It has to be said straightway that general medical practice in the country is not and has never been what it has become in the metropolitan areas of Australia.
In the first place there is still a relative shortage of doctors in the rural areas, even in the larger centres such as Albury-Wodonga.
Furthermore there still not as many highly specialised doctors in country towns as are readily available in the big cities .Nor are there the highly sophisticatedprocedural treatments on tap, nor are there enough specialists in some disciplines actually living in these areas; for example, we have visiting neurologists and neurosurgeons, visiting ophthamologists, visiting dermatologists and so on in other disciplines, but they do not live here.
So it was common in times gone past that a country doctor had to become a GENERALIST within his capacities and training; so it was that in my first country general practice.
Dr. Pitts performed Obstetrics, Paediatrics, Operative surgery (at that stage there was only one general surgeon for the whole of the Goulburn Valley area extending from Seymour up to the southern Riverina, there was only one specialist obstetrician/gynaecologist, no orthopaedic surgeon, only one ophthalmologist and in the early years no specialists in general medicine or anaesthesia) and so he was able to offer general medical treatment for most of the patients who came to my door.
I gave anaesthetics, treated uncomplicated fractures, attended to heart attacks and all the usual medical conditions such as chest infections, heart conditions, most of the childhood illnesses and an increasing number of orthopaedic medical conditions—sore shoulders and arms, tennis and golfer’s elbows, wrist sprains as well as fractures, lots of sporting injuries and an almost unbelievable number of people with neck pain and low back pain, with and without sciatica.
Dr Pitts had the good fortune to be registrar to Mr. Norman Little a prominent orthopaedic surgeon in Sydney in my years at Lewisham General Hospital, and learned a lot from assisting at operations and attending inpatient and outpatient clinics with him.
Mr Little used to carry out manipulations under anaesthesia at the hospital whilst Dr Pitts acted as his assistant, and they would see the favourable results of his work at the follow-up outpatient clinic the following week. Dr Pitts also had the privilege of acting as his only assistant at many of the spinal operations that he performed.
This was the start of Dr Pitts’ long-term interest in the management of spinal and other orthopaedic medical conditions.
Perforce Dr.Pitts undertook these various tasks through the help and with referral to the local specialists when needed, and for the rest expanded his knowledge and training by all available means so as to better serve the people. There were thankfully a few competent practitioners in the town and we enjoyed a co-operative and mutually satisfying association for those 12 years.
If Dr. Pitts referred a patient to a surgeon in Melbourne it was usually to Mr. Desmond Hurley, one of his teachers who rose to the position of Senior Inpatient Surgeon at St.Vincent’s Hospital; and Dr Pitts would frequently go to Melbourne to assist at operations there and at other larger hospitals.