Concurrent 2 - Old time medicine for old-timers: A pragmatic approach to rural aged care
Tracks
Track 2
| Friday, June 26, 2026 |
| 11:00 AM - 11:55 AM |
| Mossman |
Details
An increasing part of our clinical time is spent on aged care.
The care of frail aged patients can be particularly challenging. The guidelines we follow for younger patients do not necessarily apply and can result in undesirable outcomes.
This presentation will discuss tools and techniques to transform our care for these patients from a “heart-sink” experience into relationships that we enjoy, making both their lives and ours richer.
Speaker
Dr Tony McLellan
Gp
Alice Street Medical Centre
Old time medicine for old-timers: A pragmatic approach to rural aged care
Abstract
The proportion of patients over 75 years of age in an average General Practice has more than doubled in the last 30 years and will continue to increase, especially the extreme older age group. The care of frail aged patients can be particularly challenging. They often suffer with multiple morbidities and have accumulated enormous medication loads. The guidelines we follow for younger patients do not necessarily apply and can result in undesirable outcomes.
This presentation will discuss
• Use of tools such as the “Frailty Index”, life expectancy data and perioperative risk. calculators to facilitate preemptive and realistic discussions about future care.
• Rationalisation of “preventative health care.”
• The role of rural generalists as Geriatricians and General Physicians to the extreme aged and severely frail elderly patients.
• The recruitment of Nurse Practitioners to share the load.
• The rewards of a more pragmatic approach to treating this cohort.
The presentation will raise points for discussion and will last 35 minutes. It is anticipated that the audience will have experience and ideas to share on the topic so that the last 20 minutes will be saved for discussion.
This presentation will discuss
• Use of tools such as the “Frailty Index”, life expectancy data and perioperative risk. calculators to facilitate preemptive and realistic discussions about future care.
• Rationalisation of “preventative health care.”
• The role of rural generalists as Geriatricians and General Physicians to the extreme aged and severely frail elderly patients.
• The recruitment of Nurse Practitioners to share the load.
• The rewards of a more pragmatic approach to treating this cohort.
The presentation will raise points for discussion and will last 35 minutes. It is anticipated that the audience will have experience and ideas to share on the topic so that the last 20 minutes will be saved for discussion.
Biography
Tony is a rural doctor who has worked in Atherton for the last 40 years.
He was raised in Mackay, North Queensland, and graduated in medicine from the University of Queensland in 1981. He had so much fun in 2nd year medicine that he did it twice.
Post graduate hospital years in Cairns included relieving in Mareeba and Cooktown and inspired a hunger for rural practice.
After completing a Diploma of Obstetrics and a year sailing, Tony was recruited from Dunk Island to Atherton Hospital where he worked as a PHO and then SMO for 9 years. During that time he pioneered the role of a Rural Generalist SMO, acquired an FRACGP, championed use of Diagnostic Ultrasound by rural doctors, and became Medical Director of the Cairns Rural Health Training Unit.
After going into private General Practice in 1994 he continued procedural obstetrics until 2014, both as a private GP Obstetrician and Hospital VMO.
From 2000 - 2002 he was the ACRRM Training Supervisor for the Atherton Tablelands helped develop the ACRRM Clinical Guidelines.
Tony is a proud husband, father and grandfather, an amateur bass guitarist, and a keen wood worker with ambitions of becoming a luthier.
Mrs Heidi Baker
Nurse Practitioner
Alice Street Medical Centre
Speaker
Biography
A dedicated nursing professional with over a decade of experience in regional and rural Queensland healthcare, she began her career in 2011 as an Assistant in Nursing before progressing through Enrolled and Registered Nurse roles working within Aged Care and the hospital setting. In 2017 she transitioned into general practice I where she has since grown into clinical leadership positions.
Passionate about improving health outcomes in underserved rural communities, she has established and led nurse-led services including wound care clinics, cervical screening, and immunisation initiatives across both general practice and aged care settings. She holds a Graduate Certificate in Chronic Health Care Nursing from QUT and in 2025 completed her Master of Nurse Practitioner through the University of Queensland. She is currently working as a Nurse Practitioner across the Atherton Health Hub, Alice Street Medical Centre and Carinya Home for the Aged, bringing advanced clinical skills and a commitment to evidence-based, patient-centred care to the communities she serves.
