Dr. Gillian Braunold: Dedicated volunteer doctor who runs the contraception clinic
It proved to be an insightful interview with volunteer Dr. Gillian Braunold who runs the contraception clinic at the Terem – Public Health Clinic in Tel Aviv (see ESRAmagazine #181) two mornings a week. Last year, 1,300 women gave birth via the clinic’s gynaecological services.
I found Dr. Braunold occupying a corner room in the clinic speaking to a young female Eritrean patient with the help of a translator. Experienced and efficient, she nevertheless exhibits a deep and heartfelt concern for her patients – a difficult combination.
What brings a former London family doctor – a relatively recent immigrant – to work in such an environment?
Far from being a totally new experience for her, the patient profile is, in fact, familiar territory. The work here provides a comfortable setting because of her many years working as a General Practitioner (family doctor) in Kilburn, north-west of London – work that included running a contraception clinic with a similar set of patients.
Because of Israel’s rules regarding doctors, Dr. Braunold is not the clinic’s gynaecologist, whereas in the UK, as a family doctor with a specialized training in gynaecology and contraception, she was fully qualified for all contraceptive prescribing and fitting.
What is the main difference between her work in London and in Tel Aviv? There she saw three or four women for contraception per quarter whereas here it is six per week.
“My experience has soared,” she laughs. “My skills have improved and so has my interpreting of the patient. I think I could do it blindfolded,” she is happy to reveal.
It is, however, difficult to use male interpreters, Dr. Braunold notes. Translators are used differently in Britain and Israel.
“There is an element of advocacy by the translators here that is very helpful,” states Dr. Braunold. “They are tuned into the patients culturally and emotionally. They understand where they come from and where they need to go.”
What was her first day like? “I walked through the door and felt at home. It was just like Kilburn. It was the sort of work I had been doing with the sort of faces I was used to – similarly demographically.
“I felt at home and still do,” she explained, adding with a wry smile, “I just miss the Iranians, whom we don’t have a lot of here!”
Initially, when Dr. Braunold also worked as a voluntary GP in the Tel Aviv walk-in clinic, she would get to know more about the family circumstances of her patients, but as that was not her field of expertise, she decided to concentrate on the contraception clinic.
She must not allow herself to get emotionally attached although she must remain culturally sensitive at all times.
Her own career path and personal life have taught her strength of character and determination in the face of personal tragedy.
Born in South Africa to the highly respected Professor Percy and Mrs Queenie Grosberg, Dr. Braunold moved with her family to Leeds (UK), and later qualified as a doctor at London’s Charing Cross Medical School in 1979.
“I always wanted to be a doctor. I liked the idea of taking responsibility,” she revealed. “After marrying while studying I considered what I could do part-time.”
Initially she considered radiology because ultra-sound was then taking off, but then she saw an advertisement for a trainee GP in Borehamwood north of London.
The appointment was serendipitous as the practice was that of Dr. John Marks, chairman of the BMA (British Medical Association). The trainee subsequent to Gillian was Dr. Laurence Buckman, who also went on to become chairman of the BMA GP section.
Inside Terem, where Dr. Gillian Braunold works
It proved to be a hothouse of medical politics. When she became frustrated by the on-call arrangements for doctors, instead of pursuing a petition, Dr. Marks advised her to get herself on the local medical committee, and that was the catalyst for her involvement in the wider field of medical politics.
She went on to practise as a GP for almost 30 years from 1982 to 2011 in Kilburn, London – a multi-ethnic, culturally diverse and deprived area. Most of the patients were refugees and asylum seekers “from every war-torn country” who had been placed in council (public) housing.
“Most knew no English and the demographic was even more diverse than Israel’s,” she said. Great use was made of interpreters and often there was no family member present.
When she started, she was married to Max Braunold and the mother of one girl. Two boys came along soon afterwards and all her children came into the clinic, sometimes helping out at the reception, as they grew up. The patients saw her children growing up and Dr. Braunold had a close relationship with them all.
It is not surprising that she is justly proud of how the Kilburn practice grew. When she started, there were two doctors and 3,000 registered patients. When she left, there were six doctors, a number of ancillary staff and almost 8,000 patients.
One might have imagined that this growth in her work would have provided sufficient challenge, but Dr. Braunold nurtured her additional career interests – developing and attaining an illustrious career.
These interests took two main forms: the adoption of IT (Information Technology) and the politics of the medical profession – particularly with regard to GP training.
Her goal was to make the practice paper-free. She achieved this in 2000, having installed computers as early as 1985, thus making her practice one of the first adopters of IT.
She also trained other doctors and, through this, was elected as one of the four London representatives on the GP committee of the BMA.
Her portfolio in this role was IT and she became the deputy chair of the BMA’s IT committee. In that capacity she became the GP voice on IT to the British government and the National Health Service in general.
In 2004 there was a major push by the then Prime Minister Tony Blair to digitize the NHS, backed by a £3 billion pound budget.
The Summary Care Record Program became part of that initiative – a program that would enable instant information-sharing between hospitals and GPs, to enable any doctor dealing with a patient to access his or her complete health data and history.
The BMA invited Dr. Braunold to become the national clinical lead on that program in a job shared with Professor Mike Pringle, president of the Royal College of General Practitioners. Despite the high ideals, Dr. Braunold admits: “It proved a difficult period because of negative publicity and complex politics.”
But now she is gratified that 98% of English patients are covered by a summary care record and it is used to a great extent in emergency care.
The system is on an “opt out” basis for a patient’s inclusion in the database but “opt in” at the point of use, either by the patient or by a next of kin.
Dr. Braunold reflects: “At the time, it was an incredibly hard battle but, of all the things we did, I am incredibly proud it received international acclaim.”
However, she felt that the British government would not be able to procure another patient IT program called “Health Space”.
“It will happen, but not through the government,” she added. In the absence of an ID number, which is not used in the UK, it would take some time to make a secure digital identification viable, and people are still working quite hard on that.
Gillian lost her husband, Max, in March 2011. With parents in Netanya and the two eldest of her three children in Israel, she decided to make aliyah and arrived a year later in March 2012.
She considers herself fortunate to have met a lovely Israeli man, and in October 2013 married David Decker. Personal tragedy struck yet again when David passed away in August 2014, although Gillian still keeps in touch with his family.
Nevertheless, Dr. Braunold continues her work with determination, ensuring that her medical skills and knowledge are put to good use for some of the less fortunate in Israel.