Locums for a Small World Blog

All work and no play makes Bentch a dull doctor

Posted by Jesse Black

Dr. Leonard BentchNowhere in Dr. Leonard Bentch's CV does it mention his knack for writing, but his talents extend well beyond Internal Medicine. A retired physician, Dr. Bentch was sailing the Caribbean when he received a call that took him on a six-month locum adventure with his wife, Sue. He recently put his many remembrances to paper, and we're proud to present the last of the three-part series here (if you missed the first installments, read them here and there.)

 

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New Zealand was definitely not all work. Day and weekend hikes in Cormandel were precursors for even more spectacular and rigorous multi-day experiences: Tongariro Crossing, Milford Track, the Siberia Experience, Franz Joseph (for glacier hiking), and more. 

We flew to Sydney with a transfer to Hobart, arriving just in time to revel in the celebrations marking the completion of the Sydney-Hobart Yacht Race, which is probably the most vigorous and dangerous ocean race in the entire world. Hundreds of sailboats complete in a 680 nautical mile journey with colorful spinnakers prodding their hulls forward for just a few more miles to cross the finish line. The not so fortunate ones crept into

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Constitution Harbor with busted masts, defrocked rigging, and tired crews. Celebration with beer by the barrel, fish and chips by the bushel, and hugs and kisses from anxious family and friends by the score spilled onto the venerable quays and marina of this picturesque and noble seaport.

Out from Hobart, the countryside reminded us of Texas: dry, relatively flat, small towns with limestone buildings built during the mid 19th century, friendly and tough people throughout. The restored convict prison at Port Arthur was an incredible site. The endless views along the South Pacific, the long stretches of barrier islands offering sanctuary to countless sea birds, and the knowledge of the magical legacy of Captain Cook inspires reflection of times long past. The Captain Cook museum, a small locally maintained facility, is well worth the stop. 

We thoroughly enjoyed driving from Hobart to Launceston. The graceful river arch at Campbell Town and the restored windmill at Ross are particularly striking remembrances of beautifully simple classic architecture. In Launceston, we enjoyed a river boat cruise up into Tamar River Gorge. So enticing was this spectacular geography, that we returned for a day hike, ending with a luxurious swim in the huge public pool and adjacent Tamar River cascades. The swing bridge hovering hundreds of feet above the cascading river offered a fabulous walk and photo opportunity.

Launceston to Sydney is only 45 minutes by air, but nearly a world apart. Launceston is a quaint provincial town, while Sydney is one of the most cosmopolitan urban environments in the world. The famous Opera House and background bridge are icons for all and both lived up to their reputations. Travel within Sydney by foot, subway, or ferry is easy, fun and rewarding. The harbor scene is spectacular and a cruise is well worth the time. We enjoyed international food, regional Australian wines, and "hip" music.

Our six months Down Under seemed to fly by. Between work and travel, it felt like we were only in country for only a few weeks - though we made the most of our journey in the short time we had in New Zealand. To truly appreciate this area, aptly named the "Land of the Long White Cloud", you really have to experience it for yourself.

Topics: Port Arthur Tasmania, Tamar River Gorge, Siberia Experience NZ, Dr. Leonard Bentch, Sydney to Hobart Yacht Race, Launceston

"Mister" Bentch goes to NZ: A locum Down Under, Part II

Posted by Jesse Black

Dr. Leonard BentchNowhere in Dr. Leonard Bentch's CV does it mention his knack for writing, but his talents extend well beyond Internal Medicine. A retired physician, Dr. Bentch was sailing the Caribbean when he received a call that took him on a six-month locum adventure with his wife, Sue. He recently put his many remembrances to paper, and we're proud to present the second of three installments here. (If you missed the first installment, you can read it now).

new zealand island boats 123rfRight off the bat, I noticed a few subtle differences between the way medicine is practiced in the States and the way it's done in New Zealand. Aside from the relaxed dress code - business casual and no lab coats - the Department of Medicine structure is a bit different. Altogether, there were approximately thirty full-time Physicians; however in the British system, Board Certified Internists are called "Doctor" and Surgeons are not Physicians, but "Mister or Ms." But hey, what's in a name?

yachts-new-zealandAs a Physician and Gastroenterologist, or "Mister" as I became known, my work included a combination of general and specialty medicine. I saw acute admissions with my team of House Officers every fourth day and night, made teaching rounds daily, supervised the newly reinvented Handover Conference, attended Journal Club, House Surgeon conferences, made presentations at M & M conference, and gave teaching conferences.

outdoor-dining-tables-new-zealandIn addition, I saw GI outpatient consultations three afternoons per week, reorganized the Chronic Liver Disease clinic (which met twice weekly), performed 3 "lists" of general endoscopy per week and also participated in the ERCP list. I worked with the New Zealand Hepatitis Foundation, where we helped organize a treatment program for patients with chronic liver disease so they could be followed by their General Practitioners. Another highlight was a presentation I gave on Chronic Liver Disease to an area Medical Society. Put together, it was an active, fascinating, and mind-stretching experience.

new zealand boat and island 123rfThe nursing staff was exceptional; wonderfully trained and competent. Several were originally from New Zealand, but many were traveling nurses trained in other British Commonwealth nations. They labored with minimal resources, by our standards, to provide continuity of care - especially necessary in a teaching hospital.

Patient care in New Zealand was decidedly different from the United States. Resources are in such limited supply that evidence-based approaches to patient care were much more important. I found this rigorous attention to literature very refreshing. 

new zealand sheep 123rfNot every person with COPD who was admitted with cough and respiratory insufficiency was automatically treated with antibiotics; not every person readmitted with CHF received an echocardiogram or even a Cardiologist; not every person with headache automatically received an MRI and not every person with abdominal pain had a CT scan. The formulary was barebones, but covered the bases. Specialty help was there, including radiology, pathology, surgery, and all the medical subspecialties, but one did not feel obligated to request consultation on every case.

Kiwis do not expect extraordinary care when the natural history of their disease process is clear. Futile and unnecessary care was minimal. End-of-life care was excellent. 

Also, my office was fantastic. I was in a new building adjacent to the operating rooms; next door to the Cardiologists with views of the beautiful roof top gardens which provide a tranquil space for thinking, meeting house staff and colleagues, and enjoying lunch. My two office mates, a Rheumatologist and an ID physician, both full-time staff, offered a vast experience in medicine, an academic approach both to patient care and teaching, and a warm welcome. We were to become good friends. 

Check back here often for more updates from Dr. Bentch. Or better yet, subscribe to this blog and receive a weekly update!

Topics: New Zealand Department of Medicine, New Zealand Hepatitis Foundation, Locum Tenens, New Zealand, Dr. Leonard Bentch

Retired doctor sets sail in Caribbean, but locum winds blow him to New Zealand

Posted by Jesse Black

Dr. Leonard BentchNowhere in Dr. Leonard Bentch's CV does it mention his knack for writing, but his talents extend well beyond Internal Medicine. A retired physician, Dr. Bentch was sailing the Caribbean when he received a call that took him on a six-month locum adventure with his wife, Sue. He recently put his many remembrances to paper, and we're proud to present the first of three installments here.

australia sunset dock 123rfTwenty miles off the Coast of Martinique Island in the Caribbean, at the beginning of a two-month sail of the Windward Islands and the Grenadines, we recieved a phone call on a cell phone we'd brought along in case of emergencies. We did not expect to hear the voice of a Global Medical recruiter on the other line, but there they were, asking if we'd be interested in a six-month locum position in New Zealand. Recently retired from active practice, I'd forgotten that I'd completed a GMS application several months earlier. I looked at my wife; we smiled, and quickly concurred.

plane-wing-new-zealandOur plane descended into New Zealand fourteen hours outside of Los Angeles. Condensation on the port side windows cleared as our plane dropped through the clouds. The rising sun, with rays parallel to the vast ocean, reflected off a mirage of white skyscrapers. The span of the Auckland Bridge came into view, then the first image of New Zealand: a land of more boats than cars, more sheep than people, and more visitors than citizens. We were Down Under, approaching the Antipodes, the land of the Southern Cross.

new zealand clearwater bay 123rfUpon arrival, I met with the representative of the New Zealand Medical Council for the official interview and inspection of documents. GMS had thoroughly briefed me on expectations and provided me with a list of documents that I needed to bring. The interview was worthwhile and informative, mostly having to do with the organization of New Zealand health care, the Medical Council expectations, and the issue of medical liability.

With the interview process completed, it was back to the hotel to gather my wife and our belongings. We decided to rent a van and enjoy the scenic six-hour drive from Auckland to our new home.

Our condominium was a modern complex with stunning architecture that afforded us a fabulous view of the harbor. We were within walking distance of the pristine 50-mile beach, which stretched eastward in a gentle arc from Mt. Maunganui (our local extinct volcano).

As we unpacked our things it all of the sudden became real for us. This was to be our home for the next six months! A beach-side community of spectacular architecture, parks, boardwalks, cafes, restaurants, shops and bars. What more could we ask for?

We quickly found a favorite local hangout. Eggs Benedict seemed to be the classic breakfast offering everywhere, but we also learned to enjoy the flavorful Tarakihi fish, tempting savory pies, local Millsreef Sauvignon Blanc and Pinot Noir, and the local beers: Speights, Emersons and Monteith's.

Sue quickly found out about Yoga and aerobics classes and the public library. We enjoyed the Salt Water pools, either swimming in the "cold pools" or relaxing in the jet streams and showers of hot pools that are geothermically heated by Pacific Ocean water.

First run movies were playing at out local theatre; daily runs, walks and hikes around and to the top of Mt. Maunganui offered exercise; and the never-ending vistas of the wind, sky, tides, and changing flora continuously tantalized our senses.

A European-style walking community - with everything within walking distance - supplied all our domestic needs. Separated by time and geography from her world as professor of Law and Fullbright Scholar, Sue enjoyed keeping house, shopping, preparing local foods, reading, keeping up with all that was going on and making friends and aquaintances among the panoply of people making up our new home. Although recently retired, I was all about the business of rediscovering medicine and was quickly getting my second wind...

Check back here often for more updates from Dr. Bentch. Or better yet, subscribe to this blog and receive a weekly update!

Topics: Caribbean, New Zealand Medical Council, New Zealand, Dr. Leonard Bentch

Locums for a Small World Blog

Twice a month, our inquisitive locum tenens community asks us to tackle topics ranging from cuisine and culture to recreation and entertainment. We also include great storytelling from our doctors. Have a topic you’d like to read about? Let us know.

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