Is this Australia’s grumpiest GP?
Dr Lou Lewis is a GP with a view. Australian Doctor finds out what he’s really like.
Dr Lou Lewis is surely Australia's crankiest GP, measured by the thousands of comments he's made on the Australian Doctor website.
A wide-ranging list of topics gets his goat, from GPs in suits (living in the past), chaperones (why are they needed?), e-health and the MyHealthRecord (fiasco), practice incentive program payments (bureaucratic crap) and, of course, those evergreen targets — the doings of the AMA and the RACGP.
This ex-boxer, on the surface at least, appears to have carried his pugilist ways from beyond the ring — where he's been a competitor, trainer, medico and official — to the often more brutal debates around general practice, its present and its future.
That is the perception, anyway.
But walk up a flight of stairs to catch Dr Lewis at his practice, and he doesn't seem that stroppy. Perhaps you would say he's a bit like a big bear. He is warm, amiable, even to the patient who calls seeking advice on her blocked nose, or to his daughter, who later rings him from home to let him know she's taken $50 out of ‘the drawer', which is the family funding resource for his children.
"As long as they let me know they are taking the money, I trust them."
And as he collects his regular order from the cafe downstairs, there's definitely banter and chat between Lou and the barista. There are no angry eyes.
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So what kind of GP is Dr Lewis? He runs a streamlined operation at his two-room practice on a busy road in the southern Sydney suburb of Matraville, part of the infamous Bra Boys' stomping grounds.
And he is that rare breed that was meant to be rendered extinct by the rise of multidisciplinary care and the corporate empires — a solo GP. There is no nurse, no practice manager, no receptionist and no EFTPOS machine. It's just Dr Lewis, the waiting room and his patients, who know it's only cash or cheque as they take their place in the queue.
Dr Lewis rents these rooms from his friend and medicopolitical figure, Associate Professor John Gullotta, a GP who has served his time in the state AMA branch. It was a deal sealed years ago, with a handshake and no paperwork.
"That's old school, and the way I practise is old-school medicine too," Dr Lewis says.
No after hours
"I am one of the busiest doctors around. People come here from as far away as Seven Hills, not because I am the only doctor in town but because they are happy to come here.
"And if, after 40 years of being a doctor, you've never been sued or had any official complaint made against you, you must be doing something right. That's the way I feel about it anyway."
He sets his own hours, taking off a couple of afternoons a week, and has never done after hours or worked weekends.
While he and some of his patients go back decades, he says he doesn't believe in getting too involved in their lives or taking more time than necessary in a consultation. There are also very few care plans written.
The walls of the waiting room are plastered with framed or laminated photos of famous boxers and martial arts experts, their arms around their buddy and doctor, smiling for the camera.
The faces include Kostya Tszyu, Anthony Mundine and Garth Wood, as well as kickboxer Lauryn Eagle.
And some of them are his patients too.
"Kostya Tszyu has been here, and Anthony Mundine comes here, and they wait their turn. These are some of the world's greatest boxers, yet everyone is equal here," says Dr Lewis.
Boxers were his first patients when he started out 40 years ago: a patient base that came from his time as a competitor in the ring, then later as a medic, trainer and administrator.
Of a Cypriot background with a few doctors in the family, he and his brother Alex studied medicine at different universities, Alex at the University of NSW and Lou at the University of Sydney.
Dr Lewis said he had always loved a fight and never stepped back from a physical confrontation as a boy. When his brother announced he'd joined his university boxing team, it spurred on Dr Lewis to do the same.
And they were both pretty good at it.
Dr Lewis has overseen possibly thousands of fights as a physician. He's also campaigned for safer and fairer boxing, along with women's rights to box, although he's stepped back from most of those roles now.
The AMA, along with the wider medical profession, hates boxing, describing it as violence for entertainment and warning of the huge physical damage ‘the sweet science' inflicts.
Dr Lewis thinks differently.
"Boxing is the fairest sport of all. It's one on one, between two people who want to fight, under rules and regulations, of equal weights, usually equal experience and with seven or eight different people who can stop the fight at any time," he says.
"The AMA's stance — it's all bullshit, and I'll tell you why. The AMA are the biggest hypocrites in the world with boxing because they say it causes head injuries," he says getting into his stride.
"If you could prove to me categorically that it was more dangerous than football or any of the other sports, I'd say let's stop it.
"Rugby league is more dangerous than gridiron, yet it's socially acceptable. But how can it be socially acceptable to have people bash each other from one end of the field to the other and not be prepared or able to defend themselves because they have this ball?"
Fighting the good fight
"I really hate this hypocrisy," Dr Lewis laments, but it's unlikely his issues with this alleged hypocrisy, or bureaucratic stupidity, of the medicopolitical debate will be resolved anytime soon. However, he says he's in for the long haul.
"I've never fought for the sake of just fighting. I've always fought for a reason, and that's always been for good and not evil," he says.
On the Australian Doctor forum, he has a reputation for dishing it out. But he says he fights fair.
Yes, he is prepared to back his stance but also back down and apologise if he believes he's gone too far.
He stresses that unlike some, he uses his real name, his writings rarely attack other doctors taking part in the forum.
But there are numerous institutions, he believes, that are failing the profession, and this makes them fair game.
The RACGP is "worse than the mafia", partly because it charges $2000 to collect doctors' CPD points, and the doctors need to remain registered to practise, whether they are members of the RACGP or not.
The AMA is "a bunch of wankers" and a lobby group for specialists, not GPs.
He believes both bodies have not fought hard enough for GPs' rights and financial recognition.
As for Health Care Homes, the big federal reform of Medicare that will mean voluntarily enrolled patients and possibly the end of fee-for-service for managing chronic conditions, he says: "What is this? No one understands what this is all about."
And then there is e-health and the MyHealthRecord: "Look at the recent census fiasco," Dr Lewis points out.
I'm certainly cranky
So is he grumpy? Is he the grumpiest GP in Australia?
"I'm not a grumpy person," he says, shaking his head smiling as he sits in his sparse practice room.
"What I can't stand is the way general practice has been decimated by everyone — by the government, by the medical centres, by pharmacies — who all want a bit of our pie.
"I'm certainly cranky, but not with doctors. What I am is disgusted at bodies like the AMA and RACGP, who are totally useless when they all pretend to represent us.
"They are so out of touch with reality, and neither of those organisations are worth two bob."
Dr Lewis says he is coming out fighting, at least online, to preserve his way of practice — the solo GP, the small family practice, which he says is dying a slow death.
"We are pushing shit up a hill," he says. "Everything is geared against us; everything they do is not for the solo GP but for the big organisations. It's as simple as that."
Carmel Sparke is an Australian Doctor reporter.