Dr Michael Crampton, GP of the Year, has taken an active role in clinical computerisation, integrated care, vaccination safety and medical education, as well as continuing to care for families he’s known for 30 years
Dr Michael Crampton, the Royal Australian College of General Practitioners’ GP of the Year, says he is “blessed” to still be treating a family who walked through the doors of his first practice 30 years ago.
“I’m still treating all three generations today”, he tells the MJA.
That connectivity doesn’t apply only to his patients. As a medical educator, Dr Crampton has been supervising registrars for 15 years.
“I’m old enough and grey enough now to have seen a full cycle of that as well”, he says.
“[Medical education] is an incredibly important part of my career and I think of most GPs’ [careers], because we need to pass on to the next generation important aspects of our craft of general practice.
“It’s more than knowledge, it’s a whole series of skills which really need to be applied with practice over time.
“My greatest joy as far as medical education is concerned is watching the younger doctors that we have trained over time become the senior and experienced doctors and start setting up their own practices and start training their own registrars, becoming the medical educators of the future.
“It’s an incredibly joyous experience to see that”, he says.
Dr Crampton finished his MB BS at the University of New South Wales in February of 1981 — “I know that only too well as my daughter was born on the same day” — did his hospital training at St Vincent’s Hospital in Sydney and spent 4 years at Westmead Hospital before settling into general practice in Sydney’s west, where he has been ever since.
The exception was a 3-year stint at Monash University in Melbourne from 1987 after being invited to become the inaugural RACGP Computer Fellow.
“During my university time in the late 70s it started to become apparent to myself and many, many others that there was a role for computers in our knowledge management and management of patient records, over time”, Dr Crampton says.
While working at Westmead Hospital, he became involved with people working with the RACGP in the area of health records and took part in discussions about standards for computerised health records.
“That led me into work with the RACGP’s computer conferences, which it started in the early 1980s and ran about every 2 years, showing GPs what could be done with computers.”
Later, as the RACGP’s Computer Fellow, Dr Crampton had a two-pronged role — educational, through the conferences, and a development role.
“We looked at various issues that might be slowing down the uptake of clinical computerisation and the first issue that we came across was a simple legislative restriction”, he says.
In the 1980s a prescription had to be handwritten to be considered legal.
“Clearly that was at odds with trying to run them through a computer system, so on behalf of the RACGP a number of us had individual negotiations with each of the state health departments to get legislation changed to allow for printed prescriptions to be legal prescriptions.
“That’s an example of the kinds of things the College was able to be engaged with during the late 80s and early 90s.”
Dr Crampton is optimistic about the ongoing rollout of the Personally Controlled Electronic Health Record System and other clinical computerisation measures.
“I’m now convinced that major changes like that are generational rather than something that is going to happen over a short period of time, because there are so many drivers and reasons why people do and don’t make changes to how they operate their practices”, he says.
“We’ve got fantastic capacity now with our computerised systems. Some doctors unfortunately are still using their computer systems as a very simplistic typewriter whereas other doctors are using their databases incredibly intelligently and using them to review what’s happening within their individual patients and also what’s happening across the practice.
“All those capacities are not as widespread yet as you’d like it to be, but the system continues to change.”
Another passion for Dr Crampton has been the safety and effectiveness of vaccines. He is on the Therapeutic Goods Administration’s (TGA) newly formed Advisory Committee on the Safety of Vaccines (ACSOV) which emerged from the 2011 review of the management of adverse events associated with influenza vaccines administered to children under 5 years of age, undertaken by Professor John Horvath.
“I was invited to participate in the implementation committee following the Horvath review. One of the recommendations was the formation of ACSOV and I’ve managed to find myself on the committee”, Dr Crampton says.
“It’s an interesting place to be. ACSOV is meant to give expert advice and, believe me, there are some amazing experts sitting around the table who I get to listen to and join in with.”
The ability of antivaccination and anti-immunisation lobby groups to gain traction in the media and social media realms remains a frustration but Dr Crampton remains optimistic and proactive.
“I’m not surprised the less well informed comment can get a guernsey fairly similar to very well informed comment and that can run around the system”, he says.
“Am I disappointed? Yes a little bit, but the only way we can manage those is to make sure we are promoting excellent advice.
“One of our strategies has been to make that advice into bite-sized chunks so that GPs can make use of that information in conversations with their patients.”
Despite all the challenges confronting general practice — dilution of skills, reduction in areas of work, funding issues — Dr Crampton remains optimistic about the future of general practice in Australia.
“There are always challenges, but I’m still of the opinion that most people, particularly as they get older, want to have a close relationship with an individual GP who is their health adviser”, he says.
“It’s because many people want that kind of health advisory relationship that they can get from a person rather than a computer or a book that I’m still positive for the future of general practice.”
Despite his busy schedule as clinical director of WentWest, a company working to provide integrated primary care to patients in the Western Sydney Local Health District, Dr Crampton still manages to practise for 2 “very full” days a week.
“One of the messages to pass on to registrars is that as time passes you move from being a doctor who patients come to see, to being the doctor that they come to see”, he says.
“They form that trusting relationship with you and they come to seek your advice about what to do about their health care.
“It absolutely gives me a lot of joy.”
As for being named the RACGP’s GP of the Year, Dr Crampton remains amazed and humbled by it.
“I think there are many people who are eligible candidates for receiving this award because I know many of my colleagues and I’m sure there are many others I don’t know who work across all of these kinds of areas in general practice”, he says.
“I encourage every GP to consider what they can contribute because they have things to contribute, I know that for a fact.
“And I certainly encourage GPs to consider participating in ongoing training for the future generation.”
The full interview with Dr Crampton is available as a podcast at www.mja.com.au/multimedia/podcasts, and as a video at www.mja.com.au/multimedia
- Cate Swannell