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COVID 19 rooms policy Aug 2022

Dear all, we have this year instituted a policy that requires all patients and support people to be double vaccinated to physically attend the rooms. In the event that they are unvaccinated they can present an unused RAT test to the rooms fifteen minutes prior to their appointment and present their negative test to the front desk to be seen.

I hope this is not regarded as discriminatory but our patients are more likely to be elderly, with advanced cancer, or on chemotherapy and therefore are less immunocompetent. In the interests of protecting our patients and the staff who see these patients everyday ,we will maintain this policy into next year.

If this does not align with your beliefs, we will respectfully decline your attendance and refer you back to your GP. Telehealth is not an adequate alternative as we cannot examine you for the above reasons.

Apologies to all, this remains a very unpleasant time for health care workers and vulnerable patients, even if others choose to move on with their lives.

Of course, an appropriate fitted clean mask remains a requirement for rooms attendance for the above reasons.

E-scams

Dear all, scamming is unfortunately part of our life. Scams may be by phone, text or email. If at any stage you have been called or messaged by us and if you are unsure, do not respond or open any links. Contact us by usual means to confirm the veracity of any communication. Do not open any links or files proported to be from the rooms unless you are sure.

Shane.

Update on Telehealth July 2022

As of the start of July 2022, the Federal Government is no longer Medicare reimbursing telephone consultations. Telehealth (TH)(i.e. video) consultations are still reimbursed. In my view medical care is more effective face to face. It removes distractions and allows me a better chance to assess your health.

However, I may on occasion feel a TH appointment is reasonable or appropriate, maybe for geographical reasons, physical frailty , or because a recent physical examination was completed. By all means discuss with me if you feel TH is reasonable for your next appointment.

Note TH is charged the same amount as a F2F consultation. As mentioned in previous blogs, if anything they generate more work for our team.

Stay well Shane

COVID-19 in 2022!

June 2022

Dear all, we are in a post-lockdown era where we are living with the virus, thankfully in a well-vaccinated community. Nevertheless, oncology patients are a more vulnerable group, due to their condition, their treatment or because many of our patients are elderly .

It is therefore mandatory for patients and their carer (s) to continue to wear an appropriate mask to the rooms that covers nose and mouth. We would ask that a maximum of two carers be present at any consultation.

Patients and carers must be at least double vaccinated for COVID -19; alternatively unvaccinated patients or carers must present with an unused RAT test to be performed in the rest room adjacent to the consulting suite. This is mandatory for ongoing attendance at the rooms.

Finally, whilst many non-COVID coughs and colds are about, we ask you do NOT attend the rooms with these symptoms regardless of a negative RAT or PCR. We can change your appointment to telehealth for the day.

Many thanks to my patients and families who have thus far respected the need for caution at this time.

Telehealth update Oct 2021

Oct 2021

dear all, it does seem as though in the peri-COVID world we are all getting more used to video communication like Zoom and we have the opportunity WHEN appropriate to use telehealth (TH) as a way to conduct appointments.

It needs to be clear that this is simply for the moment a risk minimization strategy during the pandemic to protect the staff and patients from exposure to COVID 19. It is not intended to replace face-to-face consultations, particularly for patient, carer, or doctor convenience.

A TH consultation will miss the benefits of a face-to-face (F2F) consultation which includes a better assessment of the physical state of the patient, and improved rapport. If we have recommended or requested a F2F consultation it is important to comply with this to optimize the quality of care. If a patient requests a TH consultation, it will be approved if it is considered safe and reasonable.

You’re most welcome to request a F2F consultation if that is your preference. We do feel very strongly that patients and carers need to have received at least one CV19 vaccination. If this is not the case, please let us know prior to attendance so this can be discussed further. Mask wearing will be a requirement for the foreseeable future.

TH (or telephone ) consultations are billed the same as a F2F appointment except in occasional cases. These appointments still demand secretarial time with treatment and test bookings, script management, and letter dictation. We do not regard them as a ‘soft option ‘ requiring less time or focus from the staff or patient.

Please allocate time for your appointment and carry it out in a quiet space free from distractions. The car or dog walk is not an appropriate time to discuss medical care.

If you have concerns about the quality of the interaction during a TH appointment please feedback your concerns immediately to our office so we can address your concerns.

Warm regards all, Shane.

Update Telehealth

Aug 2020

Unfortunately with Covid19, we are back to telehealth for the time being. If you have some issue that requires a physical examination please discuss with my staff. With masks and distancing a face to face appointment is manageable. For other patients, we will defer routine breast examinations for a recall date in September or October. Remember this is intended to protect all patients and staff and their families, but particularly those patients who are immunosuppressed.

Please endeavour to be set up with an appropriate device. This is far preferable to a phone call. Please allocate the time and be in the right physical and mental space for a discussion. Have a pen and pad ready for any notes and have questions prepared and support people sitting with you. Having a consultation whilst driving or walking the dog is not ideal and will be unlikely to result in a quality outcome.

Most have so far been supportive of this process. Please note that telehealth should not be regarded as an inferior consultation and it should not be expected to be discounted. The consultation still requires expertise, thought, a letter to the GP or referring doctor and more work from my administrative staff faxing and posting scripts and investigation requests than usual. We have also had numerous requests for letters for work and travel exemptions that take time. Your understanding at this time is much appreciated

COVID 19 update presentation

April 2020

From Assoc Prof Pat Charles infectious diseases physician at Austin Health.

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.