and changing processes for better patient outcomes.
DMacA: Let’s talk about some of your other interests, because you do a lot of work with the Australian Association of Academic Primary Care.
LS: AAAPC as, it’s formally known in Australia, is the leading organization in Australia for academic primary care researchers. And it’s a proudly multidisciplinary group. We have allied health, nursing, general practice, methodologists, scientists who all come together. It is one of the sister organizations to NAPCRG, although NAPCRG is way bigger. I remember going to my first NAPCRG annual meeting and being blown away at the size and the number of people. The Australian- New Zealand conference that happens each year is a lot about relationships and networking, and nurturing new researchers. I’ve been to conferences- disease topic conferences- which are often very intimidating and I’ve seen some really awful questioning of junior researchers by senior researchers. And what I love about the primary care research community, in both Australia and New Zealand, and anywhere I’ve been, is that it is more about that nurturing, that curiosity, that learning together, and valuing other people’s perspectives.
“I also really appreciate that our North American colleagues are open to learning from people from all around the world. We’ve seen, for example, increasing participation from colleagues in Japan. The Netherlands always has a massive contingent which is fantastic because they have such a strong primary care system in the Netherlands.”
Liz with Prof. dr Pauline Boeckxstaens at NAPRCG 2023
DMacA: You’ve given me a nice introduction to the next topic I was going to ask you about, because you’re very involved in NAPCRG…
LS: I was first introduced to NAPCRG at the conference that was held in Mexico, which I think was 2015. The AAAPC has a joint prize with NAPCRG and I’d applied for the prize and didn’t get it but I thought, I’ll go anyway. What really blew my mind was the amazing methodology that our North American colleagues often pioneer, explore, and present. I always come away feeling like I’ve got new ideas and perspectives and thinking about my own work. It’s been a really important organization for me growing up as a junior researcher. And it’s really great to see the global perspective that NAPCRG is taking with the first non North American president, my very good friend and colleague, Tim Olde Hartman from the Netherlands. He’s doing such an amazing job in that leadership position. NAPCRG has been a really key part of my career.
DMacA: Looking at that global perspective, you’ve very modest because you didn’t talk about your own role.
LS: I have been the chair of the International Committee, and I really love that role. It’s about bringing together members from non North America, although we have some North American members there as well to give it that perspective. I’ve been on that committee for quite a while now. Professor Felicity Goodyear-Smith from New Zealand was the chair when I started in that committee, then handed on to Tim Olde Hartman and then it was myself. Doctor David Blane from Scotland is now the chair. The board really values the perspective of the International Committee and they listen, which is so important for an organization that wants to have that kind of international reach.
There is so much good stuff going on in North American primary care research that we can all learn from but I also really appreciate that our North American colleagues are open to learning from people from all around the world. We’ve seen, for example, increasing participation from colleagues in Japan. The Netherlands always has a massive contingent which is fantastic because they have such a strong primary care system in the Netherlands. The only difficulty is that the annual meeting is such a long way and I always seem to make really poor flight choices and end up on planes for 36 hours or something crazy. But if you’re living in Australia and want to see the world, you I do end up spending a lot of your life on planes.
“… Some primary care research does have a disease specific focus but it needs to work within a health service that is serving the whole person. That’s ‘generalism’.
DMacA: You have another big interest and that’s in the editorial world. Tell us about the editorial component of your work.
LS: I’m Co- Editor in Chief at the Australian Journal of Primary Health, together with Professor Virginia Lewis, is from La Trobe University in Melbourne. Ginny invited me to join her in that leadership role and I’m absolutely loving working alongside her. I was an Associate Editor at the Journal for a number of years and I’ve been on different editorial committees and boards of different journals. I guess the difference at the Australian Journal of Primary Health is that, as an Associate Editor, you get a lot of responsibility in handling papers yourself, which I think is fantastic. It means you get a broad perspective on papers. Sometimes, if there is just one editorial path, a lot of power given is to the editor if they’re the ones making the final chop every time. We have more of a dispersed leadership at the Journal and it means that people can grow their editorial experience. I don’t think I would have been able to step into an editor-in-chief position if I hadn’t had that hands-on experience of handling papers, working with authors, and looking at reviews. It’s been such a valuable experience. It’s a little journal in terms of the international world but we try to be a nurturing place where people are welcome to submit their work, but also a nurturing editorial committee growing new editors. Quite a few people that have come through the pipeline of our editorial group have gone on to leadership positions in publishing and editing. Professor Lauren Ball was as Associate Editor for a number of years, and she’s now Editor in Chief at the Journal of Human Nutrition and Dietetics, which is fantastic.
DMacA: Extending your editorial interest is the CRISP project. Tell us about that.
LS: CRISP– (Consensus Reporting Items for Studies in Primary Care) . It’s a labour of love. Professor Bill Phillips, a really close colleague, mentor and friend, is Emeritus Professor at the University of Washington in Seattle. It’s a NAPCRG story.
Bill and I met over a cup of tea, probably eight plus years ago now and, at that time, I was trying to do a scoping review looking at primary care interventions and was so frustrated at how the people involved in the interventions were being described- that catchall phrase of the health care provider. It was just a big mix of a heterogenous group of people and, when you’re trying to work out why and how an intervention is working, it’s very frustrating with that sort of reporting. At the time Bill was having similar but different issues with another review, so we connected over that frustration. Bill had already thought about research reporting guidelines for primary care and I guess we came together over that common problem. CRISP stands for the Consensus Reporting Items for Studies In Primary care. Bill is really good at titles of projects and acronyms and this is one of his. Having primary care reporting guidelines was not warmly welcomed in all quarters. I don’t know about you but I can’t really stand checklists and things like that, it’s so boring. It’s a bit like having to have vegetables with the interesting other parts of the meal! But it’s really important because if we don’t have primary care research reporting guidelines, we aren’t acknowledging that primary care is a research specialty of its own, that we have our own unique questions, our own challenges. Primary care is seen as just a little bit of everything else. But, no, it’s a generalist specialty that really deserves and needs its own focus. What CRISP has shed light on is that primary care research is very different from doing research in a subspecialty with a disease specific focus. Some primary care research does have a disease specific focus but it needs to work within a health service that is serving the whole person. That’s ‘generalism’. It’s been picked up very quickly by a lot of journals that now include a recommendation to use CRISP in their instructions to authors. It’s a nice thing to use in a peer review. If you’re looking at a paper and something not quite gelling, or there’s something missing, the checklist can help you communicate with an author that this is not quite right for your primary care audience. And on the translation side, Bill is an amazing networker and connector so we’ve now got a Spanish translation and a German translation. Our French Canadian colleagues have done a French translation. Japanese is on its way. Chinese is all done. It’s brought out a lot of our primary care research colleagues around the world that I wouldn’t have met in any other way. It’s been a really nice way to expand our network and the people we know. Actually, that’s my favourite bit of academia, meeting people from around the world and hearing different stories and perspectives.
Liz with husband Ryan Bellairs on a Gold Coast beach, March 2025
DMacA: You’ve done so much, you’ve been involved in so many different areas of primary care, and way beyond primary care. My final question is, how do you keep balance in your life?
LS: That’s a great question. I think I’m getting better at it. I’ve had times in my life where I’ve actually been working crazy hours and, in academia, the work will soak up every minute you allow it to. It’s a job where there is no end of the string. I’ve now come to terms with that. My to-do list will never be done. But it’s about pacing because it’s not like clinical practice where there are things that must be done today- the patient must be informed of a result. But academia is a little bit different. I’ve now learned I can take time for the family in the evening and just come back to that piece of work tomorrow, because it will still be there, and often coming back fresh after a good night’s sleep makes you much more productive. But I’m very lucky to have a very supportive husband who has been an amazing partner in all of this. If you don’t have that kind of partnership in your home life, you can’t get as much done at work. If you’ve got an unfair share of the labour at home, which a lot of working women do, then you can’t you can’t get as much done. So I’ve had that lucky partnership at home and a broader supportive family and social circle. And that’s what helps me to have balance.
DMacA: Liz, it’s been absolutely fabulous chatting to you. Thank you very much for sharing so much of your life and your career and the secrets of your success. Thank you very much indeed.
Some other key links:
- A BJGP podcast about the REACH project Episode 134: How can we integrate brief conversations about alcohol reduction into practice? Lessons from an Australian intervention – BJGP Life–
- Key results from PhD research –Increasing general practitioners’ confidence and self-efficacy in managing obesity: a mixed methods study | BMJ Open
- ABMJ analysis piece about obesity –Challenging assumptions in obesity research | The BMJ
- A methods piece on critical realism https://academic.oup.com/fampra/article/37/1/143/5678730 with Prof Alex Clark
1 comment
Thank you Domhnall for the invitation to be part of Medics Voice. You have captured my story so well.
Thanks for creating and curating this library.