No such thing as an ordinary day in the Royal Flying Doctor Service

In all my years of reporting from outback Australia, one organisation has stood out to me from all others in all my travels, for having the respect and appreciation of everyone in the bush.

And that’s the Royal Flying Doctor Service.

The Royal Flying Doctors Service in Queensland operates 24 hours a day, every day of the year, doing aeromedical retrievals across the vast expanse of the state, and caring for more than 330 000 Australians each year.

As well as the dramatic plane rescues, the RFDS also delivers primary and preventative health care to some of the most remote areas in Australia, and indeed the world. 

Dr Aidan Fenoglio is one of the on-call doctors on the roster for the RFDS, based in Brisbane and Charleville.

“It's unpredictable. Things change. We can have the most thought-out plans, but they get thrown out the window at a moment's notice if a phone call comes through,” he says.

“We're on standby ready to respond at a moment's notice. So we're at base.”

“We're also responsible for helping those that are in rural remote locations who may not need air medical retrieval but just might need to have a conversation or a discussion about their symptoms or concerns.”

A challenging but rewarding job

All RFDS aircraft are staffed with a pilot, flight nurse and a medical officer, and are fully pressurised and configured to resemble mini-intensive care units. They are fitted with either a Lifeport or TAS system and a stretcher loading system that is fully compatible with road ambulances.

Dr Fenoglio says he thrives on the challenges of the job.

The previous day, our interview had to be rescheduled because Dr Fenoglio was flown out to a woman in labour who needed assistance. 

“We try to avoid a delivery within the aircraft or flying at all costs,” he says.

“We don't like doing things in flight. If we're going to do things, we'll do them on the ground, but everything is about risk management in this job as well.”

“Fortunately yesterday, things went all to plan, and we were able to transport the patient because she had higher healthcare needs and needed to be delivering in a safe environment. And we got her to that environment, and she didn't deliver in the meantime.”

He says callouts could involve anything from heart attacks, motorbike trauma, mustering issues, people wrestling with bees, or even more run of the mill medical emergencies like you see in the city but which are made far more complex in a remote or rural setting. 

“It sounds a bit odd, but I really do enjoy looking after critically unwell and sick patients. I don't want anyone to be unwell, but at the same time, if they are, I'm happy to be called and be able to assist,” Dr Fenoglio says. 

“It’s what we're trained to do and I think that having that buy-in from the community to the organisation and to be able to assist them in their time of need and for them to be truly a very thankful community as well, it's a very special job that we do here. 

“We work within a great team with our pilots, flight nurses and even our base and admin staff, they're the glue that keeps us going and it's a nice change away from that, we'll say metropolitan healthcare system, which I also work within. 

“It's very different work. I feel very fortunate and blessed to be a part of the team here and I don't see myself moving on anytime soon.”

Embracing rural medicine

Dr Fenoglio started his training at James Cook University, after coming to medicine later in his life.

“I never really had a strong aspiration through my high school years to become a doctor, but I was fortunate enough to have the grades and back then James Cook University was only fresh in its journey of having a medical school.”

“Once I got into medical school, I became very interested in rural medicine. I was around a lot of very good mentors and rural generalists, rural GPs and became aware of RFDS as an organisation. I was actually a John Flynn scholar with the RFDS as a medical student.”

“So I've always had that affiliation with the organisation and once I became a doctor and then a `grown up’ doctor with my sub-specialty training, it was only natural for me to gravitate back towards RFDS.”

The varied background of all the RFDS doctors’ training is also one of the services’ strengths, he says.

“My work in retrieval medicine is as a retrieval physician or specialist, but I'm by trade an emergency specialist. Having said that though, others that work within the Royal Flying Doctor Retrieval sphere might come from an intensive care background, an anaesthetic background, a rural generalist background and predominantly now it seems to be how the workforce is shifting to an emergency medicine specialty background.”

“You acquire that skillset over time, but the actual letters after someone's name can be very variable.”

He urged doctors to consider working for the RFDS and reach out for support on that pathway.

“Hopefully my junior doctor colleagues or those doctors-to-be of the future will consider working within this environment and if people are hearing this or listening to this, reach out to the organisation,” he says.

“I'm sure they'd be happy — I'm certainly happy — lots of docs are happy to be mentors or assist with people on their journey to hopefully work for the organisation.”

“Royal Flying Doctors Service Queensland will be able to link you in with rural pathways, but also Base is always happy to welcome people to the Visitors Centre here in Charleville. We're always happy to come out and have a chat as long as we're not busy doing RFDS things.”

You can hear Dr Fenoglio tell his story on the Streets of Your Town – The Outback Project podcast on your favourite podcast provider.