medicJUNE 2020 SAVOLUME 33 NUMBER 3 The new normal Practising medicine during and after the pandemic POST-OP COMPLICATIONS – THE HIDDEN PANDEMIC • VALE SENIOR MEMBERS • POLIO’S PERMANENT REMINDERS • THE DEANS’ LISTS Dr Jones & Partners is pleased to introduce Dr Malalagama, Dr Paterson and Dr Moon Dr Geethal Malalagama and Dr Helen Moon join our experienced team of drjones.com.au/ radiologists. Dr Malalagama has a keen interest in Neuroradiology, Abdominal imaging and more broadly in CT and MR imaging. Dr Malalagama also holds doctors a position at the Flinders Medical Centre. Dr Helen Moon has a special interest in trauma imaging and delivering medical student education. Dr Moon additionally holds a position at the Royal Adelaide Hospital. We also warmly welcome back Dr Felix Paterson, who has recently returned from Hobart after completing his second year of Nuclear Medicine training with Calvary Lenah Valley (I-MED) and the Royal Hobart Hospital. Dr Paterson will work across both radiology and nuclear medicine, with a special interest in Oncology, PET, Nuclear Medicine and Neurology. We are delighted to have Dr Malalagama, Dr Moon and Dr Paterson join our specialist doctor team. Enquiries & Bookings: CRICdrjones.com.au/, 1800 875 290book For all enquiriesdrjones.com.au/ &online-referring bookings call 1800 875 290 2 | medicSA Doctor Led • Patient Focused • Quality Driven drjones.com.au Contents 5 President’s report Australian Medical Association (South Australia) Inc. 6 Editor’s letter Level 1, 175 Fullarton Road, Dulwich SA 5065 7 Moving house PO Box 134 North Adelaide SA 5006 9 Partners in protection Telephone: (08) 8361 0100 10 Hidden figures – SA doctors look to reduce Facsimile: (08) 8267 5349 post‑op complications Email: [email protected] Website: www.amasa.org.au 13 On the frontline Executive contacts • SA President faces COVID‑19 committee President • Speaking for GPs – Profiling Dr Danny Byrne Dr Chris Moy: [email protected] • Questions on notice – experts’ perspective on medicSA SA’s performance Editorial • A specialist’s story Editor: Dr Philip Harding Managing Editor: Karen Phillips • Future perfect – a care model for the next pandemic Cover image • Consultants on call – the known and unknown Feverpitched, iStock outcomes of telehealth Advertising [email protected] 29 Caring for the most vulnerable – the special cases of Aboriginal communities and palliative patients Production Typeset and printed for the AMA(SA) by 33 Sock it to ’em – embracing the campaign for Douglas Press Pty Ltd. doctors’ health ISSN 1447-9255 (Print) 34 On the Dean’s list – leading SA’s medical schools ISSN 2209-0096 (Digital) Disclaimer 50 Vale – remembering Dr Peter Hetzel and Dr Andy Czechowicz Neither the Australian Medical Association (South Australia) Inc nor any of its servants and agents will have any liability in any way arising from information or advice that is contained in medicSA. The statements or opinions that are expressed in the magazine reflect the views of the authors and do not represent the official policy of the Australian Medical Association (South Australia) unless this is so stated. Although all accepted advertising material is expected to conform to ethical standards, such acceptance does not imply endorsement by the magazine. All matter in the magazine is covered by copyright, and must not be reproduced, stored in a retrieval system, or transmitted 42 in any form by electronic or mechanical means, photocopying, or recording, without written permission. Images are reproduced with permission What will COVID‑19 bring? under limited license. These Victorian boys of the 1930s suffered from one of the worst diseases to afflict Australian children: polio. Decades after they survived the pandemic itself, they would be forced to bear other symptoms related to polio, including worsening fatigue and new pain, that no one expected – and that today’s doctors are still learning to recognise and diagnose. South_agency, iStock South_agency, © medicSA | 3 Dr Divya Sabharwal General practitioner South Australia Leading support in your times of need – it’s why more doctors choose Avant Avant is more than an insurer, we provide holistic support for doctors that helps them practise at their best through uncertain and challenging times. 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MJN313 05/20 (1170) 210mmx297mm_SA Medic_MAY20.indd 1 13/5/20 1:20 pm REPORT Not remotely normal ne evening during the height effects of reduced social connectedness of the physical distancing and mental health stresses, compounded restrictions, my wife and I by unheard-of economic challenges. received a text query from our Doctors are not only at the front line Odaughter, Natasha, who was alone in of caring for patients in this new society; her bedroom from which happy music we are struggling with the changes, too. was thumping and computer-generated With this is mind, #CrazySocks4Docs President’s flashes were seen emanating from the came as a timely reminder that we gap under her closed door. When my doctors are human and that we must report wife Monika decided to respond with consider both our own mental health a vocal answer, she was met with two needs and those of our colleagues. Only happy but abrupt text communications Dr Chris Moy then can we genuinely heal our patients. from my daughter: ‘I’m busy’ followed Much like my daughter’s attitude by ‘I’m at a party’. towards her virtual party, one factor It’s been a strange and intense that has created an unexpected positive five months for us all. I guess a psychological element during this time pandemic will do that. has been the ‘can do’ approach that has While we doctors have experienced dominated over the naysayers. Contrast varying degrees of anxiety and this with the pervasive air of negativity, exhaustion in facing both the health cynicism and pettiness that can be threat of COVID-19 on our patients found when some decision-makers or and ourselves, and the impacts on our community members find reasons not to businesses, there has been an inspiring change things for the better. spirit of community permeating our With this in mind, I point to the profession. In a column published article on page 10 regarding the need in the Sunday Mail in late March, I to reduce the genuinely extraordinary asked South Australians to be kind, and appalling number of patients who generous and big-hearted. I have to say suffer and die from post-operative that with few exceptions, the people complications. This is the third most of this state have come through. In frequent cause of death worldwide, with giving evidence to Legislative Council COVID-19 Response Committee in late 4.2 million people dying within the first May, I reported that if South Australia 30 days of surgery each year. Australia was a footy team, the newspaper report does no better; in addition to reducing could have summarised performances harm to our patients, it is estimated that in the early stages of this critical game even a 15 per cent reduction in post- as ‘all played well’. operative complications would lower We as the medical profession – for costs by $1.2 billion a year – a relevant which the AMA is the only voluntary statistic in our debt-affected post-COVID organisation representing all doctors – world. Implementing changes to reduce … one factor that should feel a significant level of pride in these complications seems to be not a our parts in the effort. And as I write this ‘can do’ but a ‘must do’. has created an in mid-June, South Australia is one of the Led by organisations such as the unexpected positive safest places in the world to be. AMA, doctors around the world have Yet still we function within what made such a difference in confronting psychological element is being termed ‘the new normal’. the virus so far. I hope that, for the sake during this time has Handshakes and hugs have been of our patients, we can continue this removed from our social encounters spirit so that health in South Australia been the ‘can do’ and may never return. A return to continues to adapt and ‘do’. And, as a approach that has emphasising hand washing, harking result, we can extend this current mood back to the times of polio, is an irony in of each of us playing our part into the dominated over the our supposedly first world society. And quiet satisfaction found in careers of naysayers … physical distancing is leading to the twin contribution and service.