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Surgical News May 2013 / Page 3 Surgicalthe royaL a ustraLasian News CoLLege of surgeons May 2013 Vol: 12 No:10 The Golden Nov/Dec Scalpel games 2011 - a test of surgical skill Value of the Audit Improving patient outcomes The College of Surgeons of Australia and New Zealand c ntents 10 Alcohol-fuelled violence Why we need to talk about it 16 Global Burden of Surgical Disease How surgeons can advance the agenda 18 A test of skill Medics compete in surgical battle of skills 22 Medico-Legal The ongoing saga of Jayant Patel 12 6 Relationships & Advocacy 22 Your Practice Card 8 Surgical Snips A new web facility for 14 Poison’d Chalice members 17 Dr BB G-loved 28 PD Workshops 25 International 33 Case Note Review Development 37 Curmudgeon’s Corner Continuing a vision in the 46 Book Club Pacific 26 Successful Scholar Ajay Iyengar’s research UpToDate® with heart To learn more or to 32 Morbidity Audit and Logbook Tool subscribe risk-free, visit This key tool continues learn.uptodate.com/UTD improvement for Fellows Or call +1-781-392-2000. Patients don’t just expect you to have all the right answers. 18 34 They expect you to have them right now. Fortunately, there’s SurgicalTHE ROYAL AUSTRALASIAN News COLLEGE OF SURGEONS MAY 2013 Vol: 12 No:10 UpToDate, the only reliable clinical resource that anticipates your The Golden Nov/Dec Correspondence to Surgical News should be sent to: Scalpel games 2011 - a test of surgical skill questions, then helps you find accurate answers quickly – often in [email protected] Letters to the Editor should be sent to: [email protected] the time it takes to go from one patient to another. Over 700,000 Or The Editor, Surgical News, Royal Australasian College of Surgeons, clinicians worldwide rely on UpToDate for FAST clinical answers College of Surgeons Gardens. 250-290 Spring Street, East Melbourne, Victoria 3002 T: +61 3 9249 1200 F: +61 9249 1219 W: www.surgeons.org Value of the Audit they trust. Shouldn’t you? Join your colleagues and subscribe to ISSN1443-9603 (Print) ISSN 1443-9565 (Online) Improving patient outcomes UpToDate risk-free today! The College of Surgeons of Surgical News Editor: David Hillis / © 2013 Royal Australasian College of Surgeons / All copyright is reserved. Australia and New Zealand Linked in The editor reserves the rights to change material submitted / The College privacy policy and disclaimer apply – www.surgeons.org The College and the publisher are not responsible for errors or consequences from reliance on information in this publication. Statements represent ON THE COVER: the views of the author and not necessarily the College. Information is not intended to be advice or relied on in any particular circumstance. Value of the Audit. Follow UpToDate Advertisements and products advertised are not endorsed by the College. The advertiser takes all responsibility for representations and claims. Improving patient Published for the Royal Australasian College of Surgeons by RL Media Pty Ltd. ACN 081 735 891, ABN 44081 735 891of 129 Bouverie St, Carlton. Vic 3053. outcomes of the Audit Surgical News May 2013 / PAGE 3 RACS_Print_Ad.indd 1 4/4/13 8:31 AM RESULTS OF 2013 ELECTIONS TO COUNCIL their approach is a different level of interaction, a The results of the 2013 elections to Council President’s different level of sophisticated advocacy that our Perspective were tabled at the Annual General Meeting College is now putting its mind to. in Auckland on 9 May 2012. What is our record to date, and where do we go to from here? Congratulations to all successful candidates I remain incredibly proud of the contribution and sincere thanks to all candidates who that our College has made to emerging countries nominated. like the Pacific Island Nations, Papua New Guinea, The pro bono contribution of Fellows has Timor Leste, and Myanmar. Between 1995 and been, and continues to be the College’s 2012, the Pacific Island Program delivered more most valuable asset and resource. We are than 60,000 consultations, and 16,000 operations Global burden of surgical disease grateful for their commitment. were performed. More importantly we have built s an active clinician, I can conceptualise the needs of the capacity in the local health systems as we have next patient, deliver a surgical service within a hospital undertaken these activities. In short, we have tried FELLOWSHIP ELECTED Aand I have a good understanding of surgical service to leave a lasting footprint. COUNCILLORS requirements nationally. I have introduced trauma courses to All enormously good work. It gives us credibility There were ten Fellowship Elected SE Asia and the Pacific and have, I think, a good understanding and a platform of solid contribution to take Councillor positions to be filled. of differing needs in different countries. However, when it our advocacy to the higher levels of bringing comes to the issue of the global burden of surgical disease, it the surgical burden of disease more fully to Re-elected to Council are is an entirely different level of interaction. College Fellows as the attention of groups like the World Health practising surgeons should at least try to understand the issue Organization. This in itself is challenging; trying John Charles Batten, Orthopaedic, TAS and to do so will need to think ‘outside’ their usual focus of to interest national governments in what they may Ian Craig Bennett, General, QLD providing high quality care to the next patient. perceive as a self serving agenda is tough. This is Graeme John Campbell, General, VIC A few figures that were highlighted at our recent not a short term initiative. It is a most important Catherine Mary Ferguson, Otolaryngology, symposium: of 7 billion people on the planet, piece of work which our College needs to progress Head & Neck, NZ 2 billion do not have access to surgical care. There are over the years ahead. Barry Stephen O’Loughlin, General, QLD 1.2 million deaths a year from road traffic accidents – the We have already made some headway. We Julian Anderson Smith, Cardiothoracic, VIC population of Adelaide; 50 million are injured – twice the have hosted two recent meetings on the Global Marianne Vonau, Neurosurgery, QLD population of Australia and New Zealand. There are Burden of Surgical Disease. These meetings have David Allan Watters, General, VIC 2,000 childhood deaths a DAY from road accidents. There had representatives from across the globe and are enormous numbers of congenital anomalies with across medical specialities. Working together Simon Alan Williams, Orthopaedic, VIC 200,000 children having club feet that would warrant we have prepared a draft poster on the care of surgical correction. contaminated wounds at the request of surgeons Newly elected to Council is While Australia and New Zealand focus discussions on What has now been demonstrated is that in public health in Indonesia. formerly co-opted Councillor the rights of home births and the professional profile of terms, the best value for money spent within the surgical At a recent meeting held in the College chaired Sean Guy Hamilton, Plastic and midwives and obstetricians, around the world there are arena is from the following four areas: by David Watters and Russell Gruen, we decided Reconstructive, WA 1,600 obstetric deaths per day. In South Sudan, the world’s 1. Timely, good quality surgical management of trauma to progress a simple statement: “Access to Safe newest nation, every third woman delivering a child dies. For 2. Abdominal and other surgical emergencies Surgery and Anaesthesia when needed” every woman who dies in childbirth, there are 20 times that 3. Comprehensive emergency obstetric and neonatal care (an article detailing this event can be found on SPECIALTY ELECTED number who have complications. As an example, there are 4. Elective conditions that have a distinct impact on the page 12). The Australian and New Zealand College COUNCILLORS about 2 million cases of obstetric fistulae each year. quality of life, such as cataracts, talipes, hernias. of Anaesthetists has indicated it is keen to work Re-elected to Council is So the numbers are enormous. And where does surgical with us to progress this aim. Michael John Grigg, Vascular Surgery, Victoria care actually occur? It is no surprise that the wealthiest The challenge for this College and for surgery around We have consensus that WHO’s metrics to assess 30 per cent of the world’s population receives 74 per cent the world, is to ensure the profile for the surgical burden peri-operative mortality should be collected to Newly elected to Council is of the surgical procedures. The poorest one third receives of disease is properly understood. We may understand it, provide data on need and we should use that data Roger Stewart Paterson, Orthopaedic Surgery, only 3.5 per cent of the surgical procedures. Some countries and our surgical colleagues internationally also do, but to to advocate strongly with Australia’s representative have multiple millions within their population who would achieve action over time with the capacity for sustainable on WHO to progress this issue. There is a lot more South Australia benefit from surgical care. The Global Burden of Disease is impact, means that we must convince groups like the World I could say about progressing advocacy in this measured in terms of disability adjusted life years (DALYs) Health Organization that this is of vital importance. WHO area, as it is more sophisticated and complex than Thank you to the scrutineers David Scott and and this shows that approximately 15 per cent of the total has 193 member states and with their substantial ‘reach’ can some of the work we have done thus far.
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