Riwka ensures no surprises for registrars.

Practice manager Riwka Hagen ensures GP registrars have a comprehensive orientation at the start of their term, setting up a rewarding and happy learning experience.

After 25 years in practice management, Riwka Hagen has a well-established routine in helping registrars reap the rewards of their term in general practice.

Her well-honed processes and skilled interactions with trainees also ensures a happy and successful experience in the apprenticeship training model for GPs.

“I first and foremost remember that the registrar is there in a training capacity – the primary objective is their need to learn,” Riwka, 50, said.

Next on her list is a comprehensive and friendly orientation, which starts from the moment a registrar first walks in the door at Gisborne Medical Centre, Victoria.

“I make a segregated time to have a really detailed conversation with them about how the practice operates,” Riwka said.

“It’s about relationship building; making sure the registrar understands while day-to-day they may not see much of the practice manager, I let them know I am there as their agent. You are there to facilitate what their needs may be.”

The meeting with Riwka, closely followed with scheduled orientations with other team members, sets the foundation for ongoing positive interactions for registrars taking the leap from hospital training to general practice.

Riwka spends an uninterrupted hour with the registrar early in their two-day orientation, which works through a detailed checklist with the team, including nurses, senior administration and GP supervisor.

As well as detailing practice processes, Riwka explains to the registrar that they are not seen as a guest, but as an “integral part of the team”.  She encourages them to ask questions and seek help as soon as an issue arises.

Riwka, also likes to prepare young doctors for the inevitability – and importance – of feedback, building their ability for a positive response and averting a “meltdown”. She explains her role is to provide feedback from doctors, staff and patients.

“I explain that getting critical feedback is not uncommon. It’s not disciplinary in its nature; it’s part of the industry and it’s very much a part of learning.

In the event of a complaint, the registrar is informed about what to expect. “I will explain to them what comes to me and they will have an opportunity to explain what happened.”

Furthermore, Riwka also debunks the mystery of whose role it is to inform any would-be complainants of outcomes, explaining it is her role to speak to patients about resolutions.

Whether such issues are reasonable or not, the situation is then reviewed as a learning opportunity. And again, the registrar is prepped to embrace this scenario.

Adverse events, including resolutions and any resulting changes to practice processes, are discussed during the practice’s regular clinical meetings.

The cultural practice of positive transparency and a collaborative learning environment gives registrars the opportunity – and confidence – to “put their hand up when something goes wrong” and to “learn from mistakes”, Riwka said.

“Our feedback mechanisms are about not having secrets, so there are no surprises when the registrar gets to the end of their term.

“Part of the success of their placement here is that we have well-developed systems in place and a clarity about our processes.”

Registrars are further supported by well-planned rosters and collaborative scheduling of appointments, which increases alongside the registrar’s growing confidence.

“Patient scheduling should not undermine their confidence. They start slow and we make adjustments along the way, taking cues from the registrar,” Riwka said.

Reflecting on her own career in supporting possibly more than 50 registrars at various workplaces, Riwka is enthusiastic.

“I have enjoyed teaching, training, mentoring, supporting and watching registrars develop from being shy and uncomfortable to becoming really capable GPs.”