For Dr Margaret Johnston, returning to Shetland was about more than coming home. It was about raising a family in a place she loves and embracing a way of life she knew she couldn't find anywhere else. She shares her story of coming back and why she's never looked back.
Leaving home at the age of eighteen, Margaret Johnston didn’t expect to settle back in Shetland.
When her eldest son arrived, life’s priorities became very different. She knew. "We wouldn't bring up our family anywhere else. That was it."
She came home and hasn't looked back. It's a decision she has not regretted for a moment.
Margaret is based at Scalloway Health Centre, which she describes as “amazing”. Her day begins with some admin: clinic letters, patient queries, prescription requests and outpatient notes. At 9am, the whole team gathers for a “huddle”.
"We meet up as a team: reception, GPs, ANPs, practice nurses, healthcare support workers, district and community nurses. We go through anybody we might be worried about, anybody that might need extra input, and then we answer each other's questions. It's a nice time to touch base with everybody before the day starts."
On a full day, there are usually two GPs, two ANPs, practice nurses, a healthcare assistant, community nurses and sometimes a pharmacist, all supported by an admin team she credits warmly.
After morning clinic comes the part Margaret loves most: home visits. The patches she covers take her through the central mainland, through some of Shetland's most striking landscapes. "We cover Burra, Scalloway, Trondra, Whiteness, Weisdale, some of Tingwall and Gulberwick. It's lovely."
She admits with a smile that her home visits sometimes run over time. "You get offered a cup of tea sometimes, and I shouldn't say yes, but sometimes I do."
But the value of these home visits goes well beyond a welcome brew.
Margaret explains: "Home visits are a really important part of holistic care. You see the patient in their own environment. You are then able to make much better clinical decisions based on where they are, what supports they have, what supports they need, mobility, transport links, all these things that are hard to gauge in the consulting room. It's just so much more patient-centred to manage people when you see them at home."
Before returning to Shetland, Margaret spent three years in Jersey, an experience she describes as formative. The island surprised her. "I thought it would be similar to Shetland, but it's very different. There's this finance, high-flying, affluent, glamorous side, and then there's the traditional and tranquil farming Jersey, and it's two very different worlds."
Professionally, it made her a better doctor. With no registrars needing clinical skills signed off, junior doctors took on more than they might have elsewhere. "You get to do so much and you learn so much as a result."
But Jersey, with its population of over a hundred thousand, couldn't offer what Shetland could. "I said to my consultant one time: I wish I could go for a walk and not meet anybody. There are people everywhere."
When she came home, she felt a fresh appreciation of the space Shetland offers.
"One of my favourite things to do in Shetland is to go over the hills at Aith at mum and dad's. There's just an expanse of…. well, nothing but everything at the same time. The lochs, the hills, the sea. You couldn’t get that in Jersey."
One of my favourite things to do in Shetland is to go over the hills at Aith at mum and dad's. There's just an expanse of…. well, nothing but everything at the same time. The lochs, the hills, the sea. You couldn’t get that in Jersey.
Ask Margaret about the experience of caring for people she knows outside the surgery and she's unequivocal. "For me, seeing my patients out and about isn’t awkward. Knowing my patients makes looking after them easier."
And she feels strongly about what that connection means. "It’s an absolute privilege to treat the people within our community. It's a positive cycle. You care for them, they care for others, positive things are more likely within the community, the community cares for the health centre and so on.”
She's also clear about what continuity of care means in practice. In a city surgery you might never see the same doctor twice. Here, patients have a GP who has known them for years. "I've been with people through various health journeys. You know what's going on. You don't have to backtrack."
The relationships with hospital colleagues matter too. "I know who I'm referring to. I know what they're going to do. Knowing your secondary care colleagues makes looking after patients safer and more efficient."
Family life has flourished here too. Her three boys, she says, are "gloriously wild and are free, safe and supported in Shetland." We are lucky to have many family and friends who live nearby who look out for us.
For anyone considering a move, Margaret's advice is simple: reach out and try it. "Make contact with somebody. It doesn't matter who. We'll get you sorted. Tell us what you need and I'm sure it can be facilitated. You don't know what life could be like if you've not tried it."
And if it doesn't work out? "You'll have had a great experience regardless. Just give it a bash."
Interested in developing your healthcare career in Shetland? See our healthcare career page for more case studies and our find a job page for the latest NHS Shetland vacancies.
