This morning we began a ritual of encounter

By Emma McCleary, Senior Communications Advisor

22 March 2021

Category: Equity


This year, for the first time, 麻豆视频入口 combined the orientation day for GPEP year one registrars with the Hauora M膩ori Health Day that usually happens further into the year. The new two-day events, named Te Ahunga, were held at marae across the country with the intention of understanding the importance of indigenous health and equity, and the positive effect a GP can have on the health transformation of their community.聽

It was a warm February morning when the Hawke鈥檚 Bay and Gisborne contingent were welcomed with a p艒whiri onto Te Aranga Marae in Hastings. The group included College CEO Lynne Hayman, College Board member and lead medical educator Dr Kiriana Bird, Tumuaki Head of Equity Te Oraiti Reedy, medical educator鈥檚 Dr Patrick McHugh and Dr Stefan Freudenberg, and nine GPEP year one registrars.聽

The p艒whiri (ritual of encounter), is a way of meeting; acknowledging the history and stories of the people present and understanding whakapapa so that connections can be made, and bonds formed.

The start of any new relationship needs certain events to ignite a spark. Physical distance, conversation, and being open to the experience of sharing. It鈥檚 a ritual we can do several times a week without realising and one that, depending how it鈥檚 approached, can change the course of a life.

Te Ahunga 2021
GPEP year 1 students are Hawke's Bay Te Ahunga, February 2021.

When you鈥檙e a GP and your ritual of encounter is meeting with a patient, you both bring history and beliefs to the scenario and what happens next depends on how you begin your ritual. Every person carries with them, regardless of age or ethnicity, a rich history; their heritage, their lineage, their experiences, the strands of themselves; the loves of their life, and their suffering. It all comes together to make us who we are.聽

When manuhiri are welcomed onto Te Aranga marae, they travel through a Waharoa, a passageway known as Te Kowhao O Te Ngira, or the 鈥榚ye of the needle. It鈥檚 a physical representation of the concept of threads (people) coming together to thread into one strand. At Te Ahunga Hawke鈥檚 Bay those threads are diverse: registrars who鈥檝e had careers in marketing and advertising, one doctor who used to work as a roofer, one on her fourth specialisation (general practice will follow paediatric surgery, urgent care, and emergency medicine), people who鈥檝e training overseas, and those who followed their parent鈥檚 path to medical school.聽

When our strands reach the wharenui we share stories and song. It鈥檚 intimate. Open. Honest. And it鈥檚 the kind of deliberate, revealing, best-practice relationship that should be how patients encounter their GP. It鈥檚 the stories that allow others to say, 鈥渞epeat your grandmother鈥檚 name, I think I knew her,鈥 and 鈥淚 visited your country in the 1970s and this is what I loved about it.鈥澛

It鈥檚 how GPs should encounter their patients, but it often isn鈥檛.

Te Aranga kaum膩tua Des Ratima shared a story with the registrars of his friend with a hip issue so severe he could no longer sit in church. He spoke of accompanying his friend to see his GP because after three years he was making no progress on getting a hip replacement. His GP, with his back to his patient during the consultation and tapping on his computer (clearly distracted) had decided before any discussion that this man鈥檚 need was for more painkillers. There was no ritual of encounter, no eye contact, no openness, no face-to-face.聽

After changing GPs, the patient was in the hospital within a week for his hip operation. His life changed. He鈥檚 no longer in pain, he can provide for his family, and he can sit in church because someone took the time to listen before they spoke; because they took the time to acknowledge the strands of that patient鈥檚 story; they stopped and listened before they started the medicine.聽

鈥淚 will always carry what I carry but I鈥檒l only share with you what I want to,鈥 says kaum膩tua Des. For the new GPEP year one registrars it鈥檚 a key clue about how to best engage with their patients, and a very Hauora M膩ori approach.聽

It鈥檚 easy to become 鈥榯oo busy鈥 or to not take a minute to stop and greet another person. It鈥檚 always easy to take the easy option, to think you understand the issue, the surface detail of what another person has said to you. But take the time to listen, share, and encounter another person and you may just change a life. The chance of that increases markedly if the life you encounter is in a GP-patient relationship.

Registrars listening at Te Ahunga 2021