Latest Blogs

Teleconferencing

Dear all, given the current situation -our rooms have moved to teleconferencing or phone calls for appointments unless there is an extreme need for a face to face appointment. This is with the intention of protecting; 1) the patients, who may be at higher risk of significant infection from age or. being immunocompromised, and; 2) the staff, because we cannot guarantee backup if we fall ill. There is to a point government support for at risk patients with bulk billing for teleconferencing . This does not allow for the appropriate funding. of a private practice in the medium term and depending on whether you do or. don’t sit under current Medicare guidelines for bulk billing, the duration of the consultation and the need for letter, referrals and scripts , you may incur an out of pocket cost rather than be bulk billed. With regard to the choice of teleconferencing or phone, I would much prefer. to ‘see the patient’. I am using encrypted software (doxy.me) for privacy. This will work best on a computer , especially with a direct Ethernet connection rather than WiFi although the latter is reasonable. These consultations are intended to be equivalent to a room consultation, without the examination. Please take the time to eliminate distractions at home so you can get the most value from your consultation. The Doxy.me will also work with any smartphone. We can either email the link to your computer or SMS it to your phone. All you need to do is accept the link. Please contact Melissa if you have any concerns by phone or email. Good luck, stay well and #stayathome. Shane

GenieCanHelp….this App looks good

Called GenieCanHelp. (looks like a neat way to keep all your meds, appointments, contacts together. Many of my patients are older and not all are IT literate (I hope that offends no one). They are however often accompanied by caring family or friends, who may be happy to store such info on their smartphones.. just a thought.

Spring thought of the day ..apps

dear all, it occurred to me how useful the smartphone would be  as  a patient management tool. That statement  may be a no-brainer but  i think it is well known how under utilised our IT systems are. Having a quick trawl through the Apple App Store (I am sure there is an Android equivalent for pretty much well everything!), there are some  free apps that can track medication lists/doses and provide reminders when scripts are due. Apps such as Evernote are great;  recordings of consultations can be kept (I hate my voice on tape but never  mind) and results can be photographed and stored. This apps can be connected to similar computer-based applications that are password protected.

Finally, the good old calendar with alarms can be used for appointments. I must say I love the Week Cal app as it nicely shows the whole week which the Apple Cal isn’t so brilliant at.

Over time , the various patient or consumer resources will become app friendly. I note with interest that there is a BreaCan Navigator app.

Happy Spring. Shane

new immunotherapy

The oncology world appears to be on the verge of revolution, not simply evolution. The notion of immunotherapy as a means of cancer therapy has been one of the oncological “holy grails” for years. Major developments have been seen in melanoma first with ipilimumab which targets CTLA-4 and augments the immune attack on cancer. The inhibitors against PD1 and PDl1 have a different mechanism blocking immune tolerance to cancer, or as I like to think of it, removing the cancer camouflage, exposing it to attack. The Austin and other institutions are now in the throes of Phase I-III studies testing these new agents. This was as a result of data such as http://www.nejm.org/doi/full/10.1056/NEJMoa1200690 where an efficacy signal was seen for the first time.

clinical trials

For those who are interested we have a whole host of studies in lung cancer at the Austin hospital testing agents targeting EGFR, ALK and PD1/PDL1. The breast cancer portfolio was a wee bit quiet  for a year but this is expanding including studies in triple negative breast cancer. Phase I studies run by A/P Hui Gan include a novel PARP inhibitor (attractive in breast and ovarian cancer  partic in the BRCA +ve patients).

We are very collaborative in Melbourne and I work closely with colleagues at Peter Mac , Royal Melbourne Hospital (only to name a few centres) to give patients the option to participate in studies that suit their particular circumstances better. This is often under the auspices of Cancer Trials Australia (see introduction).  We strongly encourage patients to consider trials. Ultimately as their clinician, I want them to personally  benefit from such participation. It is  true that altruism is maybe  an important part of developing  new and better treatments and improved outcomes in cancer medicine, and in health in general. SW Aug 2014