It’s Time to #ScrubOut #DudScrubs

An unavoidable part of working in operating theatres is the requirement to wear what is formally known as “Perioperative Attire”, but casually known as “scrubs”. While the term “scrubs” is now used to refer to similar clothing worn anywhere in the hospital, the primary purpose of theatre scrubs is to reduce the introduction of environmental pathogens into the theatre environment, thereby reducing the incidence of surgical site infections. Most hospitals require staff to wear scrubs supplied and laundered by the hospital. So essentially, scrubs are a mandatory workplace uniform, supplied by the hospital, to be worn by staff to improve patient outcomes.

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Day-to-Day Living in Suva c.2012

I spent three months at the end of 2012 working in Suva, Fiji as the ASA Pacific Fellow, which was a position they created and funded in order to help prepare anaesthetic trainees for their exams. At the end of the stay I wrote a short piece describing some of the practical aspects of living there with my young family, in case it proved helpful to other Fellows that came after me. I thought I’d re-post here for similar reasons, but also as an historical snapshot as a significant part of my medical career that has had a lasting impact on me and my family. Fiji is a strategic hub for training doctors working all around the South Pacific, so if you get the chance to contribute in some way, I highly recommend you do.

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A Purple Patch for a Power Problem

Part of my job as an Anaesthesia Quality and Safety Fellow is to monitor reports made though our Anaesthesia Safety Monitoring Project, which allows staff to report latent safety threats, near-misses, faulty or badly designed equipment and pretty much anything that might pose a threat to patient safety. Below is the text of a “Letter to the Editor” that I wrote explaining how we were able to quickly and cheaply respond to an issue highlighted by one of these reports. The letter was published in the Canadian Journal of Anesthesia, and it can be accessed here (login required) or viewed online here by anyone.

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Vale Professor Geoff Cutfield

I was deeply saddened to hear of the passing of Professor Geoff Cutfield earlier this year. He’s had a lasting impact on me as a doctor, anaesthetist and a  human being. Following his death, people who were unable to make the funeral in New Zealand were given the opportunity to provide something to be read out at the service to help celebrate the phenomenal life he lead. Below is my contribution to that celebration.

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The Problem with Miracle Cancer Cures

Having just started my fifth antibody based medication, this one to try and get on top of my auto-immune colitis, I’m acutely aware of the various tensions, conflicts and ethical dilemmas raised in this article. My melanoma, while not completely gone, has been well controlled by the immunotherapy I received. The main story for me in recent years has been managing the side-effects of the immunotherapy as well as the multiude of medical appointments, blood-tests, scans and so on. But it has taken me from seriously considering palliative care having been given a median survival of 3-4 months, to being back at work part-time some 5 years later. Fortunately, as I am part of clincial trial, combined with Medicare and private health insurance, my out of pocket costs have been manageable. But as these expensive interventions become mainstream, and cancer is increasingly converted from a death sentence into a chronic disease, there will be serious challenges ahead for the health budget, of both governments and individuals.

Opinion | The Problem With Miracle Cancer Cures

Opinion | The Problem With Miracle Cancer Cures

If immunotherapy worked most of the time, this would be an unambiguously happy story. But it doesn’t.

Source: www.nytimes.com/2018/04/19/opinion/sunday/problem-miracle-cancer-cures.html

ANZCA Primary Exam Tutorials & Resources

I occasionally give some tutorials to anaesthetic trainees sitting the ANZCA Primary Exam. I thought it would be worth collecting some of the resources I use into one location so that I can provide a link for pre-reading, revision etc, but also in case anyone else outside my hospital network might find them useful. I may well add additional content and links to post over time, so it may be worth checking in again at some point.

Click here to go straight to the tutorial resources.

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Petition to extend the opt-out period for MyHealthRecord

Chances are, if you are reading this blog post, then you have heard about the governments plan to change MyHealthRecord from “opt-in” to “opt-out”. But it’s increasingly apparent that there are many who haven’t, including some who haven’t heard about MyHealthRecord full stop. This is a problem.
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“MHR-as-Imagined” vs “MHR-as-Done”

A little while back I wrote a post on my early experiences with MyHealthRecord (MHR), discussed its strengths and weaknesses, and made some suggestions for improvement. At that point, it was still opt-in, but on July 16th a three month phase in period started whereby people can opt-out, before an MHR is created automatically for them. In the lead up to that date, and in the time since, MHR has been the subject of some robust discussion on both mainstream and social media. While the concept itself has been generally well received, there is significant controversy and debate over numerous aspects of the system, the legislation underlying it, as well as the government’s handling of the roll-out. Continue reading ““MHR-as-Imagined” vs “MHR-as-Done””

Progress Notes-Chronological

As discussed here, I was diagnosed with advanced melanoma in late 2013. It has been a wild ride since, and I thought it would be good to document the many steps in my journey. I’m hoping this will be a useful record not just for myself, but my family and friends, as well as those that might be facing a similar journey themselves. This document will evolve over time, both as I go back through the last few years and find things to add, but also as my story continues to unfold.

To see my medical history organised by system, see this post here.

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