Featured Doctor

ROCHFORT, Dr Andrée

Ireland - Family doctor

What work do you do now?

I am a GP in rural practice in Ireland and an academic GP as Director of Quality Improvement with the Irish College of General Practitioners (ICGP) in Dublin.

On the clinical side of work, I practice as a general practitioner in County Wexford, a beautiful rural county in the south east of Ireland with glorious beaches and scenic hill walks. The practice is a busy group practice with a dynamic and varied team. In the practice kitchen we have a lot of laughter and chat together at lunch breaks and during tea breaks when there is an opportunity to cross paths during intensive long days seeing new patients every ten minutes. These are important minutes in a work day which help to sustain a GP team. We miss these interactions since we implemented social distancing in the tea room and our meetings now take place online from our individual consultation rooms! Being an academic GP practice we have an active in-house peer group CPD programme for the GPs and nurses and the practice trains GP Trainees and hosts medical students also.

Tell us more about your ICGP work?

My ICGP work is a programme of medical education and guidance on quality improvement and safety in healthcare delivery in general practice, focussing in particular on Human Factors for quality and safety of care. The role evolved from and incorporates my initial position of Director of the ICGP Doctors Health in Practice programme, a system of supports, services and medical education for GPs own personal and professional health, and wellbeing at work by promoting good physical, psychological and occupational health.

The basis for quality rests on structures, processes and outcomes, and healthcare delivery is deeply dependent on the quality of human interactions, and influenced by the processes of decision-making of both the professional and the patient. The complexity of options and choices in healthcare has increased dramatically in recent decades and the next decade will bring about even more complexities with telemedicine and digital health developing rapidly.

Ireland has a population of just under five million and has 3,500 GPs so we are a small but very dynamic college. The ICGP has a very strong role in supporting family doctors through the pandemic, and has moved rapidly to deliver medical education and continuous professional development online during restrictions so that general practice can stay connected and up to date with best practices in infection control and delivery of services to patients.

The “bigger picture thinking” role of an academic GP with external liaison and representation gives me some work life balance. In ICGP, I am a member of a number of committees including Membership Services, Quality Safety & Standards, and I also report to Education Governance Committee. During the pandemic I developed a series of digital “Doctors Health and Wellbeing Bulletins” to support GPs work life balance and creativity at a difficult time. It is important to highlight the value of mental health promotion and healthy lifestyles for health workers as being equally as important as how we promote it for our patients.

My work in the area of professional health has also led me to a very productive experience of working on the scientific committees for a series of European conferences of the European Association for Physician Health along with colleagues from different medical specialties across a number of European countries who are part of this forum.

What of your involvement in WONCA Europe and EQuiP?

As the national representative from the Irish College to EQuiP, the European Society for Quality & Safety in General Practice, a network organisation of WONCA Europe, I co-chair the EQuiP working group on Professional Health and Patient Safety with Dr Isabelle Dupie.

EQuiP brings together the European colleges of general practice representatives in quality and safety to assist GPs and practice staff on topics of risk management, patient safety and continuous quality improvement. Outputs are disseminated through conference presentations, policy statements and publications and online. In 2018, I was honoured to represent EQuiP on the WONCA Europe Working Group on Taking Action on Overdiagnosis, and under the chairmanship of Prof Johann Sigurdsson we developed a position paper which was approved by WONCA Europe. Family medicine across Europe and the world has demonstrated the critical importance of high quality general medical services to patients at local community level is the key to an effective functioning health system.

Your interests at work and privately?

In clinical practice: paediatrics, adolescent health and care of the elderly are my main clinical interests. Occupational medicine is also a topic of interest, and following a term on the Board of the Faculty of Occupational Medicine in Dublin, I developed a course curriculum for an e-learning course for GPs in occupational medicine. As family doctors we see that the work patients do has a two-way influential relationship with their overall health and wellbeing; it is the same for doctors.

Clinical risk management, patient safety at transitions in healthcare, reducing harms from over-intervention in medicine, patient self-management support in chronic conditions, planetary health and lifestyle medicine are other interests.
I am active in a charity called the Medical Benevolent Society of Ireland, and a member of its central committee. This organisation provides financial support to doctors and their families who experience hardship through illness, accident or bereavement, on the basis of social worker assessment

One of my proudest achievements has been as a football manager, team coach and mentor. This was a volunteer role with a ladies football team for teenagers from several different schools and backgrounds. This three year term taught me that team members with different skills and strengths and abilities are needed to make up a successful team. We won the county championship title in two of those years and had a lot of fun along the way among the players and the parents, without whose support it could not have happened. I also spent two years on the management team of a county football team and our team won one national All Ireland championship title. It was time intensive but such enjoyable work. I have no idea how I managed to fit it into an already busy life but so glad I did.

Nature and the natural world is important to me, and we have a wild meadow area in our garden which this year supported a large number of larvae for peacock butterflies, and some tadpoles which have successfully developed into frogs. My husband and I love to relax in our garden after work. I enjoy the visual arts and have learned a lot from one of my daughters who has a degree in fine art, while another daughter being a nutritionist keeps us all informed about the importance of good nutrition and sustainable food production. Young people are the future of the planet indeed, and they need all the support they can get from adults and from their GPs.