Where the doctor happens to be Maori, and where there is a significant Maori population, special care is necessary where whanau, hapu and community are intricately interwoven. To purposely disturb this environment for personal reasons is irresponsible and disturbing.
Being a Maori doctor attains to it a certain cultural charisma which should not in any way be abused.
Maori are a wairua people, they read people in an often non verbal way. Body language they are sensitive to. Verbal communication may be metaphorical, vague and understanding based on ability to read the scene and people concerned. Emotion is a feature.
A tangi can illustrate an element of the Maori world. Whakapapa can be critical. Any attempts to disturb this environment for selfish reasons is to be frowned upon as offensive and immoral.
If we are now able to draw our attention to the nature of medical practice in Aotearoa New Zealand this evolves mainly around solo practice or group practice.
Solo general practice, where a doctor prefers to work on his own, is probably more a feature in the cities and is now uncommon in rural areas, where medical collegial contact is infrequent. Keeping up with the latest developments in the profession, along with administrative overloads, are mitigating factors. Long hours can also be a feature for a doctor's life and family.
A group practice is the practical norm in today's environment. Opportunities to discuss a patient professionally with colleagues makes for improved patient care. To discuss the latest medical trends and developments leads to improved personal professional development. Group practice allows for patient cover should a doctor be held up or called away urgently.
Locum cover is not so much a feature in group practice (a bane of solo practice), and therefore there is less disturbance of patients' routine.
Obviously teamwork is an important consideration in a group practice, everyone pulling their weight. A maverick, self-centred and unreliable colleague can only lead to a poorly-functioning group practice with a lack of harmony, which soon spills over on to the patients.
Administration and administrative costs can also be minimised, allowing doctors more time to attend medically to their patients.
Teamwork is very important in any group practice, and for patients generally.
A Maori doctor in an area with a large Maori population is a must to address Maori cultural factors and to generally improve Maori self-image, psyche and ambition to achieve.
There is, however, a saddening but growing trend with young Maori doctors. The cultural aura and charisma that tends to build up about them in a Maori population, for obvious reasons of 'service to whanau and hapu,' is now becoming an unrealistic ideal and comes at a selfish cost.
Maori health providers on the east coast have experienced this development only too well.
B C Gregory
Kaitaia
