Announcer
You're listening to a two part podcast featuring Mitchell Beggs-Mowczan and hosted by Danny Teece-Johnson talking about the benefits of a regular 715 health check.
Danny
Yaama, yaama, yaama. Hello and welcome to this very exciting podcast here today where we're going to talk about the 715 health check. The 715 health check is probably one of the most beneficial yet underutilised Aboriginal health programs that we have in our health communities across Australia. My name is Danny Teece-Johnson, I'm a Gomeroi man from Moree, New South Wales. I'm joined today by a very well-known young man to the health community out at Penrith. He's a community health worker, his name is Mitchell Beggs-Mowczan.
Mitchell
How are you going guys?
Danny
Did I get it right?
Mitchell
Yeah, you did.
Danny
Mitch, can you start by introducing yourself, your mob, where you're from and what you do for work, my brother?
Mitchell
Sure, brother. Yeah. Thanks for having me. So, my name's, as you said, Mitchell Beggs-Mowczan. I'm an Aboriginal Liaison Officer from Nepean Blue Mountains Primary Health Network. Proud-
Danny
Shout out to the west, bro. Shout out to the west.
Mitchell
West side. Proud Wiradjuri man, born and bred on Dahrug Land - Nan was from Condobolin. Come from the family, very big family, my family are Lords from out at Condo and Nan moved here when she was a young girl and raised all her family out at South West Sydney. So, born and bred at Napean hospital.
Danny
It's a lot of the story from our mob out West and the Great Dividing Range over the other side there that move into the city and grow our families up here on the side of this Great Dividing Range. Can you tell us a bit about your story growing up? I guess, how did you become a health worker? How did you get into health and I guess why is this so important to you?
Mitchell
Yeah, sure, brother. So, went to school out at Colyton in Western Sydney, grew up in Western Sydney and you know, I went to school, did my year 12 and thought that I wanted to be a plumber when I left school. So, I did that for about a year and a half.
Danny
Plumbing, health. Similarities.
Mitchell
Yeah. You see the similarities. So, I did that for a little bit and now I realised this wasn't what I wanted to do with my life. And my cousin was actually an Aboriginal Outreach Worker in our Blacktown office. And she told me all about the Closing the Gap program. And I said, "Oh, that's something I want to do." Look, I want to give back to not only people in the world but especially our mob and she asked me to go for a job out in Penrith and I was lucky enough to get the job. And yeah, I've been there for nine years, mate. And my job is to, to help our mob and you know, link as many Aboriginal people in with health services, mainstream health services, Aboriginal health services, and to really increase them 715's and to make sure that our health professionals in our area are culturally aware and they know how to work and effectively engage with Aboriginal people. So, mate, love me job, love helping our mob and very rewarding.
Danny
I can feel the passion coming across the table here. What inspired you to specifically focusing on health and not only as a career for you, but as a passion? Obviously, the way you're talking, you can feel it's very important to you.
Mitchell
Yeah.
Danny
And I guess for our men it's not something that we, I guess that we've really grabbed hold of just talking about health, getting involved in health. There are some great champions out there, but not enough. Why is it so important for you?
Mitchell
Oh look, so I actually, before I was a plumber, I was actually doing, I used to go out and teach our traditional Indigenous games with the young fellas out there. And you know I've always had a passion for health. Played sport, going to the gym every day, looked after my own health and I realized that I wanted to help other people with their health as well and when this job opportunity come up to link Aboriginal people in with health services, but also help them along that journey, culturally, just to break down barriers, I said, "This is what I want to do for the rest of my life."
Mitchell
I started off as an Aboriginal Outreach Worker. I then turned to an Indigenous Health Project Officer. So, going out and making sure our health professionals are all culturally sensitive. I'm now the Aboriginal Liaison Officer, so I have a really, really big passion for Aboriginal health. But in particular, working with our men. I help facilitate an Aboriginal men's group out in our area. And I just see how well other Aboriginal men engage with Aboriginal men and we just get it, the fellas will tell me a story and I'm able to dig that little bit deeper to sort of get to the crux of what they're after and to make them feel as comfortable as possible to be able to access health services. So yeah, brother, I've been very fortunate in my life to be able to help our men and help our young fellas.
Danny
Yep. You got into health quite early. You said you went to the gym and you're looking after yourself. I'm allergic to gyms, always have been my whole life. Even when I was 14 or 15, I didn't care about gyms it was just boring for me. And as I got into my teenage years, I guess I was like a lot of young black fellas, I treated my body like a fun park basically like Luna Park. I just partied a lot, I didn't listen to any of the messages that were out there and there weren't many messages out there. I'm 44 now, so we're talking 20 years ago, and I'd never heard of 715's or you know, regular health checks or all that. What made you aware of your own health?
Mitchell
Look I actually my whole life I've grown up playing rugby league.
Danny
Yeah.
Mitchell
And when I would play rugby league and progress to the high levels, we started getting into the gym, I started getting taught by some of the best-
Danny
Oh so you went into representative footie.
Mitchell
Yeah.
Danny
Not just the community footy where training is a couple of VB's, a game of touch footy then jump home.
Mitchell
Yeah, I was playing a little bit of representative footy and used to get trained by some of the best strength and conditioning coaches that were on offer. So, they taught me a lot of things that I could give back to our mob. So, I actually volunteer my time every afternoon training some of our black fellas down at the gym and help with our state knockout team, Burbaga Burawa.
Danny
Had to give them a shout out there.
Mitchell
Shout out to the team.
Danny
Had to drop it in didn't you? Go the boomerangs, go the boomies. Anyway bra, you were saying so.
Mitchell
Yeah. So, it's just something that I've sort of picked up over the time and something that I knew that I could give back to other people that were struggling to get a healthy weight try and look at living a healthy lifestyle and stuff like that. So yeah, I like to volunteer me time down at the gym just to train people and just help others to achieve what I was lucky to learn in my time and pass on them skills so then they can pass on to the future generations. So yeah, it's a really big passion of mine.
Danny
Yeh, it's really good work what you do. And I guess the biggest challenge is getting whether it's an uncle JoJo or cousin Bobby or little nip nephew Sammy, I'll say, shout out to you at Bowraville, but how do we get these young fellas to listen to what you're saying about health and make them? Because I'm reflecting on my 20 year old self too. You know, when I was 25, I was bulletproof, I was invincible. I drank a lot, I smoked a lot, I didn't think of any of the health consequences in the future.
Mitchell
Sure.
Danny
That would lay in front of me now I'm on high blood pressure tablets now because of the way I lived my life. When I was younger.
Mitchell
Yeah.
Danny
I didn't take things seriously back then. How do we get that message to young people now that the way you're living your life now has consequences for Uncle Danny when he's 44?
Mitchell
Yeah definitely.
Danny
So how do we get that message across?
Mitchell
That's a very good question actually. And it's something that you sort of have to be very flexible with, in my opinion. Some of the young fellas that have worked with in the past it's finding what they enjoy. So, the gym may not be for everyone, but they may enjoy other sort of physical activity and stuff like that and it's about connecting with that fellas as well. Building that connection, building that relationship. You can't expect someone to open up about their health history or to trust you to train them at the gym if you don't have that relationship, that core relationship built on trust. That's what I really try and do is to try and form that connection with the young fellas, so they have trust in me and to be, like I said, flexible. If I know that the young fella, he's been having a bit of trouble at school all engage him in the gym and say, "Hey bro, look, you want to come down and have a train?"
Mitchell
And it's funny how being around the older fellas just makes them sort of mature that little bit and take note of their own health and it also helps them set a goal. I want to look like that, or I want to be healthy. I want to be able to make rep 40 sides. I want to be able to, for the older fellas, I want to be able to play with my grandkids past 50 and not feel like I'm tired. So, I really try to be flexible with the mob. Yeah. Like I said, try and engage them in a way that is suitable to that individual.
Danny
Yeah, that's really good advice. You can't just preach one away.
Mitchell
Absolutely.
Danny
There's different messages and different way that we talk to the individual and we take the social emotional wellbeing into account and do it that way.
Mitchell
Absolutely. It's funny how that first question with black fellas, it's, ‘Hey, where are you from? Who's your mob?’ And that, that question of, ‘Oh Hey, I'm a blah, blah, blah,’ and then you can connect where they're from.
Danny
That's the opener isn't it? Who's your mob, where you from, what people?
Mitchell
That's it, break that barrier down.
Danny
And then the doors come open then get out the chicken soup and away we go.
Mitchell
We're on.
Danny
Talk all night long. Now Mitch, let's get down to the nitty gritty of a 715. I only found out, actually, I'll be honest with you, I only found out yesterday how it was named a 715 and that Sister Myra from over at 33 [inaudible 00:10:03] taught me it was the code from the Medicare card.
Mitchell
That's it.
Danny
And that's where the 715 name comes from and I never knew that. Yeah, I just got told you have to go and do your 715. I got to do my 715. I don't know what it means but I've got to go do it.
Mitchell
What's that?
Danny
Yeah, Yeah. So, can you talk us through what is a 715 what are the processes around it and why is it so damn important for our men, our mob to get this done?
Mitchell
Yeah, sure. So, as you said, so some people will know it as different names, but some of the main ones are Aboriginal health assessment, also known as 715 because that's the number that's billed to Medicare. The 715 is something that I really drive in the community and is part of my core business at work is to try and get as many Aboriginal people to have a 715. The first process for a 715 would be to find a regular GP. Find a GP that you have trust with, a GP that you may see as your regular GP, they have to be signed up with the program. So when you go with a GP, what they will first do is they will, excuse me, they will ask you to fill out a form, fill out and on that form it may say, do you identify as Aboriginal Torres Strait Islander and once it's been identified that you are an Aboriginal or Torres Strait Islander person they will put it through in the system.
Danny
You can tick both. You can tick both if you are both.
Mitchell
And/or. Basically, the first step is to let the practice know that you identify. The practice then will then we hope that they would ask you, "Would you be interested in having a 715 Aboriginal Health Assessment." If the practice doesn't ask you if you'd like it, we encourage mob to ask themselves to say, "Hey, I'd like to have a 715." So, part of the process will be, some practices are different, but most practices you'll go in with a practice nurse first. They'll do some of your height, weight, blood pressures. They'll ask you about family history of chronic disease. They may ask you some other questions, they may ask you about how your mental health going if this is-
Danny
This is mob asking this. This is like your community health worker.
Mitchell
Yeah.
Danny
This is your mob and it's totally private, details won't be shared anywhere.
Mitchell
Absolutely not.
Danny
It's a culturally safe environment.
Mitchell
Culturally safe brother and anything that's said in that appointment stays in that appointment. It's strictly confidential.
Danny
Because I know mob may have a bit of a problem if they feel like some questions are a bit intrusive.
Mitchell
Absolutely.
Danny
And they sort of shut down, I've seen it happen before.
Mitchell
Yeah. It's one of the big reasons why a mob won't go in and get a health assessment out of fear of finding out something they don't want to find out or fear that other people might find out about their health history and stuff like that.
Danny
Yeah, yeah.
Mitchell
I can assure you that these health professionals, the Aboriginal health workers, nurses, doctors, even reception, they're bound by confidentiality.
Danny
Locked down like the CIA.
Mitchell
That's it.
Danny
It's in lockdown.
Mitchell
You ain't getting through to that-
Danny
Through the presidential office. It isn't getting out there my peoples.
Mitchell
No. It's strictly confidential, anything that's said in there will stay in that appointment. So, once they go in with the nurse or the Aboriginal health worker, the first process, then they'll go in with the GP. The GP will do their thing, sign off on all the paperwork, send it through to Medicare, the patient will then be registered with the program. So, some of the benefits that the mob can access after that is the PBS. So, the Pharmaceutical Benefits Scheme, which some of the mob may know was a CTG at the top of this group,
Danny
Close the gap.
Mitchell
Yeah, close the gap. So basically, what that means is then the mob will be able to access cheaper and/or slash free medication, which is a really good thing for our mob to utilize and it's there to be utilized. The other thing is they can access some subsidized allied health visits, which is a really, really good thing as well. If the mob need to see a physio or you know podiatrist or anything of the like, this program they can actually get some subsidized visits through this program and through having a 715 as well, which is also-
Danny
Yeah, if you got that, the old dicky knee.
Mitchell
That's it.
Danny
You know, you can go off to a specialist and get it checked out and have to get it fixed up.
Mitchell
That's it.
Danny
The old side step from back in the day our local JJ on the sidesteps.
Mitchell
Be playing the knockout in no time again.
Danny
Seriously they are the things that you can't access.
Mitchell
Absolutely.
Danny
Our mob don't know this. You can get a specialist referral services, whether it'd be your knee, it could be your brain, could be your eye, it could be your ear, could be your nose.
Mitchell
Absolutely.
Danny
It could be anything.
Mitchell
Absolutely. And you know, we encourage the mob to sort of to speak up about this when they walk into a surgery to ask the GP if they haven't already been asking to self-identify in surgeries to let reception know, "Hey, I'm an Aboriginal endo Torres Strait Island person and I've heard about the 715. I'm interested in having one of these." We would hope that the GP or the receptionist would let the patient know. But if that doesn't happen, we encourage mob to speak up and say, "Hey, I want to have one of these."
Danny
Yeah and value that importance of it.
Mitchell
Absolutely, bro.
Danny
Exactly. All right. Okay. How important is it when we get our 715 to be honest, like it's hard enough, you're going through the process as a health worker?
Mitchell
Yep.
Danny
You're given our mob the info.
Mitchell
Yep.
Danny
You've got that info across to our mob. They've switched on a light bulb, and gone, "Yep. I'm going to get my 715 done", this is really important.
Mitchell
Absolutely.
Danny
They get into their 715 and they do what I did the first time, I lied. I lied about what I did with my life because I was nervous. I was just nervous and like they're asking are you drinker, are you a smoker and how many do you drink? And I was like, "Oh, I don't want them to think I'm an alcoholic, so I'll say this much." And they were like, "How much cigarettes do you have? Do you do this? Do you do this?" So, I was lying about stuff because I didn't want to come across as a bit of a loony tune in the first instance.
Mitchell
Yeah.
Danny
I didn't want the doctor to think I was an alco.
Mitchell
Yep.
Danny
You know, because I was worried about that perception, that stereotype on black fellas, the doctor was not Indigenous. But I lied, and so when I got my results back, they weren't really truthful. You know what I mean? And so, you're sort of lying to yourself and you're defeating the purpose of the 715 and I realized that later. How important is it to be honest and, and feel okay in these checks?
Mitchell
Yeah, sure. Like you just said what you just said is not a new concept. A lot of, I've been with a lot of black fellas and a lot of mob that go in there and they'll say something, and I thought, "Oh, maybe that's not the truth, bro." Right. You know what I mean? Like, or you know?
Danny
How many is that? I only smoke 2 cigarettes, I promise doc. Only two a day, only two a day.
Mitchell
‘How many times you exercise in a week?’ ‘Oh, every day, you know.’ ‘Are you sure?’
Danny
Because we do this and we've got to talk about this because the honesty is so important because it's a true reflection of who we are and our health.
Mitchell
That's it, bro. Look that can come down to a few things shame. Some fellas might be, ‘Oh I'm not exercising that many times a week’, or they're going to judge me or think... Or, ‘I am having a couple of drinks a week, they're going to, stereotype me’, and all that sort of thing.
Danny
Yeah.
Mitchell
That's why as I mentioned before, it's really important to get a GP and a practice that you feel really comfortable with. A GP that you can connect with, that you feel comfortable enough to sort of open up about some of the issues that can be hard to talk about. Telling someone that you have a couple of casual drinks a week or something like that, it can be quite intimidating sometimes. I know myself as well when they say it, "I'm like, oh yeah, only a casual".
Danny
And you're a health worker.
Mitchell
So you know, it can be, but that it's that fear of judgment, it's that fear of stereotype. And especially for us men, you don't know what they're thinking when you sort of say those things are, they going to judge me, are they going to... So, it is important to be 100% honest. Family history is another big one.
Danny
Yeah.
Mitchell
As we all know, some of our mobs it's rife through our community chronic disease and stuff like that. So, when they do ask you these questions they're only asking for your own benefit. Do you have chronic disease that runs through the family? How do you go with exercise, your diet, etcetera? So, look, it's so important to be honest, because you get the best health outcome at the end of it, if you're honest. And then they can shape your health plan basically to suit that.
Danny
Yeah.
Mitchell
So they might be able to, if you're not exercising properly, they may be able to refer you to an exercise physiologist, which will only improve your health and your weight and stuff like that. If you can't afford a certain diet, they might be able to refer you to a dietician who can then help you with other options which are still healthy and stuff like that. So, 100% mate, it's good to be honest, so you can get the best health outcome at the end of the day.
Danny
In some of your experiences, for me... why don't we go there in the first place? Why don't we go to the doctors in the first place? And for me, I guess when I, when I did my first 715, I totally lied about everything. Not everything, but most things because I was just worried about the perception on me. But then about six months later I was just feeling worse, I was just feeling run down, I was feeling tired every day. I was still smoking, still drinking, I was doing all that sort of stuff. So, I went back to the doctor and I said to my mate down at the Redfern AMS he was the nurse, and I told him I was like, "I want to do my 715 again because I just totally lied last time." I was getting worried about my own health, because how tired I was getting and fatigue that I was constantly feeling and stuff like that.
Danny
And so I went back in there and I did it all again. And I was totally honest this time exactly how much I smoke, how much I drank, how much I exercise and all of this.
Mitchell
Yeah.
Danny
And my report came back and it was totally different and they actually picked up that I had a liver issue because I was drinking too much and a lot of journalists do this it's a high pressure job. A lot of health practitioners a lot of professionals, but just if you're in a high pressure job, sometimes you self-medicate with alcohol at night time or cigarettes during the daytime or whatnot. So, they actually picked up because I'd actually had that trust down there and the health worker and admitted that I'd lied and went and got it done again, and they picked up that I had a liver issue and then I had to sort of cut down my drinking. I've actually stopped drinking for a while.
Mitchell
Yeah.
Danny
To get it sorted out. It wasn't chronically bad, but it could lead that way if I kept going and I didn't pull myself up. Now it was only because I had that trust in the health worker and because I was feeling I was going down physically and mentally that I woke up to myself and went and got it done properly.
Mitchell
Yeah.
Danny
How do we get more of that happening?
Mitchell
Yeah. Look, I think sometimes too, some of us aren't health professionals so we may not see it as a big issue at the time. "Oh yeah, I have a couple of drinks here, I have this, or you know, or I felt a little bit of chest pain but it's not that much sort of thing." It's good to just sort of be honest and open about that and say, "Oh look, the other day I did have a bit of chest pain because it could be the start of something which could get worse if not treated there and then on the spot. We know what our men are like, Aboriginal men, we might not see our own health as a priority as long as the mob are okay, I'll be fine sort of thing.
Mitchell
And it can be shamed sometimes for some of our fellas to sort of admit, ‘I'm not feeling well. My mental health is not the best, or physical health’. Even things like getting your prostate checked some fellas may say that a shame. But one of the big things that we want to do is to break down the barriers for men and to be open, honest and not be ashamed to go in there and have health assessments. To get health check-ups, really before it becomes a big issue.
Danny
Because prostate cancer is one of the biggest killer of men around the world.
Mitchell
Absolutely.
Danny
It has a huge cancer rate.
Mitchell
Absolutely.
Danny
And a cure rate with that cancer rate. But a lot of our men don't go get their prostate checked. I know I was actually having a joke about this with the sisters yesterday, out at Moray they've got a program out there for the men over 50 ‘get your boogalahs checked’ because we use humour to try and break down that barrier.
Mitchell
Absolutely.
Danny
Because that's pretty intrusive getting your prostate checked and things like that and even talking about it with your brothers or your uncles you know.
Mitchell
Absolutely. Yeah.
Danny
Have to talk about it you know.
Mitchell
Yeah, look, it's quite an intrusive test.
Danny
‘Hey Unc how's your prostate?’ ‘Yeah, yeah, it's not too bad, thanks, yeah.’
Mitchell
One of the things that we sort of promote in the community with our Aboriginal men it may be a couple of minutes of sort of discomfort, but you we'd rather you go through that little bit of discomfort to make sure that you're okay for the future and to be around for your mob before it gets too bad. And unfortunately, I've worked with too many men in the past accompanied them in their appointments where they've let their health go too long and they sort of didn't prioritize it when it was sort of a littler problem then it did become a big problem. So that's what we want to do is to break down walls for our Aboriginal men to access health services and to really break down that shame factor.
Danny
Yeah.
Mitchell
And you know, that there is no shame in yarning about your health and these people aren't here to judge, they're here to help so.
Danny
That's what’s really critical what you said I reckon, it's nipping in the bud before it does become a bigger problem. And that's why I've got a 19 year old now and I was like, "Look after your health, stop bloody smoking. Because what you're doing now is going to impact you when you get to my age at 44 and you're going to have a range of health issues that you're going to have to address because you drank and smoke and you didn't exercise enough and you didn't do this and you didn't do that." And I think nipping it in the bud early, it doesn't matter what age you are either, whether you're 50 or the 15-
Mitchell
It's never too late to start, is it?
Danny
No. We were just talking out the front here before about brother Seany Choolburra, one of our funniest black fellas ever.
Mitchell
Shout out to Seany.
Danny
Yes. Old uncle, now but he just got his 715 done at the age of 50, that's incredible for me. I'm 44 I think I got my first one down at about 35 I think it was - up in Nambucca Heads. But you know, it doesn't matter what age you are, and that's why it's so important that us fellas now we've got kids start talking about, our young kids about health and getting these checks done and...
Mitchell
Yeah look, I had my first 715 when I first started in the role probably about nine years ago, and I went in there real nervous. I went in there not knowing and I think that's what a lot of our men are real fearful of is not knowing. What am I going in here to do and sort of thing and when I walked out of there, I went, what was I nervous about? You know what I mean? Like it's a standardised health check, they would nonjudgmental. Again, I was a bit nervous of finding out something that, what if I have this, what if I had that? But I walked out of there and felt 100% comfortable and I was really glad.
Mitchell
I do it annually now and I make sure that I promote that what I'm promoting in the community I'm doing myself and I'll make sure that all my family has it too, every year. And all my men's groups and stuff that I'm involved in it's a real big thing for us is to make sure that men are looking after their health and screening themselves every year, just to make sure. You might be okay, but just to make sure that there's nothing else going on under the surface.
Danny
A lot of our mob do live in isolation or they can be in a family group not really talking about their health issues. Can we accompany mob to GP's? Can they have a support person with them like? Is that okay?
Mitchell
Yeah, absolutely mate look, I know that over the years working in the closing the gap program, that was part of my role to make Aboriginal people feel culturally safe when they walk into a doctors surgery to have their 715. So, there are programs available for cultural support. Also, I encourage mob if that person doesn't feel comfortable with a worker to go in and encourage people to get brothers, sisters, moms, whatever they feel comfortable in their mob.
Danny
So it doesn't have to be a health professional, you can get one of your mob to come with you.
Mitchell
Absolutely. Absolutely, yeah.
Danny
Not many mob know this.
Mitchell
No.
Danny
It's such strict GP, doctor, patient code and all that sort of stuff.
Mitchell
Yeah.
Danny
You can, as a black fellas, you can have mob, a health professional.
Mitchell
Even though it's about the patient that support can be really helpful for people and really allow that person to open up because they feel comfortable. They've got someone else there that they feel safe with and yeah, it's actually strongly encouraged.
Danny
I'll be man enough to admit that when I did get my liver results back last time, that I did take my girlfriend with me as support and she sat in the room with me because I was scared.
Mitchell
Yeah. Yeah.
Danny
And I'll be honest with you.
Mitchell
Yeah. It's a regular thing with our mob brother that they just having other Aboriginal people around or family around or a worker around just takes down that little barrier and allows that person to feel a little bit more comfortable.
Danny
Yeah. It's very important to know your mob out there that you can have a support person. It could be your brother, your sister, your mother, your auntie. You probably don't want my mother sitting in there with you because she loud. Shout out to you mum you loud, you loud, you loud. Mum's a health practitioner herself, she works up at the Armadale Hospital in the Kidney Dialysis unit, looking after the mob up there. So, shout out Mum, because of you I'm loud and proud.
Announcer
You’ve been listening to a podcast talking about the benefits of a 715 health check. For more information visit health.gov.au/715-health-check. Your health is in your hands.