Dr Payne says working as a GP on remote islands is a privilege
Does flying island doctor Rebecca Payne have one of the world’s most fulfilling jobs?
As an out-of-hours island GP, she provides healthcare to some of the most remote communities in the world, all while experiencing “magic moments”, from seeing baby seals and emperor penguins to the northern lights.
“Every day I pinch myself and think, ‘I cannot believe this is the life I’m living.’ I absolutely love my job,” she said.
Dr Payne was working for the Care Quality Commission when she got chatting to another doctor who worked on the Orkney islands in Scotland.
“I was like, ‘Wow, that sort of island job would be my dream but it would never be practical, I’ve got two kids and my husband works full-time.’ And she said, ‘No, no, no, hear me out, my job is amazing and we’re recruiting.'”
Dr Payne has now been working for NHS Orkney for four years, often flying between the archipelago’s islands.
She is on a rota with seven other doctors who each spend one week in eight on Orkney.
Image source, Rebecca Payne
Dr Payne recently worked as a flying doctor in the Falklands
She spends the rest of her time working from home in Cardiff as a researcher for Oxford University and occasionally working on other islands as a locum – a doctor used to temporarily fill shifts.
Working in remote settings brings with it some very particular challenges.
“Some of the small islands I work on you might be the only healthcare professional, so your job involves everything from managing emergencies, sorting out helicopters, managing asthma, collecting medication from the ferry, taking blood and taking it to the aeroplane for collection.
“It’s whatever comes in through the door type of medicine… from a kid who’s got a bead up their nose to somebody who’s had a massive heart attack.”
Poor weather conditions mean getting on or off an island is not always straightforward.
She was once trapped on Eadie, one of the islands of Orkney, over new year because a big storm meant her plane was cancelled.
She said something common to island communities was people not seeking help as soon as they should.
“Sometimes, particularly farmers, will try treating themselves that little bit longer than maybe they should and so people sometimes come in a lot more poorly than they might in other settings,” she explained.
Dr Payne said the worst situation was somebody deteriorating in a storm and needing a helicopter retrieval.
“You’d get them into hospital sooner rather than later on an island setting… everything happens two steps sooner in order to avoid a really sick patient in a really remote location,” she said.
In her four years in the job, Dr Payne has developed a real love for Orkney.
“It’s just the most magical place you can imagine,” she said.
“The light is amazing… it’s got this kind of otherworldliness to it.”
She added patients there really appreciated their doctors.
“They know it’s not easy to get doctors there, particularly in bad weather and to work somewhere where people are just grateful is so rewarding,” she said.
When she works on Barra in the Outer Hebrides, an island chain off the west coast of mainland Scotland, her plane has to land on the beach – “just one of the most incredible experiences of my life”.
Last summer she fulfilled a dream to spend a month in the Falkland Islands in the South Atlantic Ocean approximately 400 miles (650km) off South America.
Her job involved covering the hospital, A&E and out of hours GP services – her two teenage children and husband were even able to join her for part of it.
About 10 minutes away from the archipelago’s only hospital – King Edward VII Hospital – Gentoo penguins can be seen on the beach.
Image source, Gareth Payne
Dr Payne’s husband Gareth captured photos of penguins on their trip to the Falklands
The family were able to watch them come in from the sea on their bellies and waddle across the beaches fast as they could to avoid patrolling sealions.
“They were just the cutest,” said Dr Payne.
“You wake up and think ‘did it really happened?’ Was I dreaming from the minute I turned up at Brize Norton to take an RAF flight?’.”
About 10% of the population of the Falkland Islands live on islands that cover an area about two-thirds of the size of Wales.
She described one particular shift when she was working as the flying doctor covering the islands as “one of the best days of my entire life”.
There are no scheduled flights to the smaller islands so people email where they want to go or what they need to be transported and a timetable for the eight-seater Britten-Norman Islander aircraft is constructed around that.
On this particular shift she was sitting next to the pilot with a sheep shearer and noisy cat on the way back to being reunited with its owner, but the flight was also used to help a farmer find some missing cows from the air.
After taking blood in the back of a 4×4, there were stops to drop off the cat and house calls to see three more patients.
Image source, Gareth Payne
The Falklands is home to seals
The landing strip was muddy so instead they landed on the beach, doing a fly-over first to scare off any penguins.
“I was thinking, ‘I cannot believe I could be sitting in a surgery somewhere or I could be wild and free and looking out for penguins on a beach after delivering healthcare to the remotest communities in the world’,” she said.
On another memorable day in the Falkland Islands the family drove across beaches and moors in a 4×4 to visit Volunteer Point to see penguins.
“There were penguins everywhere, there were king penguins sitting in little groups with all the babies in the middle and the adults around them keeping them safe… totally unforgettable,” she said.
What can the rest of the world learn from the way healthcare is delivered on islands?
“I’ve never been on an island yet where I felt like a bad doctor because generally you have the time and the setup that allows you to deliver great care, and that gets me out of bed in the morning,” said Dr Payne.
“There are many islands where people living there don’t have access to a hospital without getting on a ferry… it’s the amazing general practice they receive that makes the difference.”
Dr Payne will be in the Orkney islands with her family this Christmas and then she her sights on St Helena, a remote volcanic outpost in the South Atlantic Ocean.
Image source, Rebecca Payne
A plane collecting Dr Payne from Kirkwall airport on Orkney
She believes jobs like hers are “the real antidote to people getting midcareer blues and thinking about early retirement”.
“Mixing it up and using your skills in a different setting can really bring the love back for what we do and so I would say to colleagues that are maybe feelings burnt out or disillusioned to just go for a short locum at one of these places, try something really different, because it really can bring the joy back.”
She added: “I get to be in these amazing places, working with incredible people and being able to make a difference when it matters most.”
