Page 1

• The Tattoo Craze • Religion at Midland Hospital • Women Switch to Medicine • Profile: Ruth Tarvydas • E-Poll: Sex Assault, Euthanasia, Eating Disorders and more

Women’s Health Major Sponsors

April 2013

www.mforum.com.au


INNOVATIVE NEW THINKING IN SLENDER NEW SLENDER RANGE FOR LOT LIVING. 10M WIDE HOMESITES.

THE SHINO FROM $482,200

THE KELAN FROM $453,400

THE TANU FROM $485,500

THE ADINA FROM $480,250

Sub-dividing? Or simply seeking the ultimate in effortless, stylish living for your narrow lot? Prepare to have your expectations raised by the Slender Range, an inspiring new release of narrow-lot homes suited to a 10m wide homesite. Each home possesses Webb & Brown-Neaves’ incredibly high standards, such as stone kitchen and bathroom benchtops, full external render and internal painting. What’s more, you’ll be building a beautiful Webb & Brown-Neaves home; homes renowned for their craftsmanship, quality and style. Build slender, live large with Webb & Brown-Neaves.

Call Steve Connelly on 6365 2945 for more information or visit wbhomes.com.au Display homes are open weekends 1-5pm, Mon & Wed 2-5pm. ALKIMOS - SALT, 3 Shipmaster Avenue. Ph: 9562 3350. ALKIMOS - PEARL, 5 Shipmaster Avenue. Ph: 9562 3350.

ALKIMOS - THE BAYFIELD, 82 Shipmaster Avenue. Ph: 9563 0743. BURNS BEACH - THE AZUMI, 91 Grand Ocean Entrance. Ph: 6365 4056. FLOREAT - THE MEDALLION, 6 Hurdles Drive. Ph: 6365 4605. MOSMAN PARK - THE PACIFICA, 70 Mathieson Ave. Ph: 9431 7600.

NORTH COOGEE - THE SOUTH BAY, 20 Orsino Boulevard. Ph: 9434 9085. SOUTHERN RIVER - THE PAGODA, 3 Trumpet Street. Ph: 9398 6366. SWANBOURNE - THE RAFFLES, 3 Swanway Crescent. Ph: 9284 7796. WANDI - THE BRINDABELLA, 4 Bruny Meander. Ph: 9437 2079.

Photographs included in this advert may depict fixtures, finishes, features, furnishings and landscaping not supplied by Webb and Brown-Neaves including, but not limited to, planter boxes, retaining walls, water features, pergolas, screens, fences, outdoor kitchens, barbeques, window fittings and floor coverings. Webb and Brown-Neaves does not supply swimming pools, pool decks and fences. For more information on the inclusions of our homes please contact one of our building and design consultants.

#BG-3172WBN


Major Sponsors

CONTENTS FEATURES

CLINICAL FOCUS

6 Ruth Tarvydas:

3 Non-invasive Test

Passion for Fashion

for Down Syndrome 1SPG4ZEOFZ4BDLT

18 WA Ink: The Tattoo

7 Radiofrequency

Craze 22 Eating Disorders –

System Overload 24 Right Turn Into

Medicine

NEWS & VIEWS 2 Letters:

6

Catheter Ablation for AF %S5JN(BUUPSOB

39 Postnatal Depression %S#FBUF)BSSJTPO

43 Flu Vaccination in

Pregnancy %S%POOB.BL

t1SPGFTTJPOJT#FJOH)JKBDLFE  CZ%S.FSWZO)JSTDI

45 Removing Tattoos



t3FWBMJEBUJPO+VTU0OF.PSF )PPQ CZ%S"OHVT8IJUGJFME

47 Over-diagnosis



t-FUT5BMLUP&BDI0UIFS  CZ%S-J[5PNQLJOT



t1MFBUP(1T  CZ.T$BSPMF3VUUFS



t3VSBM7PJDF/FFEFEJO $BOCFSSB CZ%S.JLF&BUPO



t4IPVMEFSJOHUIF#MBNF  CZ%S1FUFS)POFZ

8 Have You Heard? 10 Pass the Parcel at

%S%BWJE.BJO

in Breast Cancer Screening %S-J[8ZMJF

49 Support Group: Ishar

18

Midland Hospital

Multicultural Women’s Health Centre

LIFESTYLE 50 Antarctica – Andrew’s

Last Frontier 52 Culture: Bell’s Henry 4

12 Sexual Assault

53 Wine Review:

Resource Centre

Lavina Wines

35 AMA Desktop Toolkit

%S$SBJH%SVNNPOE.8

37 Beneath the Drapes

54 Satire: Midlife Crisis

Party

37 Practice Tip:

Empowering Staff 41 Aged Care Views 43 Immunisation Booklet 47 Raphael Centre Freo 49 Women in High Heels #Z%S/JDPMF-FFLT

.T8FOEZ8BSEFMM

22

22 Diagnosing Eating

.T1JQ#SFOOBO

Disorders

20 Inspiration from

27 Euthanasia; Postnatal

Tragedy

.T3FCFDDB%BWJFT

31 Showing ‘Love and

Fairness’ .S"OUPJOF#MPFNFO

16 Doctors Drum

E-Polls:

Silent Epidemic

Sex Work is a Health Issue

E-POLL & EVENTS 3FQPSUBOETPDJBMQJDUVSFT

14 Sexual Assault – the

28 Decriminalisation of

56 The Funny Side

Breakfast

GUEST COLUMNS

.T.BSZ%PF

55 Competitions

24

Depression; Sexual Assault; Tattoos 28 Decriminalisation of

the Sex Industry 43 Flu Vax in Pregnancy 51 Perfect Gift for a

Woman

33 Working the System .S,JN4OPXCBMM

medicalforum

1


PUBLISHERS Ms Jenny Heyden - Director Dr Rob McEvoy - Director

MEDICAL FORUM MAGAZINE 8 Hawker Ave, Warwick WA 6024 Telephone (08) 9203 5222 Facsimile (08) 9203 5333 Email editor@mforum.com.au www.mforum.com.au

ISSN: 1837–2783 ADVERTISING Mr Glenn Bradbury advertising@mforum.com.au (0403 282 510) EDITORIAL TEAM Managing Editor Ms Jan Hallam editor@mforum.com.au (0430 322 066) Medical Editor Dr Rob McEvoy (0411 380 937) rob@mforum.com.au Clinical Services Directory Editor Ms Jenny Heyden (0403 350 810) jen@mforum.com.au Journalist Mr Peter McClelland journalist@mforum.com.au EDITORIAL ADVISORY PANEL Dr John Alvarez Dr Scott Blackwell Ms Michele Kosky Dr Joe Kosterich Dr Alistair Vickery Dr Olga Ward SYNDICATION AND REPRODUCTION Contributors should be aware the publishers assert the right to syndicate material appearing in Medical Forum on the MedicalHub.com.au website. Contributors who wish to reproduce any material as it appears in Medical Forum must contact the publishers for copyright permission. DISCLAIMER Medical Forum is published by HealthBooks as an independent publication for the medical profession in Western Australia. The support of all advertisers, sponsors and contributors is welcome. Neither the publisher nor any of its servants will have any liability for the information or advice contained in Medical Forum . The statements or opinions expressed in the magazine reect the views of the authors. Readers should independently verify information or advice. Publication of an advertisement or clinical column does not imply endorsement by the publisher or its contributors for the promoted product, service or treatment. Advertisers are responsible for ensuring that advertisements comply with Commonwealth, State and Territory laws. It is the responsibility of the advertiser to ensure that advertisements comply with the Trades Practices Act 1974 as amended. All advertisements are accepted for publication on condition that the advertiser indemniďŹ es the publisher and its servants against all actions, suits, claims, loss and or damages resulting from anything published on behalf of the advertiser. EDITORIAL POLICY This publication protects and maintains its editorial independence from all sponsors or advertisers. GRAPHIC DESIGN 2 Thinking Hats

Letters to the Editor

Profession is being hijacked

Parent details necessary for paediatricians

Dear Editor, In response to Dr Joanna Flynn, Chair of the Medical Board of Australia (Letters, February 2013) I graduated in 1964, became a GP in 1968 and retired in 2007. In that time I had no adverse contact with the Medical Board. I saw my role as seeing patients, and took little interest in medical politics. This was my mistake because while I wasn't looking my profession was hijacked by bureaucrats and lawyers. I am now informed: t *BN3FTQFDUFEGPSNZIJHIMZEFEJDBUFETFSWJDF t *BNOPUDPNQFUFOUUPXSJUFBTDSJQUPSSFGFSSBM for a patient who can't get an appointment with an overloaded GP. I also can't write repeats for a disabled friend who can't find a GP willing to provide home visits. t *NBZOPUSFRVJSFSFHJTUSBUJPOUPUFBDIPSUBLFPO advisory roles! As George Orwell has left us I  XPOEFSJGBOZPOFDBOUSBOTMBUFUIJT5SJQMFTQFBL Perhaps there is a clue in Dr Flynn's CV. *DPVMEOPUCSJOHNZTFMGUPXSJUFBDIFRVFUPTVQQPSU such stupidity. I will donate the money to charity and walk off into the sunset, sadder but wiser.

Dear Editor, 'VSUIFSUP.T"MJTPO(PVMEhTSFRVFTU -FUUFST .BSDI NBZ*QMFBTFBEENZSFRVFTUUPHFOFSBM practitioners? I work in paediatrics and process many incoming referrals which lack the necessary information to facilitate easy contact with the parents of our prospective patients. We are not always given the contact telephone numbers, and we are almost never provided with the parents' names, which makes it difficult to offer an appointment. It is especially important to know if the relevant contact person is not the parent. At present, I waste a lot of time phoning GP practices to obtain this information and occasionally I strike a pedantic medical receptionist XIPXPOhUQSPWJEFJUEVFUPQSJWBDZMBXT:PVS inclusion of this information in the referral would be greatly appreciated.

Dr Mervyn Hirsch, Dianella

Revalidation: Just one more hoop Dear Editor, I read with interest Dr Will Thornton’s piece on How Valid is Revalidation (March, 2013). Those of us at the coal-face of General Practice in the 6,LOPXUIBU3FWBMJEBUJPOJTCFJOHESJWFOCZPVS political masters, just as Appraisal was. How it will identify poor-performing doctors remains to be seen. 5IF6,hT3PZBM$PMMFHFPG(FOFSBM1SBDUJUJPOFSTDBO be commended for being proactive about engaging with our masters on exactly what is needed to revalidate, but at the end of the day this is just one more hoop for us to jump through. Dr Angus Whitfield, via Medical Forum website

Let’s talk to each other Dear Editor, In Medical Forum (Letters, March 2013) a TQFDJBMJTUTSFDFQUJPOJTUSFRVFTUFEUIBU(1TJOGPSN the specialist when a mutual patient dies. Fair enough. In my experience many patients die in hospital. The usual way I find out one of my patients has passed away is when I read it in the local paper. Our regional hospital does not inform local GPs of a patient’s demise because, as a previous medical director informed me, “it breaches patient confidentiality�. Luckily Albany is small and word gets around otherwise we, like the specialists, would be in the dark about our patients.

Ms Carole Rutter, Medical Secretary

Shouldering the blame Dear Editor, 3&Surgery for traumatic shoulder instability (March edition). Arthroscopic rotator cuff repair is relatively new and there has been no published data to suggest it is better or worse than standard open or arthroscopically assisted surgery. As technical skills improve, surgeons will switch CFUXFFOUIFWBSJPVTUFDIOJRVFTBOEUIFDMJOJDBM results should also improve. I am more concerned about the medical understanding of rotator cuff tear pathology. It mainly affects older people, and in most cases results from gradual wear and tear over time; deterioration or improvement is gradual, allowing the trial of prolonged conservative treatment before deciding on surgery. However, there is a subset of patients for whom prolonged conservative treatment has a detrimental effect. Older athletes who have an acute, significant cuff tear as a result of a traumatic event, with significant immediate functional loss should have the injury assessed early. A very large rotator cuff tear (two tendons or more) DBOSFUSBDURVJUFBMPOHXBZ BOEUIFJOWPMWFE muscles can undergo fatty degeneration within months. If these big tears are not repaired early, the results of surgical treatment are poor. I have seen many patients who were referred too MBUF BOEIBWFSFRVJSFESFWFSTFTIPVMEFSKPJOU replacement for what initially would have been a very repairable tear. Dr Peter Honey, Orthopaedic Surgeon, West Perth

Continued on P4

Dr Liz Tompkins, GP Obstetrician, Albany

medicalforum


Superior Non-invasive Test for Down Syndrome Until recently, routine pregnancy screening for Downs (and some other chromosomal aneuploidies) relied on both maternal blood and foetal ultrasound data, that is, the First Trimester Screen (FTS). Positive FTS tests are referred for invasive chorionic villus sampling (CVS) for definitive diagnosis. The high false positive rate of FTS (5%) results in significant maternal anxiety and morbidity from unnecessary CVS, and there are also false negatives. Analysis of cell-free DNA in maternal blood is a recent advance that allows foetal DNA to be accurately and non-invasively assessed. Clinipath Pathology now offers a new pre-natal screening test that has near diagnostic accuracy.

Basis of testing 5IFOFXUFTU WFSJGJÂĽ SFRVJSFTPOMZBTJNQMF blood test so it is non-invasive and can be performed from 10 weeks gestation on. The analysis is performed by Verinata, a CLIA certified specialist laboratory in the USA. During pregnancy, the maternal blood contains a mixture of maternal and foetal cell-free DNA. The verifiÂŽ test analyses the cell-free DNA and can detect trisomies in chromosome 21 (Down syndrome),  &EXBSETTZOESPNF BOE 1BUBV syndrome). Additional testing for the most common foetal sex aneuploidies including Turner syndrome (Monosomy X), Triple X (XXX), Klinefelter syndrome 99: BOE+BDPCTTZOESPNF 9:: JTBMTP available at no extra charge if specifically SFRVFTUFE5PHFUIFSUIFTFDISPNPTPNBM abnormalities make up ~80% of all prenatal chromosomal abnormalities.

Intended Use The test is designed for patients at 10+ week’s gestation with singleton pregnancies, considered at high risk due to any of the following:

medicalforum

By Dr Sydney Sacks, Chemical Pathologist (in conjunction with other Sonic Healthcare Pathologists)

verifiÂŽ test performance Unlike FTS, verifiÂŽ is not influenced by maternal age, maternal weight, ethnicity or gestational age. Test performance, markedly superior to FTS, is shown here: (see table) Chr

N

Sensitivity

95% CI

Specificity

95% CI

21

500

>99.9% (90/90)

96.0 – 100.00

99.8% (409/410)

98.7 – 100.00

18

501

97.4% (37/38)

86.2 – 99.9

99.6% (461/463)

98.5 – 100.00

13

501

87.5% (14/16)

61.7 – 98.5

>99.9% (485/485)

99.2 – 100.00

X

508

95.0% (19/20)

75.1 - 99.9

99.0% (483/488)

97.6 - 99.7

The verifi™ test has an option for information on common sex aneuploidies, previously known only through invasive results. Chr N

Sensitivity

95% CI

Specificity

95% CI

Accuracy 95% CI

XX

508 97.6% (243/249) 94.8 – 99.1 99.2% (257/259) 97.2–99.9 98.4%

96.9 – 99.3

XY

508 99.1% (227/229)

97.7 – 99.7

96.9 – 99.9 98.9% (276/279) 96.9–99.8 99.0%

XXX, XXY, XYY Limited data of these more rare aneuploidies preclude performance calculations.

Sex chromosome mosaicism cannot be distinguished by this method (occurrence <0.3%). *Test performance data on file. t "EWBODFENBUFSOBMBHF t 1PTJUJWF'54TDSFFOSFTVMUT t 1SFTFODFPGVMUSBTPVOEBCOPSNBMJUJFT t 1SFWJPVTBGGFDUFEQSFHOBODZGPSGPFUBM aneuploidy As verifiÂŽ test performance is significantly superior to FTS, the risks from false positive and false negative results are minimised, and a decision as to whether to proceed to CVS can be made accordingly.

Test ordering and reporting verifiâ&#x201E;˘ pre-natal test is available only at specific Clinipath Pathology collection centres and must be pre-booked on 5FTUSFRVFTUT JOJUJBMMZPOMZ BWBJMBCMFUPPCTUFUSJDJBOT SFRVJSFBTQFDJBM SFRVFTUGPSN

chromosomes option is selected, results for .POPTPNZ9 999 99:BOE9::XJMM also be performed at no additional cost. (If no aneuploidies are detected, foetal sex will be reported.)

Test Cost WFSJGJÂ&#x2122;QSFOBUBMUFTUEPFTOPURVBMJGZGPS a Medicare rebate. Out-of-pocket cost to the patient totals $1250*, payable on credit card at the time of testing. The referrer has the assurance that testing is performed by a CLIA certified, state-of-the-art USA laboratory. *Correct as of February 2013, but subject to change without notice.

The test report contains results for chromosomes 21, 18 and 13. If the sex

3


Letters to the Editor

Rural Voice Needed in Canberra Dear Editor, I read with interest your report on GP groups in WA (February, 2013) and would like to remind your readers about the functions of Rural Doctors Association (WA). RDAWA is solely dedicated to representing your rural interests in the world of politics and negotiation. Many of the benefits that doctors enjoy as VMO, DMO, visiting specialists etc are the result of RDAWA's continuing negotiation. Without RDAA and RDAWA there would be no GP retention payments nor Locum Relief under ROALS. We are currently lobbying all parliamentary jurisdictions to have the appalling ASGC -RA rural classification system revoked or altered to reflect the realities of rural and remote medical services delivery. There is strong acknowledgement from some MPs now that the system is unfair and out of touch with rural medicine. RDAWA as part of RDA is putting pressure on the federal government to ensure that the extra money granted to Medicare Locals (MLs) is distributed to those doing the work, not swallowed up in increased administration. Current indications are that unless we

unite and force the issue, there will be no guaranteed increase in your payments despite the increased federal spending. Figures of $180,000 in increased admin costs have been quoted for some MLs around Australia. The MLs out of eight have replied to RDA’s request for information on how they intend to support their after-hours doctors. RDAWA will continue to follow up the responses of our MLs regarding the funding allocations. We advise all doctors who are delivering afterhours care to make contact with your ML and make sure they are reflecting your needs and transferring the extra funding to you. Although we are working on behalf of all rural doctors, only a fraction of the 741 GPs working in rural WA [including RFDS, GP Registrars, WACHS DMOs – excluding Peel, Bunbury, Geraldton, Kalgoorlie, and regular FIFO doctors] and the 145 rural resident specialists [including all specialists living rurally, not visiting from Perth] are actively supporting our work through their membership. We need your support to continue to have the rural voice heard in Canberra and strongly urge you to join either online at www.rdaa. com.au/membership/how-to-join/ruraldoctors-association-of-western-australia or by mail.

CLARIFICATION The Hip Prosthesis Story on page 35 (March edition) was written by Dr Rob McEvoy and not Prof Piers Yates who wrote MoM hip replacements. What are the issues? alongside. Medical Forum apologises for any confusion.

We want to hear what you think. Send in your letters by May 10 to editor@mforum.com.au

Dr Mike Eaton, RDA(WA) president, Dardanup

Practice stress reduction Since 2002, WA based Medifit has helped hundreds of healthcare providers across Australia create their dream practices. Medifit are medical design and construction specialists. Our experience and efficiency combine to provide a level of service and quality of outcome that is second to none in this space. From initial design concepts, through construction, fitout and beyond, we will deliver the practice you want, in the timeframe and budget you need, without the stress. If you’re thinking of building or refurbishing a practice, contact us today for a no obligation consultation. Your patients won’t be the only ones smiling.

1300 728 133 www.medifit.com.au

4MEDIFIT_MFWA_HP_Ad_Jan2013.indd 1

medicalforum 7/02/2013 11:04:59 AM


medicalforum

5


Spotlight

The Passion for Fashion Sheâ&#x20AC;&#x2122;s famous for designing the sexiest red carpet gowns but for Ruth Tarvydas, standing out in a crowd has come naturally for more than three decades. Ruth Tarvydas is a hard woman to catch. The WA fashion designer squeezed in a chat with Medical Forum last month in between packing off a consignment to Harrods and putting the finishing touches to her first resort range, putting paid to last yearâ&#x20AC;&#x2122;s premature headlines of her business demise. Despite the hard economic times, which saw her close her signature shop in King St but reopen in Claremont with the help of businessman John Bond, Ruthâ&#x20AC;&#x2122;s international wholesale business has continued to fire. Thatâ&#x20AC;&#x2122;s down to her own determination and passion for what sheâ&#x20AC;&#x2122;s be doing since she was a teenager. â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;ve seen recessions and you have to ride them and make the necessary decisions for your business. Itâ&#x20AC;&#x2122;s not something that frightens or worries me too much, though reading last yearâ&#x20AC;&#x2122;s headlines were tough.â&#x20AC;? i3FBEJOHA5BSWZEBTDPMMBQTFT ZPVBMNPTU believe it, but then you pull yourself up and TBZ AIBOHPOZPVWFHPUUPNBLFBEFMJWFSZUP Harrods, youâ&#x20AC;&#x2122;ve got to do a new collection, youâ&#x20AC;&#x2122;ve got a showing in Paris. Come on, move your arse and get on with itâ&#x20AC;&#x2122;.â&#x20AC;? As a child growing up with a sister seven ZFBSTPMEFS 3VUIXBTUSBOTGJYFECZIFS sisterâ&#x20AC;&#x2122;s weekend transformations from awkward teenager to exotic princess. â&#x20AC;&#x153;I could not believe it. The prettier the dress the prettier she looked.â&#x20AC;? But while she yearned for the pretty dresses, she was in no rush to join the date race. â&#x20AC;&#x153;I saw my sister getting so stressed about whether she would have a date on a Saturday night â&#x20AC;&#x201C; as if being dateless meant she was JOBEFRVBUFTPNFIPX*UIPVHIUUIFSFXBT no way I was ever going to be like that. So I decided as a young teenager that I was never going to get married or stress out over a man. And I held that line. I held on to my independence.â&#x20AC;? 8IFO3VUIHPUIFSDIBODFUPUBLFUPUIF social stage, the era had changed. She had begun making her own clothes which had the same show-stopping effect as her designs do today. â&#x20AC;&#x153;All my friends wanted to borrow my dresses, especially the party clothes. I did lend them to girlfriends and they ended up not with just my dresses but with my boyfriends as well. The boys just followed the dress! How funny was that! When I opened my shop, one of those girls walked in, and *UIPVHIU ASJHIU ZPVDBOQBZGPSUIFHPXOT now! I got my revenge.â&#x20AC;? 6

QRuth Tarvydas with celebrity client Ashley Roberts from the Pussy Cat Dolls. Inset: Ruth modelling her crochet bikinis in the 1970s

3VUIPQFOFEIFSGJSTUTIPQJOXJUIUIF help of her brother Harvey, who was at the time in first year medicine at UWA. i.ZQBSFOUTXFOUUP&VSPQFGPSBTJYNPOUI holiday and Harvey and I had the house to ourselves and we thought what a perfect time to open a shop because Mum and Dad were not here to worry about us. We occupied the back room of a pharmacy in Hay St, near London Court, but the pharmacist gave us the front window, so we had these amazing dresses on show. Crochet bikinis wrapped with chain belts, minis and hot-pants and see-through tops, whatever was exciting in that era. â&#x20AC;&#x153;Crowds would gather in front of the window â&#x20AC;&#x201C; we even had TV stations filming the crowd of girls that would flock to the shop. The shop was so full that the pharmacist allowed the girls to change behind his shelves. The Sixties and Seventies were something else.â&#x20AC;? The House of Tarvydas was born. 4VDDFTTDBNFRVJDLMZGPS3VUIBOEUIF pressure of being in the limelight began to take its toll. â&#x20AC;&#x153;The problem was that the Press kept using me as a model, and Iâ&#x20AC;&#x2122;m not a model, Iâ&#x20AC;&#x2122;m not a model size. So you change your appetite, you think you slim your legs by not drinking water, you do this and you do that BOEPCWJPVTMZJUTOPUIFBMUIZ:PVPOMZEP

it because you want the next photo to look better. Suddenly I realised what I was doing and luckily for me I could stop.â&#x20AC;? â&#x20AC;&#x153;But you can see how some girls are taken in CZJU*GZPVTFFBQIPUPUIBUTOPURVJUFSJHIU and youâ&#x20AC;&#x2122;re the only person who can fix it, a young teenager takes charge in any way she can. Models today certainly feel the pressure and itâ&#x20AC;&#x2122;s totally unrealistic, especially when there is so much Photoshopping about â&#x20AC;Ś but they still tell them they have to lose weight.â&#x20AC;? Up until his death from an aneurysm in "VHVTU  )BSWFZIBECFFOPOFPG3VUIT greatest supporters. He was deregistered JO8"JOCVU3VUITBZTTIFIBTCFFO inundated with stories from patients who attribute their survival and good health to his ministrations when others had abandoned them. i)BSWFZXPSLFEPVUTJEFUIFTRVBSFBOEXBT ahead of the pack so it breaks my heart that he hasnâ&#x20AC;&#x2122;t been recognized. His last words to NFXFSFA-FBSOUPCFMJFWF 3VUIJF -FBSOUP believeâ&#x20AC;&#x2122;. I reflect on those powerful words every day. It keeps me going and inspires me to take his work forward.â&#x20AC;? O

By Ms Jan Hallam medicalforum


3BEJPGSFRVFODZDBUIFUFS ablation to prevent AF Management of AF (atrial fibrillation) principally aims to control symptoms and prevent stroke. Although antiarrhythmic drug therapies (ADT) such as amiodarone, flecainide or sotalol are generally first-line in the management of symptomatic AF patients, they have limitations including: limited efficacy (approaching 50% at 6-12 months); frequent side effects; and adverse events. This had led to the evolution of radiofrequency catheter ablation (RFA), which is an effective rhythm control strategy in appropriately selected symptomatic patients.

Indication for catheter ablation Symptoms are the primary driver. Current guidelines recommend RFA in paroxysmal AF patients with symptomatic recurrences who have failed or are intolerant to ADT (class I), and in symptomatic persistent AF patients who have failed or are intolerant to ADT (class IIA). For patients with highly symptomatic paroxysmal AF with a low risk profile for catheter ablation, RFA should be considered firstly. There is also evidence that the same strategy may benefit patients with AF-related co-morbidity, such as heart failure or reduced left ventricular function. The desire to cease oral anticoagulant therapy is not a sole indication for this procedure due to the risk of late recurrences, many of which may be clinically ‘silent’. The long term decision to anticoagulate is based on thromboembolic risk (using a scheme like the CHA2DS2VASc score)2.

Procedure Over a decade ago, finger-like extensions of atrial tissue into the pulmonary veins were found to be critical in initiating and “triggering” AF (Haissaguerre et al1) and led to catheter ablation techniques. Circumferential ablation to the antral aspect of the pulmonary veins (pulmonary vein isolation) is applied via a point-by-point approach with an irrigated ablation catheter. Radiofrequency energy heats the tissue

medicalforum

and creates a scar that targets the “trigger” for the majority of AF episodes and aims to prevent arrhythmia initiation (see figure 1). Access to the left atrium is gained via a percutaneous femoral venous approach and double transeptal puncture from the right atrium.

Dr Tim Gattorna MBBS (Syd) FRACP Tim Gattorna is a cardiologist and electrophysiologist, whose areas of interest include cardiac arrhythmias (including catheter ablation), along with the implantation and management of cardiac devices. He has a clinical appointment at Royal Perth Hospital and Western Cardiology.

Success and complication rates Recent studies comparing RFA and ADT have demonstrated significantly improved efficacy, quality of life (QOL) and symptoms with RFA. The success of maintaining sinus rhythm is about 70% but varies between patients and may require multiple procedures to achieve success owing to recovered conduction from the pulmonary veins. Newer technologies, including contact force catheters, offer greater procedural success and reduced complications. The procedure carries a 2-3% risk of major complications including stroke (0.6%), cardiac tamponade (1%) and peripheral vascular complications (1%). The estimated mortality rate is 0.1%.

Procedural success – the importance of timing AF itself induces structural and electrophysiological changes that can further perpetuate the arrhythmia. These pathophysiological considerations suggest that rhythm control therapy is best performed early after diagnosis when these changes are potentially reversible. There may be a “window of opportunity” for effective therapy before irreversible atrial remodelling occurs. AF requires a substrate for its maintenance and further ablation within the atria, in addition to the targeting of pulmonary vein triggers, is required in patients with persistent AF or with evidence of structural heart disease. This is termed “substrate modification” and efficacy in such patients is less favourable, with a higher rate of repeat procedures.

QFigure 1: 3D Electroanatomical map of the left atrium and pulmonary veins demonstrating circumferential ablation (pulmonary vein isolation). Posterior view. Red dots = ablation sites, Yellow =right upper pulmonary vein, Light blue = right inferior pulmonary vein, Dark blue = left upper pulmonary vein, Purple= left inferior pulmonary vein, Red = left atrial appendage, Grey = left atrial body

FAVOURABLE FACTORS IN REFERRAL FOR RFA t 'BJMFEUSJBMPG"%5 t :PVOHFSBHF MFTTUIBOZFBST

t (SFBUFSTZNQUPNT t 1BSPYZTNBMMPOF"' t /PPSNJOJNBMTUSVDUVSBMIFBSUEJTFBTF or left atrial enlargement t "DDFQUBODFPGSJTLCFOFGJUSBUJPPG3'" t 6OEFSTUBOEJOHPGBOUJDPBHVMBUJPOOFFE CBTFEPO$)"%47"4DTDPSF

t 5SFBUNFOUPQUJNJTBUJPOPG co-morbidities (incl. sleep apnoea, obesity or hypertension)

References: 1. Haissaguerre M et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. NEJM 1998; 339: 659-666 2. Friberg L et al. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur Heart J. 2012;33(12):1500

7


Have You Heard? Jail and the mentally ill

Inquiry slams AHPRA ")13"IBTCFFOHFUUJOHBQBTUJOHJOUIF 7JDUPSJBO-FHJTMBUJWF$PVODJM*ORVJSZ into its performance. The Australian Society of Ophthalmologists has wading JODMBJNJOH")13"IBTOPUTVDDFTTGVMMZ implemented a national scheme to eliminate waste and duplication, certainly not low-cost and low-impact. It claims no enhanced service delivery, patient safety or national administrative efficiency. It says resolution of state-based issues have become exceedingly difficult and doctors BSFTVGGPDBUJOHJOSFEUBQF")13"JT bureaucratically bloated â&#x20AC;&#x201C; offices in every capital city and 700 staff (costing $53m) to manage input from 475 board members; reports to nine health ministers across the nation so the buck stops nowhere; received $122m and overspent this by $6m. ASO wants a return to previous state and territory boards.

All about procedures The Federal Court fined Cotton-On Kids Pty Ltd $1 million after it supplied unsafe childrenâ&#x20AC;&#x2122;s nightdresses and pyjamas (breached mandatory standards for flammability). The ACCC took civil proceedings under the Competition and Consumer Act 2010. At the time of the CSFBDI$PUUPO0OEJEOPUIBWFBEFRVBUF RVBMJUZBTTVSBODFBOEDPOUSPMQSPDFEVSFT to ensure compliance. Medical device manufacturers are having to counter consumer discontent after the breast implant, cardiac catheter, and hip prosthesis QSPCMFNT5IF&6BJNTUPUJHIUFOJUT regulatory process from 2014 to keep pace with technological and scientific progress. The extra tracking and testing may delay QSPEVDUMBVODIFTCZZFBSTBTUIF&6IBT been an easier nut to crack than the FDA in the USA.

Marlon Noble walked out of Greenough 3FHJPOBM1SJTPOMBTUZFBS BGUFSZFBST without conviction, having been accused of sexually assaulting two children in Carnarvon in 2001 and deemed unfit for trial due to an intellectual disability. Intense public interest set him free. He is not alone. Margaret Doherty, in our March edition (see www.medicalhub.com.au) says the Mentally Impaired Accused Act 1996 can incarcerate someone indefinitely, without appropriate treatment (45% in prison, 60% "CPSJHJOBM BOEXJUIJOGSFRVFOUSFWJFXUIBU lacks transparency. Mental health advocates claim more than 30 mentally impaired people across WA are in this boat.

Whatâ&#x20AC;&#x2122;s in a press release National Health Peformance Authority figures on GP access came out for the first time recently. Health consumers were saying they waited too long for GP appointments (13% nationally). Health Minister Tanya Plibersek said Medicare Locals were important because they gathered the info. The AMA said it illustrated why we need more GPs. And NHPA got to report on the performance of one aspect of healthcare for the Council of Australian Governments. Fortunately, in 2010â&#x20AC;&#x201C;11, between 86% to 96% of health consumers felt their GP always or often showed respect for what they had to say, and between 80% to 94% felt their GP always or often spent enough time with them. See www.nhpa.gov.au for more.

2'#-+0);174.#0)7#)'X$7+.&+0);174&4'#/

    T     T 8'4;*1/'9'$7+.&+570+37'T'&'5+)0 #0&$7+.&6157+6;17#0&;174.+('56;.'T *#659*;9'.+/+66*'07/$'41(241,'%65 9'6#%-.'h61'0574'9'4'#$.'61)+8';17 6*'6+/'X%#4'#0&#66'06+10;17&'5'48'T 6/'#059'4'#$.'61(1%75+06'06.;10;17X ;174#52+4#6+105#0&+052+4#6+10X'0574+0) 9'/#+06#+06*'*+)*'5637#.+6;5'48+%' #0&%4#(65/#05*+2#6'8'4;56#)'T 1%1/241/+5'5T7566*'*1/';178' #.9#;5&4'#/'&1(T  +5+6%+%+4'..1*1/'5T%1/T#7 14%#..JFJKIEGJ61(+0&176/14'T

  ©   ©   n 

8

medicalforum


Common sense prevails

Still helping docs Doctors Health Advisory Service (DHAS WA), previously Colleague of First Contact, has a 24/7 confidential phone service (9321 3098) to access GP advice. Itâ&#x20AC;&#x2122;s for all doctors and medical students who need help with personal or health problems. Doctors, a concerned family member, friend, colleague or staff member can phone anonymously about issues ranging from depression, substance abuse, grief or illness, even concerns about impaired performance. Calls are exempt from the mandatory SFQPSUJOHSFRVJSFNFOUTPGUIF.FEJDBM Board of Australia. DHAS WA dovetails in with the GPs for Doctors program run by Medicare Locals. Teaching hospital TUBGGDBOBMTPVTFUIF&NQMPZFF"TTJTUBODF Programme â&#x20AC;&#x201C; free professional counselling by Converge International 24/7 on 1800 337 068. And junior hospital doctors can get help at www.jmohealth.org.au

6OUJMJUMBQTFEJONJE UIF3"$(1 ACCC deal allowed GPs in the same practice to agree on fees. After a little hooha, the federal AMA took up the cause for all GPs (not just its GP members) and has struck another similar deal with the ACCC. It started in March and runs five years. GPs in the same practice can also negotiate collectively with hospitals and Medicare Locals on fees (e.g. after-hours services). The ACCC says public benefits will flow from their approval.

Broker breakdown As we went to press, paediatrician Flemming Nielsen and his ex-Citigroup CSPLFS3PC$BUFOBJOBKPJOUUSJBMXFSF fighting insider trading charges laid by ASIC in April 2011, for share transactions back in 2006. Of particular interest to doctors with self-managed superannuation funds was evidence by Bell Potter JOWFTUNFOUBEWJTFS3PDDP5BTTPOF  reported in The West Australian. He said brokers might not be thinking what you are thinking when they use â&#x20AC;&#x153;rumoursâ&#x20AC;? and â&#x20AC;&#x153;sourcesâ&#x20AC;? to convince their clients to buy and sell, and thereby generate a brokerage fee. Both Mr Catena and another ex-Citigroup broker Mr Hebbard, also facing insider trader charges, were banned in February 2009 by ASIC from providing financial services for five years.

GP Representation Fremantle GP Hilary Fine was elected to the board of Fremantle Local recently, from candidates amongst whom pharmacy was strongly represented. She said GPs are grappling with more complexity and medicolegal concerns while chasing worklife balance. Add decreasing profits and compliance with changes and she is not surprised involvement in GP representative groups is dwindling or is left to die-hards. Pharmacists, on the other hand, jump at the opportunity to be part of the future and of primary care turf. She said Medicare Locals offer an opportunity to develop local health care that fragmented general QSBDUJDFTIPVMEHSBTQ.FBOXIJMF IFS&BTU Fremantle Medical Centre, which recently achieved Super Clinic status, threw an event at Fremantle warehouse PS Art Space, is supporting Warlukurlangu Aboriginal artists whose designs are incorporated into fashion. O

Lifeâ&#x20AC;&#x2122;s challenges are our specialty. At The Hollywood Clinic, we understand everyone needs a little help along the way when lifeâ&#x20AC;&#x2122;s challenges get too big. Thatâ&#x20AC;&#x2122;s where our experienced specialists are on hand to help your patients get back to business. Our 40 bed private facility based in Nedlands is staďŹ&#x20AC;ed by highly experienced and caring mental health experts. The Clinic oďŹ&#x20AC;ers day-patient and in-patient programs designed to support a range of challenges including alcohol dependency, eating disorders and trauma. If you would like more information on a speciďŹ c program our Program Coordinators would be happy to chat with you. GPs can refer patients directly to The Hollywood Clinic by calling Clinical Nurse Manager, Caroline Dinnie, on 9346 6805.

Treatment Programs Alcohol Treatment Art Therapy Bulimia and Eating Disorders Mood & Anxiety Management Post Traumatic Stress Disorder The Seniors Program Trauma & Recovery Womenâ&#x20AC;&#x2122;s Trauma

Program Coordinator Lucy Anderson Dena Lawrence Jennifer King Susan Aston Doug Brewer Stephanie Mattys Doug Brewer Doug Brewer

Telephone 08 9346 6861 08 9346 6821 08 9346 6817 or 0414 237 228 08 9346 6809 08 9346 6810 08 9346 6815 08 9346 6810 08 9346 6810

AMAZING M E N TA L H E A LT H hollywoodprivatehospital.com.au

medicalforum

9


News & Views

Pass The Parcel – Midland Health Campus While everyone is talking generalities, Midland doctors are asking specifics on how the Catholic ethos of St John of God (SJOG), managers of Midland Health Campus (MHC), will impact on local patient services. Medical Forum compiled a list of relevant scenarios with the help of GPs and specialists who wanted answers (see below), and put them to Health Minister Dr Kim Hames. He handballed it to SJOG Health Care for a response. Their response returns us to where we started, more generalities (see right). With no explanation from the Health Minister or SJOG on how scenarios depicted will be dealt with, we ask is it safe to assume the outcomes given are largely accurate? SJOG says it has “well established processes for RVJDLMZBTTFTTJOHUIFBQQSPQSJBUFSFTQPOTF to each individual case” but prefers not to debate them in public. Public or not, doctors are entitled to direct answers. Having not seen the doctor employment or hospital management contracts for Midland

Public Hospital, all we can do is echo the main concerns expressed amongst doctors on behalf of their health consumers: t 1VCMJDQBUJFOUTXJMMOPUCFPGGFSFE contraceptive and termination of pregnancy (TOP) advice, when needed, at the point of care. This could generate added physical risk for patients and medicolegal risk for doctors. t %PDUPSTFNQMPZFECZ.JEMBOE)FBMUI Campus could be prevented from advising public or private patients on matters relating to contraception and pregnancy termination (other than the Catholic stance on these matters). t (1TBOEQFSIBQTTQFDJBMJTUTXJMMCF asked by the Health Minister to provide services that MHC management decline to provide, when these services have not yet been defined (what, where, when and how). And will they only be available off-site? Doctors we speak to have genuine concern for the relatively large number of patients in

the Midland area who are “disadvantaged”, and rely on the public hospital system. This concern is outside the philosophical angst amongst some that a management contract that forces West Australians to comply with the views of a minority community group in a secular, taxpayer-funded public hospital, is wrong. Many services will be provided by MHC beyond the scenarios listed here. The Government has clearly decided the cost-benefit analysis of these makes it a worthwhile overall outcome for the community, despite limitations. Services at the public hospital will include “a significantly expanded emergency department […] general surgery (including day surgery) [… and] obstetric services, including antenatal and postnatal care”, the latter including outpatient services. SJOGHC will build its 60-bed private hospital alongside, to open at the same time. O

By Dr Rob McEvoy

Contentious Clinical Scenarios This is a sample of the clinical scenarios, said by those who know to be relatively common, that were presented to the Health Minister. For obvious reasons, we have stuck with scenarios in which the Catholic ethos as Hospital Policy might be seen to disadvantage patients, put them at increased risk, or make the treating doctor medicolegally vulnerable. While public patients from disadvantaged backgrounds (social unrest, drug and alcohol problems, mobility difficulties) are a big consideration, situations apply to any patient, mostly women, private or public.

O LOT at Caesarian not used. Due for her fourth child by repeat elective caesarean, all unplanned pregnancies. Both parents prior to caesarean request tubal ligation at LSCS, for contraceptive reasons. Obstetrician does not have obstetrical reasons to want tubal ligation. OUTCOME: Contraception cannot be discussed (Hospital Policy) during antenatal or postnatal visits to the hospital, or after

10

delivery on the birthing ward. Woman delivers and leaves the hospital at risk of another unwanted pregnancy in the postnatal period and waits to be put on list for tubal ligation under GA (with its additional risk).

implant. IUD inserted at D&C is the preferred option. OUTCOME: Needs referral to outside the hospital (Hospital Policy) and runs risk for unwanted pregnancy meanwhile, due to wait times for appropriately skilled doctor.

O Vasectomy opportunity forgone. Six

O Contraceptive use blocks other uses.

week post natal follow-up. FlFO father of child attends unexpectedly with mother and baby asking for referral for vasectomy so they can arrange this for his next return home visit (leaving for up North tomorrow). Referral is declined (Hospital Policy). OUTCOME: Woman risks unwanted pregnancy because partner, who is hard to get to commit, is now disinclined. All her three previous children were born due to “contraceptive failures” and mother is not sure if she can afford tubal ligation privately.

Fertile woman with Polycystic Ovary Syndrome or heavy periods consults in outpatients and also seeks some way to prevent pregnancy. OUTCOME Progestogen impregnated IUD and other forms of oral contraceptive pill cannot be offered to control periods due to dual purpose of contraception (Hospital Policy).

O IUD opportunity missed. Urgent D&C for incomplete miscarriage in younger woman with an unplanned pregnancy. Instances of failed oral contraception in the past and is intolerant for progestogen

O Unwanted pregnancy puts mother and child at risk. Woman with one young child with Foetal Alcohol Spectrum Disorder and drinking problem is admitted following an overdose, for mental health risk assessment. She asks for a progestogen implant to prevent unwanted future pregnancy. Neither her social worker or treating doctor can think of contraindications. OUTCOME. Her request

medicalforum


News & Views

Questions Still Remain Dr Marcus Rumpus is a recently retired obstetrician and gynaecologist who treated public patients at the Swan Districts Hospital. Medical Forum spoke to Dr Rumpus who told us his concerns about the terms of some gynaecological procedures at Midland. â&#x20AC;&#x153;When the contract was offered to SJOG oOPUUP3BNTBZTBTBOUJDJQBUFEo*SBJTFE UIFRVFTUJPOPGXIBUXPVMECFUIFFUIPT behind non-Catholic activities at a meeting of the Swan District MAC. There had been no contemplation of Catholic impact on medical freedom prior to that at the MAC. â&#x20AC;&#x153; â&#x20AC;&#x153;I was advised that contemplation of ways around the problem would be addressed and be available on campus. The then medical superintendent [December 2011] SFTQPOEFEUPBRVFTUJPOBTUPIPXUIFOFX public hospital would service sterilisation BOE501BOETBJE A4+0(XJMMXPSLXJUIJO the Clinical Framework and will be contracted to provide these services but the methodology of how they will do this is yet to be determinedâ&#x20AC;&#x2122;.â&#x20AC;? Marcus says he received platitudes from Health Minister Kim Hames who said the MHC would deliver an obstetrics and gynaecology service (inclusive of appropriate investigations, theatre and

outpatients services) to all eligible patients in the public hospital. )FRVPUFEGSPNB+VOFMFUUFSGSPN the Minister that said, however, â&#x20AC;&#x153;There is a very small number of procedures that SJGHC is unable to deliver including contraception, termination and sterilisation <y>5IFSFRVJSFEQSPDFEVSFTUIBUDBOOPU be delivered by SJGHC will be delivered by other service providers on the MHC site. Planning for the best delivery model is currently in progress.â&#x20AC;? The same comment was repeated two months later by Mr Ian Wight-Pickin, the Health Ministerâ&#x20AC;&#x2122;s Chief of Staff. â&#x20AC;&#x153;We should be able to sterilise female patients either electively or in parallel to another procedure,â&#x20AC;? Marcus said Mr Barnett had no reply to this at a meeting JO&MMFOCSPPLBCPVU"VHVTU"U the Mercy Hospital I was allowed to insert MirenaTM as a system to combat menorrhagia, so that could still be a loophole for contraception. But why should we practise through loopholes?â&#x20AC;? â&#x20AC;&#x153;Doctors should be free to investigate early pregnancies and if appropriate on eugenic grounds terminate pregnancy in the first

trimester, essentially as STOP under GA.â&#x20AC;? )FRVFSJFEXIFUIFSUIFGSFFEPNPGEPDUPST to manage patients at their local public hospital would be impinged on by the new management so they â&#x20AC;&#x153;cannot freely discuss with patients all potential managements [which] strikes me as not being able to fully professionally adviseâ&#x20AC;?. He said employment contracts seem to be the order of the day now but when he was a VMO he was never thwarted form having full discussions with patients at Catholic hospitals, â&#x20AC;&#x153;though sometimes the accompanying nurse withdrewâ&#x20AC;?. O

Scan the QR to tell us what you think or email editor@mforum. com.au

SJOG Explains is declined (Hospital Policy) and with no fixed abode or regular GP, she is lost to follow-up and returns six months later 16 weeks pregnant. Using legal aid, she sues the doctor for not giving appropriate treatment to prevent pregnancy.

O Acute ectopic, declined sterilisation. Woman booked for sterilisation elsewhere presents with acute ectopic and needs surgery under GA to deal with the ectopic. OUTCOME. Requested sterilisation cannot be performed at the same time (Hospital Policy).

O Prevention of ectopic when treating heavy periods. Endometrial ablation for heavy periods in a woman still at risk of pregnancy. Laparoscopic tubal ligation is usually offered with ablation, to reduce the risk of tubal pregnancy; more so if other forms of contraception are contraindicated/likely to fail. OUTCOME. Any woman who wishes sterilisation as the preferred contraceptive method must have both procedures performed elsewhere (Hospital Policy).

medicalforum

Here are excerpts from the Media Statement given to Medical Forum by SJOGH, and provided by Dr Allan Pelkowitz Director of Medical Services at SJOG Midland Public and Private Hospitals. He was in the same role at Calvary Health Care, Canberra, a co-located public and private hospital operated by a Catholic not-for-profit group. â&#x20AC;&#x153;As each patientâ&#x20AC;&#x2122;s case is dealt with according [to] its specific circumstances, which are often DPNQMFYBOESFMBUJWFMZVOJRVF XFEPOPU believe that debating hypothetical scenarios through the media produces meaningful outcomes.â&#x20AC;? i3BUIFS XFIPQFUIFNFEJDBMDPNNVOJUZ will be given the opportunity to avail itself fully of the information presented here, as our intention is to reassure and inform them about our approach to operating St John of God Midland Public Hospital to ensure the best possible outcomes for all patients regardless of their circumstances, background or beliefs.â&#x20AC;? â&#x20AC;&#x153;Scenarios, not dissimilar to those you mention, are regularly managed with care, compassion and satisfactory clinical outcomes at the existing 21 Catholic-operated public hospitals around Australia, five of which run public emergency departments.â&#x20AC;?

â&#x20AC;&#x153;St John of God Health Care has well FTUBCMJTIFEQSPDFTTFTGPSRVJDLMZBTTFTTJOHUIF appropriate response to each individual case. This includes ensuring our accredited doctors and caregivers are fully informed about our approach to ethical health care delivery. The same situation will apply at Midland.â&#x20AC;? â&#x20AC;&#x153;Likewise, local GPs will be well informed about the services we will provide at the new hospital, allowing them to refer their patients appropriately.â&#x20AC;? â&#x20AC;&#x153;Specialists and GPs already understand that whether or not a treatment is provided depends on a number of factors, including whether or not the treatment is available at that facility and whether it is medically indicated.â&#x20AC;? â&#x20AC;&#x153;Patients will not be disadvantaged in any way because the State has already committed to fund the reproductive services we will not provide, in other facilities in the Midland area.â&#x20AC;? See www.medicalhub.com.au for full version. 11


News & Views

Breaking the Silence on Sexual Assault Despite protests by thousands, violent crimes against women continue unabated. In WA a team of doctors and professionals try to ease the pain. The gang rape and subsequent murder of a young Indian woman in New Delhi in December made international headlines and prompted mass rallies across India from outraged citizens calling for sweeping law and police reform. Closer to home, the rape and murder of Jill Meagher in suburban Melbourne in September also had hundreds of people protesting on the streets and prompted the development of a free phone app using GPS technology to report sexual assaults. If one thing has been served by these horrendous crimes against women is that sexual assault is, if briefly, back in the spotlight. In Western Australia, the incidence of sexual assault continues unabated. Dr Christine Bassindale, the coordinator of medical and forensic services at the Sexual "TTBVMU3FTPVSDF$FOUSF 4"3$ JO4VCJBDP reflected on a 2010 report in Medical Forum UIBUQVUUIFOVNCFSPGQBUJFOUTVTJOH4"3$ as between 340 and 400 a year.

Providing support to medical colleagues is an important part of our work. â&#x20AC;&#x153;The figures are still very similar. In 2012 we saw 324 people which was a slight decrease on the 2011 figures of 342. We donâ&#x20AC;&#x2122;t think for a moment that the incidence of sexual assault has decreased â&#x20AC;&#x201C; in fact itâ&#x20AC;&#x2122;s probably gone up because of the serious underreporting of the crime.â&#x20AC;? A 2007 report from the Office of Crime Prevention said the rate of sexual assault in WA had been steadily increasing since 2004. There were 1385 reported cases of sexual assault in 2003 and by the end of 2006 the number of reported cases increased to 1786 (Australian Bureau of Statistics, 2006). Christine said that about half of the people XIPBSFUSFBUFEBU4"3$IBWFTQPLFOUP police first, the other half are either selfreferrals or those who have been referred by hospitals or GPs, though she stressed that it varies from time to time. i4PNFQFPQMFDPNFUP4"3$QVSFMZGPSUIFJS health needs â&#x20AC;&#x201C; to access health care and

12

counselling â&#x20AC;&#x201C; and donâ&#x20AC;&#x2122;t feel able to pursue the matter through the courts. However, we keep forensic evidence for about three months to give people the chance to decide if they want take the complaint further. Itâ&#x20AC;&#x2122;s a fine line.â&#x20AC;? 5IFNBOBHFSPG4"3$ .T5BOZB5PXFST said the centre had a positive working relationship with police but emphasized that it was separate from the police. â&#x20AC;&#x153;Working well with police minimises the work that the complainant has to do, so itâ&#x20AC;&#x2122;s important to have a good working relationship, but there are a lot of people who are absolutely clear that they donâ&#x20AC;&#x2122;t want the police involved. We donâ&#x20AC;&#x2122;t exert any pressure on people to go to the police. People have a right to make a choice what path they want to go down.â&#x20AC;? $ISJTUJOFTBJEUIBU4"3$XBTOPUPOMZB hours service to victims of sexual assault but also doctors who may need advice if a patient makes a disclosure or an allegation of sexual assault. There are 12 doctors providing the 24-hours service and many more counsellors. â&#x20AC;&#x153;Providing support to medical colleagues is an important part of our work. We deal with these issues all they time but GPs may only deal with it once a year or few years, so to be able to access the service can be useful. Itâ&#x20AC;&#x2122;s also important for doctors to know that 4"3$EPFTOUKVTUQSPWJEFBNFEJDBMTFSWJDF but a free counselling service as well.â&#x20AC;? This on-call support for doctors is particularly important for those in rural and remote areas.

5BOZBTBJEUIBU4"3$OPXUSBJOTSVSBM nurses to do forensic examinations in rural areas. â&#x20AC;&#x153;This is to support doctors in regional &%TXIPEPOUIBWFUIFUJNFPSSFTPVSDFT to do 3-4 hour forensic exam. We provide a three-day intensive training program, which on completion the nurse will be signed off by the Commissioner of Police as TPNFPOFEFFNFERVBMJGJFEUPQFSGPSNUIBU examination. So the doctor can do the initial medical and then the nurse can take over to do the forensic.â&#x20AC;?

Our therapeutic services handle any sexual assault, be it childhood sexual abuse or recent sexual assault. &%/VSTFTBSFBMTPCFJOHUSBJOFEUP take mouth swabs and urine samples as preliminary tests. 4"3$TDPNNJUNFOUUPFEVDBUJPOBOE training extends to the wider community with programs in schools and government and non-government agencies. Tanya TBJEUIBU4"3$XJMMSFTQPOEXJUICPUI therapeutic and medical services to victims of sexual assault and individual and PSHBOJTBUJPOBMSFRVFTUTGPSUSBJOJOH â&#x20AC;&#x153;Our therapeutic services handle any sexual assault, be it childhood sexual abuse or recent sexual assault, from Clarkson to 3PDLJOHIBNBOEFWFOJOQSJTPOTwO

By Ms Jan Hallam

FACTS: SARC SERVICES t 4"3$QSPWJEFTBGSFFIPVSFNFSHFODZNFEJDBMGPSFOTJDBOEDPVOTFMMJOHTFSWJDFJO .FUSPQPMJUBO1FSUIGPSQFPQMFZFBSTBOEPWFSXIPIBWFCFFOTFYVBMMZBTTBVMUFEXJUIJOUIF QSFWJPVTEBZT t 4"3$BMTPQSPWJEFTDPVOTFMMJOHBDSPTTNFUSPQPMJUBO1FSUIUPQFPQMFXIPIBWFFYQFSJFODFE TFYVBMBTTBVMUBOETFYVBMBCVTFJOUIFQBTU t 4"3$EPDUPSTBSFBWBJMBCMFGPSDPOTVMUBUJPOXJUIEPDUPSTBOEPUIFSIFBMUIQSPGFTTJPOBMT TFFLJOHJOGPSNBUJPOPOSFTQPOEJOHUPQBUJFOUTXIPIBWFFYQFSJFODFETFYVBMBTTBVMU t 4"3$PGGFSTBSBOHFPGUSBJOJOHBOEFEVDBUJPOQSPHSBNTGPSIFBMUIQSPGFTTJPOBMTBOEDBO develop specific programs on request. t 4"3$IPVSFNFSHFODZMJOF  PS GSFFDBMM

8FCTJUFIUUQLFNIIFBMUIXBHPWBVTFSWJDFTTBSDJOEFYIUN

medicalforum


Your mortgage is not a matter of life and death It’s far more serious than that

Taking ou out a mortgage is not for the fainthearted: the amount of trouble involved c can send your stress levels sky-high. Too many go-betweens and traps to fall into... Or just too many options. At Investe Investec, we take the mortgage business terribly seriously too, but we like to make it simple. We specialise in providing financial solutions to medica medical and dental professionals, so we understand your needs and the varying income profiles of the sector. Investec’s commercial and residential mortgages are tailored to match your cashflow – you can even borrow up to 100% of the property price in some instances. Our mortgage specialists will look for the very best deal on the market and, most importantly, they’ll do the hard work so you’ll be able to get on with life – no stress.

Take a look at investec.com.au/medical or call one of our financial specialists on 1300 131 141 to find out how we can help.

O u t o f t h e O r d i n a r y™

Home loans | Car finance | Transactional banking and overdrafts | Savings and deposits | Credit cards | Foreign exchange | Goodwill and practice purchase loans Commercial and industrial property finance | Equipment and fit-out finance | SMSF lending and deposits | Income protection and life insurance Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL 234975, Australian Credit Licence No. 234975 (Investec Bank). All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Information contained in this document is general in nature and does not take into account your personal financial or investment needs or circumstances. We reserve the right to cease offering these products at any time without notice. You should obtain independent financial, tax and legal advice, as appropriate. Insurance products are offered by Experien Insurance Services (Representative No. 320626) the preferred supplier of insurance products to Investec Bank.

medicalforum

13


Guest Column

Sexual Assault â&#x20AC;&#x201C; the Silent Epidemic Ms Pip Brennan was asleep in her new home with her young child when a violent intruder irrevocably changed her life but she refused to be diminished.

I

tâ&#x20AC;&#x2122;s a womanâ&#x20AC;&#x2122;s worst nightmareâ&#x20AC;? â&#x20AC;&#x201C; itâ&#x20AC;&#x2122;s a phrase bandied about by police and later justice services in relation to my case. And yes, it was. As a university-educated, internationally travelled professional who was building a reputation as a community based volunteer, I did not ever, for one single moment, think anything like this could ever happen to me.

At the age of 36, having recently moved with my 3½-year-old child into a new home, I was sexually assaulted by an intruder in the wee hours of May 10, 2002. This violent, atypical incident propelled me on a journey of learning about the impact of sexual violence on women, and how overwhelmingly silent the curse on our society is. I learned about many other womenâ&#x20AC;&#x2122;s nightmares, which on closer inspection seemed a whole lot worse than mine. The majority of women are assaulted by someone they know, or even love. While I suffered at my loss of the sense of goodness of human beings, I had no issue with the perpetrator in my case as I didnâ&#x20AC;&#x2122;t know who he was. Time does not heal this wound. Like a cancer, surviving sexual assault seems to remain in your system, and more potently so if you go along with the need to be silent, leaving the wound to fester and grow. I waited more than nine months after the assault to attend a support group. I realised

how fresh I was when I entered the group with women who were dealing with rapes that had occurred in some cases more than two decades beforehand. For some, their whole lives had bent around a wound that they could not bring themselves to admit was there. Their lives had seen a range of maladaptive strategies women can adopt to manage the effects of trauma; eating disorders, drug abuse, alcohol abuse, sexual acting out. None of which effectively manage the anxiety and depression. For me, I raged, raged, raged against the insult from day one, and while it was important for me to learn the importance of measured disclosure, I never had a festering wound. There is no ongoing deficit for me. I was fortunate in so many aspects of this difficult journey. My GP explained to me that I had post-traumatic stress, and gave me something to go away and research and develop my own plan to ensure that post-traumatic stress did not develop into a disorder. Through my journey I met women with a range of what might seem to be very strange anxieties and hang-ups. To me they seemed to be caught in a constant time warp where innocuous situations were setting off alarm bells. Being abused as a child heightens the likelihood of being assaulted as an adult. Why, I wondered out loud, did the Sexual "TTBVMU3FTPVSDF$FOUSFMPPLBGUFSTVSWJWPST of both abuse and assault? I was in a one-

POPOFDPVOTFMMJOHTFTTJPOBU4"3$XIFO* QPTFEUIJTRVFTUJPO#FDBVTF NZDPVOTFMMPS advised, they are often the same person. In other words, by being abused as a child, you heighten your risk of being assaulted as an adult. With all the alarm bells going off for the wrong reasons, the alarm bells may fail to go off for the right reason, leaving abuse survivors more vulnerable to assault. I lived in the world 36 years before even knowing this. As a very fortunate woman, I have enjoyed a very positive life. This one appalling incident in my life led me unwillingly to a better understanding of this most difficult of areas. I am forever grateful to the many service providers who helped me in the different stages in the journey. I am also forever grateful for the wonderful fellow survivors I met through healing from this trauma. I remain absolutely convinced of the importance of the recovery approach, believing that women can be whole again with the right support including ongoing counselling and well-conducted group UIFSBQZ8FNBZOPUFWFSCFRVJUFUIFTBNF again, but we need not be diminished. ED: Pip Brennan has been working in the community sector since 1999, mainly in the area of womenâ&#x20AC;&#x2122;s health. She is currently managing a not-for-profit organisation, Community Midwifery WA. She continues to volunteer as a victim representative. O

GESB â&#x20AC;&#x201C; End of Financial Year Tax Strategies Les Conceicao â&#x20AC;&#x201C; GESB Award Winning Financial Adviser If you are a GESB Member, Les is able to provide you with comprehensive strategies to optimise your tax savings. Les has over 13 years experience as a licensed ďŹ nancial adviser with over 5 years as a senior ďŹ nancial adviser with GESB Financial Advice and is a multiple award winner of the GESB Financial Adviser of the Year. Following the recent closure of GESB Financial Advice, Les is available to assist you with your superannuation and retirement planning needs. Les has specialised knowledge to create tailored tax-effective strategies to maximise your beneďŹ ts from: sÂŹÂŹ'%3"ÂŹ7ESTÂŹ3TATEÂŹ3UPERÂŹ ÂŹ ÂŹ sÂŹÂŹ'%3"ÂŹ'OLDÂŹ3TATEÂŹ3UPER Additionally, Les is also able to assist you to maximise beneďŹ ts from Self Managed Super Funds and portfolio management. We help our clients achieve a secure and happy retirement. To make an appointment with Les, please call Marie on 08 6462 1989 or Les on 08 6462 1960. RBS Morgans Limited ABN 49 010 669 726 AFSL 235410 A Participant of ASX Group. A Professional Partner of the Financial Planning Association of Australia

14

RBS Morgans Perth | 08 6462 1999 Level 20, 140 St Georges Tce Perth WA 6000

www.rbsmorgans.com/perth

medicalforum


       

 

medicalforum

15


'Doctors Never Had Doctors Drum: Giving Doctors Voice Do A few people got hot under the collar and everyone enjoyed letting loose on this topic â&#x20AC;&#x201C; mixed responses from the 60 or so general practitioners and specialists at the recent inaugural Doctors Drum breakfast. On the panel, medicos from different walks of life, a consumer advocate, legal eagle, and financier all added flavour, in a relaxed style. The breakfast was great, the MC ran things on time, parking was easy, and virtually no politics â&#x20AC;&#x201C; a recipe for success! #FBDITJEFOFHBUJWFJPOT SFBE3FOEF[WPVT Hotel, Scarborough) had everyone in good spirits for a stimulating and lively discussion LJDLFEPGGCZUIF"#$T3VTTFMM8PPMG5IF panel was an interesting mix â&#x20AC;&#x201C; Ms Michele Kosky (consumer advocate), Dr Neale Fong, %S.JDIBFM4UBOGPSE 4+0()$$&0 %S Shelley Davies (GP), lawyer Ms Karina Hafford (Slater & Gordon*), and Mr John Boyle (Nab Health/Medfin*).

Loud and Proud

Doctors are a privileged lot, able to change, but are also discerning about it. The ADPOWFSTBUJPOPGUIFNFFUJOHGMPXFEJOBMM directions. Neale and Michael both cited the shortage of doctors and rapid 2.5% population growth as good for the profession. â&#x20AC;&#x153;Thereâ&#x20AC;&#x2122;s always going to be work around for doctors and with an ageing population, every person over the age of 50 needs a doctor,â&#x20AC;? Michael said. Karina, as a compensation lawyer, may have felt she was in the lionâ&#x20AC;&#x2122;s den. â&#x20AC;&#x153;I deal with people who have suffered catastrophic injury as a result of medical negligence. Now I know I have your attention! I have an important message: Apologising to someone does not mean admitting liability and often thatâ&#x20AC;&#x2122;s mostly what people want,â&#x20AC;? she emphasised. She added we might think negligence claims have skyrocketed but numbers were stable and legislative changes made it hard for

complainants to win. Generally, the courts were supportive of doctors. From the finance perspective John said the medical industryâ&#x20AC;&#x2122;s outlook was good, with the current shortage of doctors seen by marketing people as an upside. Doctors needed help to grow wealth. Mind you, some GPs present were critical of the poor remuneration for their intensity of work; others recognised that a strong commitment to patients could impact poorly on their home life. Panellist Michele said there were bigger issues than money. â&#x20AC;&#x153;There has been a deskilling of general practice and GPs are disrespected by medical specialists so GPs need to redesign the agenda and stop triaging for specialists. GPs have to seize the time for themselves.â&#x20AC;? Some GPs thought this an oversimplification and bureaucracy was strangling their work. So, why bother?

After the event, we decided to use the air in everyoneâ&#x20AC;&#x2122;s wings and asked some to complete this sentence. â&#x20AC;&#x153;Doctors can feel proud becauseâ&#x20AC;Śâ&#x20AC;?

QLeft; Dr George Crisp, Dr James Salvaris, Prof Kingsley Faulkner, Dr Fiona Sharp and Dr Geoff Mullins

Our training was rigorous for the responsibilities. UWA can take credit. But disease management of bureaucracy? Reinvest in general practice now and move into the urban landscape â&#x20AC;&#x201C; Dr Don Prendergast, Midland

QDr Michael Stanford and Mr John Boyle

QThe Panel in action. Right: Ms Karina Hafford makes her point.

QDr Scott Blackwell Ms Giz Watson

QDr Fatin Wadji and Dr Cathy Parsons

Doctors Drum sponsored by: 16

medicalforum


It So Good?' Midland GP Don Prendergast bemoaned the bureaucracy that resulted from â&#x20AC;&#x153;so-called health reformsâ&#x20AC;?. â&#x20AC;&#x153;If they all stopped tomorrow, we would still carry on just as before. We have to respond to public demand, but we need to be resourced better. And when it comes to chronic management, allied health is ripping us off.â&#x20AC;? A professor in the room, Prof Kingsley Faulkner, the Director of Clinical Teaching at Notre Dame University, raised the issue of UIFMBDLPGRVBMJUZUFBDIJOHTVHHFTUJOHUIBU while teaching shouldnâ&#x20AC;&#x2122;t be over-emphasised, it shouldnâ&#x20AC;&#x2122;t be overlooked either. Neale put in a plug for the Curtin University bid for a third medical school, saying demand for doctors was driving more doctor training CVUUIBUEPDUPSTXFSFOPUOFDFTTBSJMZSFRVJSFE to do all teaching. â&#x20AC;&#x153;Weâ&#x20AC;&#x2122;ve got to seriously look at inter-professional education. Itâ&#x20AC;&#x2122;s working in aged care where medical students

are supervised by other professions. Not all medical students have to operate in a surgical theatre.â&#x20AC;? This notion came too late for panellist Shelley Davies, who recounted her own recent experiences as a junior doctor and of students RVFVJOHPVUTJEFPQFSBUJOHUIFBUSFTIPQJOHUP be picked by the consultant surgeon. Michael added that the problems of supply and the financial situation were best solved collaboratively. â&#x20AC;&#x153;We need a coalition of people â&#x20AC;&#x201C; GPs, government, the colleges and the community â&#x20AC;&#x201C; to work on these problems. They are not intractable.â&#x20AC;? &WFSZPOFUIFOIFBEFEPGGGPSXPSL TPNFUIF wiser, all well fed and thought-provoked! O

WELCOME TO THE 21ST CENTURY! Dr Colin Hughes, from the Centrepoint Medical Centre in Midland, won the fabulous Doctors Drum Breakfast door prize of an iPad 2 donated by the Telstra Business Centre, Morley (contact Jasmine Lane, 9275 7451). Colin told Medical Forumâ&#x20AC;&#x2122;s Jenny Heyden (pictured with Colin) that the breakfast was a marvellous initiative, bringing together a well-balanced panel and doctors from different disciplines. â&#x20AC;&#x153;A special thanks to Telstra for donating the iPad and helping to bring at least one GP into the 21st century. It is much appreciated,â&#x20AC;? he said.

* Both companies were keen sponsors of the event.

QLeft: The Panel â&#x20AC;&#x201C; l to r, Dr Shelley Davies, Mr Russell Woolf, Ms Michele Kosky and Dr Neale Fong

QBelow: Dr Rob McEvoy, Dr Monica Lacey, Mr Siri Siriwardene, and Dr Rimi Roper

QDr Ryan Foo, Dr Don Prendergast and Dr Rohan Gay

They are still the only people to hold hospitals and our medical system together and despite financial, organisational, bureaucratic adversity, we still give a damn. â&#x20AC;&#x201C; Dr Harsha Chandraratna, Murdoch

QDr Lin Arias, Dr Angeline Barker, Ms Claire Turton, Dr Patrick Golden and Dr Harsha Chandraratna

They continue to assess, diagnose and treat patients regardless of the bureaucratic burden and the complaints about renumeration. Medicine and nursing are the most noble of human aspirations. â&#x20AC;&#x201C; Ms Michele Kosky, Nedlands medicalforum

Next Doctors Drum Breakfast! Friday, June 28 3FOEF[WPVT)PUFM $20 a head <RVBMJGJFTGPSBEPPSQSJ[F>

%0$5034 5)&$"3&'"$503

17


Feature

WA Ink â&#x20AC;&#x201C; a Booming Business Tattoos are no longer the sole province of sailors and bikies. They have become a fashion statement or a badge of belonging, but they can also be a health risk. The Consumer

Another friend had a small butterfly done on her ankle and it ended up looking like a dark splodge. That was a backyard job.â&#x20AC;?

A terrible family accident was the catalyst for Chloe Massarottoâ&#x20AC;&#x2122;s first visit to a tattooist when she was 20 yearsPME'PVSZFBSTBOEBRVJUFB few tattoos later, Chloeâ&#x20AC;&#x2122;s GP is faintly amused when she walks into the surgery for a vaccination.

â&#x20AC;&#x153;I donâ&#x20AC;&#x2122;t think Iâ&#x20AC;&#x2122;ll ever regret any of mine. Itâ&#x20AC;&#x2122;s not like Iâ&#x20AC;&#x2122;ve got any weird stuff and Iâ&#x20AC;&#x2122;d never get a boyfriendâ&#x20AC;&#x2122;s name tattooed anywhere.â&#x20AC;? Thereâ&#x20AC;&#x2122;s a generational aspect to permanently inked skin and even some younger doctors are stepping out in tattooed style. Within a professional environment discretion is sometimes SFRVJSFE

â&#x20AC;&#x153;In November 2009 my sister was hit by a drunk driver and spent six months in hospital. Sheâ&#x20AC;&#x2122;s in a XIFFMDIBJSOPX*IBEA1BUJFODF tattooed on the back of my neck because I needed a lot of it to deal with the whole thing. I just felt utterly helpless,â&#x20AC;? she said.

â&#x20AC;&#x153;Most of my tattoos are on the inside of my wrist so theyâ&#x20AC;&#x2122;re not that obvious. My manager is fine with them but I have had comments from other staff members who reckon theyâ&#x20AC;&#x2122;re inappropriate. Amongst my generation theyâ&#x20AC;&#x2122;re so common now.â&#x20AC;?

â&#x20AC;&#x153;I told my parents before I had the tattoo done. They werenâ&#x20AC;&#x2122;t too impressed at the time but theyâ&#x20AC;&#x2122;re OK now. And my GP thinks my TRVFBNJTIOFTTXJUIWBDDJOBUJPOT is rather amusing given that Iâ&#x20AC;&#x2122;ve got so many tattoos.â&#x20AC;?

The Tattooist John Paradisi has been wielding the tattoo gun professionally in Perth for more than 30 years. First there was the Subway Tattoo Company, then Living Art Tattoo and now the Black Quill. John regards himself as an artist.

There are many different stories behind a tattoo. â&#x20AC;&#x153;I know someone who got tattooed because he lost a bet,â&#x20AC;? added Chloe i)FTHPUA-FGUBOEA3JHIUJOLFE on his feet.â&#x20AC;? Chloe has three stars on her shoulder which is a sign of the Q Chloe Massarotto shows off her inking. bond between her two sisters. All three girls have the same tattoo albeit on different parts of their BTPOHBOEA$BSQF%JFNJTXSJUUFOPOUIF anatomy. Birds are a persistent theme for other side. Iâ&#x20AC;&#x2122;ve also got an ambigram [written Chloeâ&#x20AC;&#x2122;s living art, as is the written word. script read in two different ways] on my hip. â&#x20AC;&#x153;I have an owl on my thigh and small birds Tilt your head to the left, Beautiful, and tilt it on my wrist but most of my tattoos are words. the other way, Disaster.â&#x20AC;? Iâ&#x20AC;&#x2122;ve got Mum on one wrist and Dad on the Chloe says she thinks about it long and hard other, over my right ribs there are lyrics from before the ink hits the skin and adds that her tattooist came highly recommended and his fee would be the envy of some in the medical FACTS: Health Checks for Tatts profession. t 5BUUPP1BSMPVSTNVTUDPNQMZXJUIUIF8" )FBMUI"DUo4LJO1FOFUSBUJPO3FHVMBUJPOT   t 8IJMFUIFJOEVTUSZJTTFMGSFHVMBUFE MPDBM government environmental health officers EPTQPUDIFDLTBUMFBTUUXJDFBZFBS t 6TFGVMXFCTJUF XXXQVCMJDIFBMUIXBHPWBV search for tattoo

** See clinical update for the latest in tattoo removals, P45. ** See E-poll on p27

18

â&#x20AC;&#x153;A good operator isnâ&#x20AC;&#x2122;t cheap. The birds on my wrist cost $150 each and the price varies according to size and complexity. Some tattooists charge by the hour, anything between $100-$150/hr. I put a lot of thought into each tattoo and Iâ&#x20AC;&#x2122;ll often sit on it for anything up to a year before I make a decision.â&#x20AC;? â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;ve got a friend who hates the one sheâ&#x20AC;&#x2122;s got. She had her ex-boyfriendâ&#x20AC;&#x2122;s name tattooed on her hand and now sheâ&#x20AC;&#x2122;s getting married to someone else. Sheâ&#x20AC;&#x2122;s lucky really, because they do fade away on your hands and fingers.

â&#x20AC;&#x153;When someone comes through the door I take a good look at them. Iâ&#x20AC;&#x2122;m pretty reluctant to go ahead if they havenâ&#x20AC;&#x2122;t got a clear idea of the sort of thing theyâ&#x20AC;&#x2122;re after. We do get people walking in affected by drugs or alcohol and we just show them the door,â&#x20AC;? John said. There is a clearly displayed sign at Johnâ&#x20AC;&#x2122;s TUVEJPTUBUJOHA8FBDDFQUOPMJBCJMJUZGPSB tattoo obtained under false pretences.â&#x20AC;&#x2122; â&#x20AC;&#x153;The legal age for a tattoo in WA is 18 and we check that rigorously but we do have younger kids coming in with their parents. Usually theyâ&#x20AC;&#x2122;ve grown up in families that are wellversed in the industry so they know whatâ&#x20AC;&#x2122;s going on. Iâ&#x20AC;&#x2122;m always very cautious if people want tattoos in certain places, like on their neck or near the face.â&#x20AC;? Tattoo parlours in WA fall under the ambit PGUIF)FBMUI4LJO1FOFUSBUJPO3FHVMBUJPOT 1998. (see box left) These guidelines, available POUIF8")FBMUIXFCTJUFTFUPVUSFRVJSFE standards of infection control. Individual tattoo parlours are scrutinised BCPVUUXJDFBZFBSCZMPDBM&OWJSPONFOUBM Health Officers, with the Black Quill coming under the gaze of Perth City Council, to ensure minimum standards of infection control such as basic hygiene, disinfection medicalforum


BOETUFSJMJTBUJPOSFRVJSFNFOUTUPSFEVDFUIF spread of infectious diseases such as hepatitis B, C and HIV/AIDS. The website warns those considering going to amateurs or cheaper options overseas for tattoos that they place their health at risk. According to John, the demand for tattoos is booming, but he sounds a warning about Bali tattooing. â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;ve seen the industry grow from about six studios in the 1980s to more than 60 now. The standard varies enormously and we do see some Bali horror stories. In fact, we fix a lot of them up. They go over there, party hard and then rush off and get a tattoo.â&#x20AC;? â&#x20AC;&#x153;I try to give as much guidance as possible but my philosophy is that everyone gets the tattoo they deserve. I had one woman who wanted her vagina turned into a butterfly. Interestingly, she wanted me to do it for free. I told her to go somewhere else.â&#x20AC;? A skilled practitioner can resurrect a botched inking. The tattoo gun even has a place when it comes to hiding disfiguring marks. â&#x20AC;&#x153;Thereâ&#x20AC;&#x2122;s always something we can do with a tattoo thatâ&#x20AC;&#x2122;s gone horribly wrong. And Iâ&#x20AC;&#x2122;ve

Q Tattooist John Paradisi at work on an elaborate tattoo for client Claudette

had people come in with scars and burns but thatâ&#x20AC;&#x2122;s a different ball-game. It takes a lot of courage for them to walk through the door BOE*WFIFMQFERVJUFBGFXPWFSUIFZFBSTw

of females in the industry now, in fact itâ&#x20AC;&#x2122;d be about 50/50. My daughterâ&#x20AC;&#x2122;s coming back to work here now that her kids are getting to school-age.â&#x20AC;?

Thereâ&#x20AC;&#x2122;s no formal training or accreditation for a tattooing career. And, just like everywhere else, the girls are making their mark.

â&#x20AC;&#x153;One thing Iâ&#x20AC;&#x2122;d say to doctors is that if tattoos are done in a professional studio thereâ&#x20AC;&#x2122;s no chance of blood-borne diseases. I love my job and Iâ&#x20AC;&#x2122;ve made a good living out of it. Itâ&#x20AC;&#x2122;s fed my family for 30 years.â&#x20AC;? O

i"MMUIFUSBJOJOHJTEPOFJOIPVTF:PVXBUDI people sketching designs and learn from more experienced tattooists. There are a lot

By Mr Peter McClelland

Everything in your life will be going along smoothly. & then something unexpected happens. & thereâ&#x20AC;&#x2122;s a family drama, or you have to get your affairs in order. & now you need a good lawyer. & someone nearby you can trust. & so you call 1800 555 777 or visit slatergordon com.au.

& Proud Sponsors of the Doctors Drum Seminars.

Perth, Joondalup, Bunbury medicalforum

19


Guest Column

Inspiration from Tragedy When Mary Doe* discovered her husband had been sexually abusing their daughter, her fears and isolation prompted her to do something which has benefited her whole community.

I

canâ&#x20AC;&#x2122;t tell you, heâ&#x20AC;&#x2122;ll go to jailâ&#x20AC;?. These words, from the mouth of my distraught daughter one morning while driving up the highway after collecting her from school, will remain with me forever.

I had been called 20 minutes earlier by the TDIPPMQSJODJQBMSFRVFTUJOHUIBU*DPNFUP the school immediately to collect her as she had cut herself in front of other students. What not again! This was the fourth time in as many weeks, what was going on? We had talked, I had taken her to counselling, what the hell was the problem with my daughter? What wasnâ&#x20AC;&#x2122;t she telling me? We were just an ordinary middle-class family â&#x20AC;&#x201C; husband, wife, two kids, two dogs, a couple of guinea pigs, small farm, both working, kids at school. Then in September 2009, our lives (as we knew them) changed forever. During the months after my daughterâ&#x20AC;&#x2122;s disclosure and her fatherâ&#x20AC;&#x2122;s arrest for sexually abusing her, I remember having so many RVFTUJPOTJONZIFBE8IBU*SFBMMZOFFEFE to do was to talk with other mothers who had gone through similar circumstances.

How did they cope? How did their children cope? What happens in a court case? How do the other siblings that are not involved cope with losing their father? Questions only other parents could answer but client confidentiality prevented my counsellors from putting me in touch with them. Whoâ&#x20AC;&#x2122;s to say they would want to talk to me anyway? &JHIUFFONPOUITBGUFSNZEBVHIUFST disclosure, I established Albany Wolfpack in conjunction with the amazing Jo, a Child Counsellor at the Child Sexual Abuse Treatment Service at Anglicare WA. I felt a strong desire to create a local support group so that other parents wouldnâ&#x20AC;&#x2122;t feel that they were alone. I was overwhelmed by the number of sexual abuse cases here in Albany and thought, well if anything good was going to come out of our horrendous mess, let it be something that helps other people who may find themselves in the same situation. They can know they are not alone, and together, we can get through it.

Albany Wolfpack is for non-offending parents, family and carers of sexually abused children in and around the Albany area. We meet every second Thursday evening of the month at the Albany Anglicare offices. We have a small group that regularly attends, all with different stories, issues and problems and we can each offer a variety of real life experiences and advice. We usually start the first half of our meeting with a casual chat then Jo joins us, presenting new information or research or just taking RVFTUJPOTGSPNUIFHSPVQ Together we talk about problems we might be having and work to resolve them. Our goal is to promote the teaching of protective behaviours in schools. In my daughterâ&#x20AC;&#x2122;s case, had she known what was inappropriate and how to feel safe, her childhood would have been very different. Contact albanywolfpack@gmail.com ED: *Nom de Plume for legal reasons. O

Do you want a sea change, tree change or lifestyle change? Rural Health Select has vacancies from Albany to Broome and from Kalgoorlie to Carnarvon.

If you are looking for a change â&#x20AC;Ś â&#x20AC;Ś WEâ&#x20AC;&#x2122;LL FIND YOUR PERFECT FIT E recruit@ruralhealthwest.com.au T 08 6389 4500 W www.ruralhealthselect.com.au

20

medicalforum


Designed around you See your dream home brought to life before it’s built.

Every home starts with a foundation and every home design starts with an inspiration. At Domination Homes, our inspiration is you. It’s your vision that drives everything we do. We like to build homes that reflect the people who live in them. Whether it’s a custom designed home or a home from our designer range that’s personalised to your tastes, when you choose to build a Domination Home, you can be assured you’ll be getting a home that expresses your lifestyle. We can even take you on a virtual tour of your home before it’s built, so you can see your dream home brought to life. Come and sit down with us today so we can start designing your future.

Contact Marco DeCarolis Call 9262 7400 or 0419 378 662 marco@dominationhomes.com.au dominationhomes.com.au medicalforum

21


Feature

Eating Orders:Tough Love, Persistent Care Are we on the threshold of a binge of eating disorders? Patients are getting younger and resources are sadly deficient but there is some help at hand. Three Eating Disorder experts provide their insights. They all agree that current resources in Perth need to be improved, particularly for those patients over the age of 16. GPs are given the message that early detection is important, and to watch for the warning signs and keep asking questions but there is a catch – success in identifying cases may unearth more unmet need. A/Prof Sue Byrne is a clinical psychologist based at UWA and the Centre for Clinical Interventions (CCI) in Northbridge – a psychosocial QA/Prof Sue Byrne, research and psychologist training centre administered through the North Metropolitan Health Service. Acknowledging that GPs are on the frontline, she says she wants to help GPs to identify patients more easily and initiate early intervention. “GPs need to watch and listen for the signs. Any reported change in eating habits, irritability and a change in demeanour, excessive exercise or sudden disappearances to the toilet need to be explored further. :PVIBWFUPBTLRVFTUJPOT JUTOPUUIFTPSU of disorder where people will volunteer information. Anorexia nervosa is easier to pick up than bulimia because people are not likely to disclose bingeing and purging because they’re so ashamed of it,” Sue said.

“There’s a far better chance of recovery if we catch this disease before it’s gone too far down the track. It’s vital these young women, and nine out of 10 are female, are picked up as early as possible.” The reason GPs are such an important part PGUIFFRVBUJPOJTUIFQBVDJUZPGSFTPVSDFTJO Perth. i3FTPVSDFTGPSFBUJOHEJTDPSEFSTJO8"BSF hopeless, just ridiculous. There’s an excellent clinic at PMH, but for young people and adults we have one outpatient service in the public system. There’s a six-month waiting list to get into the CCI in Northbridge. If someone needs to be hospitalised and they’re over the age of 16 they have to go to a psychiatric ward of an adult hospital. In-patient programs are non-existent in Perth – it’s a total disaster!” “We run training programs and workshops for GPs at CCI, but they’re a pretty hard bunch to get to because they’re so busy. We try to work closely with GPs because of the medical complications associated with eating disorders.” She said the current diagnostic criteria are RVJUFTUSJDU GPSFYBNQMFUIFSJHJEEFMJOFBUJPO of a BMI of <17.5. The reality of eating disorders is a lot more complex than that. “The next diagnostic manual will reflect some of the newer developments. For example, binge-eating hasn’t been looked at carefully until recently and it wasn’t being diagnosed properly. There’s much more awareness that it’s a clinically significant disorder. For children and adolescents, there’s TUSPOHFWJEFODFUIBUBAUPVHIMPWFA[FSP tolerance’ developed at the Maudsley Centre in London works well. And there are some

E-Poll: Diagnosing eating disorders "SPVOEIBMGUIF(1TBOE4QFDJBMJTUTQPMMFETBJEUIFZGFMUQPPSMZTLJMMFEUPNBLFBEJBHOPTJT of a problem that patients mostly hide anyway. Most families are on the doctor’s side but BCPVUBUIJSEPGEPDUPSTGFFMDPNNVOJUZSFTPVSDFTBSFMBDLJOHGPSBMPOHUFSNQSPCMFNXJUIB strong mental health component. Only 3% said there were no barriers to diagnosis.

Q

What are the biggest barrier(s) to doctors diagnosing an eating disorder [multiple choice]?

1BUJFOUJTTLJMMFEJOIJEJOHUIFGBDU



%PDUPSMBDLTTLJMMTJOBTLJOHUIFSJHIURVFTUJPOT



The mental health nature of the problem



%PDUPSLOPXTUIFSFJTBMBDLPGUSFBUNFOUSFTPVSDFT PODFVODPWFSFE



The long term nature of the problem



Resistance from the patients' families



Other



/JMoOPCBSSJFSTUPEJBHOPTJT

3%

22

really interesting new developments at King’s College, also in London, focusing on neurocognitive treatments.” ED: UWA is currently seeking volunteers for the SWAN Study (Strong Without Anorexia Nervosa). Contact: Dr Karina Allen: treatmenttrial-psy@uwa.edu.au 6488 7428

QMs Kate Fleming, nutritionist

Ms Kate Fleming is a nutritionist who works closely with Prof Byrne and at the Hollywood Clinic. Kate underscores the cultural fixation on food and the importance of early intervention.

“Food has become central in all our lives. Chefs are the new rock stars! There’s a passionate interest in food and nutrition and, thanks to the internet, there’s a lot of both information and misinformation. For young people and adolescents there are strong social components linked with reward and gratification. It’s all part of our fast-paced life and food is only one part of that, but it’s a significant part,” Kate said. “There’s fairly overwhelming evidence that BAGBNJMZCBTFENPEFMPGUSFBUNFOUXPSLT well with patients under the age of 18. Family NFNCFSTBDU RVJUFMJUFSBMMZ BTDBSFSTBOE play a significant role in the recovery. It’s exhausting, because the average recovery time is between five and seven years. I have a male client who I’ve been seeing for eight years. &BSMZJOUFSWFOUJPOJTDSJUJDBMCVUJUEPFTMFBEUP better outcomes.” Diagnosis can be difficult and Kate encourages GPs to fully engage with their patients. “I think some GPs may be reluctant to acknowledge a client has an eating disorder. It’s an illness that you can’t always measure because the human body is highly adaptive to starvation. A person may look absolutely fine and still be very unwell. Test results may be RVJUFOPSNBMCVUUIBUEPFTOUNFBOUIFSFJTOU a problem.” “There’s an uncertainty surrounding it, we don’t entirely know how to treat it successfully and there can be a veering away from actually DPNJOHPVUBOETBZJOH AZPVEPIBWFBOPSFYJB and this is what we need to do’. Sometimes just letting the person know that there are support structures can be worthwhile.” medicalforum


QDr Sue Martin, General Practitioner

Dr Sue Martin is a Leederville GP with a postgraduate diploma in Primary Psychiatry. She also works closely with Sue Byrne at CCI and at WA Healthâ&#x20AC;&#x2122;s &BUJOH%JTPSEFST 3FTFBSDI$FOUSF

â&#x20AC;&#x153;I probably see a lot more eating disorders than most GPs. If youâ&#x20AC;&#x2122;re UBMLJOHBCPVUAEJTPSEFSFEFBUJOHoTLJQQJOH meals, over-eating and restricting intake â&#x20AC;&#x201C; it would be about 20% of my practice load. There are males too, particularly under the age of 25. A lot of psychiatrists send me their patients and, if a GP feels out of their depth with this illness, theyâ&#x20AC;&#x2122;ll refer people as well. We all feel confused and frustrated at times because itâ&#x20AC;&#x2122;s a very complex disease.â&#x20AC;? Adding to that frustration is the fact that some patients can go to extraordinary lengths to conceal their weight. â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;ve had patients who will drink lots of water before they come in to see me and others whoâ&#x20AC;&#x2122;ll hide weights underneath their clothing. :PVIBWFUPUSZBOEUSVTUUIFNCVUTPNFUJNFT they make that very difficult. Itâ&#x20AC;&#x2122;s important to develop a good rapport and there are times when you have to go a little more gently than their medical condition dictates.â&#x20AC;? â&#x20AC;&#x153;My advice to GPs is not to underestimate UIFWBMVFPGDIFDLJOHIFJHIUBOEXFJHIU:PV might be very surprised when you do a BMI! And for younger children, PMH has BMI charts that are very useful particularly when you track it over a few months.â&#x20AC;? â&#x20AC;&#x153;The important thing is to keep them coming back. Itâ&#x20AC;&#x2122;s the follow-up thatâ&#x20AC;&#x2122;s hard because when they lose weight theyâ&#x20AC;&#x2122;re happy. Itâ&#x20AC;&#x2122;s doubly hard for GPs when the patient is over the age of 18 due to the lack of back-up. *UTFJUIFSUIF&NFSHFODZ%FQBSUNFOUPSB psychiatrist and the latter can take months to get an appointment. Self-harm and suicide are real risks, in fact the death rate linked with anorexia is about 10%. And once their BMI drops below 16 their ability to think rationally is almost non-existent.â&#x20AC;? O

FACTS: Eating Disorder Resources CCI Northbridge: www.cci.health.wa.gov.au 1I PMH Eating Disorder Clinic: XXXQNIIFBMUIXBHPWBVTFSWJDFT eating_disorders 1I Hollywood Clinic: www.hollywood.ramsayhealth.com.au 1I Eating Disorders Report 2012: www.thebutterflyfoundation.org.au National Eating Disorders Collaboration www.nedc.com.au

Case Study:

â&#x20AC;&#x2DC;A Hungry Body is a Happy Bodyâ&#x20AC;&#x2122; Freedom was 15-year-old when she began trying to control her changing world by controlling what she ate. Dropping to a perilous 31kg, Freedom was in danger. Now a healthy 24-year-old woman she speaks candidly about her decline and recovery from the insidious, and sometimes fatal, Anorexia Nervosa. â&#x20AC;&#x153;This disease runs away with you, itâ&#x20AC;&#x2122;s all about control and then you become driven CZJU*UTBVOJRVFJMMOFTTBOEFBDIQFSTPO experiences it differently. Itâ&#x20AC;&#x2122;s so much a part of you that itâ&#x20AC;&#x2122;s difficult to separate from it and, at the time, I wouldnâ&#x20AC;&#x2122;t have known who I was without the disease.â&#x20AC;? â&#x20AC;&#x153;It began in 2003, just before my 15th birthday when Iâ&#x20AC;&#x2122;d just changed to a new school. I was coming in as an outsider JO:FBSBOEBMPUPGGSJFOETIJQTBOE DMJRVFTIBEBMSFBEZGPSNFE*UXBTB private, Anglican all-girls school where heterosexuality was the norm and I was only just coming to terms with my own sexuality. [Freedom is openly gay] My diary was stolen and read out to about half the year group. That was the trigger point.â&#x20AC;? â&#x20AC;&#x153;I had six months of self-harm and depression and then the eating disorder kicked in. I didnâ&#x20AC;&#x2122;t know how to change my behaviour and I made an effort to hide everything.â&#x20AC;? â&#x20AC;&#x153;I felt entirely out of control and, for me, controlling food was a way of regaining it. I had a regime combining excessive exercise and restricting food intake â&#x20AC;&#x201C; star jumps and sit-ups, sometimes more than 800 a day. I had a mental obsession with time-frames, periods when it was acceptable to exercise and eat. If I hadnâ&#x20AC;&#x2122;t eaten my lunch between 11.30am and 12.15pm then I wouldnâ&#x20AC;&#x2122;t allow myself to eat lunch. And Iâ&#x20AC;&#x2122;d make sure I was busy during that time, so then Iâ&#x20AC;&#x2122;d skip lunch.â&#x20AC;? â&#x20AC;&#x153;I did try to make myself vomit but couldnâ&#x20AC;&#x2122;t make it happen. Iâ&#x20AC;&#x2122;m glad because I think *EIBWFTQJSBMMFEEPXOWFSZRVJDLMZ*U wouldnâ&#x20AC;&#x2122;t have ended well.â&#x20AC;?

i.ZNPUUPXBTABIVOHSZCPEZJTBIBQQZ bodyâ&#x20AC;&#x2122;.â&#x20AC;? â&#x20AC;&#x153;In mid-2004, my GP sent me to a dietician and I think that was her way of trying to intervene without jeopardising our relationship. Iâ&#x20AC;&#x2122;d become a vegetarian and then a vegan and that made it easier to explain my weight loss. It was an ethically motivated decision, but it acted as a camouflage and it worked well.â&#x20AC;? â&#x20AC;&#x153;When I was at my thinnest I was 31kg. Food had become a complete and utter obsession and Iâ&#x20AC;&#x2122;d torture myself by reading recipe books. There was a well-known young woman with anorexia named Bronte Cullis. At one stage she dropped down to 38kg and I can remember being very pleased that I was thinner than sheâ&#x20AC;&#x2122;d been. Itâ&#x20AC;&#x2122;s a disturbing thing to look back and sometimes I feel ashamed that I put my parents through it all.â&#x20AC;? â&#x20AC;&#x153;In 2006 I had a light-bulb moment. Weâ&#x20AC;&#x2122;d moved to Perth and Iâ&#x20AC;&#x2122;d started university here and I started to thrive in that environment. The vegan diet helped because it gave me a more holistic view of eating and reminded me that food was actually OK.â&#x20AC;? â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;m a much stronger person now and I have a great relationship with my partner and my parents. I donâ&#x20AC;&#x2122;t think Iâ&#x20AC;&#x2122;ll ever have that acute weight loss again. Itâ&#x20AC;&#x2122;s an illness that leaves you with mental scars and thatâ&#x20AC;&#x2122;s not surprising because your brain has been conditioned into a highly damaging pattern of thinking, but I have coping mechanisms to deal with these issues now.â&#x20AC;?O

By Mr Peter McClelland

Top 25 Eating Disorder Blogs www.eatingdisorderhope.com

medicalforum

23


Feature

Turn Right for Medicine Three women explain their fascinating and varied journeys into medicine and the sacrifices they make to follow their dreams.

QDr Kim Badcoe, center, with daughters Lucy and Michelle.

Kim Badcoe, 53 Kim has been a customs investigation officer who has helped draft compensation legislation for the survivors of the Maralinga nuclear tests; a return to university saw her become a manager of software development in the State Government. So at 53 where else would she be than completing her second intern year as a junior doctor based at Joondalup? The irrepressible Kim was bubbling with excitement when Medical Forum caught up with her at Glengarry Hospital where she is doing a term of rehab and palliative care. She had received word that she had been accepted for GP training next year. â&#x20AC;&#x153;Itâ&#x20AC;&#x2122;s all turned out how I wanted,â&#x20AC;? she said. Studying medicine at any time of life is a hard gig but for the mother of three it meant giving up the security of a well-paid job to throw her growing family into the washing machine of a demanding university course. Add the breakdown of her marriage in her fifth year, and from the outside it looks like a costly decision, but Kim has no regrets. â&#x20AC;&#x153;Medicine wasnâ&#x20AC;&#x2122;t good for my relationship but overall it probably was an advantage. My kids are rapt â&#x20AC;&#x201C; they are so proud and supportive of me. My younger daughter is planning on being a doctor, my older EBVHIUFSJTUFBDIJOHEFTJHOBU5"'& and my son has just finished a degree in nanotechnology and business. They were all there at my graduation last year.â&#x20AC;? Medicine captured her imagination as a small girl when her father, Major Peter Badcoe, a distinguished veteran of the Vietnam War, gave her a book on field medicine in war zones. â&#x20AC;&#x153;I was fascinated by this book. I read it and reread it but then when I got to high school 24

I got distracted by friends them that Iâ&#x20AC;&#x2122;m only an intern. The upside and boys and didnâ&#x20AC;&#x2122;t study is that patients do listen more carefully to hard, so medicine wasnâ&#x20AC;&#x2122;t an what I say compared to the interns who option.â&#x20AC;? look about 16.â&#x20AC;? Kim is hoping to go into a coastal rural GP practice where she will get Life has taken her down to know her patients and their families and some fascinating roads but they get to know her. she was still searching for a path that would fulfil her. Lisa Mumford, 28 â&#x20AC;&#x153;I only feel happy when Lisa is a fourth-year medical student I am challenged. I was at UWA, a part-time policewoman and driving down Marmion mother to 12-month-old Riley. Avenue one day â&#x20AC;&#x201C; I was in my mid-40s â&#x20AC;&#x201C; and I heard Like Kim, Lisa had always wanted to do an advert on the radio medicine but didnâ&#x20AC;&#x2122;t get the grades at school for post-grad med and I so opted for the working life ending up UIPVHIU A*DPVMEEPUIBU working in the coronial section of the police It was insane, which, of service. But there was a moment several years course, everyone pointed out to me. I had no biological science, I was middle-aged with a pile of kids. I had to give up about a $1 million in salary to do it but I reckon itâ&#x20AC;&#x2122;s still a bargain. It was exactly the right thing to do.â&#x20AC;? Kim described her university course as insanely hard and intense but her children would help, testing her at night and she ploughed on. â&#x20AC;&#x153;The UWA staff were also really supportive. 5IFSFXPVMECFEBZTXIFO*KVTUTBJEA*DBOU do thisâ&#x20AC;&#x2122;. My pharmacology lecturer said, A&WFSZPOFBUUIFTUBSUPGUIFZFBSTBZTUIJT8F only had two people fail last year, the odds are you can do this. Just relax and take it one step at a timeâ&#x20AC;&#x2122;.â&#x20AC;? And her fellow students embraced her. â&#x20AC;&#x153;I was older than some of their mothers but I was invited to so many of their 21st birthday parties. As far as they were concerned I was just doing the same thing as them. Sometimes I felt as old as Methuselah spending all day with 22-year-old, slim, QLisa Mumford with son Riley. gorgeous women with flawless skin, but you get over that.â&#x20AC;? BHPXIFOTIFTUPQQFEBOEBTLFEIFSTFMGAXIZ Once Kim hit the hospital wards, the didnâ&#x20AC;&#x2122;t I do medicine?â&#x20AC;&#x2122;. enormity of a doctorâ&#x20AC;&#x2122;s life hit her. â&#x20AC;&#x153;I just stopped and thought, well thereâ&#x20AC;&#x2122;s i:PVKVTUDBOUUBLFZPVSFZFPGGUIFCBMMGPS nothing stopping me now, so I applied a second because you can hurt someone straight away to study part-time going into BOEUIBUTBSFBMMZGSJHIUFOJOHUIJOH:PVBSF science for 2½ years before being accepted surrounded by really supportive people but into medicine, working part-time as I go.â&#x20AC;? at the same time they are tired and stressed i&WFSZZFBSJUHFUTIBSEFS:PVUIJOLJUDBOU too and they donâ&#x20AC;&#x2122;t want you to keep making get any harder, but it does.â&#x20AC;? mistakes. I was a little OCD checking and Lisa is on maternity leave from the police rechecking. A couple of times Iâ&#x20AC;&#x2122;d go home service, so financially itâ&#x20AC;&#x2122;s tough on her and then come back in again to recheck.â&#x20AC;? and her husband but she says motherhood But there was a lighter side to her hospital has forced her to manage her time more experiences. efficiently and last year, with baby on her hip, â&#x20AC;&#x153;Most of the registrars and consultants are she achieved her best grades. younger than me and some patients just She is keen to return to a rural setting assume that the older person in the corner when her training is complete and is even scribbling notes is the doctor, so they ignore DPOUFNQMBUJOHBQQMZJOHGPSUIF3VSBM$MJOJDBM the consultant. I have to keep explaining to medicalforum


QElise Brigden during her Kimberley placement week.

School next year.

Elise Brigden, 32 Now a final year Notre Dame medical student, Elise, who hails from Sydney, was an electrical engineer in the Royal Australia Navy for 10 years before deciding on her career switch. Always a high achiever at school, she defied everyone’s assumptions that she’d go from high school into medicine or law. “I was more interested in doing something that was a bit more active and I wanted to challenge myself. I think I would have been wrong for medicine at that age. I wanted to join the navy to see the world!” And see it she did, doing tours of duty to the Persian Gulf and numerous trips to South&BTU"TJBBOEUIF1BDJGJDCVUBSPBEUSJQUP Toodyay with a car full of young doctors sowed the medicine seed. “They were talking generally about their lives JO&% BOBFTUIFUJDT BOEBCPVUUIFUIJOHT they were having trouble with. I’m a bit of a problem solver and my job was becoming more and more management and less engineering, so medicine sounded attractive.” Having passed with flying colours one of the most challenging of engineering courses, &MJTFTBZTNFEJDJOFUISPXTVQEJGGFSFOU difficulties. “I defy anyone to say that post-grad medicine is not challenging. It’s the volume that’s demanding rather than the concepts. :PVIBWFUPBNBTTTVDIBMBSHFWPMVNF of information each week and make the connections – that’s where it’s challenging.” 8IJMF&MJTFIBTZFUUPEFDJEFPOXIFSFIFS future doctoring will take her, she’s relishing the chance to have a case list. “Such a lot of what we do at the moment is learning focused because that’s what we’re here for, but I’m looking forward to being responsible for patient care. That’s been one of the huge changes of going back to study. In the navy I ran my department and made decisions but that’s not me just now.” O

By Ms Jan Hallam medicalforum

THE WAIT IS OVER - THE ALL-NEW SUBARU FORESTER HAS ARRIVED It's smarter and safer with new hi-tech luxurious interiors and advanced safety features – all combined with Subaru's legendary grip, balance and control to take you further.

FORESTER 2.5¡-S CVT. > > > >

Symmetrical All-Wheel Drive Premium Multi-Function Display Bluetooth®1 wireless technology Rear view reverse camera

> > > >

X-Mode EyeSightTM & satellite navigation Electric sunroof & leather seat trim2 Smart key & 18 inch alloy wheels

VISIT YOUR LOCAL SUBARU RETAILER TODAY OR VIEW THE FULL RANGE AT NEWFORESTER.COM.AU

1. Bluetooth® is a registered trademark of Bluetooth SIG Inc. System operation ability is subject to the Bluetooth® wireless SUB0329_XX_S_XXXX technology specification of individual’s phone. 2. Some parts of seating not full natural leather.

25


Hollywood Private Hospital Monash Avenue NEDLANDS WA 6009 Telephone: 08 9346 6000 www.hollywoodprivatehospital.com.au 26

medicalforum


E-Poll

Doctors Facing the Hard Questions &VUIBOBTJBBOEUIFEJMFNNBTJUQPTFT the medical profession always make headlines. In Medical Forum we are always canvassing the view of our readership and last month we posed in an FQPMMUIFTBNFRVFTUJPOXFBTLFEEPDUPST in July 2008 regarding professional support for legislation on voluntary euthanasia. Last edition 328 GPs and Specialists responded and it seems that while the number of doctors who donâ&#x20AC;&#x2122;t support euthanasia has remained almost the same, some of the undecided have migrated to the affirmative. O

Euthanasia

Q

Has a patient or relative every raised voluntary euthanasia as an acceptable option, in the course of your professional work? :FT



/P



6OEFDJEFE



Q

If legislation on voluntary euthanasia in WA could be drafted with suitable safeguards, do you think it would be supported by the medical profession? 



:FT





/P





6OTVSF





This month we polled readers on a wide range of issues for our womenâ&#x20AC;&#x2122;s edition, ranging from post-natal depression, sexual assault and the services available for victims and decriminalisation of the sex industry XJUIBRVFTUJPOPOUIFOFXGBTIJPO statement, tattoos. There were 197 GPs (Male 55%, Female 45%) who responded.

Sexual Assault

Q

If a patient confides in you that they have been sexually assaulted, do you feel confident in assisting that person gather evidence and make a complaint? :FT



/P



6ODFSUBJO



&%/PTJHOJGJDBOUEJGGFSFODFJO NBMFWTGFNBMFSFTQPOTFT

medicalforum

QEuthanasia featured in the recent state election.

Q

Did you know that the Sexual Assault Resource Centre (SARC) can offer any doctor phone advice 24 hours a day? :FT



/P



6ODFSUBJO



&%/PTJHOJGJDBOUEJGGFSFODFJO NBMFWTGFNBMFSFTQPOTFT

Postnatal Depression

Q

Which of these factors would you think play a major role in the development of postnatal depression in women [Choose 4 maximum]? 6ODFSUBJOUZBCPVUQBSFOUIPPE due to inadequate modelling from FYUFOEFEGBNJMZ



1SFFYJTUJOHQSPCMFNTJO relationship(s) with people who are close.



Realistic fears around the impending childâ&#x20AC;&#x2122;s living environment.



Emotional or physical isolation.



Past traumatic events that re-surface during or after pregnancy.



Traumatising intervention in childbirth, past or current pregnancy.



Other.



6ODFSUBJO

1%

/POFPGUIFBCPWF

1%

Tattoos and You

Q

Permanent tattoos have become more fashionable in Australia and some people consider them a mark of individuality. Some wear them openly and others privately. For whatever reason, have YOU been tattooed? :FT



/P



Prefer not to say



Q

You answered yes to the first question, so our follow-up question is â&#x20AC;Ś What best describes your current attitude to YOUR tattoo? /PSFHSFUT SFBMMZMJLFJU



1SFGFSUPLFFQJUCVUXJTIFEJUXBT done differently.

1

Would remove it if this was easily done.

1

.BLFTNFGFFMNPSFBUUSBDUJWFBOE personable.

1

)BUFJUoXBTBCBEEFDJTJPO

1

/POFPGUIFBCPWF



Other:



&%0OMZSFTQPOTFTUPUIJTRVFTUJPO TP BDUVBMOVNCFSTBSFHJWFO

27


Guest Column

Decriminalisation Is a Health Issue â&#x20AC;&#x153;Are you sure you want to keep being a doctor? You could catch something!â&#x20AC;? Former sex worker now Magenta educator Rebecca Davies says doctors ask similar questions of sex workers.

D

octors and Sex Workers â&#x20AC;&#x201C; weâ&#x20AC;&#x2122;re really not all that different. We both work with people in an intimate capacity; some of us work in practice with others and some of us work on our own for ourselves. Some of us have fields of specialty, some work on the street, some of us travel for work, some of us work long hours. The pay scale has similarities too, but we certainly aren't treated the same! *GZPVBSFXPSLJOHJOBO&NFSHFODZ Department, you could be exposed to a multitude of infections and BBVs, so you are taught how to minimise the risk of exposure. Sex workers are also taught how to minimise risk of exposure through peer education. The most recent research shows that sex workers in Australia have at least as low rates of STIs as the general population(1). In Perth, condom use at work approaches 100%, with similar results across Australia. It is also worth noting that these figures include migrant and FIFO (Fly In Fly Out) sex workers. Despite this, we are often treated by medical personnel as if we don't know how to look after ourselves, that we have not made a rational choice to be in the job or that we are incapable of deciding what is best for VT8FBSFBMTPBTLFEJSSFMFWBOURVFTUJPOT CBTFEVQPOTUFSFPUZQFTTVDIBTXFSFZPV TFYVBMMZBCVTFEBTBDIJME  iIPXNVDIBSF you paid?â&#x20AC;? or worse still, some doctors think

disclosure of our work is a good excuse to hit on us during a consultation. Communication between our professions is vital. So if I hear someone using words like AQSPTUJUVUFBOEAQSPTUJUVUJPOSBUIFSUIBO ATFYXPSLFSBOEATFYXPSL *BNVOMJLFMZ to disclose my sex work history and an opportunity is lost. The media is hot on the heels of FIFO sex workers and I am perplexed as to why. It's not news. Sex workers go where the work is. Insinuations that FIFO sex workers are responsible for a rise in STIs is not supported by research (2). Chances are youâ&#x20AC;&#x2122;ve met a sex worker and just don't know it. I worked in the WA sex industry for six years and was as much a part of the community as anyone else. I volunteered doing Meals on Wheels and helped out at the hospital canteen. I've been on the P&C at my daughterâ&#x20AC;&#x2122;s school. I've been a university student. Most people have no idea I was a sex worker. We are a diverse community, just as the medical profession, and like you, expect to be treated with respect and dignity. We are also mothers, daughters, sisters, brothers, fathers and sons. We want the decriminalisation of our industry, so we can enjoy the same human rights and work protections as everyone else. Decriminalisation is proven in practice to have the best health outcomes for both sex workers and the community, so this is as much a health issue as it is a human rights issue and as such should involve every doctor(3,4)

References 1 Donovan, B., et al. (2012). The Sex Industry in New South Wales: a Report to the NSW Ministry of Health. Sydney: Kirby Institute, University of NSW. 2 Donovan, B., et al. (2010). The Sex Industry in Western Australia: a Report to the Western Australian Government. Sydney: National Centre in HIV Epidemiology and Clinical Research, University of NSW. 3 Bellamy, P. (2012). Prostitution law reform in New Zealand, Parliamentary Library Research Paper. 4 Ministry of Justice, (2008), Report of the Prostitution Law Review Committee on the operation of the Prostitution Law Reform Act 2003. O

E-Poll: Doctors on Decriminalisation

Q

Do you believe decriminalisation of the sex industry would improve health outcomes for sex workers?

:FT



/P



6ODFSUBJO



&%/PTJHOJGJDBOUEJGGFSFODFCFUXFFONBMF BOEGFNBMFSFTQPOTFT

Q

What about those in the community who use sex worker services?

:FT



/P



6ODFSUBJO



&%5IFSFXBTOPTJHOJGJDBOUEJGGFSFODF CFUXFFONBMFBOEGFNBMFSFQPOTFTPOUIF A:FTBMUIPVHINPSFXPNFOGBWPVSFEUIF A6ODFSUBJOSFTQPOTF  PWFSUIFA/P SFTQPOTF  DPNQBSFEUPNFO

Dr Ross Agnello Tel: 9448 9955 Dr Malcolm Burvill Tel: 9275 2522 Dr Ian Chan Tel: 9388 1828 Dr Steve Colley Tel: 9385 6665 Dr Dru Daniels Tel: 9381 3409 Dr Blasco Dâ&#x20AC;&#x2122;Souza Tel: 9258 5999 Dr Graham Furness Tel: 9440 4033

EYE SURGERY FOUNDATION

Dr Annette Gebauer Tel: 9386 9922

0VS7JTJPO*T*NQSPWFE7JTJPO

Dr Boon Ham Tel: 9474 1411

Dr David Greer Tel: 9481 1916 Dr Philip House Tel: 9316 2156 Dr Brad Johnson Tel: 9301 0060

Expert Day Surgery for t$BUBSBDU&YUSBDUJPOBOE-FOT*NQMBOU t1UFSZHJVN t(MBVDPNB t0DVMPQMBTUJD4VSHFSZ t4USBCJTNVT t$PSOFBM5SBOTQMBOU

Tel: 9216 7900 28

Dr Jane Khan Tel: 9385 6665 t" MMUZQFTPG3FGSBDUJWF4VSHFSZ LASIK, LASEK, PRK, CTK, Phakic Lens and Refractive Lens Exchange (RLE)

Dr Ross Littlewood Tel: 9374 0620 Certified to ISO 9001 Standard

Dr Nigel Morlet Tel: 9385 6665 Dr Robert Patrick Tel: 9300 9600 Dr Jo Richards Tel: 9321 5996

Supporting Ophthalmic Teaching and Research

E: info@eyesurgeryfoundation.com.au 42 ORD STREET WEST PERTH WA 6005

Dr Stuart Ross Tel: 9250 7702 Dr Angus Turner Tel: 9381 0802 Dr Michael Wertheim Tel: 9312 6033

medicalforum


Low Dose CT It should be the norm. It is with us. Itâ&#x20AC;&#x2122;s available at every one of our 15 comprehensive sites; every scan, every time. You can put your patientsâ&#x20AC;&#x2122; minds at rest when you refer them to Perth Radiological Clinic.

www.perthradclinic.com.au medicalforum

Leaders in Medical Imaging Caring for Western Australians for 65 years 29


MOTE Medicine on the Edge

Medicine on the Edge ȨČ?ČŁÉ?ɤǸȾȨÉ&#x153;É´ 4Č&#x2021;ɨČ?Č˝É&#x153;ɤÉ&#x2018;Č?É&#x2022; Medicine On The Edge (MOTE) believes that you learn best when both your mind and body are stimulated. Our courses and medical conferences are designed to take you to the edge of knowledge and to the edge of adventure. We promise to deliver high quality education in a fun and stimulating environment. Our courses will be totally interactive and will combine practical hands-on sessions with case discussions, evidence based reviews, networking opportunities and plenty of chances to ask questions. Upcoming meetings: Â&#x2021; Â&#x2021; Â&#x2021; Â&#x2021; Â&#x2021; Â&#x2021; Â&#x2021;

0DFKX

3LFFKX

Adventures in Medicine - Cycling in Italy Altitude and Expedition Medicine - Hiking the Incas and Salcantay Case Studies in Emergency Medicine 1 - Cycling in France Case Studies in Emergency Medicine 2 - Picos de Europa, Spain Marine Medicine - Resort Latitude Zero, Telo Islands Sumatra Medicine and Extremes of Temperatures - Skiing in Japan Annual Update in Altitude and Expedition Medicine - Mt Kilimanjaro

QFH

&\FOLQJLQ)UD

DWUD

6XUĂ&#x20AC;QJLQ6XP

LQ

D URSD6S

(X 3LFRVGH

6NLLQJ

LQ-DS

DQ

0W.LOLPDQMDUR

geoffr@medicine-on-the-edge.com.au www.mote.net.au Tel: +61 400 005 668 30

medicalforum me ed diica alfo or ru um


Guest Column

Showing â&#x20AC;&#x2DC;Love and Fairnessâ&#x20AC;&#x2122; For 15 years Mr Antoine Bloemen was circuit magistrate in the North-West and found different ways to serve justice while administering the law.

A

t the outset I would like to make it very clear that I am not writing as an expert or specialist. My views are based on 15 years of living and working with Aboriginal people in the Pilbara and Kimberley as the local Magistrate. In 1995, when I was sent to the North-West, my circuit JODMVEFE,BSSBUIB 3PFCPVSOF  Newman and Marble Bar. After being there for a while I opened a court in Nullagine. In travelling around the Pilbara and Kimberley I was shocked and dismayed at QMagistrate Antoine Bloemen with two elders in the the living conditions of local Kalumburu community court. Aboriginal people. Many of those appearing before me were for a broken leg when the malnourished and had little idea of personal only course is to set it and hygiene. Instead of a decent meal, many lived put it in a cast. on soft drinks, junk food and alcohol. The Pilbara and Kimberley I decided that if I was going to spend some have few criminals but years of my life in the North-West, I would many alcoholics. Over do my utmost to help Aboriginal people. consumption of alcohol QAntoine, Bishop of the Kimberley Christopher Saunders and then District Court The children who appeared before me were was and is one of the main Judge Peter Blaxell with four wardens and children at the presentation and often in poor health, suffered from foetal reasons why so many people blessing of the 30 bicycles at the Wirrrimanu/Balgo community in 2000. The alcohol syndrome and had limited literacy appear in court, not all of wardens rule was "no school, no bike". The bikes were donated by the legal and and numeracy skills. It made me sad to see so them Aboriginal. The curbs medical communities. many human beings living in such neglected POMJRVPSPVUMFUIPVSTIBWF conditions in a country like Australia. would tell them that I would deal with them helped curtail sights such as with love and fairness, but in return they would occur at places like Halls Creek where Most of the people I met were good of heart must give me and the court the same respect large groups of people from the desert would and very courteous, but I could see that and courtesy. Surprisingly, in every case, they wait hours for 10am opening. most had lost their dignity, self-confidence would come to attention and show respect. It and pride. There I was, a magistrate These changes have largely come about clearly indicates that if you show respect and administering the Common Law system in through the efforts of local community demand respect, people will react positively. a very different culture with its own Law. groups spearheaded by women elders. While most people spoke several Aboriginal In 2008 I retired as Magistrate in the Pilbara I have formed a close relationship with MBOHVBHFT UIFJS&OHMJTIXBTMJNJUFE*ODPVSU BOEUIF,JNCFSMFZ XIJDIBU TRLN  many Aboriginal people in the Pilbara they would call me â&#x20AC;&#x153;bossâ&#x20AC;? which I hated. I was, in my time, the largest judicial circuit and Kimberley over the years. Most are would say I am not your boss; I'm a normal JOUIFXPSME*UJTOPXEJWJEFEJOUPUIF&BTU fine people. Many do not want to consume human being doing my job. and West Kimberly with a Magistrate in excess alcohol, but have no support or Kununurra and in Broome. I glance back When I sat in one of the six remote FODPVSBHFNFOUGSPNBOZPOFUPTUPQ&WFO at my time with a good feeling but admit communities, I invited several respected men after successfully completing a program at that I donâ&#x20AC;&#x2122;t know if I have made any lasting and women elders to sit with me. Before court one of the drug and alcohol rehabilitation DIBOHFT5IBURVFTUJPO*MFBWFGPSPUIFSTUP started we would have an informal talk about centres, the lack of personal support, public decide, but I gave the people all I could. In community issues or things that they thought transport and work possibilities make it return, I have met and had the help of many I should know. During court I would ask difficult not to return to old habits. wonderful people, especially my wife, Anne, their advice in relation to the young people's However, alcoholism is hardest on the who has stood by me all the way. O family, upbringing and their thoughts on children. Many have no food, no care, no sentencing options. ED: Antoine Bloemen continues to live and love, no discipline, no consistent parenting work in the Kimberley. He is a member of There is no juvenile detention in the Northand have been on their own from a very the Kimberley Training Institute Governing West so many sentences could not be early age. So why are we surprised that the Council and an independent director of implemented because of placement options Childrenâ&#x20AC;&#x2122;s Court list is so long? the Nyamba-Buru Yawuru, Ltd Aboriginal and supervision. So I always sought advice In my experience, what most children are corporation. from the elders and, in most cases, followed seeking is love and positive attention. Often, it. Why give an impractical sentence? It when appearing in court, they would hang would be like a doctor prescribing medicine onto their chair when asked to stand up. I medicalforum

31


Confidence that lasts Approved for up to 5 years continuous use with over 99% contraceptive efficacy1

Start a conversation... MIRENA® Minimum Product Information Mirena®, levonorgestrel 52 mg, intrauterine drug delivery system. Indications: Contraception, idiopathic menorrhagia and prevention of endometrial hyperplasia during oestrogen replacement therapy. Contraindications: Known/suspected pregnancy; current or recurrent pelvic inflammatory disease; lower genital tract infection; postpartum endometritis; infected abortion during the past three months; cervicitis; cervical dysplasia; uterine or cervical malignancy; progestogen-dependent tumours; undiagnosed abnormal uterine bleeding; congenital or acquired uterine anomaly including fibroids if they distort the uterine cavity; conditions associated with increased infection susceptibility; acute liver disease/ tumour; hypersensitivity to the constituents. Precautions: migraine; exceptionally severe headache; jaundice; marked increase in blood pressure; severe arterial disease; young nulligravid women; post-menopausal women with advanced uterine atrophy; thrombosis; breast cancer; congenital or valvular heart disease; diabetes; pelvic infections; expulsion; uterine perforation; ectopic pregnancy; sexually transmitted diseases; lost threads; delayed follicular atresia. Adverse effects: headache; abdominal/pelvic pain; changes in menstrual bleeding; vulvovaginitis; genital discharge; depressed mood; depression; nervousness; decreased libido; migraine; nausea; acne; hirsutism; back pain; upper genital tract infection; ovarian cyst; dysmenorrhoea; breast tenderness/pain; intrauterine contraceptive device expelled (partial and complete); weight increased; uterine perforation. Others: refer to full Product Information. Interactions: CYP450 inducers e.g. anticonvulsants & anti-infectives. Dosage & administration: Initial release rate 20 microgram levonorgestrel per 24 hours. Mirena has an in-situ life of 5 years; Inserted into the uterine cavity by trained healthcare professional. Minimum Product Information last updated 7 June 2012. References: 1. Approved Product Information.

Please review product information before prescribing. Full product information is available from Bayer Australia Ltd. PBS dispensed price $266.32. ABN 22 000 138 714, 875 Pacific Highway, Pymble NSW 2073. Registered Trademark of Bayer AG, Germany. L.AU.WH.12.2011.0209

PBS Information: Restricted Benefit. Contraception. Idiopathic menorrhagia where oral therapies are ineffective or contraindicated. 32

medicalforum


Guest Column

Working the System After three years, Mr Kim Snowball has prematurely left the director-generalâ&#x20AC;&#x2122;s office. Here he looks back at the highlights and the challenges ahead.

M

y reason for working in the health sector has always been to improve health outcomes. Thatâ&#x20AC;&#x2122;s not a 12-month project or even a term-of government plan, itâ&#x20AC;&#x2122;s a culture. When you focus on that, issues come into sharp relief. Aboriginal health is very obviously one of those issues. Itâ&#x20AC;&#x2122;s impossible to stand by while Aboriginal people suffer from diseases which have been eradicated to a large extent for the rest of the population. WA Health and Close the Gap have made probably the biggest investment of health funds, effort and resources into Aboriginal health outcomes, but most importantly itâ&#x20AC;&#x2122;s been a collaboration with Aboriginal people and organisations. Thatâ&#x20AC;&#x2122;s been an enormous shift in thinking. When I came into the role, the relationship between the department and Treasury and the Government was difficult and put a dark cloud over what we were trying to do as a health system. One of my first jobs was to stabilise the financial position and to forge

a new relationship with Government that focused on activity and delivery. Government needed to know what they were getting for taxpayersâ&#x20AC;&#x2122; money. We had UPEFNPOTUSBUFUIJOHTMJLFIPXNBOZ&% presentations were being made and at what MFWFMPGRVBMJUZ*UXBTHPPEGPSFWFSZPOF Not only did the Government know what it was buying and investing in, it gave us an opportunity to hold people accountable in our hospitals and health service. We could TBZAXFOFFEZPVUPEFMJWFSNPSFFMFDUJWF surgery and within the boundaries of acceptable clinical waiting timesâ&#x20AC;&#x2122;. Things like the 4-hour rule helped drive that. That was probably the biggest change in our hospitals in my term. I had the great joy of seeing figures from the Australia Institute of Health and Welfare which put WA Hospitals way ahead of the rest of the country. The credit for that goes to all our staff â&#x20AC;&#x201C; our doctors, nurses, support workers â&#x20AC;&#x201C; XIPIBWFDPNCJOFEUPTBZ AZFTXFEPOFFEUP DIBOHFIPXPVS&%TBOEIPTQJUBMTPQFSBUFUP improve our performances.â&#x20AC;&#x2122;

Other future challenges will be workforce related. The system is employing more medical and allied staff than the national average but we are way off the mark in general practice. We are going to have to have a radical growth in GPs to keep pace with the rapid population growth. And itâ&#x20AC;&#x2122;s not just a RVFTUJPOPGOVNCFST JUTBCPVUXIFSFUIFZ are needed to work. General practice is a federal responsibility but we must take an interest because we are a system, regardless of who funds what part. If general practice is not working, other parts of the system have to pick that up. My very loud message is that general practice is a priority for this State â&#x20AC;Ś thatâ&#x20AC;&#x2122;s where we should be concentrating our effort. There are other specialist priorities in WA but GP numbers stand out. As I head out the door, one of the things Iâ&#x20AC;&#x2122;m most proud of is that I leave a health system which thinks and behaves like a health system and that can respond to the challenges ahead. O

â&#x20AC;&#x153;Unplanned pregnancy & family planning servicesâ&#x20AC;? Our experienced Dr Marieâ&#x201E;˘ team provides caring and non-judgemental support and services.

Increase your patientsâ&#x20AC;&#x2122; sense of security

Surgical & medical abortion on

Our Silver Chain Alarm comes with a small water resistant pendant that is worn around the neck, so that help is always just the press of a button away.

Contraceptive inserts STI checks Vasectomy

We also have a fall detector for your patients that are prone to falls and for those situations where they may not have time to press the pendant.

Decision-based counselling g DR0194

24 hour aftercare Part of the Marie Stopes International global partnership Model pictured for illustrative purposes only

8 Sayer Street Midland WA 6056 www.drmarie.org.au

Referrals and enquiries freecall 1800 003 707 medicalforum

Our experienced operators will answer your patientâ&#x20AC;&#x2122;s call 24/7, determine the appropriate response and will stay on the line until help arrives. To find out more call us on 1300 557 551 or visit silverchain.org.au/alarms

SC0556

33


Put your patient’s heart

in our hands

Integrated Cardiology and Radiology Every scan read by an accredited specialist Dual source CT – faster, sharper and purpose built Preferred provider for many of WA’s leading Cardiologists Low dose radiation – every patient every time

178 Cambridge Street Wembley tel: 6382 3888 fax: 6382 3800

envisionmi.com.au 34

CT

w

MRI

w

X-RAY

w

ULTRASOUND

w

NUCMED

w

DENTAL medicalforum


IT In Practice

AMAâ&#x20AC;&#x2122;s GP Desktop Practice Support Toolkit The federal AMA launched its GP Desktop Practice Support Toolkit MBTUZFBS'PSNFNCFS(1TXIPIBWFBMPHJOJUSFRVJSFTBCSPXTFS and creation of a desktop shortcut that links you to a variety of documents or websites presented to you as hyperlinks listed in an &YDFMTQSFBETIFFU1SPUFDUJPOPGUIFTIBSFE&YDFMEPDVNFOUNFBOT you cannot customise the spreadsheet for your use and the indexing system takes some getting used to. Most importantly, there is no search GVODUJPOUIBUXPVMEMJOLZPVRVJDLMZUPBEPDVNFOUUJUMF

PIVET MEDICAL CENTRE Specialists in Reproductive Medicine & Gynaecological Services

Gynae News

by Medical Director Dr John Yovich

Day-case Hysterectomy â&#x20AC;Ś whatever next !? IVF in humans began with a â&#x20AC;&#x2DC;marriageâ&#x20AC;&#x2122; between reproductive scientist Robert Edwards (now Nobel Laureate) and the British pioneer of laparoscopic surgery, gynaecologist Patrick Steptoe. When I travelled to the UK in 1976, I â&#x20AC;&#x2DC;shadowedâ&#x20AC;&#x2122; these men to learn their respective crafts.

During our test drive, when the AMA said it had placed the Academy of Science booklet about vaccination on the Toolkit site, we went MPPLJOH&WFOUVBMMZ XFGPVOEUIFIZQFSMJOLCZUSBDLJOHi3FGFSFODF Materialâ&#x20AC;? which was only on the home page, then â&#x20AC;&#x153;Factsheetsâ&#x20AC;? as a TVCIFBEJOHPOUIFOFYUQBHF UIFi*OGPSNBUJPO0UIFS3FTPVSDFTw page according to the tag at the bottom of the spreadsheet) where the document was listed under its name The Science of Immunisation: Questions and Answers. Clicking on the hyperlink downloaded (slowly) the 18mb high resolution version of the pdf document, when a much smaller 1mb version was available from www.science.org.au. There are tabs that allow State-specific documents to be listed (e.g. Advance Care Directive Form for WA). All hyperlinks connect back to the original source document, such as on the WA Health website but many of these downloads are pdfs and there is no back button in your browser that will take you to the homepage of the parent website. If you know how to fiddle with the url in the browser window, you can get there. The secret to navigation in this spreadsheet format is to use the tabs at the bottom as much as you can, although be aware not all the subheadings on the first index page are presented as tabs. O

(BUF )PMMZXPPE1SJWBUF)PTQJUBM .POBTI"WFOVF /FEMBOET8" .BJM10#PY #SPBEXBZ /FEMBOET)FBMUIMJOLDPDQFSUI T: 6424 8596 '9389 1770 W: www.circleofcare.org.au We may have outgrown our Circle of Care logo, but we are still building on ZFBSTPGFYQFSJFODFXJUIXFJHIUDPOUSPMTVSHFSZJODMVEJOH Adjustable Gastric Banding and Sleeve Gastrectomy, our multidisciplinary team is founded on the basis that maintaining a healthy weight requires attention to what we eat, how we eat, why we eat, and IPXNVDIFYFSDJTFXFEP Jeff Hamdorf and Sue Taylor have gathered surgeons, primary care QIZTJDJBOT EJFUJUJBOT QTZDIPMPHJTUTBOEFYFSDJTFQIZTJPMPHJTUTVOEFSPOF banner to provide the best outcomes, not just the most weight loss.

medicalforum

Laparoscopy was introduced to KEMH in 1971 where I learnt the WHFKQLTXHVGHVFULEHGE\6WHSWRH²Ă&#x20AC;UVWO\GLDJQRVWLFODS G\H then lap steri and later follicle aspiration for IVF, extending to WXEDOWUDQVIHUVRIJDPHWHV *,)7 DQGHPEU\RV 35267 7(67  then more advanced procedures such as ventro-suspension and reversal of sterilisation. Many techniques were pioneered at PIVET and published. The progression of laparoscopic surgery to myomectomies, full excisional surgery for endometriosis and hysterectomy started around 1990-1 at PIVET but as a relatively quiet advance, in the shadow of the IVF revolution. None-the-less, it is now more prominent as advances in instrumentation enable slick, speedy and uncomplicated surgery. Advanced uterine manipulators have become inexpensive and disposable (e.g. the V-care device) and these, combined with improved bi-polar electrocautery systems, barbed V-lock sutures, high-powered electronic morsellation devices and intra-mural pitressin, means the vast majority of gynae cases can be conducted without blood loss as day-cases. We have OHDUQWWRSUHVHUYHWKHSHOYLFĂ RRUDWWDFKPHQWVDQGWKHVH are completely undisturbed in those having the Supraloop technique. Surgical skills take a long period to perfect, made much easier with smart young anaesthetists in support. I have taught my laparoscopic skills to two PIVET gynaecologists, Ă&#x20AC;UVWO\3KLOLS5RZODQGVDQGQRZ*D\DWUL%RUXGHZKRDUHWDNLQJ the techniques to a higher level. We work together on the more complex cases. Hysterectomies are now 1 hour per case, home the very next morning (although same evening requests are common), and return-to-work is as soon as 10 days. We are amazed. An impressive evolution!!

0RUVHOODWHGZHHNĂ&#x20AC;EURLGXWHUXVDIWHU6XSUDORRS +\VWHUHFWRP\PLQXWHSURFHGXUHDVGD\FDVH ZLWKUHWXUQWRZRUNWHDFKLQJDWGD\V

*\QDHFRORJLVW DGYDQFHG ODSDURVFRSLF VXUJHRQ3KLOLS 5RZODQGV

NOW AT 3 LOCATIONS LEEDERVILLE, JOONDALUP & BUNBURY

For ALL appts/queries: T:9422 5400 F: 9382 4576 E: info@pivet.com.au W: www.pivet.com.au

35


New YAZ Flex is just a â&#x20AC;&#x2DC;Clykâ&#x201E;˘â&#x20AC;&#x2DC; away ÂŽ

1

Take one pill

Take 2 pills. You missed 1 pill and are 4 hours late taking 2nd pill

Use additional contraception

You are on day 1 of your 4â&#x20AC;&#x201C;day break

REMINDS... them to take their pill on time with a visual and audible alarm. 2

ALERTS AND ADVISES... them what to do if 1 or more pills are missed. 2

INFORMS... them when additional contraception due to missed pills is required. 2

GUIDES... them through their personal F\FOHVDQGGD\EUHDN 2

References: 1. YAZÂŽ Flex Approved Product Information, April 2012. 2. Clykâ&#x201E;˘ Instructions for Use, April 2012. YAZÂŽ Flex Minimum Product Information: 3 mg drospirenone, 20 mcg ethinyloestradiol. Indications: Use as an oral contraceptive. Treatment of moderate acne vulgaris in women who seek oral contraception. Contraindications: Presence or a history of venous or arterial thrombotic/thromboembolic events (e.g. deep venous thrombosis, pulmonary embolism, myocardial infarction) or of a cerebrovascular accident, prodromi of a thrombosis (e.g. transient ischaemic attack, angina pectoris), diabetes mellitus with vascular involvement, severe hepatic disease (as long as liver function values have not returned to normal), liver tumours (benign or malignant), malignant conditions of the genital organs or the breasts (if VH[VWHURLGLQĂ&#x20AC;XHQFHG PLJUDLQH ZLWKIRFDOQHXURORJLFDOV\PSWRPV SDQFUHDWLWLV RUDKLVWRU\WKHUHRILIDVVRFLDWHGZLWKVHYHUHK\SHUWULJO\FHULGHPLD XQGLDJQRVHGYDJLQDOEOHHGLQJ VHYHUHUHQDOLQVXIÂżFLHQF\RUDFXWHUHQDOIDLOXUHNQRZQRUVXVSHFWHGSUHJQDQF\ &DWHJRU\% DQGK\SHUVHQVLWLYLW\WRDQ\RIWKHLQJUHGLHQWVFRQWDLQHGLQ<$=)OH[Precautions: Circulatory disorders, age, smoking, obesity, family history of VTE or DVT, dyslipoproteinaemia, prolonged immobilisation, surgery, neoplasms, chloasma, hypertension, migraine, GHSUHVVLRQYDOYXODUKHDUWGLVHDVHDWULDOÂżEULOODWLRQ2WKHUVUHIHUWRIXOOSURGXFWLQIRUPDWLRQInteractions: HIV protease inhibitors, non-nucleoside reverse transcriptase inhibitors, DQWLFRQYXOVDQWVDQWLELRWLFVDQWLIXQJDOVDQG6W-RKQÂśV:RUW2WKHUVUHIHUWRIXOOSURGXFWLQIRUPDWLRQAdverse Effects: Nausea, depression, depressive mood, headache (including PLJUDLQH EUHDVWSDLQPHWURUUKDJLDDPHQRUUKRHDXQVFKHGXOHGXWHULQHJHQLWDOWUDFWEOHHGLQJHPRWLRQDOODELOLW\97(2WKHUVUHIHUWRIXOOSURGXFWLQIRUPDWLRQDosage: YAZ Flex is an extended cycle oral contraceptive and can only be used in combination with a dedicated CLYK tablet dispenser. CLYK is a tablet dispenser designed to support the user to follow the <$=)OH[UHJLPHQ7KHLQVWUXFWLRQVIRUXVHSURYLGHGZLWK&/<.VKRXOGEHUHDGFDUHIXOO\EHIRUHDQGGXULQJXVH2QFHWKHGLVSHQVHUSDFNFRQWDLQLQJWKH<$=)OH[WDEOHWVDUHLQVHUWHG into CLYK, follow the prompts displayed on the screen to take YAZ Flex. Tablet taking is continuous. Date of approved TGA Product Information: Last updated 23 January 2013.

PBS Information: This product is not listed on the PBS. Please review Product Information before prescribing. Full Product Information is available on request from Bayer Australia Limited. %D\HU$XVWUDOLD/LPLWHG$%13DFLÂżF+LJKZD\3\PEOH16:Â&#x160;5HJLVWHUHGWUDGHPDUNRIWKH%D\HU*URXS*HUPDQ\/$8:+ 36

medicalforum


BENEATH the Drapes X Dr David Russell-Weisz will be acting Director-General of Health after Mr Kim Snowball departed from the post last month. %S3VTTFMM8FJT[XJMMBDUJOUIFQPTJUJPOVOUJM"QSJM)FDPOUJOVFT BT$&0PGUIF'JPOB4UBOMFZ)PTQJUBMDPNNJTTJPOJOHQSPKFDU X Dr Shane Kelly XIPIBTCFFO$&0PG4+0()4VCJBDPGPSUIF QBTUFJHIUZFBST IBTCFFOBQQPJOUFE$&0PGUIF/PSUI.FUSPQPMJUBO Health Service. X Dr Paul Mark, formerly Area Director of Medical Services for South Metropolitan Health Service, has been appointed Director of Clinical Services at Fiona Stanley Hospital.

 6ROXWLRQ3URYLGHUVIRU *HQHUDO3UDFWLFH 

H3,3&RPSOLDQW &RPSDWLEOH 'LVSHQVHG$Q\ZKHUH

X Dr Hannah Seymour DPOTVMUBOUHFSJBUSJDJBOBU31) JTUIFGJSTU Clinical Commissioning Lead at Fiona Stanley Hospital. X Bethesda Hospital has won the 2012/13 Asia Pacific Hand )ZHJFOF&YDFMMFODF"XBSE)PTQJUBMSFQSFTFOUBUJWFTXJMMUSBWFM to Shanghai this month to receive the award and showcase their infection control initiatives at the International Congress of the Asia Pacific Society of Infection Control. X Mr Jason Loveridge has been appointed a non-executive director PG3FTPOBODF)FBMUI X Ms Stacey Boyne QSFWJPVTMZ.BSLFUJOH134+0(4VCJBDP has moved to Diabetes WA. Catriona McNee previously at SJOG Murdoch moves to SJOG Subiaco. X News of the death of former Qantas chief Mr James Strong hit Pain Australia heavily. Mr Strong was the inaugural chairman of the organisation. He was aged 68. X Former facilities manager at Healthscope in Victoria, Mr Andrew Bond, has been appointed Director of Corporate Services and Hospital Development at the St John of God Midland Public and Private Hospitals. X Specialist Pathologist Professor Vince Caruso was recently awarded an Order of Australia Medal (OAM) in the General Division for service to Medicine in the field of Pathology. An awards ceremony will be held at Government House this month. X Ms Pam Lewis IBTSFTJHOFEBT&YFDVUJWF%JSFDUPSPG)PTQJUBM and Health Services at Mercy Hospital and Ms Elaine Pavlos has replaced her. ED. Pam is now consulting privately part time.

Practice Tips Empower Staff to Perform %PZPVTPNFUJNFTGFFMZPVSFOPUHFUUJOHZPVSTUBGGUPXPSLUPUIFJSGVMM QPUFOUJBM 5IBUZPVKVTULOPXUIFZSFDBQBCMFPGNPSF CVUZPVEPOU LOPXIPXUPHFUUIFNUPSFBMJTFUIFJSGVMMDBQBCJMJUJFT :PVDBOHFUNPSFGSPNZPVSTUBGGCZHJWJOHUIFNQFSNJTTJPOUPNBLF NJTUBLFT8FBMMMFBSOUISPVHIPVSNJTUBLFTBOEXPSLJTXIFSFNBLJOH NJTUBLFTTIPVMECFBOFTTFOUJBMQBSUPGBMFBSOJOHFOWJSPONFOU.BLF ZPVSXPSLQMBDFBiTBGFwQMBDFGPSNJTUBLFToUFBDIZPVSFNQMPZFF IPXUPGJYIJTIFSPXONJTUBLFTSBUIFSUIBOEJWJOHJOBOEGJYJOHUIFN ZPVSTFMG5IJTXJMMOPUPOMZFNQPXFSZPVSFNQMPZFFUPGJYGVUVSF NJTUBLFT CVUBMTPUPTIBSFUIFLOPXMFEHFXJUIPUIFSTUBGGNFNCFST &ODPVSBHFBOFYDIBOHFPGJEFBTCFUXFFOTUBGGNFNCFSToXIBUJT a problem for one may have already be solved by another. Permitting an open forum in which everyoneâ&#x20AC;&#x2122;s ideas are heard and considered empowers people to share their thoughts and leaves them feeling valued by the employer. "XPSLQMBDFJOXIJDIBOFNQMPZFFJTWBMVFEBOEOFWFSNBEFUPGFFM UIFZIBWFNBEFBiTUVQJENJTUBLFwXJMMTPPOIBWFUIFCFTUQFSGPSNJOH FNQMPZFFTXPSLJOHUPUIFJSGVMMQPUFOUJBM

medicalforum

'RQÂśWGHOD\VLJQRQDQGLQVWDOO

0HGL6HFXUHÂ&#x160;WRTXDOLI\IRUWKHH3,3SD\PHQW ZZZPHGLVHFXUHFRPDX 6&5,376 ,WQRORQJHUPDWWHUVZKLFKHOHFWURQLFVFULSWVHUYLFH WKHSKDUPDFLVWXVHV0HGL6HFXUHÂ&#x160;SUHVFULSWLRQV DUHDEOHEHVFDQQHGLQHYHU\H3UHVFULSWLRQHQDEOHG SKDUPDF\LQ$XVWUDOLD 0RUHFRPSDWDEOHZRUNLQJFOLQLFDOV\VWHPV %HVW3UDFWLFH*HQLH=HGPHG0HGWHFK0RQHW 0HGLQHW3URÂżOHDQG0' ,IZRUULHGDERXWH3,3ZHFDQKHOS\RXFRQYHUWWR DQRWKHUVXLWDEOHFOLQLFDOV\VWHP 0HGL6HFXUHÂ&#x160;ZLOOQRWVORZ\RXGRZQ

 &RQJUDWXODWLRQV %DOODMXUD)DPLO\3UDFWLFH 'DONHLWK0HGLFDO&HQWUH .LDUD)DPLO\3UDFWLFH 4XLQQV0LQGDULH6XSHUFOLQLF 6WLUN0HGLFDO*URXS

&RQJUDWXODWLRQVWRWKHVH:$SUDFWLFHVRQWKHLU VXFFHVVIXOFRQYHUVLRQIURP3UDFWL[WR%HVW 3UDFWLFH7KH\DOOFRQWLQXHWRSURYLGH RXWVWDQGLQJSDWLHQWFDUHDQGHQKDQFHG VHUYLFHVWKURXJKHKHDOWK

 9LFNL:HVWRQ  :$/RFDO 6XSSRUW 6HUYLFH  %RRNIRULQVWDOODWLRQ &DOO

6&5,376  37


Qlaira®... the first and only oestradiol OC Pill indicated for heavy menstrual bleeding * 1

*For treatment of heavy and/or prolonged menstrual bleeding in women without organic pathology who desire oral contraception.1

MINIMUM PRODUCT INFORMATION QLAIRA® oestradiol valerate / dienogest. INDICATIONS: Oral contraception. Treatment of heavy and/or prolonged menstrual bleeding in women without organic pathology who desire oral contraception. DOSAGE AND ADMINISTRATION: One tablet daily. CONTRAINDICATIONS: Presence or history of venous or arterial thrombotic/thromboembolic events (e.g. deep venous thrombosis, pulmonary embolism, myocardial infarction), cerebrovascular accident, prodromi of thrombosis (e.g. transient ischaemic attack, angina pectoris); presence of severe or multiple risk factor(s) for venous or arterial thrombosis; history of migraine with focal neurological symptoms; diabetes mellitus with vascular involvement; pancreatitis or a history thereof if associated with severe hypertriglyceridemia; severe hepatic disease as long as liver function values have not returned to normal; presence or history of liver tumours (benign or malignant); known or suspected sex-steroid influenced malignancies (e.g. of genital organs or breasts); undiagnosed vaginal bleeding; known or suspected pregnancy; hypersensitivity to active substances or excipients. PRECAUTIONS: Circulatory disorders; risk of venous or arterial thrombotic/thromboembolic events; diabetes mellitus; systemic lupus erythematosus; haemolytic uremic syndrome; chronic inflammatory bowel disease (Crohn’s disease, ulcerative colitis); sickle cell disease; migraine; hypertriglyceridaemia; pancreatitis; hypertension; jaundice and/or pruritus related cholestasis; gallstone; porphyria; Sydenham’s chorea; herpes gestationis; otosclerosis-related hearing loss; angioedema; liver function disturbance; chloasma; galactose intolerance, Lapp lactase deficiency, glucose-galactose malabsorption; bleeding irregularities; pregnancy, lactation. INTERACTIONS: Medicines that induce microsomal enzymes (e.g. cytochrome P450 enzymes), phenytoin, barbiturates, primidone, carbamazepine, rifampicin, oxcarbazepine, topiramate, felbamate, griseofulvin, St. John’s wort (hypericum perforatum), HIV protease (e.g. ritonavir), nevirapine, antibiotics (e.g. penicillins, tetracyclines), CYP3A4 inhibitors (e.g. azole antifungals, ketoconazole, cimetidine, verapamil, macrolides, diltiazem, antidepressants, grapefruit juice, erythromycin), lamotrigine. ADVERSE EFFECTS: Headache, migraine, abdominal pain, nausea, acne, amenorrhea, breast discomfort, dysmenorrhoea, intracyclic bleeding (metrorrhagia), genital discharge, menorrhagia, uterine/vaginal bleeding, spotting, weight increased, blood pressure changes, vulvovaginal mycotic infection, emotional disorder, insomnia, libido decreased, mood changes, liver enzyme increased, fatigue. DATE OF TGA APPROVED PRODUCT INFORMATION: 10 November 2010.

Before prescribing please review full Product Information available on request from Bayer Australia Ltd, ABN 22 000 138 714, 875 Pacific Highway, Pymble, NSW 2073. ® Registered Trademark of Bayer Group, Germany L.AU.WH.11.2011.0192.

PBS Information: This product is not listed on the PBS 38

medicalforum


Guest Column

Postnatal Depression By Dr Beate Harrison, Perinatal and Infant Psychiatrist, Clinical Director Raphael Centre Murdoch. Tel 6226 9455

P

ostnatal depression often starts in pregnancy yet late diagnosis of the disorder is common. This leads to poorer social, emotional and cognitive outcomes for the mother and infant. Clinical acumen and the use of simple validated screening tools during the antenatal and postnatal periods are important to prevent this.

New mothers at risk During the transition to parenthood and after childbirth, psychological distress and difficulties are common. Biological, hormonal, identity and relationship changes and challenges confer increased risk for mental health disorders. While women are more prone to depression than men throughout their lives, a significant peak of first episodes occurs after childbirth. Up to 15% of new mothers meet criteria for postnatal depression. Late presentation of depression is still an issue, despite campaigns such as Beyond Blue increasing awareness and reducing stigma, thus promoting help-seeking in this patient group.

Interventions by professionals 3FHVMBSDPOUBDUXJUIQSJNBSZDBSF  obstetric and paediatric health services offers early intervention opportunities. Many obstetricians now screen early with well-validated and simple screening UPPMTTVDIBTUIF&EJOCVSHI1PTUOBUBM %FQSFTTJPO4DBMF &1%4 UIBUDBOBMTPCF used in the antenatal period. 0OMJOFUSBJOJOHGPSUIF&%14GPS(1TJT offered through the Beyond Blue website, allowing easy and valid administration in a primary care setting. A range of other psychosocial screening tools are also available.

Are Your Financials Up-To-Date? Real Profit Business Solutions Can Provide Full Bookkeeping Services To Your Business! General bookkeeping using MYOB Payroll, superannuation, filing, GST & BAS MYOB training and consulting for you and your staff Complete MYOB installation including MYOB Point of Sale Only half the rate of your accountant We donâ&#x20AC;&#x2122;t charge for travel time within the Perth metro area

Patterns and their significance Antenatal onset of symptoms is common; around 40% of cases having onset during pregnancy. During the postnatal period, it usually takes six months to diagnose depression, with a significant proportion of cases still unrecognised during the first year of the babyâ&#x20AC;&#x2122;s life. Chronic untreated symptoms bring a worse prognosis for the mother and compromise her relationship with her infant, with less responsive interactions as a result of the poor self-esteem, confidence and withdrawal seen during depression. Cognitive and emotional issues can result for the infant in the longer term. Around 15% of fathers can also develop postnatal depression. This co-existence of paternal and maternal mental health issues lengthens parental symptoms and lessens support for the infant. Good clinical assessment is central to diagnosis of postnatal depression and should consider these risk factors: t BQSFWJPVTIJTUPSZPGEFQSFTTJPO FTQ postnatal onset or as part of Bipolar Affective Disorder ) t BNFEJDBMMZDPNQMJDBUFEQSFHOBODZ or delivery, t QSFNBUVSJUZPSNFEJDBMDPNQMJDBUJPOT in the infant, t TPDJBMEJTBEWBOUBHF BOE t BIJTUPSZPGDIJMEIPPEUSBVNBPSGBNJMZ dysfunction. medicalforum

3FGFSSBMUPBTQFDJBMJTFEQFSJOBUBMBOEJOGBOU service can offer the mother, infant and family a range of outpatient treatments. Individual psychotherapy, cognitive and behavioural therapy and interpersonal therapy are all effective in the perinatal period. Infant-parent and parenting therapy are useful to support relationship difficulties that might arise. Careful use of medication during pregnancy or while breastfeeding recognises that untreated mental illness has a range of adverse obstetric and developmental outcomes; tertiary maternity hospitals have up-to-date information on current evidence and safety. O Web Resources Beyond Blue EPDS Training www.beyondblue.com.au Perinatal Psychotropic Medicine Information Service www.ppmis.org.au

Call us at Real Profit Business Solutions

9315 1177 www.realprofit.com.au www.realprofit.com.au admin@realprofit.com.au

Suite 15, 20 Kearns Crescent, Applecross

Personal Protection Cover for Medical Doctors Guaranteed agreed value income protection offer up to $10,000 per month for medical doctors and specialists of $15,000 per month who have graduated in the last 3 years. No ďŹ nancial evidence is required to support these levels. This insurance offer is from leading insurers Asteron and TAL with both having a built in blood borne disease lump sum beneďŹ t.

For enquiries please contact Peter Allen Authorised Representative of LifeSpan Financial Planning Pty Ltd AFSL 229892

(08) 9321 7273 Email: peter@peterallenassoc.com.au

For all doctors other types of risk insurance offered include life and total and permanent disablement cover, business expenses cover and trauma cover.

Peter W. Allen & Associates F i n a n c i a l

A d v i s o r s

I have over 30 years experience of implementing the right statergy and structure in the advice process. The material provided in this advertisement is provided for information only and constitutes general ďŹ nancial product advice. It does not take into account your personel ďŹ nancial situation, objectives and needs. Consequently before taking action on the information contained in this advertisement you should consider its appropriateness to your ďŹ nancial situation objectives and needs.

39


FIRST-IN-CLASS TREATMENT FOR WOMEN WITH POSTMENOPAUSAL OSTEOPOROSIS 1,2

CONFIDENCE IN EFFICACY DELIVERED AND FRACTURE PROTECTION FOR PMO PATIENTS

2,3

A FORCE AGAINST FRACTURE

in postmenopausal osteoporosis 2 References: 1. Lewiecki EM, Womenâ&#x20AC;&#x2122;s Health 2009; 5(1): 15â&#x20AC;&#x201C;22. 2. ProliaÂŽ (denosumab) Approved Product Information www.amgen.com.au/Prolia.PI 3. Cummings SR et al. N Engl J Med 2009; 361: 756â&#x20AC;&#x201C;765.

Supported by Amgen in collaboration with GSK

PLEASE REVIEW FULL PRODUCT INFORMATION BEFORE PRESCRIBING.

PBS Information: Authority required (STREAMLINED) as treatment for postmenopausal osteoporosis. Refer to PBS Schedule for full information. Product Information is available via ProliaÂŽ Medical Information 1800 646 998 or www.amgen.com.au/Prolia.PI For information on ProliaÂŽ or to report an adverse event involving ProliaÂŽ, please contact ProliaÂŽ Medical Information on 1800 646 998. MINIMUM PRODUCT INFORMATION â&#x20AC;&#x201C; INDICATION: Treatment of osteoporosis in postmenopausal women to reduce risk of vertebral, non-vertebral and hip fractures. CONTRAINDICATIONS: Hypocalcaemia. Hypersensitivity to denosumab, CHO-derived proteins or any component. PRECAUTIONS: Correct hypocalcaemia prior to initiating therapy. Monitor calcium in patients predisposed to hypocalcaemia. Adequate intake of calcium and Vitamin D is important. ADVERSE EFFECTS: Hypocalcaemia, skin infections (predominantly cellulitis), pancreatitis, rarely jaw osteonecrosis, #very rarely atypical femoral fractures. DOSAGE AND ADMINISTRATION: Single subcutaneous injection of 60 mg, once every 6 months. Ensure adequate intake of calcium and vitamin D. No dose adjustment required in the elderly or in renal impairment. PRESENTATION: Pre-filled syringe with automatic needle guard.

#

Please note changes in product information.

$PJHQ$XVWUDOLD$%11RUWK5\GH16:3KZZZDPJHQFRPDXĂŹ*OD[R6PLWK.OLQH$%10HOERXUQH9,&ZZZJVNFRPDX 40 '0%$86$0*0DUFKĂŹ$0

medicalforum


In Practice

Aged Care Views Dr Ken Cullen is finding it hard to retire gracefully. Except for the paperwork, he enjoys the two aged care facilities he looks after. What trends has he noticed over 40 years? â&#x20AC;&#x153;Facilities have evolved from big old homes to purpose-built hotel-like accommodation with physios, OTs, visiting speech pathologists, dieticians, podiatrists, opticians, etc. Despite all this, there are still unhappy residents and families. The demands on carers are high and people going into aged care are a lot sicker than they were,â&#x20AC;? he said. i8IFO*GJSTUTUBSUFEBUUIF34-DPNQMFY UIFSFXFSFBMPUPGPME veterans with only simple medical problems who couldnâ&#x20AC;&#x2122;t manage on their own â&#x20AC;&#x201C; almost like a boarding house where people could still get on a bus and go out.â&#x20AC;? /PUBOZNPSF)FDBOCFBUIJTCFE34-BHFEDBSFGBDJMJUZ "$'  in Menora from 8am until 5pm â&#x20AC;&#x201C; a long trying day he admits but mentions spending extra time with patients and talking to relatives. â&#x20AC;&#x153;I look at medications I can cut out because I get sick of writing prescriptions and you often wonder if you are doing more harm than good â&#x20AC;&#x201C; but I donâ&#x20AC;&#x2122;t have any particular philosophy. I am guided by family wishes â&#x20AC;&#x201C; that might mean full-on care or, in many cases, just keep comfortable.â&#x20AC;? â&#x20AC;&#x153;I donâ&#x20AC;&#x2122;t get involved in the politics of it all but just do the job. Iâ&#x20AC;&#x2122;ve always felt that regular visiting would help. Mental health provides a wonderful service with visiting psychiatrists but a geriatrician to provide management advice and at the same time educate me, would be great.â&#x20AC;? His wish list to stay in the game is less paperwork, relevant CPD, help with issues around medications, perhaps a specialist to come in and do some things, and nursing staff who can be relied on. He wondered how many people are sent off in an ambulance from an aged care facility because they couldnâ&#x20AC;&#x2122;t get a GP to go there. While the hard-to-get locum and Silver Chain offer some services, often informal arrangements between the GP and experienced nurses allow things to be started prior to the doctorâ&#x20AC;&#x2122;s visit. Then again, he suspects an available GP might only stop half the hospital visits that follow falls in the elderly. Two new things might interest Ken. The first is an attempt to cut down on ACF scripts. Legislation is coming this year to allow a standard Medication Chart in ACFs, a system already trialled interstate in August as the National Residential Medication Chart /3.$ CZUIF"VTUSBMJBO$PNNJTTJPOPO4BGFUZ and Quality in Health Care. The chart is to be used to authorise supply BOEDMBJNJOHPG1#431#4ESVHTGPSQBUJFOUTJO"$'ToOPXSJUUFO TDSJQUJTSFRVJSFE FYDFQU"VUIPSJUZTDSJQUTBOETDIFEVMFEESVHT 4FF XXXDQBDPNBVBOEXXXTBGFUZBOERVBMJUZHPWBV Dr Kathleen Potter (March edition Medical Forum) now has funding to extend her research nationally from WA, having safely reduced medications by 40% in her initial trial of ACF patients, with the assistance of their GP and a co-researcher geriatrician. O

By Dr Rob McEvoy

You can now prescribe exercise! As part of our commitment to health of Western Australia the team at Obesity Surgery WA, is now offering exercise programmes at no cost. To enrol, we need a referral to our practice for exercise. Everyone gets a health review to check their suitability and will get a personal plan or get to join one of our group sessions. The service is open to anyone who needs a little help to get fitter, even if they are not considering surgery. < Mr Harsha Chandraratna Surgeon Jo Climo > Clinical Nurse & Exercise Co-ordinator

Obesity Surgery WA (08) 9332 0066 SUBIACO

medicalforum

MURDOCH 41


Consider

to reduce her worry about contraception for up to 3 years. IMPLANON NXT is highly effective because it does not rely on daily dosing1

PBS Information: IMPLANON NXT is listed on the PBS as a contraceptive. IMPLANON NXT® 68 mg etonogestrel Indication: Contraception (removed and replaced every three years to ensure continued contraceptive efficacy). Contraindications: Active thromboembolic disorders; known or suspected sex steroid sensitive malignancies; presence or history of severe hepatic disease as long as liver function values have not returned to normal; presence or history of liver tumours (benign or malignant)*; known or suspected carcinomas of the breast; undiagnosed vaginal bleeding; known or suspected pregnancy; hypersensitivity to any of the ingredients of Implanon NXT. Precautions (refer to full PI): A medical history/examination prior to insertion and replacement, especially breasts, gynaecological. Exclude pregnancy before use. Review blood pressure at three months. Medical check-ups at least once per year during use. Liver dysfunction; thromboembolism (risk/history); diabetes; hypertension; hyperlipidemia*; heavier women (see full PI); lactation; chloasma. Changes in menstrual bleeding pattern. Interactions: Hepatic enzyme inducers e.g. phenytoin, barbiturates, primidone, bosentan*, carbamazepine, rifampicin, oxycarbazepine, rifabutin, topiramate, felbamate, ritonavir, nelfinavir, nevirapine, efavirenz*, griseofulvin, St John’s Wort. Others: cyclosporin; lamotrigine; ketoconazole. Adverse effects: headache; acne; breast pain; weight increase; others see full PI. Dosage: One implant at a time is inserted subdermally and should be removed and replaced every three years for ongoing contraceptive efficacy. Based on PI amended 27 August 2012.

*Please note changes in Product Information References: 1. Implanon NXT Approved Product Information 27 August 2012.

BEFORE PRESCRIBING PLEASE REVIEW PRODUCT INFORMATION AVAILABLE FROM MSD ON 1800 818 553. Copyright © 2013 MSD Oss B.V., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. All rights reserved. Merck Sharp & Dohme(Australia) Pty Limited. Level 4, 66 Waterloo Road, North Ryde NSW 2113. WOMN-1048479-0045. First issued February 2013. PLAN5769 BBK 02/13 42

medicalforum


CLINICAL UPDATE

Will she blame you if she gets flu? S

Dr Donna Mak, Public Health Physician, Communicable Disease Control Directorate, Department of Health

he might well do, if you didnâ&#x20AC;&#x2122;t recommend flu vaccine as a routine part of antenatal care during the flu vaccination season (15 March to June/July).

In 2012, the World Health Organizationâ&#x20AC;&#x2122;s 4USBUFHJD"EWJTPSZ(SPVQPG&YQFSUT 4"(&  on Immunisation recommended pregnant women as the most important risk group for seasonal influenza vaccination because of all the risk groups, pregnant women are the most likely to benefit.1 The Australian Government BOEUIF3PZBM"VTUSBMJBOBOE/FX;FBMBOE College of Obstetricians and Gynaecologists 3"/;$0($PMMFHF4UBUFNFOU$0CT  also recommend that all pregnant women be offered vaccination against influenza. )PXFWFS MFTTUIBOPOFRVBSUFS  PG pregnant women in WA were vaccinated against flu in 2012 â&#x20AC;&#x201C; a much lower uptake p than that achieved in the elderly (68%) and adults with chronic conditions (31%).2 Why? The single most important reason is that flu vaccine is not routinely recommended or offered by antenatal care providers.

Of over 400 randomly-selected women who delivered in WA in 2012, only 36% were advised by their antenatal care provider to IBWFGMVWBDDJOFBOEBRVBSUFSXFSFPGGFSFE flu vaccination at the clinic where they attended for antenatal care. Women who attended a GP or private obstetrician for most of their antenatal care were more likely to have been vaccinated than those attending public antenatal clinics. How can we improve coverage? 'PSUVOBUFMZ MFTTUIBOBRVBSUFSPGXPNFO surveyed doubted the safety and efficacy of flu vaccine for themself and their baby, and UISFFRVBSUFSTTBJEUIBUUIFZXPVMEBDDFQU vaccination if it was recommended by their antenatal care provider.

So, during the flu vaccination season (15 March to June/July), we need to: t 3PVUJOFMZSFDPNNFOEGMVWBDDJOFUP  pregnant women, and t 0GGFSWBDDJOBUJPOBUUIFUJNFPG antenatal care. References 1. WHO. Strategic Advisory Group of Experts (SAGE) on Immunization Statement, April 2012. www.who.int/ influenza/vaccines/SAGE_information/en/index.html 2. Taksdal SE, Mak D, Joyce S, Tomlin S, Carcione D, Armstrong P, Effler P. Influenza vaccination uptake in pregnant women in Western Australia. Communicable Disease Control Conference. 19-20 March 2013, Canberra, Australia. O

Medical Forum E-Poll *O"QSJM (1TSFTQPOEFEUPUIFRVFTUJPOBCPVUGMVWBDDJOBUJPOJOQSFHOBODZXJUI 52% responding correctly that it is safe any time regardless of gestational age. We asked the TBNFRVFTUJPOUIJTNPOUIBOEEPDUPSTSFTQPOEFE5IJTZFBS BTMJHIUMZIJHIFSQSPQPSUJPO (58%) identified the correct answer

Q

When is it recommended to give influenza vaccine to a pregnant woman? (select one response)

3FTQPOTF 1. Never â&#x20AC;&#x201C; it is contraindicated in pregnancy 2. First trimester 3. Second or third trimesters 4. At any time during influenza season as long as the vaccine supply lasts and regardless of gestational age 5. Uncertain

April 2012 (n=92) 9% 2% 22%

April 2013 (n=197) 4% 7% 18%

52%

58%

14%

13%

Immunise Debate Response Scientists have upped the ante when it comes to capturing the minds of the public in the childhood immunisation stakes. The Science of Immunisation: Questions and Answers, produced by the Australian Academy of Science and endorsed by the College of Physicians and the federal AMA presents counter-arguments to current myths gaining airplay. Doctors can download a pdf version or order handout copies for patients who want to know the current situation in immunisation science, including where there medicalforum

is consensus in the scientific community and where uncertainties exist (see www.science. org.au/policy/immunisation.html. Orders of three copies or less are free). Some people of renown have put their names to the product, such as Prof Tony Basten AO, Ian Frazer AC and Sir Gus /PTTBM"0$#&*UTBCPPLMFUUPIBOEUP conscientious objectors to vaccinations, if no one else, to detail the safety and efficacy of immunisation. The overall aim is to keep Australiaâ&#x20AC;&#x2122;s immunisation rates high. O 43


44

medicalforum


CLINICAL UPDATE

Tattoos and their removal I

made the mistake once of slagging off in company those who had tattoos, only to have both of my acquaintances lift their sleeves to reveal their own ink. Middle-class tattoos are becoming the norm now. It's our culture of individuality; we want to be part of the tribe too. It doesn't seem to matter if it's Maori tribal art, or koi swimming in a Japanese pond, or a butterfly representing your dead aunt. They are everywhere. In fact, nearly 30% of youngsters in Australia have tattoos and the trend is rising, particularly in women.

By Dr David Main, South Perth. Tel 9368 6888

This includes the young doctors although it still seems to hold true that those being UBUUPPFEBSFNPSFAFEHZh JGUIJTNFBOTB higher likelihood of smoking tobacco, pot and having more sex(1). After getting a tattoo, people feel sexier and more interesting, and report higher self-esteem(2). It's by no means new. They have dug up cavemen with tattoos. The Brits were inking their family coats of arms before Hadrian, now it's their football teams. The Japanese had a three strike policy for tattoos: one crime and you got a horizontal mark, a second crime and you got a curve, and the UIJSEUJNFUIFGJOJTIFEBSUXPSLSFBEAEPHh This association with being a crook lives on but that probably represents the old school, with jailbirds and gang members.

Tattoo removal Putting tattoos on is big business, and removing them is getting that way too, as up to 50% regret the choice (3). Grown up, got a job, and the tramp stamp is no longer in. Before lasers, removing tattoos was hit and miss. Mostly miss. Tattoo pigment lies within EFSNBMGJCSPCMBTUT NPTUMZBUUIF%&KVODUJPO but extending deeper into the dermis with time. It takes a lot of getting out. Grafting, excision, dermabrasion, or physical or chemical ablation were tried. Strangely, we are now seeing lots of scarred tattoos from tannic acid injections and the like marketed under names like Tatt2Away. Intense pulsed light (IPL), likewise cannot safely remove tattoos.

Laser tattoo removal Q-switched lasers are the gold standard for tattoo removal. Q-switching produces very short pulse widths (nanoseconds) to photo-acoustically shatter ink granules and minimally affect skin cells. Ink is then removed by phagocytosis. A variety of wavelengths of visible and infrared light are used, the principles being complementary colours. A green laser (KTP) treats red ink, and red laser (dye or Alexandrite) is for green ink. Black ink, as the universal absorber, is treated with infrared :"(MBTFSBTMPOHFSXBWFMFOHUITIBWFCFUUFS dermal penetration. &GGJDBDZJTBDDFQUBCMF XJUIBEEFE considerations. Black tattoos fade slowly and almost completely over an average of 10-12 treatments at six week intervals. &BDIUSFBUNFOUTFTTJPOUBLFTCFUXFFO minutes and an hour, depending on size and complexity.

medicalforum

QRemoving tattoos with a laser can be painful and requires repeat sessions.

Amateur tattoos, eyeliner and radiotherapy UBUUPPTGBEFNVDINPSFRVJDLMZ(SFFOBOE sky-blue respond poorly though, and in many cases large, colourful tattoos such as sleeves are effectively unremovable. Other factors that lead to poorer outcomes include high ink density, distal location, and smoking. Scarring incidence is low at around 5%. Hypopigmentation is more common but often resolves over time. Darker skin types can show transient hyperpigmentation. Laser treatment is painful, although topical &.-"DSFBNBQQMJDBUJPONBLFTUIF procedure tolerable for most.

Further Reading Bernstein, E. Laser Tattoo Removal. Semin Plast Surg. 2007 August; 21(3): 175â&#x20AC;&#x201C;192. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/ PMC2884836/ References 1. Heywood W, et al. Who Gets Tattoos? Demographic and Behavioral Correlates of Ever Being Tattooed in a Representative Sample of Men and Women. Ann Epidemiol. 2012 Jan; 22(1):51-6. 2. Swami V. Marked for life? A prospective study of tattoos on appearance anxiety and dissatisfaction, perceptions of uniqueness, and self-esteem. Body Image. 2011 Jun;8(3):237-44. 3. Burris K, Kim K. Tattoo removal. Clin Dermatol. 2007;25:388â&#x20AC;&#x201C;392. O

The Future New research suggests that even shorter pulsed lasers (picosecond) may be more effective for many tattoos including green and blue. Picosecond lasers are now entering the market. Other developments include the use of topical BEKVWBOUTTVDIBTJNJRVJNPE XIJDINJHIU recruit more macrophages to the treatment site. Finally, highly laser responsive ink has been available since 2009 (Infinitink). This is bioresorbable dye within PMMA beads. It has not caught on within the tattoo industry though.

Competing interests: Dr Main provides laser tattoo removal services.

Take Home Messages t 5IPTFDPOUFNQMBUJOHHFUUJOH  UBUUPPFEBSFWFSZMJLFMZUPDIBOHF their mind afterwards. t &OTVSJOHBTFQUJDUFDIOJRVFTBSF used is important, especially overseas. t *GUIFSFJTBOZDIBODFPGMBUFS  SFNPWBM DIPPTFCMBDL BTDPMPVST are harder to remove.

45


LOW OW

HIGH

OUR CT SCORED LOWER

THAN THE NATIONAL DOSE REFERENCE LEVELS

In 2011, the Australian Radiation Protection and Nuclear Safety Agency conducted the Australian National Diagnostic Reference Level Survey. The data established a measure of multi-slice detector CT doses for current diagnostic imaging practice in Australia, allowing individual practices to compare their doses against those of their peers.1

Australian Adult MDCT DRLs - (95% Cl) (Dose Length Product, mGy.cm) 1200

1200

1000

1000 900

800 700

Imaging Central is the only private practice that offers a state of the art Siemens 128 slice CT delivering the same dose reduction technology as Princess Margaret Hospital for Children: SaďŹ re Iterative Reconstruction CARE Dose kV CARE Dose 4D Adaptive Dose Shield

450 400 248

236 188

200

0

At Imaging Central, it is easy to compare our dose achieved with others as we include it on every CT report.

612

600

600 563

Head

Neck

164

Chest

National Dose Reference Levels

Abdo Chest Lumbar Pelvis Abdo Pelvis Spine Imaging Central 2

1 Australian Government, Australian Radiation Protection and Nuclear Safety Agency., viewed 29th Jan 2013 http://www.arpansa.gov.au/services/ndrl/index.cfm 2 Imaging Central Practice Reference Level Dose measured from Oct - Dec 2012

Head to our website for more information about our dose reduction technologies 4646

.

medicalforum p: 9284 6900 f: 9284 2955 w: www.imagingcentral.com.au a: 345 Stirling Highway, Claremont medicalforum 6010


CLINICAL UPDATE

Relevance of over-diagnosis in breast cancer screening

B

reastScreen Australia commenced in 1991 and currently screens women over the age of 40 for breast cancer, targeting women aged 50-69. Since national screening programs in the United Kingdom and Europe were established there has been debate in medical journals, at times acrimonious and deeply divisive, over the benefits and harms of population screening.

Moreover, it is not possible, at the time of a woman's diagnosis and treatment, to recognise which individual cases of â&#x20AC;&#x153;breast cancerâ&#x20AC;? will eventually prove to be classified BTAPWFSEJBHOPTJT The UK independent breast screening review found that breast cancer screening extends lives through early detection and treatment. The breast screening program has an obligation to provide the public with the best estimates of benefits and harms of breast cancer screening as a starting point for a broader discussion of informed decision making.

The BreastScreen Australia Evaluation, published in 2009, demonstrated that the national program has reduced breast cancer mortality by 28%, with a participation rate of 55%. The recent report of the independent UK panel on Breast Cancer Screening found that for every 180 women regularly invited to screening, one death would be prevented. The detractors of population screening propose that the major harm to women is over diagnosis, leading to over treatment of breast cancer. Over diagnosis refers to the detection of cancers in screening that would not have become clinically apparent in the womanâ&#x20AC;&#x2122;s lifetime in the absence of screening. Due to the invasive diagnostic procedures involved in diagnosis, and the physical and psychosocial impact of breast cancer treatment, over diagnosis may be considered a seriously adverse outcome of screening.

By Dr Liz Wylie Medical Director BreastScreen WA and Head of Radiology RPH. Tel 9323 6706

QMammography in action

The independent UK screening review panel found that there is a great deal of uncertainty in respect to the extent of over diagnosis in population screening programs. (1) The most plausible estimates of over diagnosis range from 1% to 10%. Substantially higher estimates of over diagnosis reported in the literature are considered to be due to the lack of adjustment from breast cancer risk and/or lead time (2)

Cancer Australia is currently working with the Commonwealth Department of Health and Aged Care to improve information for women on the benefits and risks of screening with a view to revise client information to be made available mid-2013. References: (1) Independent Breast Screening Review A report jointly commissioned by Cancer Research UK and Department of Health (October 2012) www.cancerresearchuk.org (2) Overdiagnosis in mammographic screening for breast cancer in Europe a literature review. Donella Puliti et al, and the EUROSCREENWorkingGroup. http://jms. rsmjournals.com/content/19/suppl_1/42.full.pdf+html

O

Declaration: No competing interests

Supporting women around childbirth

T

he Raphael Centre was officially opened in Fremantle before Christmas as part of the outreach program for SJOGH. It is still early days and patients do not have to be maternity patients at a SJOG hospital to access services. All services are bulk-billed and the use of Better Access to Mental Health and Mental Health Care Plans by referring GPs makes things more accessible for the disadvantaged. The centre will have capacity for about 2000 TFTTJPOTQFSZFBS XIJDIFRVBUFTUPBSPVOE 200 clients, each with 10 sessions available to them under Better Access. Services target primarily women and their families, both preconception (e.g. past traumatic birth) or in the perinatal period (e.g. postnatal depression or anxiety), for the first four years of parenthood. To date, medicalforum

about half of the referred clients have been antenatal. The spokesperson told Medical Forum their services are available to women and their partners for anxiety, depression, or grief and loss and concerns that may arise from any antenatal screening and diagnostic tests. 3FGFSSJOHEPDUPSTTIPVMEEFUFSNJOFGPS themselves if the Catholic ethos encroaches on advice given. The community-based mental health clinic runs alongside adult counselling services at Ferns House in Fremantle, providing familyfocused therapies under Clinical Director psychiatrist Dr Beate Harrison. She is at the 3BQIBFM$FOUSFUXPEBZTBXFFLBOEIBT experience in mother-infant relationships, premature infants and parenting for mothers with perinatal psychiatric issues (see page P41). The centreâ&#x20AC;&#x2122;s full-time Clinical Services

QSJOGH Group Director of Mission Jennifer Stratton (left) and SJOG Murdochâ&#x20AC;&#x2122;s Manager Social Outreach and Advocacy Community Mental Health Peta Wootton.

Coordinator is a mental health nurse with rural and urban experience. She is assisted by three caregivers with both perinatal and infant health expertise. 4+0()FBMUI$BSF$&0%S.JDIBFM4UBOGPSE said the centre opening was a response to an ever-increasing demand for these services, including those who might otherwise fall through the cracks of an increasingly overburdened public system. 47


51 year old woman seeking relief from the symptoms of menopause

Relief and Effective Management of Menopausal Symptoms 1- 4

As effective as conventional hormone therapy in the management of menopausal symptoms5,6 PBS Information: This product is not listed on the PBS. Before prescribing please review product information available from MSD on 1800 818 553. LIVIAL (tibolone) 2.5mg. Indications: Natural or surgical menopause, prevention of bone mineral density loss (second line). Contraindications: Pregnancy and lactation; breast cancer; oestrogen dependent malignant tumours; undiagnosed genital bleeding; untreated endometrial hyperplasia; venous thromboembolism (DVT; pulmonary embolism); known thrombophilic disorders (protein C, S or antithrombin deficiency) history of arterial thromboembolic disease; liver disease; hypersensitivity to any ingredient; porphyria. Precautions: Pelvic and breast examinations should be undertaken with periodic check-ups, presence/history of leiomyoma/endometriosis; thromboembolic disorders; risk factors for oestrogen dependent tumours; hypertension; liver disorders; diabetes mellitus; cholelithiasis; migraine/severe headache; SLE; endometrial hyperplasia; epilepsy; asthma, otosclerosis. Discontinue immediately if patient develops: jaundice/deterioration in liver function; significant increase in BP; new onset of migraine-type headache; history of endometrial cancer; breast cancer; venous thromboembolism; coronary artery disease; stroke or ovarian cancer. Women should report any break-through bleeding/spotting; potential thromboembolic symptoms; tolerance to lactose. Women with pre-existing hypertriglyceridemia should be monitored for pancreatitis. Interactions: Anticoagulants; CYP3A4 substrates; CYP3A4 inducing compounds e.g. barbiturates, carbamazepine, hydantoins, rifampicin); herbal preparations containing St John’s Wort. Adverse effects: lower abdominal pain, abdominal hair growth, vaginal discharge, endometrial wall thickening, postmenopausal haemorrhage, breast tenderness, genital pruritus, vaginal candidiasis, vaginal haemorrhage, pelvic pain, cervical dysplasia, genital discharge, vulvovaginitis, weight gain, abnormal cervical smear, others: see full PI. Dosage: One tablet daily at the same time each day. Based on PI last amended 12 June 2012. References: 1. Archer DF et al., J Clin Endocrinol Metab. 92(3):911-8, 2007. 2. Lazovic G et al., Expert Opin. Pharmacother. 9(6):1039-47, 2008. 3. LIVIAL Product Information, MSD, 12 June 2012. 4. Kenemans P et al., Maturitas. 51(1):21-8, 2005. 5. Egarter Ch et al. 1996. Maturitas; 23: 55-62. 6. Hammar M et al. 1998. Br J Obstet Gynaecol; 105(8):90411. Copyright © 2013 MSD Oss B.V., a subsidiary of Merck & Co., Inc., Whitehouse Station, NJ, USA. All rights reserved. Merck Sharpe & Dohme (Australia) Pty Limited. Level 4, 66 Waterloo Road, North Ryde NSW 2113. 48

medicalforum


Support Group

Ishar Multicultural Womenâ&#x20AC;&#x2122;s Health Centre I

t was Ishar was established in 1992 in response to the influx of humanitarian refugees and migrants from non-English speaking backgrounds who were settling in Balga, Nollamara, Mirrabooka, Koondoola, Girrawheen and Westminster within the City of Stirling. It was the only Womenâ&#x20AC;&#x2122;s Health Centre specifically established for women from multicultural backgrounds. Ishar is now providing outreach services in the City of Wanneroo where another population of CaLD families is located. The services at Ishar include: t 8FMM8PNFOT$MJOJDDPOEVDUFECZ female GP (for womenâ&#x20AC;&#x2122;s health problems only) t "OUFOBUBMDMJOJD TVQQPSUFECZGFNBMF GP and midwife t 1FSJOBUBMTVQQPSUBOEIPNFWJTJUJOH by a social worker t 1IZTJPUIFSBQZ$MJOJDDPPSEJOBUFECZ female physiotherapist t 0UIFSIFBMUIBOEXFMMCFJOHTFSWJDFT including yoga and exercise, nutrition and information sessions t 1TZDIPMPHJDBMDPVOTFMMJOH t $BSFSTVQQPSUBOEDPVOTFMMJOH for carers of people with mental health issues t 'BNJMZTVQQPSUTFSWJDFJODMVEJOH sewing and craft classes, swimming lessons, and information sessions

t 08- 0MEFS8PNFOT-JGFTUZMF  Program for women over 55 Ishar takes referrals from a number of GPs though it always seeks to expand and improve its interactions with the medical profession through offering a range of services. It would like to be viewed as a highly skilled and professional organisation providing important and culturally sensitive health services for women from CaLD backgrounds. Ishar provides a safe place in which to learn about the health and social systems of Australia, and to gain to participate in their new community. O

Women in High Heels

Ishar Multicultural Womenâ&#x20AC;&#x2122;s Health Service Background:&TUBCMJTIFEJO.JSSBCPPLB JO Current WA members: Budget:  BOOVBMMZGSPN %FQBSUNFOUTPG)FBMUI'BNJMJFT )PVTJOH  $PNNVOJUZ4FSWJDFTBOE*OEJHFOPVT "GGBJST*NNJHSBUJPOBOE$JUJ[FOTIJQ8" %FQBSUNFOUGPS$PNNVOJUJFTBOEPUIFST Contact details:.POEBZ'SJEBZ  BNQN"EESFTT4VECVSZ 3PBE .JSSBCPPLB8" .JSSBCPPLB -JCSBSZ#VJMEJOH 1I 'BY  &NBJMJOGP!JTIBSPSHBVXFCTJUF www.ishar.org.au

By Dr Nicole Leeks, Orthopaedic Surgeon

There is a strong genetic predisposition for the development of bunions â&#x20AC;&#x201C; obvious when I see young girls with bunions (as young as seven), who obviously have not experienced the "wonder" of "high heels". I believe this genetic susceptibility is altered/modified by environmental influences (from long ago in medical school, is this called penetrance?). Girls or women with flat feet or pes planus are also at increased risk secondary to the midfoot pronation in the stance phase, which increases the forces through the first ray [metatarsal]. medicalforum

We know that wearing a heel excessively loads the forefoot but my feeling is that heels need to be worn all day, every day for an effect to occur and it may well only occur if that individual has flat feet and/or a genetic ssusceptibility. Why are women so prone to W b bunion formation? Who knows? Certainly, our k sshoe wear, even flat sshoes, do not have a wide toe box like w men's shoes and ttend to be

more rounded and contoured but female babies have a higher risk of developmental hip dysplasia and boys of clubfoot. Is it something to do with being female or male? Many of the high shoes currently around are more of the platform variety as opposed to the classic '60s stiletto, which means that the forefoot is actually elevated to an extent. This would presumably reduce the forefoot load. &WFOBGUFSCVOJPOTVSHFSZ *BMMPXQBUJFOUTUP wear a high heel but counsel them not to wear them every day, all day, just to try and reduce the risk of recurrence. I have so many patients with bunions coming to see me who swear they have always worn sensible shoes! And how do we account for the men who turn up with the same problem? In a nutshell, I think you are born with the risk, which can be exacerbated by inappropriate footwear!O 49


Lifestyle

ANDREWâ&#x20AC;&#x2122;S LAST FRONTIER

Mundaring medico Andrew Dunn looks back on a conference with a twist. No palm trees, no exotic cocktails but plenty of penguins and icebergs. Andrew Dunn had visited every continent except Antarctica by the time he was 25. It took him another three decades to venture into the Southern Ocean. He and Sorrento GP Lawrence Wapnah travelled there exercising both mind and body aboard the Russian vessel, Akademik Sergey Vavilov. i5IF TIJQ XBT OBNFE BGUFS B /PCFM 1SJ[F XJOOJOH 3VTTJBO QIZTJDJTU *U XBT ESPQQJOH VMUSBTPVOE MJOFT LN CFMPX UIF TVSGBDF UP detect nuclear submarines. [Ours, not theirs.] *E XBOUFE UP HP UP UIF "OUBSDUJD 1FOJOTVMB FWFS TJODF * XBT B LJE *UT BO BCTPMVUFMZ stunning place with a mountainous volcanic landscape and an incredible coastline. :PV DBO TUBOE JO POF QMBDF BOE TFF NPSF UIBO QFOHVJOTBOEFMFQIBOUTFBMT w "OESFXTBJE i"TEPDUPSTXFOFFEUPUBLFCSFBLTGSPNPVS CVTZQSPGFTTJPOBMMJWFT*UTBMTPJOUFSFTUJOHUP see elephant seals fatter than some of our QBUJFOUTw "OESFX TUSFTTFE UIBU UIF USJQ XBT B MFHJUJmate and fully accredited medical conference 50

with a distinctly international flavour. i5IFSFXFSFBSPVOEEPDUPST BNJYUVSFPG "VTUSBMJBO  ,JXJ  "NFSJDBO BOE PUIFS MFTTFS beasts. (FOFSBM1SBDUJDF*TTVFTwould be an appropriate banner and, when we werenâ&#x20AC;&#x2122;t LBZBLJOHPSHB[JOHBUXBOEFSJOHBMCBUSPTTFT  we were very busy DPOGFSFODJOHw 5IFSF XFSF BCPVU  QBTTFOHFST BOE  crew members aboard the good ship 4FSHFZ 7BWJMPW 5IF 4PVUIFSO 0DFBO JT B XJME UIJOH BOETFBTJDLOFTTXBTBDPOTUBOUDPNQBOJPO "OESFX  B CJU PG BO APME TBMU IJNTFMG  IBT B theory about that. i5IFPDFBOXBTSPMMJOHCJHUJNFBOETPNFPG UIF XBWFT XFSF TJY TUPSFZT IJHI * XBT POF PGUIFWFSZGFXXIPXBTOUTJDL5IFTFDSFU JTBMMUPEPXJUIQSPQSJPDFQUJPOBOEUIFNJYFE messages you get when the inner ear tells you youâ&#x20AC;&#x2122;re moving but the eyes tell you youâ&#x20AC;&#x2122;re OPU5IFUSJDLJTUPTUBZBCPWFEFDLBOEMPPL BUTPNFUIJOHGJYFE FWFOBDMPVE.ZBEWJDF JT UP LFFQ MPPLJOH BU UIF IPSJ[PO PS  GBJMJOH UIBU LFFQZPVSHPEEBNFZFTDMPTFEw *DFCFSHT BSF VOQSFEJDUBCMF BU UIF CFTU PG UJNFToKVTUBTLUIFDBQUBJOPGUIF5JUBOJD#VU JGZPVSFBUISJMMTFFLJOHNFEJDP"OUBSDUJDBJT an irresistible destination.

QFrom Top: Dr Andrew Dunn Kayaking in the Antarctic; Andrew with Dr Lawrence Wapnah; and Lawrence doing his Tony Abbot impersonation in the chilly waters of the Antarctic.

i8FXFSFPVUPOUIFXBUFSXIFOUISFFUTVnamis came through and the icebergs started SPMMJOH BSPVOE 5IBUT OPU HPPE JO B LBZBL "OEXIFOBLBUBCBUJDXJOETIPPUTEPXOUIF side of a mountain it can go from calm to LNIPVSJOTFDPOETw i5IFMBOETDBQFJTSBXBOEQSJNBM5IFTPPOFS4PVUI(FPSHJBJTXPSMEIFSJUBHFMJTUFEUIF

medicalforum


E-Poll:

The Best Gift for a Woman is... Because... 8FBTLFEEPDTUIJTUSJDLZRVFTUJPOJOUIJTFEJUJPOhTFQPMM5IFSFTQPOTFT GFMMJOUPWBSJPVTDBNQToUIFSPNBOUJD UIFPCWJPVT UIFTFYJTU UIFFYBTQFSBUFEBOEUIFDPVSBHFPVT8FEPOULOPXUIFHFOEFSPGUIFSFTQPOEFOUT  weâ&#x20AC;&#x2122;ll leave that for you to decide. .POFZ XBT B QPQVMBS SFTQPOTF  NPTUMZ CFDBVTF JU UPPL BXBZ UIF NFOUBMCVSOPVUPGUIJOLJOHVQUIFQFSGFDUHJGUBOE BGUFSBMM iTIFDBOEPXIBU TIFMJLFTXJUIJUw-JLFXJTFEJBNPOET GMPXFSTBOEUIFFWFSHSFFOIBOECBH (authentic and branded) were safe bets. Then there were: THE TIME-SAVING GIFTS: i%PJOHUIFEJTIFTw i5IFCFTUHJGUGPSBXPNBOJTBDPNGZCFEBOEUJNFUPTMFFQJOJUw i"NBJEoTFMGFYQMBOBUPSZ SFBMMZw i"DMPOFCFDBVTFXPNFOBSFFYQFDUFEUPCFFWFSZUIJOHUPFWFSZQFSTPO BOEJUXPVMEHJWFUIFNBOFRVBMUPDPOWFSTFXJUIw i5JNFUPMJTUFOCFDBVTFJUDPVMEIFMQSFMJFWFPOFTCVSEFOw THE ROMANTIC: i"SPNBOUJDIPMJEBZ CFDBVTFUIFZIBUFPSHBOJTJOHUIPTFUIJOHTUIFNTFMWFT oBMMUIFUJNFw i3FTQFDUyCFDBVTFSFTQFDUJOHXPNFONFBOTSFTQFDUGPSBMMIVNBOJUZw "OPUIFSEPDBEET iCFDBVTFJUNBUUFSTw i-PWFUIFZBQQSFDJBUFJUw i" TVCTDSJQUJPO UP B TQBIFBMUICFBVUZNBTTBHF QMBDF FWFSZ UXP XFFLT  CFDBVTFJGXFGFFMSFMBYFEBOECFBVUJGVMBOEDPOGJEFOU XFXJMMNBLFZPV IBQQZUPPw i"GGFDUJPOBOEMPWFCFDBVTFTIFJTBEFMJDBUFHFOEFSw &%UIBUQSPCBCMZ RVBMJGJFTBTTFYJTUCVUXFCFMJFWFJUJTIFBSUGFMUBOEPSSPNBOUJD

THE HOPEFUL: i.F CFDBVTF*hNNFw i"WJCSBUPSCFDBVTFJUHJWFTIBSNMFTTQMFBTVSFw i"OPSHBTN*UTIPXTZPVDBSFw i4JODFSJUZOPUPVUSBHFPVTIVNPVSw i3FDPHOJUJPOPGFRVBMJUZ#FDBVTFUIFZEPNPTUUIJOHTCFUUFSUIBOVTNFO THE UNIQUE: i"HSFFJOHXJUIIFSCFDBVTFJUXJMMCFUPUBMMZVOFYQFDUFEw i-JTUFOJOHCFDBVTFOPPOFFWFSEPFTw THE USEFUL: i8JOF CFDBVTFJUPQFOTVQMPUTPGIJEEFOUBMFOUw i"SFNPUFDPOUSPMCFDBVTFJUNBLFTIFSGFFMFNQPXFSFEw i$IPDPMBUFCFDBVTFOPUIJOHCFBUTHSFBUDIPDPMBUFw i,FZMFTTFOUSZCFDBVTFUIFZDBOOFWFSGJOEUIFJSDBSLFZTw i4BVDFQBOTCFDBVTFUIFZSFBMMZBQQSFDJBUFUIFNw i"NBOCFDBVTFJUJTTPNVDINPSFGVOUIBOIBWJOHTFYCZPVSTFMWFTw i"O BOOVBM HPMG DMVC TVCTDSJQUJPO GPS IJN CFDBVTF IFhMM CF DBMNFS  GJUUFS  NPSFBUUFOUJWFBOEGSFRVFOUMZBCTFOUGPSBDPVQMFPGIPVSTw THE COURAGEOUS: CFUUFS *UT HSFBU UP TFF IPX NVDI XJMEMJGF there is in a place that hasnâ&#x20AC;&#x2122;t been ruined CZ IVNBOT %POU HP UIFSF PO B CJH DSVJTF TIJQUIPVHI:PVMMIBWFNVDINPSFGVOPOB TNBMMFSFYQFEJUJPOWFTTFMXJUIJOGMBUBCMF[PEJBDTBOELBZBLTw O

By Mr Peter McClelland

medicalforum

i"DIJMECFDBVTFTIFXJMMCFGVMGJMMFEw i"NJSSPSCFDBVTFUIFZBSFQFSGFDUw i#FJOHTJOHMFMBUFSJOMJGFBTNZHSBOENPUIFSUBVHIUNF ZPVDBOHPPVU NBTUFSBOEDPNFIPNFNJTUSFTTw i$PHOJUJWFCFIBWJPVSBMUIFSBQZJOBOBUUFNQUUPDVSCUIFJSTQFOEJOHw 0S JG ZPVSFSFBMMZ TUSVHHMJOH XJUI UIJT HJGU UIJOH  UBLF UIJT BEWJDF i(JWF B XPNBO B EPH CFDBVTF UIFZ BSF MPZBM  EPOhU FYQFDU GBWPVST JO SFUVSO GPS BGGFDUJPOBOEFBUZPVSQBSUOFSTTPDLTTPZPVEPOhUIBWFUPUPVDIUIFNw 51


Theatre

for whom the

Bell Tolls One of Shakespeareâ&#x20AC;&#x2122;s great plays performed by one of the great Shakespearean actors working today â&#x20AC;Ś and itâ&#x20AC;&#x2122;s happening this month in Perth. 4P NBOZ QFPQMFT GJSTU FYQFSJFODFT PG 4IBLFTQFBSFBSFPGUIFVOIBQQZLJOEoCFJOH POF PG  CPSFE BEPMFTDFOUT SFBEJOH B MJOF FBDI GSPN .BDCFUI *U DPVME IBWF TP FBTJMZHPOFUIBUXBZGPSNFUPPJG*IBEOUCFFO TIPXO JO  B SBEJDBM  GSFTI JOUFSQSFUBUJPO of )BNMFUXJUIBGJSFCSBOE"VTUSBMJBOBDUPSCZ the name of John Bell. *UTQBSLFEBIFSPXPSTIJQPG+PIO#FMMBOEB MJGFMPOH MPWF PG 4IBLFTQFBSF UIBU IBT OFWFS dimmed. How could it possibly, when his QMBZTBSFTPHSJUUZ EJSUZ GVOOZ USBHJDoUIFZ are all about people scrambling over each other to find love, power, fame and fortune. +PIO#FMMBUNBZOPUIPQBSPVOEUIFTUBHF as Hamlet anymore but his sharp theatre NJOE OFWFS LFFQT IJN GBS GSPN UIF CPBSET *O 1FSUI UIJT NPOUI XF TIBMM TFF IJN BT 4IBLFTQFBSFTNPTUDPNQMFYPGDPNJDSPMFT  UIF CFMMJDPTF 4JS +PIO 'BMTUBGG  JO IJT PXO BEBQUBUJPOPGUIFUXP)FOSZ*7QMBZTGPSIJT PXO#FMM4IBLFTQFBSF5IFBUSF$PNQBOZ He will be directed by one of his protĂŠgĂŠes, %BNJFO3ZBO XIPBENJUUFEUPBGFXCVUUFSflies at the thought of directing his mentor. i8IFOIFHJWFTZPVUIFDBMMBOEBTLTZPVUP do it, itâ&#x20AC;&#x2122;s a pretty terrifying thing but only from UIF QFSTQFDUJWF UIBU IFT TVDI BO FYUSBPSEJOBSZ BDUPS BOE IJT LOPXMFEHF PG UIJT QMBZ JT QBSUJDVMBSMZ BNB[JOH )FT CFFO XPSLJOH PO UIJTQMBZGPSBWFSZMPOHUJNFoJUTPOFPGIJT GBWPVSJUFT * UIPVHIU UP NZTFMG  XIBU DBO * possibly offer this play and John Bell, but it is very hard to direct yourself in a play and he is BXBSFPGUIBUw 52

"DDPSEJOH UP %BNJFO  BVEJFODFT IBWFBMPUUPMPPLGPSXBSEUP i5IF )FOSZ *7 QMBZT BSF RVJOUFTTFOUJBM 4IBLFTQFBSF o UIF DPNFEZ is hilarious, the pathos is profound and the dialogue and characters are e TPQIJTUJDBUFE *UT OPU UIF TJMMZ  [BOZ Z comedy of the earlier plays. Then n alongside that there is soaring traggedy with clear psychological turnings, s, it offers so many options for interpree UBUJPOTw "U UIF IFBSU PG UIF QMBZ JT )BM  UIF 1SJODF PG 8BMFT  TPO PG )FOSZ *7  XIP IBT DPOUSPversially ascended to the throne after the EFQPTJUJPO PG IJT DPVTJO  3JDIBSE ** #VU JUT not so much a history lesson as an insight into power, corruption and big, difficult families. Hal wants to have fun, his father is furious, which tumbles Hal into the arms of TVSSPHBUFEBE UIFMPWFBCMFSPHVF 'BMTUBGG i*UT BO BNB[JOH QJFDF PG XSJUJOH w %BNJFO TBJE i*U JT B IJTUPSZ POMZ JO OBNF 8IBU 4IBLFTQFBSFJTSFBMMZUSZJOHUPEPJTHJWFVTB QMBZBCPVUNPSBMJUZ)PXEPZPVSBJTFBTPO how does a son grow up in the world without a moral compass when his real father and his TVSSPHBUFGBUIFSBSFUIJFWFTXIFSFEPFTUIJT CPZMFBSOSJHIUGSPNXSPOHw i5IFSF BSF TPNF WFSZ NPEFSO DPODFQUT PG WJPMFODF  BT XFMM *U JT B WJPMFOU  NBTDVMJOF QMBZ *U RVFTUJPOT NBMF BHHSFTTJPO BOE UIF DPTUPGXBSPOUIFPSEJOBSZDJUJ[FOTXIPBSF DPOTDSJQUFE  BT 'BMTUBGG EFTDSJCFT UIFN  BT cannon fodder. They are going to die and

there is no accordance of their sacrifice given CZUIFGJHVSFTBCPWFUIFNw .BUU.PPSFQMBZT)BMBOE%BNJFOTBZTUIF close relationship between Matt and John ripples on stage. i0OF PG UIF SFBTPOT +PIO DBTU IJN BT )BM was because theyâ&#x20AC;&#x2122;ve had this long and joyPVTSFMBUJPOTIJQPGXPSLJOHUPHFUIFS0OUIF GJSTU EBZ PG SFIFBSTBM +PIO TBJE AUIJT TIPVME feel for the audience as if the two actors EPJOH )BM BOE 'BMTUBGG IBWF B QBMQBCMF IJTtoryâ&#x20AC;&#x2122;. That has been a plus the way they trust each other and play off each other. To watch that decompose in the second half toward that final rejection is a great moment of theatre." O

By Ms Jan Hallam

'PSZPVDIBODFUPXJOUJDLFUTUPUIF "QSJMQFSGPSNBODFPG)FOSZ*7TFFUIF DPNQFUJUJPOT1

medicalforum


BIG NA M E

BIG FL AVOUR

Elicure 2012 Cabernet Franc 5IF&MJDVSFSBOHFBSFTUZMFEUPFYQSFTTUIFUFSSPJSPGUIFSFHJPOBOEXIJMFQPXFSGVM  it should not dominate. This wine is bright and youthful, the nose showing touches of redcurrant, camphor and cloves. The flavours of ripe mulberry, redcurrant and ESJFEIFSCTHJWFBMJOHFSJOHGJOJTI FOIBODFECZUIFGJOFHSBJOFE HSJQQZUBOOJOT*UT OPUBTGMPSBMBOEIFSCBMBTUZQJDBMWBSJFUBM$BC'SBOD CVUJUTBOJDF GVMMCPEJFEXJOF XIJDITIPVMEESJOLXFMMGPSTJYZFBSTPSNPSF

By Dr Craig Dummond, Master of Wine

Elicure 2010 Grenache Shiraz )FSFTBUSBEFNBSLCMFOEPGUIFSFHJPO*UTBSPNBTBSFHFOFSPVT TBWPVSZBOE SVTUJD5IFSFJTMPBETPGTPGUKBNNZGSVJU BOEXBSNBMDPIPMXJUICMBDLDVSSBOU TQJDZ BOEIFSCBMGMBWPVST*UTESJOLJOHXFMMOPXBOEXJMMEPTPGPSBGFXNPSFZFBSTUP DPNF*MPWFUIJTWBSJFUBMCMFOEGPSEBZUPEBZESJOLJOHBOEJUhTJEFBMGPSBCBSCFDVF

The long-established premium wine district of McLaren Vale almost borders Greater Adelaide these days and is well worth a visit when next in Adelaide. Being located on the Fleurieu Peninsula exerts a moderating effect on this warm Mediterranean climatic region. Hence the wines are in the true traditional Aussie style â&#x20AC;&#x201C; big, rich, ripe and complex, though they avoid the overripe â&#x20AC;&#x2DC;jammyâ&#x20AC;&#x2122; characters. Shiraz and Grenache have been the backbone of the region but the Cabernet varieties are also very signiďŹ cant.

Aurum Release 2010 Shiraz /PXXFHFUJOUPUIFCJHTUZMFT5IJTXJOFJTEFFQ GVMMCPEJFE XJUIEBSLQMVN  FBSUIBOEMFBUIFSPOUIFOPTF GPMMPXFECZKVJDZQMVNBOEEBSLDIFSSZGMBWPVST BOEDFEBSZPBL*UTIPVMEIBWFBDFMMBSMJGFPGNPSFUIBOZFBSTXJUIJUTSJQF  DPODFOUSBUFEGSVJUCBMBODFEXJUIJUTBDJECBDLCPOFJNQBSUJOHEFGJOFETUSVDUVSF Grand Royale 2010 Shiraz 5IFA(SBOEF3PZBMFTFSJFTJT-BWJOBhTJDPOJDXJOFTBUUIFUPQPGUIFJSRVBMJUZ QZSBNJE5IJTTIJSB[JTNBTTJWF"CSPPEJOHHJBOUoJUTSJQF PBLZ DPODFOUSBUFE BOEQPXFSGVM'SVJUDIBSBDUFSTBSFTUJMMWFSZQSJNBSZBUUIJTUJNFQPJOU XJUIESJFE DVSSBOUT USVGGMFT CMBDLQFQQFSBOEBUXJTUPGCJUUFSDIPDPMBUF5IFSFJTMPBETPG UPBTUZPBLBOECJHDIVOLZUBOOJOT+VTUBCBCF JUXJMMBXBLFOPWFSGJWFZFBSTBOE ESJOLXFMMGPSNPSFUIBO Grand Royale 2010 Cabernet Sauvignon

Lavina Wines is a serious player in McLaren 7BMF 5IJT GBNJMZPXOFE PQFSBUJPO QSPEVDes a range of wines including premium ACPVUJRVF XJOFT  XIJDI BSF SFWJFXFE JO this tasting, and also a large volume of TVCCSBOET BOE CVML XJOFT GPS EPNFTUJD DPOTVNQUJPOBOEFYQPSU Premium production is enhanced by hand QJDLJOH BOE B NFDIBOJTFE TPSUJOH UBCMF o B UFDIOJRVF QPQVMBS JO 'SBODF CVU  JO NZ PQJOJPO  VOEFSVUJMJTFE JO "VTUSBMJB 5IJT eliminates contaminated and damaged CVODIFTGSPNUIFGFSNFOUBUJPO'SPNUIFSF UIF CFSSJFT BSF DPMETPBLFE JO PQFO GFSNFOUFST GPS B XFFL EVSJOH XIJDI UJNF a natural fermentation commences, and PWFSTFFEFEXJUIBDPNNFSDJBMZFBTU"GUFS GFSNFOUBUJPO  HFOUMF CBTLFU QSFTTJOH UBLFT place and the wine is matured in selected 'SFODIPBLCBSSFMTGPSNPSFUIBOUXPZFBST

medicalforum

Wine Review

Lavina

5IJTJTBOPUIFSCJH ZPVUIGVMXJOF*UTIPXTBCFBVUJGVMEFFQDSJNTPODPMPVS B CPVRVFUCVSTUJOHXJUIDBTTJT WJPMFUTBOENJOU*OUIFNPVUI DBTTJTBOENVMCFSSZ  XJUIUIBUDIBSBDUFSJTUJD.D-BSFO7BMFEBSLDIPDPMBUFDBCFSOFUDIBSBDUFS5IFUBOOJOT BSFTVQQMF WFMWFUZBOEGJOF UIFGJOJTIMPOHBOEESZ*WFSZNVDIFOKPZUIJTXJOF OPXoNZGBWPVSJUFPGUIJTUBTUJOHoCVU*XPVMEBMTPHJWFJUBMJGFPGZFBST

WIN a Doctor's Dozen! Which wine was reviewer Dr Craig Drummondâ&#x20AC;&#x2122;s favourite of the tasting? Answer:

...................................................................................................................

ENTER HERE!... or you can enter online at www.MedicalHub.com.au! Competition Rules: One entry per person. Prize chosen at random. Competition open to all doctors or their practice staff on the mailing list for Medical Forum. Competition closes 5pm, March 31, 2013. To enter the draw to win this month's Doctors Dozen, return this completed coupon to 'Medical Forum's Doctors Dozen', 8 Hawker Ave, Warwick WA 6024 or fax to 9203 5333.

Name:

.........................................................................................................

E-mail: ......................................................................................................... Contact Tel:

.........................................................................................

Please send more information on Lavina Wines offers for Medical Forum readers.

53


Satire

Midlife Crisis?

Yes We Can!

At last a party to cater for the needs of the â&#x20AC;&#x2DC;previously-nowâ&#x20AC;&#x2122; generation, and our resident satirist Wendy Wardell is just the person to lead them. Now that we're in the final feverpitched five-month lap of the Federal election campaign, I'm throwing in my ten cents worth. After all, lack of an intelligent contribution hasn't held anyone else back so far. *hN DPOTJEFSJOH SVOOJOH GPS FMFDUJPO BT the sole representative of the Mid-Life Crisis Party. This is a political movement to address the interests of the bored, disaffected middle-aged. People who once had lives but who are now in danger of following )PNFBOE"XBZ CVZJOHB7PMWPPSQIPOJOH JOUPUBMLCBDLSBEJP 5IFZ NBZ CFDPNF TVDI FNQUZ IVTLT UIBU theyâ&#x20AC;&#x2122;ll fill the void by voting for the Logies or ironing their underwear. Hell, maybe FWFO PUIFS QFPQMFhT VOEFSXFBS *hWF TFFO the future and it contains /FX *EFB "N * TDBSFE :PVCFU My election platform will be the establishment of a Ministry for Mid-Life, charged with ensuring equality of access to all the

GVOTUVGG*GXFDBOhUTUBZVQMBUFFOPVHIUP reclaim the night, we can at least politely BTL GPS UIF FBSMZ FWFOJOH 8FSF QFSGFDUMZ MPDBUFE /FX :PSL NBZ CF UIF $JUZ 5IBU /FWFS 4MFFQT, but Perth is definitely the 1MBDF5IBU1SFGFSTUP#FJO#FECZ5FO *hMMCFEFNBOEJOHXFhSFHJWFOSPDLDPODFSUT at reasonable hours and segregated overBHFBSFBTJOUSFOEZESJOLJOHFTUBCMJTINFOUT 8FhWF BMSFBEZ TFFO UIF SFUVSO PG UIF SPDL bands of our youth who set aside their perTPOBMEJGGFSFODFTUPIJUUIFSPBE4VSF UIFZ IBE MJUUMF DIPJDF  UIBOLT UP QPPS TVQFSBOnuation returns and their earlier reliance on OPTUSJMCBTFEJOWFTUNFOUT#VUMJLFUIFSFTU of us, they can now appreciate the need for an afternoon nanna nap and a gig that finishes before the Berocca wears off. *hEMJLFUPTFFOFXFSBDUTUPP POFTUIBUBSF currently barely getting started by the time -BUFMJOF GJOJTIFT BOE UIF DPDPB IBT LJDLFE JO *G WFOVFT PGGFSFE BO FBSMJFS TFTTJPO GPS PWFS T UIFZ DPVME TBWF FOPVHI PO IJSFE NVTDMF UP IBWF 4U +PIO "NCVMBODF BOE an emergency chiropractor waiting in the wings. Other than an increased danger of FMFDUSJD TIPDL GSPN OZMPO USPVTFS GSJDUJPO in the Mosh Pit what could possibly go wrong? 0VSLJETXPVMEPGDPVSTFCFBQQBMMFEBUBOZ idea of partying alongside our generation, BOEUIFGFFMJOHJTFOUJSFMZNVUVBM*hWFTFFO XIBU SPBNT /PSUICSJEHF MBUF BU OJHIU BOE it's an assault my eyeballs can do without. *hE QSFGFS UP FOKPZ UIF WJUBMJUZ PG UIF 1FSUI pubs and clubs in the company of people who appreciate the role of a nice cardigan JO UIFJS GBTIJPO XBSESPCF UIPTF GPS XIPN dressing up for a night out doesn't stop at a small length of elastic. * BMTP XBOU UP FYQFSJFODF BHBJO UIF KPZ PG DPOWFSTBUJPO DPOEVDUFE PWFS B GFX ESJOLT POB4VOEBZBGUFSOPPOBUBWPMVNFMFTTUIBO B#SJBO#MFTTFEJNQFSTPOBUJPOPGB Rise up and join me, all you mid-lifers who aren't yet ready to wear your trousers at BSNQJU IFJHIU BOE HFU ZPVS BESFOBMJOF GJY GSPNUVSOJOH,FOOZ(VQUP 7PUF   .JE-JGF $SJTJT 1BSUZ "U MFBTU UIFO ZPVMM LOPX XIBU LJOE PG DSJTJT ZPVhSF electing. O

54

medicalforum


Competitions

Entering Medical Forum's COMPETITIONS has never been easier! Simply visit www.medicalhub.com.au and click on the 'COMPETITIONS' link (below the magazine cover on the left).

Theatre: Death of a Salesman 5IJTJTPOFPGUIFHSFBUFTUQMBZTPGUIFUIDFOUVSZBOETUJMM resonates in a world where buying the dream is still a potent force. Willy Loman has spent his entire life as a travelling TBMFTNBO DIBTJOH IJT GPSUVOF BOE OFWFS TVDDFFEJOH /PX  suffocated by debt, discarded by his boss and losing his grasp POSFBMJUZ IJTIPQFTSFTUPOIJTTPO#JGG#MBDL4XBO5IFBUSF Company has assembled a strong cast for this great play. May 4, Heath Ledger Theatre, 7.30pm

Operamania Movie: Drift Weâ&#x20AC;&#x2122;ve watched every move as this film evolved on our doorstep, now we can see the finished product as Myles 1PMMBSE 4BN8PSUIJOHUPOBOE9BWJFS4BNVFMSFDSFBUFT Margaret River in a drama that combines big waves and the CVTJOFTTUIBUTVSSPVOETUIFN5IFTUPSZDFOUSFTPOUIF,FMMZ CSPUIFST"OEZBOE+JNNZ XIPIBWFPOFHSFBUQBTTJPOSJEJOH CJH XBWFT %SJGU DIBSUT UIF USBOTGPSNBUJPO PG TVSGJOHT MBJECBDLMJGFTUZMFJOUPBHMPCBMQIFOPNFOPO In Cinemas May 2

Lovers of Russian high arts will be in a state of bliss XIFO UIF DPNCJOFE GPSDFT PG UIF .PTDPX /PWBZB 0QFSBBOEUIF*NQFSJBM3VTTJBO#BMMFUUBLFUPUIFTUBHF of the Perth Concert Hall for a night of dramatic arias BOE QBT EF EFVY .PSF UIBO  BSUJTUT XJMM CF UPVSJOH &YQFDU UP IFBS UIF NVTJD PG 5DIBJLPWTLZ  1VDDJOJ  .P[BSU 7FSEJBOE+PIBOO4USBVTTQMBZFECZB3VTTJBO PSDIFTUSB *U JT B TVNQUVPVT QSPEVDUJPO  UIF MJLFT OPU seen before in Perth on the one stage. April 7, Perth Concert Hall, 7.30pm

Movie: The Company You Keep " UBVU  UJHIU UISJMMFS GSPN BDUPSEJSFDUPS 3PCFSU 3FEGPSEIBTBOBNB[JOHDBTUPG4IJB-F#FPVG 4VTBO 4BSBOEPO  +VMJF $ISJTUJF  #SFOEBO (MFFTPO  3JDIBSE +FOLJOTBOE4UBOMFZ5VDDJ8IFOBGPSNFSNFNCFSPG UIFSBEJDBMQSPUFTUUFSSPSJTUPSHBOJTBUJPOUIF8FBUIFS 6OEFSHSPVOE 4BSBOEPO  UVSOT IFSTFMG JOUP UIF '#*  #FO4IFQBSE -B#FPVG BOBHHSFTTJWFZPVOHKPVSOBMist, starts searching for leads on the other members. In cinemas, 19 April

Theatre: Bell Shakespeareâ&#x20AC;&#x2122;s Henry 4 *GZPVTFFKVTUPOF4IBLFTQFBSFQMBZUIJTZFBS NBLFJU this one. This is not just one of the Bardâ&#x20AC;&#x2122;s best plays but XJUIUIFHSFBU4IBLFTQFBSFBOBDUPS+PIO#FMMUBLJOHPO UIFJDPOJDDPNJDSPMFPG'BMTUBGG JUXJMMCFBQSPEVDUJPO UPUFMMUIFHSBOELJETBCPVU5IJTTUPSZPGQPMJUJDT MFBEFSship, families and betrayal has the lot. April 11, Heath Ledger Theatre, 7.30pm

Easter Cheer with Hillsviewedico

e is one m Dr Penny Ro BOE IFS X JOFT T X IP LOPX tion si po le ab envi sheâ&#x20AC;&#x2122;s in the JDBM FE JUIPOFPG. PGXPSLJOHX VJT -P S %  T FS XSJU 'PSVNT XJOF VF FO "W  UIF 5IJSE 1BQBFMJBT  BU F 4I  Z MF X -B . U 4VSHFS Z JO es in w e Hillsview has won th  JU HPJOH UP PQFO JT E BO O EP[F r he of gathering for a Easter ness nd fo a FMMFT 'SFODI s ha BOJB BOE -BTD clan. Penny TN 5B  N GSP QMF 1JOPU GPS B %BMSZN e. gn pa Cham

MEDICAL F ORUM

WINNER FROM THE FEBRUARY ISSUE

)FBMUI1V

#VSOJOH*TTV [[MFT FTPG

 t 1SJNBSZ$B SF$IBOHFT t 5SFBUNFOU 5SFOET t 1SBDUJDF5 FDIOPMPHZ t $IJME"CVT F t &1PMMA%P DUP  *U4P(PPE ST/FWFS)BE 

F E B R U A RY 2013

Lincoln â&#x20AC;&#x201C; movie: %S.JL1BSPMB %S1BVM-BJENBO %S#JMM5IPOH %S"OESF$IPOH %S%POOB.BL %S:PIBOB,VSOJBXBO  O %S"OOF#SBEZ %S%BWJE8SJHIU%S4VF.BSUJO The Sweeney â&#x20AC;&#x201C; movie: %S1FUFS.FMWJMM4NJUI %S$BSPMJOF$IJO %S+BTPO$IJO %S4BZBOUB+BOB %S-BXSFODF$IJO  %S"MJTPO1IJMMJQT %S$IBSMFT$SPNQUPO %S4JNPO8FJHIU %S%BWJE4UPSFS%S1BUSJDL-BJ Save Your Legs â&#x20AC;&#x201C; movie: %S5SJYJF%VUUPO %S&MFBOPS,PBZ %S(MFOEB,IPP %S3JNJ3PQFS %S1IBOJ#BMBTB  %S)FMFO.FBE %S,FJUI"OBOEB %S4JNPO.BDIMJO %S:JFO$IJO %S+VMJB$IBSLFZ1BQQ %S)VJ+FSO-PI %S,BUSJOB (V[EFS %S-ZEJB1FUFS %S'SBOL8JMMJT%S+VMJF$PQFNBO Two Gentlemen of Verona â&#x20AC;&#x201C; theatre: %S$BSPM%FMMBS%S,BSFO1SPTTFS Kupenga Kwa Hamlet â&#x20AC;&#x201C; theatre: %S#BSSZ-FPOBSE%S5IPNBT-FF I Give It a Year â&#x20AC;&#x201C; movie: %S,BWJUB,BOPEJB %S+FOOZ4UFENPO %S.FJMZO)FX %S,FOESJDL-JOH %S/BSFMMF7VKDJDI  %S&SJD,IPOH %S-ZOFUUF4QPPOFS %S"WSJM$IPOH%S)FMFO$MBSLF

'FTUJWF'VO1 IPUPT %PDUPST%SVN #S Catch the Fire FBLGBTU works, p30 (VFTU$PMVN OT .BHHPUT %SV  HT $FOUSFMJO L 6SCBO1 SBDUJDF

Major Sponsors

February 201 3

www.mforum.co m.au

medicalforum

$10.5 0

55


funnyside e QQHorsing Around "XPNBOIBTCFFOUBLFOJOUPIPTQJUBMBGUFS eating horse meat burgers from Tesco. Her condition is said to be stable. Tesco Quarter Pounders: The affordable way to buy your daughter the pony she's always wanted!

QQYou Know

Youâ&#x20AC;&#x2122;re a Doctor When â&#x20AC;¦

yXIFOZPVTIPVUBU UIF57EVSJOHNFEJDBM shows to correct their pronunciation. Then give up correcting and just wince instead. yXIFOZPVLOPXTPNFPGZPVSQBUJFOUT better than your own family. yXIFOZPVCFBU"--UIFRVJ[DPOUFTUBOUT on the medical questions. yXIFOZPVDBOXBUDIUIFTMPXNPUJPO replays during a football game, determine UIFOBUVSFBOEFYUFOUPGUIFJOKVSJFTBOE are right most of the time in predicting the SFTVMUTPGUIF.3* yXIFOQFPQMFCFHJO disrobing in your local TVQFSNBSLFUUPTIPXZPV how well their incisions have healed. yXIFOQFPQMFUIJOLZPVSFBMMZ want to see what they blew out of their nose. yXIFOZPVWFIBEUPEFDJEF whether eating or going to the bathroom is more important because you donâ&#x20AC;&#x2122;t have time to do both. yXIFOZPVDBOTMFFQ standing up. yXIFOZPVBSFCFJOHDIBSHFEUXJDFUIF BNPVOUZPVSOFJHICPVSJTGPSBCSBLFKPC yXIFOZPVBSFBGSBJEUPUFMMQFPQMFXIBU you do for a living at school functions. yXIFOXJUIJOBGFXNJOVUFTPGNFFUJOH TPNFPOF ZPVBTLUIFNUPUBLFPGGUIFJS DMPUIFT MJFEPXOBOEMFUUIFJSLOFFTGBMM apart, and they do so.

QQCareful at Bathtime %VSJOHBWJTJUUPNZEPDUPS *BTLFEIJN  "How do you determine whether or not an older person should be put in an old age home?" "Well," he said, "we fill up a bathtub, then XFPGGFSBUFBTQPPO BUFBDVQBOEBCVDLFU to the person to empty the bathtub." 0I *VOEFSTUBOE *TBJE"OPSNBMQFSTPO XPVMEVTFUIFCVDLFUCFDBVTFJUJTCJHHFS than the spoon or the teacup." /PIFTBJE"OPSNBMQFSTPOXPVMEQVMM UIFQMVH%PZPVXBOUBCFEOFBSUIF window?"

56

Had some burgers from Tesco for my tea MBTUOJHIU*TUJMMIBWFBCJUCFUXFFONZ teeth. I'm so hungry I could eat a horse... "DPXXBMLTJOUPBCBS#BSNBOTBZT iXIZUIFMPOHGBDF w$PXTBZTi*MMFHBM ingredients, coming over here stealing our KPCTw These Tesco burger jokes are going on a bit. Talk about flogging a deadâ&#x20AC;¦ NO! NO! NO! NO! To beef or not to beef. That is equestrian.

QQSex Education Little Tony was nine years old and was staying with his grandmother for a few days. He'd been playing outside with the PUIFSLJETGPSBXIJMFXIFOIFDBNFJOUP UIFIPVTFBOEBTLFEIFS  i(SBOENB XIBUhTJUDBMMFE when two people sleep in the same room and one is on UPQPGUIFPUIFS w 4IFXBTBMJUUMFUBLFOBCBDL  but she decided to tell him UIFUSVUIi*UhTDBMMFETFYVBM JOUFSDPVSTF EBSMJOHw -JUUMF5POZTBJE i0I 0, wBOE XFOUCBDLPVUTJEFUPQMBZ "GFXNJOVUFTMBUFS IFDBNFCBDLJO BOETBJEBOHSJMZ i(SBOENB JUJTOhUDBMMFE ATFYVBMJOUFSDPVSTF*UhTDBMMFECVOLCFET "OE+JNNZhT.VNXBOUTUPUBMLUPZPVw

QQThrillseeking Grannies

4MPXFSUIBOUIFTQFFEMJNJU /PTJS * XBTEPJOHUIFTQFFEMJNJUFYBDUMZ LJMPNFUFSTBOIPVSUIFPMEXPNBOTBZT a bit proudly. The Police officer, trying to contain a DIVDLMFFYQMBJOTUPIFSUIBUJTUIF highway number, not the speed limit. "CJUFNCBSSBTTFE UIF XPNBOHSJOTBOEUIBOLT the officer for pointing out her error. #VUCFGPSF*MFUZPV HP .BhBN *IBWFUPBTL*T FWFSZPOFJOUIJTDBS0, 5IFTF XPNFOTFFNBXGVMMZTIBLFO  and they haven't made a peep UIJTXIPMFUJNF UIFPGGJDFSBTLT "Oh, they'll be all right in a minute officer. 8FKVTUHPUPGG)JHIXBZ

QQDriving Doctors Nuts .ZOFJHICPVSXBTXPSLJOHJOIJTZBSE when he was startled by a late model car that came crashing through his hedge and ended up in his front lawn. He rushed to help an elderly lady driver out of the car and sat her down on a lawn chair. )FFYDMBJNFE :PVBQQFBSRVJUFFMEFSMZUP be driving." 8FMM ZFT *BN TIFSFQMJFEQSPVEMZ *hMMCFOFYUNPOUI BOE*BNOPXPME FOPVHIUIBU*EPOhUFWFOOFFEBESJWFShT MJDFODFBOZNPSF5IFMBTUUJNF*XFOUUP NZEPDUPS IFFYBNJOFENFBOEBTLFEJG *IBEBESJWFShTMJDFODF*UPMEIJNZFTBOE handed it to him. )FUPPLTDJTTPSTPVUPGUIFESBXFS DVU the licence into pieces, and threw them in UIFXBTUFCBTLFU TBZJOH h:PVXPOhUOFFE UIJTBOZNPSF hTP*UIBOLFEIJNBOEMFGU

4JUUJOHPOUIFTJEFPGUIFIJHIXBZXBJUJOH to catch speeding drivers, a Police Officer TFFTBDBSQVUUFSJOHBMPOHBULNI 4BZTIFUPIJNTFMG5IJT driver is just as dangerous as BTQFFEFS 4PIFUVSOTPOIJTMJHIUTBOE pulls the driver over. "QQSPBDIJOHUIFDBS IF notices that there are five old ladies, two in the front seat BOEUISFFJOUIFCBDLXJEF eyed and white as ghosts. The driver, obviously confused, says to him 0GGJDFS *EPOhUVOEFSTUBOE * XBTEPJOHFYBDUMZUIFTQFFE MJNJU8IBUTFFNTUPCFUIF problem?" "Ma'am," the officer replies, "you weren't TQFFEJOH CVUZPVTIPVMELOPXUIBUESJWJOH slower than the speed limit can also be a danger to other drivers."

medicalforum


CARDIOLOGY

8FTUFSO"VTUSBMJBT8IPT8IPGPS1BUJFOU3FGFSSBMT CLINICAL SERVICES DIRECTORY Cardiology Cosmetic Medicine - Hair Loss %FSNBUPMPHZ &BS /PTF5ISPBU Gastroenterology (FOFSBM4VSHFPOT4VCTQFDJBMUJFT (ZOBFDPMPHZ(ZOBFDPMPHJDBM4VSHFSZ (ZOBFDPMPHZ*OGFSUJMJUZ (ZOBFDPMPHZ *OGFSUJMJUZ"OESPMPHZ )BOE4VSHFPOT *OGFDUJPVT%JTFBTFT *OGFSUJMJUZ"OESPMPHZ /FVSPMPHZ /FVSPTVSHFSZ /VDMFBS.FEJDJOF Obstetrics 0CTUFUSJDT(ZOBFDPMPHZ 0CTUFUSJDBOE(ZOBFDPMPHJDBM6MUSBTPVOE Ophthalmology 0SUIPQBFEJD4VSHFPOT Orthotics 1BFEJBUSJD"EPMFTDFOU3IFVNBUPMPHZ 1BFEJBUSJD3FTQJSBUPSZ4MFFQ1IZTJDJBO 1BFEJBUSJD4VSHFSZ Pain Medicine 1PEJBUSZ4FSWJDFT Psychiatry Radiology Renal Medicine Reproductive Health 3FTQJSBUPSZ4MFFQ.FEJDJOF Rheumatology 4FYVBM)FBMUI 4QPSUT.FEJDJOF'PPU0SUIPEPUJDT 5IPSBDJD4VSHFSZ 7BTDVMBS&OEPWBTDVMBS4VSHFSZ 7BTDVMBS*NBHJOH*OUFSWFOUJPO

                                    

Dr Edmund Lee.##4 )POT '3"$1 *OUFSWFOUJPOBMDBSEJPMPHJTUXIPIBTDPNQMFUFEQPTU fellowship training in coronary stenting, structural IFBSUJOUFSWFOUJPOT JODMVEJOH"4%T 1'0T )0$.  valvuloplasties), cardiac biopsies and right heart DBUIFUFSJTBUJPOBUUIF.B[BOLPXTLJ)FBSU*OTUJUVUF $BOBEB 4VJUF.VSEPDI%SJWF.VSEPDI Phone: 9366 1891 'BY 9366 1900 $POTVMUTBU4+0(.VSEPDI 3PDLJOHIBN 8BSXJDL Mandurah, Geraldton and Bunbury. Other special interests include: t 1BDFNBLFSJNQMBOUBUJPO t Transoesophageal echocardiogram 'PSBMMBQQPJOUNFOUT DBMM9366 18916SHFOUBEWJDF0422 895 111

..............................................................................................................................................................................................

...........................................................................................................

..................................................................................................................................................................................................

......................................................................................................................................................................

.............................................................................................................................................................................

.......................................................................

...................................................

..........................................................................................................................

Heart Care Western Australia & Coastal Cardiology )FBSU$BSF8"BOE$PBTUBM$BSEJPMPHZQSPWJEFDPWFSBHFGPSBMMBTQFDUTPG BEVMUDBSEJPMPHZSFRVFTUFECZSFGFSSFSTJO8FTUFSO"VTUSBMJB

....................................................................................

.....................................................................................................................................................................................

.................................................................................................................................................................

........................................................................................................................................

..............................................................................................................................................................................................................

..............................................................................................................................................................................................

...........................................................................................................................................................................

..............................................................................................................................................................................................................

..................................................................................................................

............................................................

.......................................................................................................................................................................

.....................................................................................................................................

......................................................................................................................................................................................................................

.....................................................................

...............................................................

.........................................................................................................................................................................

.............................................................................................................................................................................................

.............................................................................................................................................................................

................................................................................................................................................................................................

.................................................................................................................................................................................................................

.....................................................................................................................................................................................

..............................................................................................................................................................

...............................................................................................................

..........................................................................................................................................................................................

Dr Bernard Hockings Dr Mark Ireland Dr Mark Nidorf Dr Peter Purnell Dr Nigel Sinclair Dr Isabel Tan Dr Peter Thompson

Dr Randall Hendriks Dr Donald Latchem Dr Vince Paul Dr Alan Whelan Dr Xiao-Fang Xu

Comprehensive cardiac services will now be provided by the new practice BU1FSUITMFBEJOHNFUSPQPMJUBOIPTQJUBMTJODMVEJOH4U+PIOPG(PE)PTQJUBM Murdoch, Mount Hospital and Hollywood Private Hospital. )FBSU$BSF8"$PBTUBMXJMMBMTPFYQBOETFSWJDFTJO+PPOEBMVQ .BOEVSBI  #VOCVSZ #VTTFMUPO %VOTCPSPVHI .BSHBSFU3JWFS "MCBOZ %FONBSL  ,BSSBUIBBOE1PSU)FEMBOE The new practice is the only cardiology group that has a clinical presence BUBMMUIFNBKPSUFBDIJOHIPTQJUBMTJO8" JODMVEJOH3PZBM1FSUI)PTQJUBM 4JS $IBSMFT(BJSEOFS)PTQJUBMBOE'SFNBOUMF)PTQJUBM We provide a full and comprehensive Cardiology service including: t $POTVMUBUJPOTo$MJOJDBM &NQMPZNFOUBOE*NNJHSBUJPO3FMBUFE t &$(BOE&YFSDJTF4USFTT5FTUJOH t &DIPDBSEJPHSBQIZ 4USFTT %PCVUBNJOF5SBOTPFTPQIBHFBM Echocardiography t Holter Monitoring and Event Monitoring t Blood Pressure Monitoring t "OHJPHSBQIZ 3FWBTDVMBSJTBUJPOXJUI"OHJPQMBTUZBOE4UFOUT t "4%$MPTVSF 7BMWVMPQMBTUZ t 1FSNBOFOU1BDFNBLFS*OTFSUJPOT *NQMBOUBCMF%FmCSJMMBUPST t Cardiac Resynchronisation t &MFDUSPQIZTJPMPHZ4UVEJFTBOE3BEJPGSFRVFODZ"CMBUJPOT t 1BDFNBLFS$IFDLT t "DDFTTUP1SJWBUFBOE1VCMJD)PTQJUBMT t 3FTPVSDFBOE"EWJTPSZ4FSWJDFUP(FOFSBM1SBDUJUJPOFST

.............................................................................................................................................................................................

.................................................................................

..............................................................................................................................................................................

..................................................................................

.................................................................................................................

Heart Care To speak to a Cardiologist call our GP Hotline: 1300 4 Heart (1300 443 278) For Appointments Phone: 08 9480 3000 Email: info@heartcarewa.com.au Web: www.heartcarewa.com.au Coastal Cardiology To speak to a Cardiologist call our GP Hotline: 08 9311 4601(24hrs on call) For Appointments Phone: 08 9311 4600 Mount, Joondalup, Murdoch, Nedlands, Yokine, Duncraig, Midland Albany, Augusta, Bunbury, Busselton, Denmark, Dunsborough, Karratha, Mandurah, Margaret River, Port Hedland, Rockingham, Northam

A P R I L 2013

medic alFORUMwa

57


CLINICAL SERVICES DIRECTORY

CARDIOLOGY

CARDIOLOGY

Western Cardiology is the largest WA cardiology practice providing comprehensive expertise in both Adult and Paediatric Cardiology in Metropolitan and Regional Centres. This is combined with both private and public Hospital inpatient management. The comprehensive cardiology services include: Dr Mark Hands Dr Eric Whitford Dr Stephen Gordon Dr Philip Cooke Dr Brendan McQuillan Dr Johan Janssen Dr Paul Stobie Dr Chris Finn Dr Eric Yamen Dr Joe Hung Dr Michelle Ammerer Dr Luigi Dâ&#x20AC;&#x2122;Orsogna Dr Darshan Kothari Dr Andre Kozlowski Dr Tim Gattorna Dr Stephen Shipton Dr Devind Bhullar

t "EVMU1BFEJBUSJDDPOTVMUBUJPOT t $POHFOJUBM)FBSU%JTFBTF t &DIPDBSEJPHSBQIZJODMVEFT4USFTT %  Transoesophageal and Paediatric Echos. t 3FTUJOHBOE4USFTT&$( 4USFTT 5IBMMJVN4UVEJFT t "NCVMBUPSZNPOJUPSJOH (Holter, BP and Event). t *NQMBOUBCMF1BDFNBLFST%FmCJMMBUPST t Cardiac Resynchronisation. t 1BDFNBLFS$MJOJD t &MFDUSPQIZTJPMPHZ4UVEJFTJODMVEJOH "SSIZUINJB"CMBUJPO t $PSPOBSZ"OHJPHSBQIZ $PSPOBSZ "OHJPQMBTUZBOE4UFOUJOH t 1FSDVUBOFPVTDMPTVSFPG"4%BOE1'0 t Percutaneous mitral and aortic valvuloplasty and septal ablation t $PSPOBSZ$BMDJVN4DPSJOH )FBSU3JTL4DBO 

Western Cardiology is an independent practice without any corporate ownership and with no ďŹ nancial equity in any cardiac catheter laboratory. We provide inpatient cardiology services for all registered health insurance funds in Australia.

Dr Michael Nguyen .##4 '3"$1 '$4"/; )BTDIBOHFEIJTSPPNTBU/FEMBOET New Address: 4VJUF)PMMZXPPE.FEJDBM$FOUSF .POBTI"WFOVF /&%-"/%48" Tel: 9389 8658'BY9200 5806 'PSVSHFOUBEWJDF NPCJMF  Special interests: *OUFSWFOUJPOBM$BSEJPMPHZ 7BTDVMBSJOUFSWFOUJPO 3FOBM%FOFSWBUJPO

A/Prof David Playford Dr Jenny Deague Dr Barry McKeown Dr Rafeeq Samie Dr Rajesh Kanna Dr Andrew Liu

We provide a comprehensive service in general cardiology and FMFDUSPQIZTJPMPHZ %S4BNJF *OUFSWFOUJPOBM$BSEJPMPHZ %S,BOOB BOE specialist services in echocardiography and cardiac testing. Armadale: Murdoch: Rockingham: Subiaco:

08 9346 9300 08 9388 2601 1800 802 601 08 9382 6111 0411 707 017

â&#x20AC;&#x201D; â&#x20AC;&#x201D; â&#x20AC;&#x201D; â&#x20AC;&#x201D; â&#x20AC;&#x201D;

For all appointments Fax Free call for country enquiries 24/7 On-call Cardiologist Chest Pain Centre: 24 hour emergency cardiac care for your private patients/hospital admission at SJOGH Subiaco

sÂŹ3UBIACOÂŹsÂŹ!PPLECROSSÂŹsÂŹ"ALCATTAÂŹsÂŹ$UNCRAIGÂŹsÂŹÂŹ*OONDALUPÂŹsÂŹ-IDLANDÂŹ sÂŹ"USSELTONÂŹsÂŹ'ERALDTONÂŹsÂŹ+ALGOORLIEÂŹsÂŹ-ANDURAHÂŹsÂŹ.ORTHAM

www.westerncardiology.com.au CARDIOTHORACIC SURGEON

Mr Ian GilďŹ llan .#$I# '3$4 &E $5I%.* '3"$4 Has recommenced practice. 0QFSBUJOHBU'SFNBOUMF5IF.PVOU)PTQJUBMT Provides a comprehensive service in adult cardiothoracic surgery including: t 7BMWVMBS)FBSU%JTFBTF t *TDIBFNJD)FBSU%JTFBTF t Lung Masses t 1MFVSBM%JTFBTF 'PSSPVUJOFBQQPJOUNFOUTQMFBTFDBMM9481 7655. 'PSNZBEWJDFBOEFNFSHFODJFT QMFBTFDBMMNFEJSFDUMZPO 0412 356 216. No gap provider for inpatients services for HBF and Medibank Private. .PVOU.FEJDBM$FOUSF 4VJUF .PVOUT#BZ3PBE 1FSUI

As a doctor-to-doctor communication, Medical Forum offers you considerable freedom to ethically

promote your services to every medical practitioner in WA.

58

medic alFORUMwa

.##4 1I% '3"$1 '$4"/; .##4 1I% '3"$1 .##4 ..FE4D '3"$1 '$4"/; '3"$1 .#$I# '$4"/; .##4 .3$1 '3"$1 .##4 '3"$1 '$4"/;

Upper Swan:

4VJUF (BMMJFST4QFDJBMJTU$FOUSF  "MCBOZ)JHIXBZ "SNBEBMF 4VJUF -FWFM 4+0()FBMUI$BSF.VSEPDI  .VSEPDI%SJWF .VSEPDI 3PDLJOHIBN,XJOBOB%JTUSJDU)PTQJUBM.FEJDBM$MJOJD  &MBOPSB%SJWF 3PDLJOHIBN 4VJUF $BNCSJEHF4QFDJBMJTU$FOUSF  $BNCSJEHF4U 4VCJBDP 4XBO%JTUSJDUT)PTQJUBM &WFMJOF3PBE 6QQFS4XBO

We have unique automated systems for remote digital reporting to ensure rapid report turn-around: t Resting and stress ECG t Holter and ambulatory blood pressure monitoring t Transthoracic and transoesophageal echo t Exercise and dobutamine stress echo t Coronary angiography t Electrophysiology services (general and AFib ablations) t Cardiac pacing t Trans-radial angiography & intervention For appointments: Telephone: 9391 1234  'BY9391 1179 E-mail: reception@heartswest.com.au www.heartswest.com.au sÂŹ3PECIALÂŹ!NNOUNCEMENTÂŹs Hearts West is the only private practice to offer 3D echocardiography and 3D transoesophageal echocardiography

COSMETIC MEDICINE - HAIR LOSS Dr Jennifer Martinick .##4 1SFTJEFOUo*OUFSOBUJPOBM4PDJFUZPG)BJS3FTUPSBUJPO 4VSHFPOT *4)34

4QFDJBMJTJOHJO)BJS3FTUPSBUJPO 0WFSZFBSTFYQFSJFODF 0WFSTVDDFTTGVMIBJSUSBOTQMBOUQSPDFEVSFT 0GGFSJOHUIFA(PME4UBOEBSEJOIBJSUSBOTQMBOUBUJPO .BSUJOJDL5FDIOJRVFÂ&#x2122; Special Interests: t )BJS5SBOTQMBOUBUJPO t3FQSPDFTTJOH t 'BDJBM)BJS5SBOTQMBOUBUJPO t)BJS-PTT5SFBUNFOUT Consulting: *NBHF 4VJUF4UJSMJOH)JHIXBZ /FEMBOET8" Appointments: 5' &NBJMKFOOZ!JNBHFDPNBVwww.martinick.com

A P R I L 2013


CLINICAL SERVICES DIRECTORY

DERMATOLOGY

GASTROENTEROLOGY

Dr. Prasad Kumarasinghe .##4 .% '$$1 '".4 '"$% %FSNBUPMPHJTU Consulting at: Hollywood Medical Centre  4VJUF /P.POBTI"WFOVF/FEMBOET8"  5FM'BY St John of God Dermatology,  4VJUF .D$PVSU4USFFU 4VCJBDP8" Westminster Specialist Centre  8BOOFSPP3PBE 8FTUNJOTUFS8" Special Interests: 1JHNFOUBSZEJTPSEFST 4LJOJOGFDUJPOT 4LJODBODFSTVSHFSZ 1IPUPUIFSBQZ

GASTROENTEROLOGIST AND HEPATOLOGIST

Dr Sam Galhenage .##4 68" '3"$1 *IBWFDPNNFODFEQSBDUJDFBUSouth Perth Endoscopy, 'PSUVOF4U4PVUI1FSUI  *PGGFSBOPQFOBDDFTTHBTUSPTDPQZBOEDPMPOPTDPQZ service, and provide consultation in general gastroenterology and hepatology, with a special interest in viral hepatitis and advanced liver disease. "DBQTVMFFOEPTDPQZTFSWJDFJTBMTPBWBJMBCMF 'PSBQQPJOUNFOUT5FM9368 2333'BY9368 2300 *BMTPDPOTVMUBU'SFNBOUMF)PTQJUBM BOEQSPWJEFPQFOBDDFTTHBTUSPTDPQZ BOEDPMPOPTDPQZGPSQVCMJDQBUJFOUTBU,BMFFZB)PTQJUBMBOE"SNBEBMF )PTQJUBMVOEFSUIF"NCVMBUPSZ4VSHFSZ*OJUJBUJWF

For all Appointments please call: 9389 6736 or Fax: 9389 6748 Dr Graham Thom .##4 )POT %$) '3"$1 '"$% %FSNBUPMPHJTUXJUIspecial interests in: t paediatric dermatology t general medical dermatology t TLJODBODFSTVSHFSZJODMVEJOH.PITNJDSPHSBQIJD surgery Phototherapy available Mohsâ&#x20AC;&#x2122; micrographic surgery available for both privately insured and non-insured patients Address:4VJUF"4PVUI#BOL$FOUSBM  .FBEPXWBMF"WF 4PVUI1FSUI Tel: 6162 1864 Fax 6162 1764 Public hospital positions at Royal Perth Hospital and Princess Margaret Hospital

Dr Kannan Venugopal .##4 .% '3"$1 (BTUSP8" )PMMZXPPE4QFDJBMJTUDFOUSF 4VJUF .POBTI"WFOVF /FEMBOET 8" Phone: 9389 6933 'BY 9389 6944 *BNQMFBTFEUPJOGPSNNZDPMMFBHVFTUIBU*IBWF commenced private practice at the above address where *PGGFS  t "EVMU(BTUSPFOUFSPMPHZBOEHFOFSBM)FQBUPMPHZ consultations. "HBQGSFF PQFOBDDFTTHBTUSPTDPQZBOEDPMPOPTDPQZTFSWJDFJTQSPWJEFEBU Hollywood Private Hospital. 1VCMJD"QQPJOUNFOU3PZBM1FSUI)PTQJUBMBOE*BMTPQSPWJEFFOEPTDPQJD TFSWJDFTBU4XBO%JTUSJDUT)PTQJUBMVOEFSUIF"NCVMBUPSZ4VSHJDBM*OJUJBUJWF  t 4QFDJBMJOUFSFTUJOUIFNBOBHFNFOUPG*OnBNNBUPSZ#PXFM%JTFBTFT "$BQTVMFFOEPTDPQZTFSWJDFJTBMTPBWBJMBCMF 'PSBQQPJOUNFOUT5FM9389 6933'BY9389 6944 'PSVSHFOUSFGFSSBMTBOEBEWJDF QMFBTFDPOUBDU

EAR, NOSE & THROAT GENERAL SURGEONS & SUBSPECIALTIES

Lions Hearing Clinic specialises in the identiďŹ cation, assessment and treatment of hearing loss. We are independent of all hearing aid manufacturers and do not receive sales commissions. We strive to provide the Bec Bennett, Manager Audiological Services best hearing outcomes for every individual. Lions Hearing Clinic offers: UĂ&#x160;Ă&#x2022;`Â&#x2C6;Â&#x153;Â?Â&#x153;}Â&#x2C6;V>Â?Ă&#x160;>Ă&#x192;Ă&#x192;iĂ&#x192;Ă&#x192;Â&#x201C;iÂ&#x2DC;Ă&#x152;Ă&#x160;vÂ&#x153;Ă&#x20AC;Ă&#x160;Ă&#x160; Ă&#x160; Ă&#x160; Â&#x2026;i>Ă&#x20AC;Â&#x2C6;Â&#x2DC;}Ă&#x160;Â?Â&#x153;Ă&#x192;Ă&#x192; UĂ&#x160;Ă&#x2022;Ă&#x20AC;>Â?Ă&#x160;Ă&#x20AC;iÂ&#x2026;>LÂ&#x2C6;Â?Â&#x2C6;Ă&#x152;>Ă&#x152;Â&#x2C6;Â&#x153;Â&#x2DC;]Ă&#x160;Â&#x2C6;Â&#x2DC;VÂ?Ă&#x2022;`Â&#x2C6;Â&#x2DC;}Ă&#x160;Ă&#x160;Ă&#x160; Ă&#x160; Â&#x2026;i>Ă&#x20AC;Â&#x2C6;Â&#x2DC;}Ă&#x160;>Â&#x2C6;`Ă&#x160;ÂŤĂ&#x20AC;iĂ&#x192;VĂ&#x20AC;Â&#x2C6;ÂŤĂ&#x152;Â&#x2C6;Â&#x153;Â&#x2DC;Ă&#x160;>Â&#x2DC;`Ă&#x160;Ă&#x160; Ă&#x160; Ă&#x160; >`Â?Ă&#x2022;Ă&#x192;Ă&#x152;Â&#x201C;iÂ&#x2DC;Ă&#x152;Ă&#x192; UĂ&#x160;,iviĂ&#x20AC;Ă&#x20AC;>Â?Ă&#x192;Ă&#x160;vÂ&#x153;Ă&#x20AC;Ă&#x160;Â&#x2C6;Â&#x201C;ÂŤÂ?>Â&#x2DC;Ă&#x152;>LÂ?iĂ&#x160;`iĂ&#x203A;Â&#x2C6;ViĂ&#x192; UĂ&#x160;6iĂ&#x192;Ă&#x152;Â&#x2C6;LĂ&#x2022;Â?>Ă&#x20AC;Ă&#x160;>Â&#x2DC;`Ă&#x160;L>Â?>Â&#x2DC;ViĂ&#x160;Ă&#x160; Ă&#x160; Ă&#x160; >Ă&#x192;Ă&#x192;iĂ&#x192;Ă&#x192;Â&#x201C;iÂ&#x2DC;Ă&#x152;Ă&#x160;>Â&#x2DC;`Ă&#x160;Ă&#x152;Ă&#x20AC;i>Ă&#x152;Â&#x201C;iÂ&#x2DC;Ă&#x152;Ă&#x160;Ă&#x160; Ă&#x160; Ă&#x160; Â&#x153;ÂŤĂ&#x152;Â&#x2C6;Â&#x153;Â&#x2DC;Ă&#x192; UĂ&#x160;*Ă&#x20AC;Â&#x153;Ă&#x203A;Â&#x2C6;Ă&#x192;Â&#x2C6;Â&#x153;Â&#x2DC;Ă&#x160;Â&#x153;vĂ&#x160;>Ă&#x192;Ă&#x192;Â&#x2C6;Ă&#x192;Ă&#x152;Â&#x2C6;Ă&#x203A;iĂ&#x160;Â?Â&#x2C6;Ă&#x192;Ă&#x152;iÂ&#x2DC;Â&#x2C6;Â&#x2DC;}Ă&#x160;Ă&#x160; Ă&#x160; `iĂ&#x203A;Â&#x2C6;ViĂ&#x192;Ă&#x160; UĂ&#x160;/Â&#x2C6;Â&#x2DC;Â&#x2DC;Â&#x2C6;Ă&#x152;Ă&#x2022;Ă&#x192;Ă&#x160;>Ă&#x192;Ă&#x192;iĂ&#x192;Ă&#x192;Â&#x201C;iÂ&#x2DC;Ă&#x152;Ă&#x192;Ă&#x160;>Â&#x2DC;`Ă&#x160;Ă&#x160; Ă&#x160; Ă&#x160; Ă&#x152;Ă&#x20AC;i>Ă&#x152;Â&#x201C;iÂ&#x2DC;Ă&#x152;Ă&#x160;Â&#x153;ÂŤĂ&#x152;Â&#x2C6;Â&#x153;Â&#x2DC;Ă&#x192;

UĂ&#x160;*Ă&#x20AC;Â&#x153;Ă&#x203A;Â&#x2C6;Ă&#x192;Â&#x2C6;Â&#x153;Â&#x2DC;Ă&#x160;Â&#x153;vĂ&#x160;VĂ&#x2022;Ă&#x192;Ă&#x152;Â&#x153;Â&#x201C;Ă&#x160;Â&#x201C;>`iĂ&#x160;i>Ă&#x20AC;Ă&#x160;Ă&#x160; Ă&#x160; ÂŤÂ?Ă&#x2022;}Ă&#x192;Ă&#x160;Â&#x2C6;Â&#x2DC;VÂ?Ă&#x2022;`Â&#x2C6;Â&#x2DC;}Ă&#x160;Ă&#x192;Ă&#x153;Â&#x2C6;Â&#x201C;]Ă&#x160;Â&#x201C;Ă&#x2022;Ă&#x192;Â&#x2C6;VÂ&#x2C6;>Â&#x2DC;Ă&#x192;Ă&#x160;Ă&#x160; Ă&#x160; >Â&#x2DC;`Ă&#x160;Â&#x2DC;Â&#x153;Â&#x2C6;Ă&#x192;iĂ&#x160;ÂŤĂ&#x20AC;Â&#x153;Ă&#x152;iVĂ&#x152;Â&#x2C6;Â&#x153;Â&#x2DC;Ă&#x160;ÂŤÂ?Ă&#x2022;}Ă&#x192; UĂ&#x160;*>i`Â&#x2C6;>Ă&#x152;Ă&#x20AC;Â&#x2C6;VĂ&#x160;Â&#x2026;i>Ă&#x20AC;Â&#x2C6;Â&#x2DC;}Ă&#x160;>Ă&#x192;Ă&#x192;iĂ&#x192;Ă&#x192;Â&#x201C;iÂ&#x2DC;Ă&#x152;Ă&#x192;Ă&#x160;Ă&#x160; UĂ&#x160;Ă&#x2022;`Â&#x2C6;Ă&#x152;Â&#x153;Ă&#x20AC;Ă&#x17E;Ă&#x160;ÂŤĂ&#x20AC;Â&#x153;ViĂ&#x192;Ă&#x192;Â&#x2C6;Â&#x2DC;}Ă&#x160;Ă&#x160; Ă&#x160; Ă&#x160; >Ă&#x192;Ă&#x192;iĂ&#x192;Ă&#x192;Â&#x201C;iÂ&#x2DC;Ă&#x152;Ă&#x192; UĂ&#x160;7Â&#x153;Ă&#x20AC;Â&#x17D;Ă&#x160; Â&#x153;Ă&#x203A;iĂ&#x20AC;]Ă&#x160;`Â&#x2C6;Ă&#x203A;iĂ&#x20AC;Ă&#x192;]Ă&#x160;>Ă&#x20AC;Â&#x201C;i`Ă&#x160;vÂ&#x153;Ă&#x20AC;ViĂ&#x192;Ă&#x160;Ă&#x160; Ă&#x160; >Â&#x2DC;`Ă&#x160;ÂŤÂ&#x2C6;Â?Â&#x153;Ă&#x152;Ă&#x192;Ă&#x160;Â&#x2026;i>Ă&#x20AC;Â&#x2C6;Â&#x2DC;}Ă&#x160;>Ă&#x192;Ă&#x192;iĂ&#x192;Ă&#x192;Â&#x201C;iÂ&#x2DC;Ă&#x152; *Ă&#x20AC;Â&#x153;Vii`Ă&#x192;Ă&#x160;vĂ&#x20AC;Â&#x153;Â&#x201C;Ă&#x160;Ă&#x152;Â&#x2026;iĂ&#x160;Â&#x2C6;Â&#x153;Â&#x2DC;Ă&#x192;Ă&#x160;i>Ă&#x20AC;Â&#x2C6;Â&#x2DC;}Ă&#x160;

Â?Â&#x2C6;Â&#x2DC;Â&#x2C6;VĂ&#x160;vĂ&#x2022;Â&#x2DC;`Ă&#x160; >Ă&#x20AC;Ă&#x160;-VÂ&#x2C6;iÂ&#x2DC;ViĂ&#x160;Â&#x2DC;Ă&#x192;Ă&#x152;Â&#x2C6;Ă&#x152;Ă&#x2022;Ă&#x152;iĂ&#x160; Ă&#x2022;Ă&#x192;Ă&#x152;Ă&#x20AC;>Â?Â&#x2C6;>½Ă&#x192;Ă&#x160;Ă&#x153;Â&#x153;Ă&#x20AC;Â?`Ă&#x160;Â?i>`Â&#x2C6;Â&#x2DC;}Ă&#x160;Ă&#x20AC;iĂ&#x192;i>Ă&#x20AC;VÂ&#x2026;Ă&#x160; ÂŤĂ&#x20AC;Â&#x153;}Ă&#x20AC;>Â&#x201C;Ă&#x192;Ă&#x160;Â&#x2C6;Â&#x2DC;Ă&#x152;Â&#x153;Ă&#x160;Â&#x2C6;Â&#x201C;ÂŤĂ&#x20AC;Â&#x153;Ă&#x203A;Â&#x2C6;Â&#x2DC;}Ă&#x160;Ă&#x152;Â&#x2026;iĂ&#x160;ÂľĂ&#x2022;>Â?Â&#x2C6;Ă&#x152;Ă&#x17E;Ă&#x160; Â&#x153;vĂ&#x160;Â?Â&#x2C6;viĂ&#x160;Â&#x153;vĂ&#x160;Ă&#x152;Â&#x2026;Â&#x153;Ă&#x192;iĂ&#x160;Ă&#x153;Â&#x2C6;Ă&#x152;Â&#x2026;Ă&#x160;>Ă&#x160;Â&#x2026;i>Ă&#x20AC;Â&#x2C6;Â&#x2DC;}Ă&#x160;Â?Â&#x153;Ă&#x192;Ă&#x192;°

For an electronic referral form visit www.lionshearing.com.au/electronicreferralpad

Joondalup T: 9300 0164 | Winthrop T: 9313 7000 | Subiaco T: 6380 4949 Nedlands T: 9346 3071 | Mt Lawley T: 9271 2355 | Middle Swan T: 9271 2355 www.lionshearing.com.au

A P R I L 2012

Mr Harsha Chandraratna .##4'3"$4 (FOFSBM4VSHFPOXJUITVCTQFDJBMJTUJOUFSFTUTJO t Management of obesity within a multidisciplinary setting including bariatric surgery - oswa.com.au t Pilonidal problems t Laparoscopic surgery including appendicectomy, cholecystectomy and hernia t Emergency surgery Consulting and Operating at:  t4U+PIOPG(PE)PTQJUBM.VSEPDI  t4U+PIOPG(PE)PTQJUBM4VCJBDP  t1FFM4QFDJBMJTU$FOUSF.BOEVSBI 'PSBMMBQQPJOUNFOUT9332 0066PS'BY9312 1619 'PSVSHFOUBEWJDFPSFNFSHFODZSFGFSSBMT "MMDPSSFTQPOEFODF4VJUF.VSEPDI%SJWF .63%0$) GENERAL & ENDOCRINE SURGERY

Mr Simon Ryan .##4'3"$4 (FOFSBM4VSHFPOXJUIQPTUGFMMPXTIJQUSBJOJOHJO &OEPDSJOF4VSHFSZ Special Interests: t Thyroid, parathyroid and adrenal diseases. t "MMBTQFDUTPGHFOFSBMTVSHFSZ FYDFQUCSFBTU surgery). Hospital Appointments: t Hollywood Private Hospital t Joondalup Health Campus t 4JS$IBSMFT(BJSEOFS)PTQJUBM Consulting From: t 4VJUF )PMMZXPPE4QFDJBMJTU.FEJDBM$FOUSF .POBTI"WFOVF /FEMBOET8" t 4VJUF +)$4QFDJBMJTU.FEJDBM$FOUSF 4IFOUPO"WFOVF +PPOEBMVQ8" 1VCMJD 1SJWBUF 8PSLFST$PNQFOTBUJPOBOE%7"QBUJFOUTXFMDPNF For All Appointments:   5FM   'BY Urgent / Emergency Referrals: .PC

medic alFORUMwa

59


CLINICAL SERVICES DIRECTORY

GENERAL SURGEONS & SUBSPECIALTIES GENERAL & UPPER GI SURGEON

Derek Chen .##4'3"$4 (FOFSBM6QQFS(*4VSHFPO Continues to provide a service covering t all aspects of general surgery t TQFDJBMJOUFSFTUJO6QQFS(*4VSHFSZ t HBTUSPTDPQZDPMPOPTDPQZ PQFOBDDFTT

Operating at t 4+0(.VSEPDI t 3PZBM1FSUI#FOUMFZ)PTQJUBMT "EESFTT Suite 1, 96 Farrington Road, Leeming, WA 6149 Contact: Tel 9312 1888 'BY9238 0765 'PSFORVJSJFTVSHFOUBEWJDFQIPOF0411 061 987 (all hours)

GENERAL, BARIATRIC & ENDOCRINE SURGERY

Jon Armstrong .##4'3"$4 -BQBSPTDPQJD#BOEJOHBOE5VCF4MFFWF(BTUSFDUPNZJOB multidisciplinary setting "MMBTQFDUTPG&OEPDSJOF4VSHFSZ (FOFSBM4VSHFSZ FYDFQUCSFBTUTVSHFSZ

'PSNPSFJOGPSNBUJPOPOPCFTJUZTVSHFSZQMFBTFTFFPVS website at www.westernobesitysurgery.com.au 'PSBQQPJOUNFOUTQMFBTFDPOUBDU9382 1779 'BY 9382 1160 .PCJMF jonarmstrong@iinet.net.au

4U+PIOPG(PE)PTQJUBM 4VCJBDP 4VJUF .D$PVSU4USFFU Integrated Colorectal Cancer and I.B.D. Unit 4QFDJBMJTUTJOUIFNVMUJEJTDJQMJOBSZUSFBUNFOUPGDPMPSFDUBMDBODFS*#% Perthâ&#x20AC;&#x2122;s leading colorectal cancer research unit 3BQJEBDDFTTUPJNBHJOHDPMPOPTDPQZ Professor Cameron Platell $PMPSFDUBM4VSHFPO

Mr Michael Levitt $PMPSFDUBMBOE(FOFSBM4VSHFPO

Professor Ian Lawrance (BTUSPFOUFSPMPHJTU

Mr Paul Salama $PMPSFDUBM4VSHFPO

Ms Christine Chidlow Continence Physiotherapist t t t t t t t

POTJUFPODPMPHZSBEJPUIFSBQZ laparoscopic colorectal surgery trans-anal endoscopic microsurgery all general colorectal surgery JOnBNNBUPSZCPXFMEJTFBTF open access colonoscopy and endoscopy all continence related issues

Urgent bookings always available for new colorectal cancer patients Happy to provide second opinions For all bookings: 9382 4577 LAPAROSCOPIC SURGERY

Chris Couch -.##4 '3"$4 '3$4 (MBT

4QFDJBMJTJOHJO Laparoscopic: t Obesity surgery t (BTUSPPFTPQIBHFBMSFnVYTVSHFSZ t Biliary surgery t Hernia surgery Operating and Consulting at: t Mount Hospital (Perth) t 8BJLJLJ1SJWBUF)PTQJUBM 3PDLJOHIBN

Tel: 1800 816 556 'SFFDBMM 'BY9592 3916 Mobile: 0417 969 373

GENERAL SURGEONS & SUBSPECIALTIES Dr Max Baumwol o.##4'3$4 &OH '3$4 &EJOC '3"$4 (FOFSBM-BQBSPTDPQJD4VSHFPO Specialising in:t -BQBSPTDPQJD4VSHFSZ JODMVEJOH-BQBSPTDPQJD)FSOJB3FQBJS (BMM 4UPOFT "QQFOEJDFDUPNZ  t $PMPSFDUBM)BFNPSSIPJE4VSHFSZ t (BTUSPJOUFTUJOBM4VSHFSZ t #SFBTU4VSHFSZ t (FOFSBM4VSHFSZ JODMVEJOH4LJO-FTJPOT $BSQBM5VOOFM 7BSJDPTF7FJOT  Operates at:4U+PIOPG(PE)PTQJUBM4VCJBDP .PVOU)PTQJUBM Perth, Mercy Hospital Mt. Lawley, Glengarry  )PTQJUBM%VODSBJH 0TCPSOF1BSL)PTQJUBM Consultations: t Leederville Clinic 0YGPSE$MPTF 8&45-&&%&37*--&8" t 8BOOFSPP4QFDJBMJTUT$FOUSF 8BOOFSPP3PBE 8"//&300 Appointments: t 1IPOF'BY GENERAL & ENDOCRINE SURGERY

Mr Dean Lisewski, #4D )POT* .##4 '3$4* '3"$4 Specialising in: t 5IZSPJE 1BSBUIZSPJEBOE"ESFOBM4VSHFSZ t .JOJNBMMZ*OWBTJWF&OEPDSJOF4VSHFSZ t -BQBSPTDPQJD4VSHFSZ t /FDLBOE4BMJWBSZ(MBOE4VSHFSZ t #JMJBSZ )FSOJBBOE&NFSHFODZ4VSHFSZ Operating at: t 4U+PIOPG(PE)PTQJUBM.VSEPDI t 'SFNBOUMF)PTQJUBM t 4JS$IBSMFT(BJSEOFS)PTQJUBM t Bentley Hospital t Peel Health Campus Consulting at:  4VJUF 4+0(.VSEPDI Tel: 9311 4141  'BY9332 4876  'PSJORVJSJFTPSUPEJTDVTTBDBTF.PCJMF BREAST & THYROID SURGERY

Dr Corinne Jones.##4 68" '3"$4'3$4 4QFDJBMJTU#SFBTU 5IZSPJEBOE1BSBUIZSPJE4VSHFPO 1FSUI 8"USBJOFE(FOFSBM4VSHFPOXJUIZFBSTQPTU GFMMPXTIJQUSBJOJOHJOCSFBTUBOEUIZSPJETVSHFSZJOUIF6, BOE'SBODF *PGGFSBTQFDJBMJTFETFSWJDFEFEJDBUFEUPCSFBTU UIZSPJE and parathyroid patients with involvement of the patientsâ&#x20AC;&#x2122; GP, specialist nurses and separate multidisciplinary team NFFUJOHTDBODFSDBTFDPOGFSFODFTGPSCSFBTUBOEUIZSPJE cancer patients. Operating at: 4U+PIOPG(PE)PTQJUBM 4+0() 4VCJBDP Consulting from:  4VJUF$ #FOEBU$FOUSF   4+0()4VCJBDP  4BMWBEP3PBE 4VCJBDP8" T 6465 9223'6465 9222 E dr.cjones@bigpond.com For urgent advice 0458 536 475 Dr Wen-Chan Yeow '3"$4 (FOFSBM4VSHFPOXJUIQPTUGFMMPXTIJQUSBJOJOHJO#SFBTU BOE0ODPQMBTUJD4VSHFSZ8JMMQSPWJEFDPNQSFIFOTJWF breast management and general surgical care. With special interest in: t Breast reconstruction t *NQMBOUBVHNFOUBUJPO t Breast reduction Consulting at: t 4VJUF 4+0(4VCJBDP$MJOJD  .D$PVSU4USFFU 4VCJBDP59382 9462' t 4VJUF 4+0(.VSEPDI.FEJDBM$FOUSF  .VSEPDI%SJWF .VSEPDI59366 1884 ' 6SHFOUBEWJDF CSFBTUPSHFOFSBMTVSHJDBM 0422 116 819

60

medic alFORUMwa

A P R I L 2013


CLINICAL SERVICES DIRECTORY

GENERAL SURGEONS & SUBSPECIALTIES

GYNAECOLOGY & GYNAECOLOGICAL SURGERY

GENERAL AND LAPAROSCOPIC L SURGERY

Professor Lincoln Brett .##4 #.FE4D #4D )POT 

Upper Gastro-Intestinal, Hepato-Pancreato-Biliary, Laparoscopic, Endoscopic & Bariatric Surgery

Advanced Laparoscopic Surgery for:

Mr Krishna Epari

Mr Alan Thomas

Consulting at: SJOG Murdoch, West Perth Operating at: SJOG Murdoch, Mount Endoscopy t (BTUSPTDPQZ$PMPOPTDPQZ 0QFO"DDFTT

t ERCP Laparoscopic Surgery including for t (BMMTUPOFT )FSOJBT 3FnVY )JBUVT)FSOJB Bariatric Surgery: t .VMUJEJTDJQMJOBSZ"TTFTTNFOU'PMMPXVQ t -BQ4MFFWF(BTUSFDUPNZ -BQ(BTUSJD#BOEJOH Surgical Assistants wanted: Please send letter & CV to info@uppergiwest.com.au Phone (08) 9334 7555 Fax (08) 9334 7577 www.uppergiwest.com.au

GENERAL AND LAPAROSCOPIC L SURGERY R

Dr Kevin Dolan #4D.#$I#'3$14'3$4&E.%'3$4'3"$4 Over 3000XFJHIUMPTTTVSHFSJFTQFSGPSNFEJO8" (FOFSBM4VSHFPOXJUIGFMMPXTIJQJO-BQBSPTDPQJDBOE 0CFTJUZ4VSHFSZ t all facets of weight loss treatment including surgery t laparoscopic cholecystectomy and hernia repair t emergency surgery t gastroscopy and colonoscopy

'3"/;$0(

t Endometriosis t Hysterectomy t *OGFSUJMJUZ t 3JTL3FEVDUJWF4VSHFSZ t Prolapse, including mesh repair t *ODPOUJOFODF Consults at:  .D$PVSU4USFFU 8FTU-FFEFSWJMMF Ph 9381 3882 Fax 9388 7425  )PMMZXPPE'FSUJMJUZ GPS*7'

 1I Operates at: 4+0(4VCJBDP )PMMZXPPE)PTQJUBM Dr Panos Maouris, .#$I# .% '3$0( '3"/;$0( General gynaecologist with special interests in FOEPNFUSJPTJT mCSPJET NFOTUSVBMEJTPSEFST QSPMBQTF  DPMQPTDPQZ--&5; FOEPNFUSJBMBCMBUJPO BEWBODFE laparoscopic surgery including hysterectomy. /P0QFSBUJPO(BQGPSQSJWBUFQBUJFOUTQVCMJDMJTUTGPS non-insured patients 0QFSBUFTBU(MFOHBSSZ #FUIFTEB .FSDZ)PMMZXPPE )PTQJUBMT QSJWBUFQBUJFOUT BOE,&.)PS+PPOEBMVQ )FBMUI$BNQVT QVCMJDOPOJOTVSFEQBUJFOUT  Appointments: Hollywood.FEJDBM$FOUSF4VJUF .POBTI"WFOVF /FEMBOET Tel 9389 9188'BY9389 9199 Or "SOJTEBMF3PBE %VODSBJH PQQPTJUF(MFOHBSSZ1SJWBUF)PTQJUBM   Tel 9203 7600'BY9203 5160

Operating and Consulting at:  (MFOHBSSZ)PTQJUBM %VODSBJH  )PMMZXPPE)PTQJUBM /FEMBOET Mercy Hospital, Mount Lawley  4+0( 4VCJBDP Correspondence  10#PY %VODSBJH8" Appointments  5   ' Online at www.walos.com.au E: manager@walos.com.au &NFSHFODJFT Dr Sue Taylor .##4 '3"$4 is happy to see general surgical patients of a public or private nature at the 8FTUFSO4VSHJDBM)FBMUICVJMEJOHBU)PMMZXPPE)PTQJUBM *UJTUIFTBNFCVJMEJOHBT$JSDMFPG$BSFCVUXJUIBOFX OBNF Special interests: t Gallbladder t Hernia t 'VOEPQMJDBUJPO 1SPVEUPCFQBSUPGUIFUFBNBQQSPBDIUP#BSJBUSJD4VSHFSZ Operates at: t Hollywood t Bethesda Hospital t 0TCPSOF1BSL)PTQJUBM t 0DDBTJPOBMMZBU,JOH&EXBSE.FNPSJBM Tel: 6424 8596'BY9389 1770 Mobile: 0419 040 535 "MMDPSSFTQPOEFODFUP10#PY#SPBEXBZ /FEMBOET (BUF )PMMZXPPE1SJWBUF)PTQJUBM

A P R I L 2012

Dr Mini Zachariah, .##4 .% .3$0( '3"/;$0( Specialises in: t "EWBODFE-BQBSPTDPQJD)ZTUFSPTDPQJDTVSHFSZ t Endometriosis t Menstrual disorders t Pelvic reconstructive surgery for prolapse VSJOBSZJODPOUJOFODF t *OGFSUJMJUZ t General gynaecology t Colposcopy Consulting from:  4VJUF )PMMZXPPE.FEJDBM$FOUSF .POBTI"WFOVF   /FEMBOET 8" Tel: (08) 9389 5000; Fax (08) 9389 5222; Email: info@zachariah.net.au  4VJUF .FSDZ.FEJDBM$FOUSF &MMFTNFSF3PBE   .PVOU-BXMFZ 8" Tel: (08) 9370 9329; Fax: (08) 9370 9350 Operating at:  )PMMZXPPE1SJWBUF)PTQJUBM .FSDZ)PTQJUBM ,&.)

medic alFORUMwa

61


CLINICAL SERVICES DIRECTORY

GYNAECOLOGY & GYNAECOLOGICAL SURGERY Gynaecology Clinics Dr Jiwan Steven Singh t 0GmDF)ZTUFSPTDPQZPOF4UPQ.FOPSSIBHJB  %6# t -BQBSPTDPQJD&OEPNFUSJPTJT4VSHFSZ t -BQBSPTDPQJD5VCBM4VSHFSZo*OGFSUJMJUZ OPO*7' 3FWFSTBMT t Laparoscopic Hysterectomy t $PMQPTDPQZ-BTFS t 1FMWJD'MPPS0QFSBUJPOT t &OEPNFUSJBM"CMBUJPO "QQPJOUNFOUT5FM 'BY No Operation Gap for Privately Insured Patients 4+0(4VCJBDP Woodvale Private Hospital for Women 5JNCFSMBOF%SJWF 8PPEWBMF Medical inventor (AGES award 2002) www.surgitools.net

GYNAECOLOGY & GYNAECOLOGICAL SURGERY Dr Phil Daborn .##4 '3"/;$0( $6 6SPHZOBFDPMPHJTU 4QFDJBMJTJOHJO t General Gynaecology  *ODMVEJOHMBQBSPTDPQJDIZTUFSFDUPNZ NBOBHFNFOU PGmCSPJET PWBSJBODZTUTBOEBCOPSNBMVUFSJOF bleeding t Female Urinary Incontinence Comprehensive urodynamics assessment, medical and surgical treatment t Primary and recurrent prolapse surgery  7BHJOBM MBQBSPTDPQJDBOENFTISFQBJS 

t Special Interests -BQBSPTDPQJD4BDSPDPMQPQFYZGPSBQJDBMWBHJOBMQSPMBQTFBOE4BDSBM /FSWF4UJNVMBUJPOGPSSFGSBDUPSZVSJOBSZEJTPSEFST

$POTVMUJOHSPPNTBSFMPDBUFEBU4VJUF #BSLFS3PBE4VCJBDP8" Phone 9382 2055 PSGBY9382 2065 or email urogynaecology@optusnet.com.au

GYNAECOLOGY AND INFERTILITY Assoc Prof. Krish Karthigasu (ZOBFDPMPHJTU (ZOBFDPMPHJDBM-BQBSPTDPQJD4VSHFPO TQFDJBMJTFTJO t "EWBODFEMBQBSPTDPQJDTVSHFSZ t Endometriosis t 1FMWJDSFDPOTUSVDUJWFTVSHFSZGPSQSPMBQTFVSJOBSZ incontinence t Menstrual disorders t General gynaecology t Colposcopy He offers consultations at Hollywood Medical Centre BOEPQFSBUFTBU,&.) 4+0(4VCJBDP )PMMZXPPE1SJWBUFBOE#FUIFTEB Hospitals.

Consultants

c/o Concept Day Hospital 218 Nicholson Road Subiaco WA 6008

'PSBMMBQQPJOUNFOUTQMFBTFSJOHUIF)PMMZXPPE.FEJDBM$FOUSF  4VJUF-FWFM.POBTI"WFOVF /FEMBOETPO 9389 8900PSGBY9389 8911. "MMDPSSFTQPOEFODFUP10#PY4VCJBDP8"

 Tel: 9382 2388 Fax: 9381 3603 Range of Services

GYNAECOLOGIC ONCOLOGY, GYNAECOLOGY & COLPOSCOPY

Dr Stuart SalďŹ nger, .##4 '3"/;$0( $(0 4QFDJBMJTJOHJO t Gynaecologic Oncology t Colposcopy t Management preinvasive disease of lower genital tract t $PNQMFYHFOFSBMHZOBFDPMPHJDTVSHFSZ t "EWBODFEMBQBSPTDPQJDQSPDFEVSFTUPUBM laparoscopic hysterectomy t 'BNJMJBM(ZOBFDPMPHJD$BODFSTBOE3JTLSFEVDUJPOTVSHFSZ 5IF$POTVMUJOH4VJUF 4U+PIOPG(PE)PTQJUBM4VCJBDP 4BMWBEP3E 4VCJBDP8" 'PSBQQPJOUNFOUTQIPOF9388 3495'BY 9388 3798 To discuss patients phone 0417 956 007

Dr Steve Harding .##4.3$0('3"/;$0( "$BNCSJEHF4USFFU 8FTU-FFEFSWJMMF Tel 6380 1864'BY 9381 8033 Email: harding.rooms@gmail.com Mobile: 0414 932 927 Special Interests: t General Gynaecology t -BQBSPTDPQJD4VSHFSZ)ZTUFSFDUPNZ&OEPNFUSJPTJT t 7BHJOBM3FDPOTUSVDUJWF4VSHFSZ t Colposcopy Operates at: 4U+PIOT 4VCJBDP #FUIFTEB)PTQJUBM )PMMZXPPE)PTQJUBM ,&.)  'SFNBOUMF)PTQJUBM

62

medic alFORUMwa

Medical & ScientiďŹ c Procedures

Website: www.conceptfertility.com.au

Contact: concept@conceptfertility.com.au

Accreditation: t t t t

RCPA RTAC NATA IS0 9001

Dr Lucy Williams .FEJDBM%JSFDUPS Dr George O'Neill Consultant Gynaecologist Dr Erica Shellabear Consultant Gynaecologist Dr Graeme Thompson Consultant Gynaecologist Dr Linda Wong Consultant Gynaecologist Dr Manju Ambekar Consultant Gynaecologist Dr Mini Zachariah Consultant Gynaecologist Dr Anne Jequier  $POTVMUBOU"OESPMPHJTU Dr Bruce Bellinge Reproductive Biologist Dr Peter Burton 4DJFOUJmD%JSFDUPS Dr Ram Tampi Pathologist Dr Keith (Barney) McCallum $POTVMUBOU(ZOBFDPMPHJTU0CTUFUSJDJBO ,BMHPPSMJF

t t t t

*OGFSUJMJUZJOWFTUJHBUJPO /BUVSBM'FSUJMJUZ&OIBODFNFOU .BMF*OGFSUJMJUZ.BOBHFNFOU "TTJTUFE3FQSPEVDUJPO

t *7'(*'5*$4* t "TTJTUFEIBUDIJOH t &NCSZPDSZPQSFTFSWBUJPO'SP[FOFNCSZP QSPHSBNNF Ovarian tissue cryopreservation t Blastocyst Culture t "SUJmDJBMJOTFNJOBUJPO IVTCBOE

t %POPSTQFSNCBOL4QFSNCBOLJOHGPSQSF vasectomy, chemotherapy or radiotherapy patients t &NCSZP0PDZUF4QFSNEPOBUJPOQSPHSBNNF t 0WVMBUJPONPOJUPSJOH)PSNPOFFWBMVBUJPO t CGH (Preimplantation genetic screening) t Preimplantation genetic diagnosis t 4FNFOFWBMVBUJPO t *OGFSUJMJUZDPVOTFMMJOH t 4VSSPHBDZ

Contact Jenny Heyden on 9203 5222 or email jen@mforum.com.au to include your listing in Medical Forumâ&#x20AC;&#x2122;s prestigious Clinical Services Directory.

A P R I L 2013


CLINICAL SERVICES DIRECTORY

GYNAECOLOGY AND INFERTILITY

GYNAECOLOGY AND INFERTILITY

of Western Australia

Â&#x2021; 3URYLGHVWKHIXOOUDQJHRILQIHUWLOLW\LQYHVWLJDWLRQVDQG DVVLVWHGUHSURGXFWLRQWKHUDSLHV Â&#x2021; IsDUHFRJQLVHGWUDLQLQJFHQWUHIRUWKH5R\DO$XVWUDOLDQDQG 1HZ=HDODQG&ROOHJHRI2EVWHWULFLDQVDQG*\QDHFRORJLVWV Â&#x2021; IsFRPPLWWHGWRDFWLQJLQWKHEHVWLQWHUHVWVRISDWLHQWV E\SURYLGLQJLQWHJUDWHGFRXQVHOOLQJLQYHVWLJDWLYHDQG WUHDWPHQWIDFLOLWLHV Â&#x2021; ProvidesDQDFFHVVDEOHVXSSRUWLYHDQGWLPHO\VHUYLFH UHVSRQVLYHWR\RXUQHHGVDVZHOODVWKHQHHGVRI\RXU SDWLHQWV Fertility Specialists of WA Bethesda Hospital Claremont Tel: (08) 9284 2333 www.fertilitywa.com.au

Fertility Specialists South 764 Canning Hwy Applecross Tel: (08) 9316 8832 www.fss.net.au

Fertility & Endometriosis

Treatment Centre

Dr Vince Chapple

Dr Jay Natalwala

MEDICAL DIRECTOR

CLINICAL DIRECTOR FERTILITY SPECIALIST

Dr Santanu Baruah

Dr Margo Norman

Dr Gian Urbani

FERTILITY SPECIALIST FERTILITY SPECIALIST

3URI5RJHU+DUW1

'U0LNH$LWNHQ1

0HGLFDO'LUHFWRU

2EVWHWULFLDQ *\QDHFRORJLVW

'U-RKQ/RYH1

'U'RUHHQ<HDS1

'U&KULV1LFKROV2

2EVWHWULFLDQ *\QDHFRORJLVW

*\QDHFRORJLVW

2EVWHWULFLDQ *\QDHFRORJLVW

'U.ULVK.DUWKLJDVX2

'U5LFKDUG0XUSK\2

'U$VKOH\0DNHSHDFH1

*\QDHFRORJLVW

2EVWHWULFLDQ *\QDHFRORJLVW

(QGRFULQRORJLVW

'U5RJHU3HUNLQV1

'U$QD3HUNRYLF1

'U:HL<LQJ&KXD

*\QDHFRORJLVW

2EVWHWULFLDQ *\QDHFRORJLVW

2EVWHWULFLDQ *\QDHFRORJLVW

Treatments Â&#x2021;Ovulation Induction Â&#x2021;Intrauterine insemination Â&#x2021;IVF and ICSI cycles Â&#x2021;Cycle tracking Â&#x2021;Donor Sperm Insemination Â&#x2021;Donor Embryo cycles Â&#x2021;VitriďŹ cation Â&#x2021;AMH Testing Â&#x2021;Halo Sperm Testing

Investigations Â&#x2021;Comprehensive fertility testing for both male and female Â&#x2021;Recurrent Miscarriage Endometriosis Â&#x2021;Advanced Endometriosis treatments

Suite 213, Joondalup Health Campus Shenton Ave, Joondalup 6027 Phone 9301 1075 Fax 9400 9962 www.fertilitynorth.com.au

Dr Simon Turner

Dr Julia Barton

MBBS, FRANZCOG, FRCOG

MBBS, FRANZCOG

Prof Lincoln Brett

Dr Bill Patton

BMedSc, BSc (Hon), MBBS, FRANZCOG

MBBch, BAO, DCG, DRCOG, MRCOG, MRCPI, FACGO, FRCOG

Dr Robert Woolcott MB.,BS. (Hons), AMP (Harvard) FRANZCOG, CREI

&RQVXOWVDW)HUWLOLW\6SHFLDOLVWV:$ &RQVXOWVDW)HUWLOLW\6SHFLDOLVWV6RXWK

south

A P R I L 2012

medic alFORUMwa

63


CLINICAL SERVICES DIRECTORY

GYNAECOLOGY, INFERTILITY & ANDROLOGY

HAND SURGEONS Lewis Blennerhassett .##4 '3"$4 )BOE4VSHFPO &YQFSUJTFJOBMMBTQFDUTPGBDVUFBOEDISPOJDIBOEEJTPSEFST CPUIQBFEJBUSJD and adult, is provided. 5IPNBT4USFFU Subiaco "MMBQQPJOUNFOUTQMFBTF1IPOF9381 6977'BY9381 5266 Emergencies phone 0438 040 993 - all hours

Pioneers in Assisted Reproduction Offering all Infertility Treatments And Advanced Laparoscopic Surgery

Mr Michael Halliday #4D )POT .##4 '3"$4 0SUIPQBFEJD4VSHFPOTQFDJBMJTJOHJOIBOEBOEVQQFSMJNCTVSHFSZ Main areas of interest: t "SUISPTDPQJDTVSHFSZPGXSJTU FMCPXBOETIPVMEFS t Chronic wrist pain and instability t &MFDUJWFIBOETVSHFSZFTQFDJBMMZGPS3IFVNBUPJE"SUISJUJT and Osteoarthritis t Hand and general orthopaedic trauma Mr Halliday consults at the Murdoch Orthopaedic Clinic. "QQPJOUNFOUTGPS.VSEPDIBSFUPCFNBEFUISPVHIUIFSPPNT on 9313 8290PS'BY9366 1488. Mobile number for emergencies and advice is 0413 148 048. Mr Craig Smith .##4'3"$4)BOE 8SJTUBOE1MBTUJD4VSHFPOIBTIJTNBJO QSBDUJDFBU$PMJO4U 8FTU1FSUIJOBTTPDJBUJPOXJUI4QFDJBMJTFE)BOE 5IFSBQZ4FSWJDFT5IJTNFBOTUIBUDPOTVMUBUJPO IBOEUIFSBQZBOETQMJOUJOH are all available at one location. His areas of interest include all acute or chronic hand and wrist injuries or disorders, as well as general plastic surgical problems. He continues to consult in Bunbury and Busselton. 'PSBQQPJOUNFOUTPSBEWJDFQMFBTFDBMM9321 4420 Mr Peter Hales 1FSUI0SUIPQBFEJDBOE4QPSUT.FEJDJOF$FOUSF 0VUSBN4USFFU 8FTU1FSUI My interests include: t "SUISPTDPQJD4VSHFSZPG4IPVMEFS &MCPX 8SJTUBOE)BOE t Wrist and Hand pain, arthritis and instability t "DVUF)BOE8SJTU5SBVNB Operating sessions at Bethesda Hospital, Claremont. 'PSBMMBQQPJOUNFOUTBOEFORVJSJFTQMFBTF Phone: 9212 4200 'BY9481 3792

Dr John Yovich Medical Director

INFECTIOUS DISEASES

Dr Philip Rowlands Consultant Gynaecologist

Dr Anne M Jequier

Dr Atef Saba

Consultant Andrologist

Consultant Gynaecologist

Dr Mark Sillender

Dr Gayatri Borude

Consultant Gynaecologist

Consultant Gynaecologist

Dr Desmond Chih .##4'3"$1'3$1" *OGFDUJPVT%JTFBTFT1IZTJDJBOBOE$MJOJDBM.JDSPCJPMPHJTU "MMBTQFDUPGBEVMUHFOFSBMJOGFDUJPVTEJTFBTFTBOEEJBHOPTUJDNJDSPCJPMPHZ including t 'FWFSPGVOLOPXOPSJHJO t #POFKPJOUJOGFDUJPOT t 4VSHJDBMJOGFDUJPOT t 4LJOTPGUUJTTVFJOGFDUJPOT t Travel related infections t Tuberculosis t "OUJCJPUJDSFTJTUBODF $POTVMUTBU+PPOEBMVQ 4+0(.VSEPDI *OQBUJFOU BOE.ZBSFF "MMDPSSFTQPOEFODFUP.D$PZ4USFFU .ZBSFF Telephone: 9317 0999 "QQPJOUNFOUT 9317 0710 'BY 9317 0977 Email: Desmond.Chih@wdp.com.au

NEUROLOGY Dr Mary Watt Consultant Gynaecologist

NOW AT 3 LOCATIONS - LEEDERVILLE, BUNBURY & JOONDALUP For all appts: Tel: (08) 9422 5400 * Fax (08) 9382 4576 Email: info@pivet.com.au * Web: www.pivet.com.au

64

medic alFORUMwa

Dr Ron Manasseh .##4 68" '3"$1 /FVSPMPHJTU $POUJOVFTUPQSBDUJDFJO(FOFSBM"EVMU/FVSPMPHZBOE&.(BU )FQCVSO)FJHIUT4IPQQJOH$FOUSF 4QFDJBMJTU$POTVMUJOH4VJUF #MBDLXBUUMF1BSBEF 1BECVSZ8" Phone: 9403 6698'BY9402 8929

A P R I L 2013


CLINICAL SERVICES DIRECTORY

NEUROLOGY Dr Isabella Taylor, .##4 68" '3"$1 1I% 6OJ.FMC

Epileptologist Specialising in: Epilepsy and EEG service (adults): t mSTUTFJ[VSFJOWFTUJHBUJPOBOENBOBHFNFOU t EJGmDVMUUPDPOUSPMFQJMFQTZ t EEG service Practice location: Hollywood Medical Centre  4VJUF .POBTI"WFOVF  /FEMBOET8" Telephone: 9386 3200  'BDTJNJMF9386 3255

NEUROSURGERY NEUROSURGERY/SPINAL SURGERY

Mr Andrew Miles .##4'3"$4 /FVSPTVSHFPO QSPWJEFT a full neurosurgical service with special interest in: t 4QJOBMTVSHFSZ1PTU'3"$4GFMMPXTIJQUSBJOJOHJO .FMCPVSOF64"JODPNQMFYTQJOBMTVSHFSZ  DISPOJDCBDLQBJO TDJBUJDBBOEDFSWJDBM SBEJDVMPQBUIZNZFMPQBUIZ - spinal instrumentation and fusion - cervical and lumbar prosthetic disc surgery t #SBJOUVNPVSTQPTU'3"$4GFMMPXTIJQUSBJOJOHJO 64"JOCSBJOUVNPVSFQJMFQTZTVSHFSZ TQFDJBMJTJOHJOEJGmDVMUUVNPVSTJOFMPRVFOUDPSUFY BXBLFDSBOJPUPNZXJUIDPSUJDBMTUJNVMBUJPOBOEGVODUJPOBMCSBJO mapping t "MMBTQFDUTPGHFOFSBMBEVMUOFVSPTVSHFSZBOETQJOBMTVSHFSZ $POTVMUBUJPOSPPNTBU4+0()PTQJUBM4VCJBDPBOE.VSEPDIGPSJOTVSFE BOEXPSLFSTDPNQFOTBUJPOQBUJFOUT OP.7*5  Please Note New Phone/Fax Numbers "MMCPPLJOHTQMFBTFQIPOF6380 2600PSGBY6380 2029 'PSBEWJDFBOEVSHFOUDPOTVMUBUJPOTBUBMMUJNFTDBMM0413 057 264.

Introducing Nexus Neurology Anthony Alvaro, Jason Burton, Nerissa Jordan and Andrew Kelly are pleased to announce that they have commenced private practice BU4U+PIOPG(PE)PTQJUBM.VSEPDI BTUIFPOMZOFVSPMPHZHSPVQJO8"  /FYVT/FVSPMPHZ We have a strong clinical presence in all of Perthâ&#x20AC;&#x2122;s major teaching IPTQJUBMT FODPNQBTTJOH31) 4$() BOE'SFNBOUMFIPTQJUBMT We offer a comprehensive neurology service for neurology and TUSPLFQBUJFOUT BOEBSFBCMFUPTFFZPVSQBUJFOUTQSPNQUMZ "MMCPPLJOHTDBOCFNBEFCZUFMFQIPOJOHPVS secretary on 9366 1960'BY9366 1963. www.nexusneurology.com.au contact@nexusneurology.com.au

NEUROSURGERY Dr David Holthouse.##4 )POT '3"$4 '1."/;$" Provides a full service for neurosurgical pain.

NUCLEAR MEDICINE

Dr Joe Cardaci .##4'3"$1 /VDMFBS.FEJDJOF1IZTJDJBO %JBHOPTUJD/VDMFBS*NBHJOHQSPWJEFTBDPNQSFIFOTJWF/VDMFBS.FEJDJOF service at Hollywood Private Hospital. 4QFDJBMJOUFSFTUTJO t .VTDVMPTLFMFUBMJNBHJOHJODMVEJOHTQPSUTJOKVSJFT t Myocardial perfusion imaging t 'VODUJPOBMCSBJOJNBHJOH t Radionuclide therapy (liver and bone metastases, benign thyroid disease) 'PSBQQPJOUNFOUTQMFBTFUFMFQIPOF9386 2844PS'BY9386 2899. Please contact me should you have any questions regarding /VDMFBS.FEJDJOFQSPDFEVSFT *DBOCFDPOUBDUFEPONZNPCJMF0412 556 901.

OBSTETRICS

Consultation at Wembley and Peel Health Campus. 8JMMTFFJOTVSFEBOE8PSLFST$PNQFOTBUJPOQBUJFOUTGPS BMMBSFBTPGQSPDFEVSBMQBJONBOBHFNFOU.7*5OPUTFFO 6OGPSUVOBUFMZXFDBOOPUTFFBOZQBUJFOUTXJUI.7*5 claims pending even if privately covered. "ENJUUJOHSJHIUTUP.PVOU)PTQJUBM )PMMZXPPE1SJWBUF Hospital and Peel Health Campus. "EESFTT$BNCSJEHF4USFFU 8FNCMFZ Phone: 9381 2422 'BY 9381 2433 &NBJM HSFFOMJ[BSE!KB[JOFU GPSBQQPJOUNFOUTBOESFGFSSBMT

 CBTTNBO!KB[JOFU GPSDPSSFTQPOEFODFBOEBEWJDF

Mobile: (medical practitioners only) 0429 104 966 Dr John Liddell /FVSPTVSHFPO .##4 '3"$4 4QFDJBMJTJOHJOBEVMUDSBOJBMBOETQJOBMOFVSPTVSHFSZoXJUIBMFBOJOHUPXBSET minimally invasive surgery. Consults at: t 4VJUF 4U+PIOPG(PE)PTQJUBM $BNCSJEHF4USFFU  4VCJBDP 'PSBMMBQQPJOUNFOUTQIPOF9382 1933'BY9388 1253 'PSVSHFOUBEWJDFPS")QIPOF0419 321 857 or 9382 6111

A P R I L 2012

Dr Julie Goad .##4 8" %3"/;$0( +VMJFJTBOFYQFSJFODFE(10CTUFUSJDJBO %FMJWFSJOHBU"UUBEBMF1SJWBUF)PTQJUBM XJUIFYDFMMFOU 4QFDJBMJTU0(CBDLVQ i/P(BQ1SPWJEFSwGPSNPTU1SJWBUF)FBMUI'VOET 1SBDUJTJOHJO0CTUFUSJDTBOE8PNFOT)FBMUIFYDMVTJWFMZ Consults at: 'BSSJOHUPO3E -FFNJOH Tel: 9313 8133'BY9313 7133 Email: admin@drjuliegoad.com.au Special interests also include: t Pre-conception advice and planning t Fertility concerns t Contraception, including ďŹ tting/removal of Mirena, IUCD and Implanon t Menstrual disturbances t PCOS t All reports and results copied to GP.

medic alFORUMwa

65


CLINICAL SERVICES DIRECTORY

OBSTETRICS & GYNAECOLOGY Dr Atef Saba, .% .3$0( '3"/;$0( "SFBTPGTQFDJBMJOUFSFTUJODMVEF t 1SFHOBODZBGUFS*7' t 'FNBMFJOGFSUJMJUZ 3FDVSSFOU.JTDBSSJBHFBOE&BSMZ Pregnancy Complications. t .BMFJOGFSUJMJUZBOE4VSHJDBM4QFSN3FUSJFWBM t "EWBODFE-BQBSPTDPQJD4VSHFSZJODMVEJOH hysterectomy myomectomy and endometriosis. t Colposcopy. Consults at: "SOJTEBMF3PBE %VODSBJH Operates at: Glengarry Private Hospital 0TCPSOF1BSL)PTQJUBM Mercy Hospital Surgical and Delivery fees will incur no gap. "EWBODFEGFSUJMJUZQSPDFEVSFTXJMMCFQSFDFEFEBU1*7&5.FEJDBM$FOUSF For all appointments Phone: 9447 7748'BY9463 6272 www.gynae-clinic.com.au info@gynae-clinic.com.au

Dr Cliff Neppe #$PNN.##$I'3"/;$0( Consults at: "SOJTEBMF3E %VODSBJH  (opposite Glengarry Private Hospital) 5FM'BY W: cliffneppe.com.au Offers Obstetrics & Gynaecology at: Private: Glengarry Private Hospital 1VCMJD0TCPSOF1BSL)PTQJUBM Special interests also include: t Colposcopy t 6SJOBSZ*ODPOUJOFODF t 1FMWJD'MPPS3FQBJS t Menorrhagia t Contraception t *OGFSUJMJUZ Dr Fred Busch.#$I# '3"/;$0( offers private Obstetrics and Gynaecology services at Glengarry Private Hospital. Specialises in:(FOFSBM0CTUFUSJDT$PNQMFYWBHJOBM TVSHFSZJODMVEJOHQFMWJDnPPSSFQBJSBOEJODPOUJOFODF TVSHFSZ-BQBSPTDPQJDTVSHFSZ)ZTUFSPTDPQJDTVSHFSZ 1FMWJDQBJOBOENFOTUSVBMEJTPSEFST$PMQPTDPQZ No Gap Provider for In-Hospital Services apart from GMHBA Health Fund. Welcomes Dept of Veteran Affairs patients. Rooms: "SOTJEBMF3PBE %VODSBJH Phone: 9448 6064 'BY 9448 6319 email: drfredbusch@drfredbusch.com.au

Dr Vincent Lee .##4.3$0('3"/;$0( Consultant Obstetrician and Gynaecologist 4VJUF -FWFM .FSDZ.FEJDBM$FOUSF &MMFTNFSF3PBE .PVOU-BXMFZ 8" Ph: 9370 9812  'BY9370 9814 4QFDJBMJTFTJO t Obstetrics t General Gynaecology t -BQBSPTDPQJDBOE)ZTUFSPTDPQJD(ZOBFDPMPHJDBM4VSHFSZ t Colposcopy t 1SPMBQTF4VSHFSZ t &OEPNFUSJBM"CMBUJPOGPSNFOPSSIBHJBDPOUSPM %S-FFBMTPPGGFSTQSJWBUF0CTUFUSJDDBSFBOEEFMJWFSTBU.FSDZ)PTQJUBM Mount Lawley. He has private operating lists at Mercy Hospital Mount -BXMFZ%S-FFJTBMTPB7JTJUJOH$POTVMUBOUUP#FOUMFZ)PTQJUBM There is No Operation Gap for Privately Insured Patients.

66

medic alFORUMwa

OBSTETRICS & GYNAECOLOGY

Murdoch Obstetrics & Gynaecology Dr Zhuoming Chu .##4 1I% 68" '3"/;$0( 4U+PIOPG(PE.VSEPDI .VSEPDI%SJWF .VSEPDI Tel: 9312-2100 'BY9312-1295 %S$IVJTB8FTUFSO"VTUSBMJBOUSBJOFE4QFDJBMJTU 0CTUFUSJDJBOBOE(ZOBFDPMPHJTU)FDPNQMFUFEIJT1I% EFHSFFJOUIF6OJWFSTJUZPG8FTUFSO"VTUSBMJBJO  and has been a full time Consultant Obstetrician and (ZOBFDPMPHJTUBU,JOH&EXBSE)PTQJUBMTJODF %S$IVDBOTQFBL$BOUPOFTF.BOEBSJO)FJTBOPgap provider with no PVUPGQPDLFUDPTUGPSHZOBFTVSHJDBMQSPDFEVSFTPSEFMJWFSJFT Special Interest: t General Obstetrics and Gynaecology t 7BHJOBM)ZTUFSFDUPNZBOE t $PMQPTDPQZBOE--&5; --&5;XJMMCF 7BHJOBM3FQBJS done at Public Hospital for uninsured t "EWBODFE-BQBSPTDPQZJODMVEJOH Patients for free) Total Laparoscopic Hysterectomy

OBSTETRICS

Dr Richard Murphy .##4 '3"$(1 '3"/;$0( Consults at: $BNCSJEHF4U 8FTU-FFEFSWJMMF8"  PQQPTJUF4U+PIOPG(PE)PTQJUBM 4VCJBDP

Ph: 9200 6140'BY9200 6150 %S.VSQIZIBTBQSJWBUF0CTUFUSJDQSBDUJDFCBTFEBU4+0( 4VCJBDP BOBQQPJOUNFOUBT$POTVMUBOU0CTUFUSJDJBOBOE (ZOBFDPMPHJTUBU,JOH&EXBSE.FNPSJBM)PTQJUBMBOE BENJUUJOHSJHIUTBU"UUBEBMFBOE.FSDZ)PTQJUBMT)FBMTP DPOTVMUTBU'FSUJMJUZ4QFDJBMJTUT4PVUI 4QFDJBMJOUFSFTUTJODMVEF0CTUFUSJDT SFDVSSFOUQSFHOBODZMPTT QFSJOBUBMMPTT and subfertility. 4VSHJDBMJOUFSFTUTJODMVEFDPNQMFYIZTUFSPTDPQJDTVSHFSZJODMVEJOH&TTVSF contraception, laparoscopy and vaginal surgery.

PWSC offers comprehensive & leading edge specialist obstetrics & gynaecology services at SJOG Murdoch, Mercy & Bethesda Hospital Dr Jason Chin .##4 .FMC '3"/;$0( Special interests: sÂŹ #OLPOSCOPYÂŹ sÂŹ -INIMALLYÂŹINVASIVEÂŹSURGERY sÂŹ 6AGINALÂŹPELVICÂŹRECONSTRUCTIVEÂŹSURGERY sÂŹ 'ENERALÂŹOBSTETRICS Dr Wei-Ying Chua .##4 68" '3"/;$0( Special interests: sÂŹ 2EPRODUCTIVEÂŹ-EDICINE & Fertility Preservation sÂŹ /FlCEÂŹ'YNAECOLOGYÂŹÂŹ#OLPOSCOPY sÂŹ ,APAROSCOPICÂŹÂŹHYSTEROSCOPICÂŹSURGERY sÂŹ 'ENERALÂŹOBSTETRICS We are a no gap provider for in hospital services for major health care funds. Consults at: Level 1 764 Canning Highway, APPLECROSS WA 6153 Phone: (08) 9315 2088 Fax: (08) 9316 0009 Email : reception@pwsc.com.au

As a doctor-to-doctor communication, Medical Forum offers you considerable freedom to ethically

promote your services to every medical practitioner in WA.

A P R I L 2013


CLINICAL SERVICES DIRECTORY

OBSTETRICS & GYNAECOLOGY

OBSTETRIC AND GYNAECOLOGICAL ULTRASOUND

POGU PERTH OBSTETRICS AND GYNAECOLOGY ULTRASOUND

Dr. Anjana Thottungal MBBS, MD, MRCOG, FRANZCOG, DDU

Offering a comprehensive range of specialist scanning services in Obstetrics and Gynaecology. Obstetrics Ultrasound Dr Pierre Smith

Dr Patrick Wu

Dr Ana Perkovic

'3"$(1 '"$33.  '3"/;$0(

.##4 )POT  '3"/;$0(

.% '3"/;$0(

Providing Comprehensive Obstetrics and Gynaecology Care at Mercy Hospital t General Gynaecology t -BQBSPTDPQJD4VSHFSZ t "CEPNJOBM7BHJOBM4VSHFSZ

t Colposcopy t *OGFSUJMJUZ OPU*7'

Tel 9370 9790 'BY 4VJUF.FSDZ.FEJDBM$FOUSF &MMFTNFSF3PBE  .PVOU-BXMFZ8" www.POGS.com.au

Early Pregnancy & First Trimester Screening Amniocentesis & Chorionic Villus Sampling Fetal Anatomy Survey & 3D/4D Scanning Fetal Growth & Well Being Assessment

Gynaecology Ultrasound Pelvic Ultrasound & 3D Pelvic Ultrasound Saline Sonography (Sonohysterography) HyCoSy & Sonovaginography Suite 1 Level 1, Mercy Medical Centre Ellesmere Road Mt Lawley WA 6050 08 6162 1074

08 7123 4403

info@pogu.com.au

www.pogu.com.au OBSTETRIC AND GYNAECOLOGICAL ULTRASOUND

Dr Peter Hugo MBChB FRCOG FRANZCOG DDU Dr Diane Davies .##4 '3"/;$0( %%6 .1)5. Prof Jan Dickinson .##4 .% '3"/;$0( %%6 $.'. Dr Kristy Milward .##4 '3"/;$0( %%6 Offering a comprehensive range of services in obstetric and gynaecological ultrasound. %JBOF%BWJFTIBTBQBSUJDVMBSJOUFSFTUJODPNQMFYHZOBFDPMPHJDBMJNBHJOH XJUITBMJOFJOGVTJPOIZTUFSPHSBQIZBOE)Z$P4ZUFDIOJRVFTBWBJMBCMF+BO %JDLJOTPOJTB3"/;$0(DFSUJmFENBUFSOBMGFUBMNFEJDJOFTVCTQFDJBMJTUBOE QSPWJEFTDPOTVMUBUJPOTGPSIJHISJTLQSFHOBODJFTBOEBGVMMSBOHFPGQSFOBUBM EJBHOPTUJDUFDIOJRVFT,SJTUZ.JMXBSEIBTFYQFSUJTFJOJOTUJMMBUJPOUFDIOJRVFT UPJNBHFUIFFOEPNFUSJVNBOEBMMBTQFDUTPGPCTUFUSJDVMUSBTPVOE7JFXPVS informative website on www.womensimagingservices.com.au. #BSLFS3PBE 4VCJBDP8" Telephone: 9382 1500'BY9382 1927 Email: wis@womensimagingservices.com.au

Offering specialised Obstetric and Gynaecological Ultrasound Â&#x2021;Routine Antenatal Ultrasound Â&#x2021;First Trimester screening Â&#x2021;2nd Trimester Anatomy assessments Â&#x2021;Growth and Biophysical Studies Â&#x2021;Amniocentesis and Chorionic Villus Sampling Ultrasound and Counselling Â&#x2021;Pelvic scanning Â&#x2021;High Risk Ovarian Malignancy Assessment Â&#x2021;Endometrial Evaluation

Conveniently located just off the Mitchell Freeway Joondalup 75 Grand Boulevard, Joondalup. Telephone (08) 9300 1814

OPHTHALMOLOGY As a doctor-to-doctor communication, Medical Forum offers you considerable freedom to ethically

promote your services to every medical practitioner in WA.

A P R I L 2012

www.perthlaservision.com.au Dr Phillip McGeorge .##4 '3"$4 '3"/;$0 with his team of dedicated eye DBSFQSPGFTTJPOBMTJTBWBJMBCMFUPQSPWJEFQBUJFOUTXJUIFYQFSUBTTFTTNFOU  consultation and treatment in laser eye surgery and refractive lens implants. 'PSBMMFORVJSJFTBOEBQQPJOUNFOUTTel: 9366 1655 or Fax: 9366 1764. Assessment & Treatment Clinic Assessment Clinic 4+0(.VSEPDI  4+0(4VCJBDP Medical Clinic Medical Clinic 4VJUF .VSEPDI%SJWF 4VJUF .D$PVSU4USFFU .VSEPDI8"  4VCJBDP8"

medic alFORUMwa

67


CLINICAL SERVICES DIRECTORY

OPHTHALMOLOGY

OPHTHALMOLOGY

Dr Nigel Morlet

Dr Jane Khan

Dr Steve Colley

MB BS FRANZCO FRACS

MB BS FRCOPHTH FRANZCO

MB BS FRANZCO

Dr Tze Lai .##4 )POT .1)$ '3"/;$0 Ophthalmologist Consulting at: t .VSEPDI&ZF$FOUSF 4VJUF  4U+PIOPG(PE)PTQJUBM.VSEPDI t 4VJUF (BMMJFST4QFDJBMJTU$FOUSF  "SNBEBMF,FMNTDPUU)PTQJUBM t Royal Perth Hospital Operating at: t 4U+PIOPG(PE)PTQJUBM.VSEPDI t "SNBEBMF)PTQJUBM t Bentley Hospital t Royal Perth Hospital 4IFJTB8FTUFSO"VTUSBMJBOUSBJOFE0QIUIBMNPMPHJTUXIPIBTDPNQMFUFE BOJOUFSOBUJPOBMMZSFOPXOFE"OUFSJPSTFHNFOUBOE(MBVDPNBGFMMPXTIJQBU Toronto, Canada. 4IFPGGFSTBDPNQSFIFOTJWFPQIUIBMNPMPHZTFSWJDFXJUITQFDJBMJOUFSFTUTJO Cataract surgery and Glaucoma management/laser/surgery. "MMBQQPJOUNFOUT Phone: 9366 1744 Fax: 9366 1764

We are delighted to introduce you to â&#x20AC;&#x153;Western Eyeâ&#x20AC;?.

Dr Robert Paul

The Western Eye clinics have an extensive range of sophisticated lasers and diagnostic equipment for both anterior and posterior segment problems.

MBBS

For those difďŹ cult to manage patients, we also have further capacity with our appointments to the Royal Perth Hospital and Fremantle Hospital Eye Clinics. Dr Nigel Morlet has extensive experience in;

FRANZCO

Specialises in Laser Eye and Refractive Surgery. He offers a comprehensive service in correcting short sightedness, longsightedness and astigmatism. WA Laser Eye Centre provides Â&#x2021;6WDWHRIWKHDUW%ODGH)UHH/DVHU7HFKQRORJ\ Â&#x2021;0XOWLIRFDOLPSODQWVIRU3UHVE\RSLFSDWLHQWV Â&#x2021;,PSODQWDEOH3KDNLFOHQVHVIRUWKRVHQRWVXLWDEOHIRUODVHU

All Enquiries

Â&#x2122;cataract and pterygium surgery, Â&#x2122;laser refractive surgery, Â&#x2122;corneal and external disease, Â&#x2122;lid and lacrimal surgery and Â&#x2122;glaucoma management.

533 Canning Highway Melville 6154

Ph: 9330 8463

Fax: 9330 6994

Suite 30 Hollywood Medical Centre 85 Monash Avenue Nedlands 6009

Dr Jane Khan specialises in; Â&#x2122;cataract and pterygium surgery, Â&#x2122;treatment of age-related macular degeneration, Â&#x2122;diagnosis of inherited or acquired retinal disease, Â&#x2122;management of the complications of diabetes, Â&#x2122;glaucoma management and Â&#x2122;hypertension and other systemic diseases.

Dr Steve Colley specialises in;

Dr Chris Kennedy 3FUJOBM4QFDJBMJTU

.##4 8" 1I% %JTUJODUJPO '3"/;$0 '3"$4

Specialises in Medical, Surgical & Laser treatment of: t Macular degeneration t %JBCFUJDFZFEJTFBTF t Retinal detachment t Retinal vein occlusion t "MMPUIFSEJTPSEFSTPG7JUSFPVT 3FUJOB.BDVMB

Â&#x2122;cataract and pterygium surgery, Â&#x2122;paediatric ophthalmology, Â&#x2122;adult strabismus, Â&#x2122;neuro-ophthalmology, Â&#x2122;lid surgery and Â&#x2122;glaucoma management.

Urgent & Emergency appointments for: t Rapidly deteriorating vision t %JTUPSUFEWJTJPO t Loss of central vision or reading ability t 4VEEFOPOTFUPGnPBUFSTPSnBTIFT t Bleeding in macula, retina or vitreous

Consulting at: Â&#x2122;5/592 Stirling Highway, Mosman Park Â&#x2122;8/420 Roberts Road, Subiaco Â&#x2122;14 Davenport Street, Karrinyup

Consults: 4U+PIOPG(PE&ZF$MJOJD 4VJUF .D$PVSU4U 4VCJBDP Operates: 4+0(4VCJBDP 1SJWBUF 0TCPSOF1BSL)PTQJUBM 1VCMJD

For appointments: Phone 08

9385 6665

westerneye.com.au

Tel: 9382-9422 

68

medic alFORUMwa

'BY9382-9423

Mobile: 0417-993-957

A P R I L 2013


CLINICAL SERVICES DIRECTORY

OPHTHALMOLOGY Dr Fred Nagle 'FMMPXPGUIF3PZBM"VTUSBMJBO$PMMFHFPG 0QIUIBMNPMPHJTUT 1PTUHSBEVBUFJO3FGSBDUJWF4VSHFSZ4ZEOFZ6OJWFSTJUZ Comprehensive Ophthalmologist

ORTHOPAEDIC SURGEONS

Murdoch Orthopaedic Clinic

4QFDJBMJTUJO$BUBSBDUBOE3FGSBDUJWF4VSHFSZ Consulting at:$MJWF4USFFU  8FTU1FSUI Phone: 08 9481 8626 Dr Michael Wertheim.#$I#'3$0QIUI'3"/;$0 Comprehensive General Ophthalmologist Consults at: t 4PVUI4USFFU&ZF$MJOJD 4VJUF$BMMFZ%SJWF  -FFNJOH t Early and Urgent appointments available Operates at: t &ZF4VSHFSZ'PVOEBUJPO 8FTU1FSUI 1SJWBUFQBUJFOUT

t ,BMFFZB)PTQJUBM &BTU'SFNBOUMF VOJOTVSFEQBUJFOUT

t Bentley Hospital (uninsured patients) Special Interests: t $BUBSBDU4VSHFSZ t General Ophthalmology t 6WFJUJT Appointments: t Phone 9312 6033'BY9312 6044

Telephone: (08) 9366 1818 Graham Forward Chairman Hip & Knee Surgery for Arthritis & Sports Injuries

Peter Ammon Foot, Ankle & Knee Surgery

Michael Anderson Hip & Knee Surgery Specialising in Joint Replacement

Robert Genat

Michael Halliday

Hip & Knee Surgery

Hand & Upper Limb Surgery

ORTHOPAEDIC SURGEONS Paul Jarrett Hand Wrist & Upper Limb Surgery

Ben Jeffcote

Orthopaedic Surgery Institute of WA

Knee & Lower Limb Surgery

Tony Jeffries Hand & Upper Limb Surgery

Gerald Lim Hip & Knee Surgery

Karl Stoffel Hip, Knee, Foot & Ankle Surgery Orthopaedic Trauma Surgery

Allan Wang Shoulder, Elbow & Hand Surgery

Benjamin Witte

Piers Yates

Knee Surgery, Arthritis & Sports Knee Injuries

Hip, Knee, Trauma, Primary and Revision Surgery

Murdoch Orthopaedic Clinic

St John of God Medical Centre Suite 10/100 Murdoch Drive Murdoch WA 6150 Telephone: (08) 9366 1818 Facsimile: (08) 9366 1829 www.murdochorthopaedic.com.au Murdoch Orthopaedic Clinic Pty Ltd ACN 064 146 774 ABN 23 070 745 210

A P R I L 2012

medic alFORUMwa

69


CLINICAL SERVICES DIRECTORY

ORTHOPAEDIC SURGEONS

Associate Professor Gareth Prosser .#$I#.3$4'3$4 0SUI '3"$4 0SUI

4VJUF .VSEPDI.FEJDBM$MJOJD 4+0(.VSEPDI)PTQJUBM .VSEPDI%SJWF .VSEPDI 8" Phone 08 9366 1960'BY08 9366 1963 Consults and operatesQSJWBUFMZBU4+0(.VSEPDI)PTQJUBM Special interests include: t )JQBOELOFFSFQMBDFNFOUJODMVEJOHIJQSFTVSGBDJOH t 3FWJTJPOIJQBOELOFFSFQMBDFNFOU t :PVOHBEVMUIJQQSPCMFNTJODMVEJOHKPJOUQSFTFSWJOHTVSHFSZ for dysplasia and impingement t Trauma surgery 0GGFSTB/P(BQ$PWFSGPSBMMNBKPS)FBMUI'VOET )FXFMDPNFT1VCMJD 1SJWBUF %7" .7*5BOE8PSLFST Compensation patients "MTPDPOTVMUTBOEPQFSBUFTBU'SFNBOUMF "SNBEBMFBOE,BMFFZBIPTQJUBMT 'PSBQQPJOUNFOUTQMFBTFDBMM9366 1960PSGBY9366 1963

Mr Peter Ammon .##4 8" '3"$4 0SUI

Foot, Ankle & Knee Orthopaedic Surgeon (fellowship trained) Practising at: t 4VCJBDP 4U+PIOPG(PE)PTQJUBM t .VSEPDI 4U+PIOPG(PE)PTQJUBM "MMBTQFDUTPGfoot and ankle disorders will be covered including t arthritis t injuries and fractures t foot deformity t neurological foot problems "MTPBDVUFBOEDISPOJDLOFFEJTPSEFST 'PSBMMBQQPJOUNFOUT QMFBTFDBMM9311 4700. 'PSBIFNFSHFODJFTDBMM0407 084 034. Mr Michael Edwards .##4 )POT '3"$4 Consults at: Mercy Orthopaedic Centre, Mercy Hospital, Mount Lawley. /PXDPOTVMUJOHBUMidland & Kalamunda. Special Interests: t 6QQFS-JNC4VSHFSZ4IPVMEFS &MCPX )BOE8SJTU t General Orthopaedic Trauma Michael operates at Mercy Hospital, Mt Lawley and holds QVCMJDQPTJUJPOBU4XBO%JTUSJDUT)PTQJUBM 'PSBMMBQQPJOUNFOUTQMFBTFQIPOF9370 9850

0SUIPQBFEJD4VSHFPO Mr Benjamin Witte '3"$4 0SUI

Murdoch Orthopaedic Clinic. t 4QPSUTLOFFJOKVSJFT t Cruciate ligament reconstruction t ,OFFSFQMBDFNFOUTVSHFSZ VOJUPUBMSFWJTJPO

t Primary total hip replacement Operates at: .VSEPDI'SFNBOUMF1FFM)FBMUI$BNQVT "MMBQQPJOUNFOUTFORVJSJFT9311 4144 'BY9311 4183 "WBJMBCMFGPS(1BEWJDFBOEVSHFOUSFGFSSBMT 

70

medic alFORUMwa

ORTHOPAEDIC SURGEONS

Western Orthopaedic Clinic Our team of nine surgeons offer a comprehensive upper and lower limb orthopaedic specialist service including joint replacement, hand surgery, sports injury surgery and peripheral nerve surgery. We offer a same day advisory service for acute cases BOEBIPVSTFSWJDFGPSBMMPVSFYJTUJOHQBUJFOUT t Peter Campbell 9489 8777 t Dermot Collopy 9489 8733 t David Colvin 9489 8788 t Jeff Ecker 9489 8744 t Sani Erak 9489 8755 t Hari Goonatillake 9489 8722 t Gerard Hardisty 9489 8711 t Alex Oâ&#x20AC;&#x2122;Beirne 9489 8799 t Angus Keogh 9489 8784 4VJUF .D$PVSU4USFFU 4VCJBDP5FM 4VJUF# .VSEPDI%SJWF .VSEPDI'BY Visit our website: www.wocwa.com for complete details

Assoc Professor Kon Kozak .##4 8" '3"$4 '"0RUI"

.ZJOUFSFTUTJODMVEF t Shoulder and Elbow Surgery t Hip and Knee Surgery t Sports Injury and Surgery .ZNBJODPOTVMUJOHSPPNTBSFBU Level 2, 280 Rokeby Road, Subiaco WA 6008 *BMTPDPOTVMUBU Glengarry Sports Medicine Centre, "SOJTEBMF3PBE %VODSBJH 'PSBMMBQQPJOUNFOUTQMFBTF1IPOF9381 3084'BY9381 3054 'PSBEWJDFBOEBGUFSIPVSTFNFSHFODJFTNPCJMF0419 902 030 Mr Brett Bairstow, B.FE4D )POT .##4 8" '3"$4 'FMMPXTIJQUSBJOFE0SUIPQBFEJD4VSHFPOXJUITQFDJBM interests including: 1SJNBSZBOE3FWJTJPO)JQBOE,OFF+PJOU3FQMBDFNFOU ,OFF"SUISPTDPQZJODMVEJOH"$-SFDPOTUSVDUJPO Main consulting rooms and regular operating lists at Mercy Hospital Mount Lawley. "MTPDPOTVMUTBOEPQFSBUFTBU+PPOEBMVQ)FBMUI$BNQVT 4VJUF -FWFM .FSDZ.FEJDBM$FOUSF &MMFTNFSF3PBE  .PVOU-BXMFZ 'PSBQQPJOUNFOUTQMFBTFUFMFQIPOF9370 9838PSGBY9370 9837 Professor Bo Nivbrant .% 1I% '3"$4 *BNDPOTVMUJOHBU.PVOU.FEJDBM$FOUSF 4VJUF -FWFM  .PVOUT#BZ3PBEBOEPQFSBUFBUUIF.PVOUIPTQJUBMBT XFMMBT4$() My areas of interest are: t )JQBOE,OFF3FQMBDFNFOUT4VSHFSZ t Resurfacing and Revisions t .JOJ*OWBTJWFBOE$PNQVUFSBJEFE+PJOUSFQMBDFNFOUT 'PSBQQPJOUNFOUTQMFBTF1IPOF9481 1990 or 'BY9481 1992

A P R I L 2013


CLINICAL SERVICES DIRECTORY

ORTHOPAEDIC SURGEONS Mr Gerald Lim .##4 8" '3"$4 consults at Murdoch 0SUIPQBFEJD$MJOJD 'SFNBOUMF)PTQJUBMBOE8BJLJLJ1SJWBUF Hospital. Special interests: t Hip Replacement surgery t ,OFF3FQMBDFNFOUTVSHFSZ t "SUISPTDPQJDLOFFTVSHFSZ )FPQFSBUFTBU4+0(.VSEPDI 'SFNBOUMF)PTQJUBM  8BJLJLJ)PTQJUBMBOE"SNBEBMF,FMNTDPUU)PTQJUBM He is able to see Privately insured, Public patients and 8PSLFShT$PNQFOTBUJPOQBUJFOUT )FPGGFSTB/P(BQ$PWFSGPSBMMNBKPS)FBMUI'VOET Please contact him at Murdoch Orthopaedic Clinic on 9366 1818 and 9311 4655 PSPONPCJMF 'BY9311 4663 Mr Ben Jeffcote #. #4 #.FE4D '3"$4 0SUI

0SUIPQBFEJD4VSHFPO Murdoch Orthopaedic Clinic 4U+PIO0G(PE.FEJDBM$FOUSF  .VSEPDI%SJWF .VSEPDI 8" 1BSLJOHBOEBTFUEPXOBSFBBWBJMBCMF OperatesGSPN4U+PIOPG(PE)PTQJUBM.VSEPDI  'SFNBOUMF)PTQJUBM3PDLJOHIBN)PTQJUBM Special interests include: t ,OFFSFQMBDFNFOUUPUBM VOJDPNQBSUNFOUBM patello-femoral and revision. t ,OFFJOKVSJFT t Patello-femoral instability and arthritis t Lower limb deformity correction 'PSQBUJFOUTXJUIBDVUFLOFFJOKVSJFTSFRVJSJOHVSHFOUSFWJFXUIFSFJTB XFFLMZ,OFF*OKVSZ$MJOJDBU4+0(.VSEPDI"DVUFMJHBNFOUBOEDBSUJMBHF injuries, patellar dislocations and osteochondral injuries can be reviewed in this clinic. We have rapid access to imaging and operating list if required. Appointments please phone 9366 1834 or Email bjeffcote@highway1.com.au /PHBQQSPWJEFSGPSBMMNBKPSIFBMUIGVOET 8PSLFST$PNQFOTBUJPOBOE.7*5 patients are welcome ORTHOPAEDIC AND FOOT/ANKLE SURGEON

Mr Reza Salleh .##4 68" '3"$4 *TQSBDUJTJOHBU4VJUF4+0(4VCJBDP$MJOJD  .D$PVSU4U 4VCJBDP *IBWFSFDFOUMZDPNQMFUFEQPTU'3"$4GFMMPXTIJQ USBJOJOHJOGPPUBOEBOLMFTVSHFSZBOELOFFBSUISPQMBTUZJO .FMCPVSOF 4ZEOFZBOEBU(VZT)PTQJUBM -POEPO "DPNQSFIFOTJWFadult foot and ankle service is provided including t deformity correction t degenerative conditions t arthroscopic and tenoscopic surgery t trauma and sports injuries as well as knee arthroscopy and arthroplasty. Telephone: 9382 9102 'BY 9382 9104 Mobile: 0418 942 235 all hours

ORTHOPAEDIC SURGEONS

Li-On Lam.##4 68" '3"$4 0SUIP

Special interests: t 4IPVMEFSTVSHFSZBMMBTQFDUTJODMVEJOHUIF arthroscopic treatment of cuff tears, instability BOEGSP[FOTIPVMEFS t ,OFFTVSHFSZJODMVEJOHKPJOUSFQMBDFNFOUBOE UIFBSUISPTDPQJDUSFBUNFOUPGTQPSUTLOFFJOKVSJFT t Hip surgery - hip replacement t Trauma Operate at:  #FUIFTEB 'SFNBOUMF ,BMFFZB 3PDLJOHIBNBOE"SNBEBMF Hospitals. Consult at:  $BNCSJEHF4U 8FNCMFZ PQQPTJUF4+0(4VCJBDP

 "MTPDPOTVMUBU'SFNBOUMF)PTQJUBMBOE3PDLJOHIBN)PTQJUBM 'PSGVSUIFSBEWJDFQIPOF0422 245 802 Johan Mostert .##4 68" '3"$4 Special interests: t ,OFFBOETIPVMEFSTVSHFSZTQPSUTNFEJDJOF and joint replacement t ,OFFBSUISPTDPQZ "$-BOEPUIFSMJHBNFOUPVT reconstruction t Patellofemoral problems t Rotator cuff injury and shoulder instability t ,OFFBOETIPVMEFSSFQMBDFNFOUJODM VOJDPNQBSUNFOUBMLOFFT IJHInFYLOFFT Private Operating at: #FUIFTEB)PTQJUBM 4+0(4VCJBDPBOE1FFM Public appointments: Princess Margaret Hospital for Children Consult at: $BNCSJEHF4U 8FNCMFZ PQQPTJUF4+0(4VCJBDP

$POTVMUJOH4VJUFT4PVUI 1FFM)FBMUI$BNQVT +PPOEBMVQ%SJWF 'PSVSHFOUSFGFSSBMTQIPOF0434 276 170 or Email: johanmostert@mac.com Website: scog.com.au for all appointments please Phone 9200 2270 or 'BY9200 2271 For all appointments please Phone 9200 2270 or Fax: 9200 2271 Website: scog.com.au

Hari Goonatillake .##4 '3"$4 (FO4VSH '3"$4 0SUIP

t 4IPVMEFS,OFF"SUISPTDPQJD3FDPOTUSVDUJWF 4VSHFSZ t 4IPVMEFS ,OFF)JQ+PJOU3FQMBDFNFOU4VSHFSZ Consulting at:  4U+PIOPG(PE.FEJDBM$MJOJD  4VJUF .D$PVSU4USFFU4VCJBDP Tel: 08 9489 8722 'BY08 9381 8877 Operating at: t 4U+PIOPG(PE)PTQJUBM 4VCJBDP t )PMMZXPPE1SJWBUF)PTQJUBM /FEMBOET 1SJWBUF %7"8PSLFST$PNQFOTBUJPO1BUJFOUT .ZFYQFSJFODFETUBGGBSFBWBJMBCMFUPNBLFBMM.3* $5 4DBO 9SBZBOE)PTQJUBMCPPLJOHT For appointments phone 9489 8722 or fax 9381 8877 www.wocwa.com

A P R I L 2012

medic alFORUMwa

71


CLINICAL SERVICES DIRECTORY

ORTHOPAEDIC SURGEONS

ORTHOPAEDIC SURGEONS

The Hollywood Orthopaedic Group offers a comprehensive orthopaedic service, excluding spinal conditions.

'PSBQQPJOUNFOUT QMFBTFQIPOFPVS3PPNTPO

Perth Shoulder Clinic, situated at Bethesda Hospital in Claremont, provides a comprehensive service for the treatment of shoulder disorders including:

1300 2 ORTHO or 9389 3800. * Arthroscopic surgery for shoulder instability and rotator cuff pathology * Shoulder Arthroplasty including revision arthroplasty * Surgery for fractures about the humerus, scapula and clavicle * On-site physiotherapy

Gavin Clark t "SUISPTDPQJDBOE4QPSUT4VSHFSZ of the Lower Limb t ,OFFBOE)JQ3FQMBDFNFOU4VSHFSZ sÂŹ9389 3838 Michael Ledger t 4IPVMEFSBOE,OFF4VSHFSZ t4QPSUT*OKVSJFT t0SUIPQBFEJD5SBVNB

Sven Goebel operates at Bethesda Hospital and SJOG Hospital Subiaco as well as Joondalup Health Campus where he is able to see public patients.

sÂŹ9389 3811 Nicole Leeks t General Orthopaedics t 'PPUBOE"OLMF4VSHFSZ t -PXFS-JNC"SUISPTDPQZ t Paediatric Orthopaedics

sÂŹ9389 3844

Clem McCormick t )JQBOE,OFF+PJOU3FQMBDFNFOU4VSHFSZ t 4QPSUT,OFF*OKVSJFT t Paediatric Orthopaedics sÂŹ9389 3888 Jonathan Spencer t 4IPVMEFSBOE,OFF4VSHFSZ t )JQ3FQMBDFNFOU4VSHFSZ t General Orthopaedics

Grant Booth operates at Bethesda Hospital and SJOG Hospital Subiaco as well as holding a public appointment at Royal Perth Hospital.

For appointments or advice contact: sÂŹ9389 3855

Aaron Tay t 6QQFS-JNC4VSHFSZ 4IPVMEFSBOE&MCPX4VSHFSZ

t 4QPSUTBOE3FQMBDFNFOU,OFF4VSHFSZ

p. 9340 6355 f. 9340 6356 reception@perthshoulderclinic.com Perth Shoulder Clinic, Bethesda Hospital 25 Queenslea Dr, Claremont 6010 www.perthshoulderclinic.com

sÂŹ9389 3866 Colin Whitewood t General Orthopaedics t )JQBOE,OFF4VSHFSZ t 4QPSUT,OFF*OKVSJFT t Paediatric Orthopaedics

Mr Peter Honey, .##4 '3"$4 0SUIPQBFEJD4VSHFPO )BOE 8SJTU &MCPX 4IPVMEFSBOE,OFF4VSHFSZ sÂŹ9389 3833

Sean Williams t General Orthopaedic Trauma t "SUISPTDPQJD,OFF4VSHFSZBOE4QPSUT,OFF*OKVSJFT t )JQBOE,OFF3FQMBDFNFOU4VSHFSZ (Primary and Revision) sÂŹ9389 3822 Homan Zandi t 6QQFS-JNC4VSHFSZ 4IPVMEFSBOE&MCPX4VSHFSZ

t )BOE4VSHFSZ sÂŹ9389 3868

Hollywood Orthopaedic Group 4PNFPGPVS4VSHFPOTBMTPDPOTVMUPOBTFTTJPOBMCBTJTJO.PVOU-BXMFZ BOE.JEMBOEBOESFHVMBSMZWJTJUSVSBMBSFBTJO"MCBOZ /BSSPHJOBOEUIF 1JMCBSB3FHJPO 1PSU)FEMBOE ,BSSBUIBBOE5PN1SJDF 

Suite 3 Hollywood Medical Centre .POBTI"WFOVF /FEMBOET8" Telephone: (08) 9389 3800t'BDTJNJMF(08) 9389 3899 XXXIPMMZXPPEPSUIPQBFEJDTDPNBV

72

medic alFORUMwa

Special interests t Joint replacement surgery of the hand, wrist, elbow, TIPVMEFSBOELOFF t "SUISPTDPQJDXSJTU FMCPX TIPVMEFSBOELOFF surgery t 5SFBUNFOUPGTQPSUJOHJOKVSJFT JODMVEJOHLOFF ligament injuries) t 5SFBUNFOUPGTJNQMFBOEDPNQMFYVQQFSMJNCGSBDUVSFTBOE dislocations. t Tendon transfer surgery (Lâ&#x20AC;&#x2122;Episcopo, Eden Lange, transfers for scapular winging) t Paediatric upper limb surgery, including correction of congenital deformity Appointments and enquiries: "MUPOB4USFFU 8FTU1FSUI  Phone: 9481 2856 Fax: 9481 2857 6SHFOUBEWJDFPSSFGFSSBMT

www.peterhoney.com.au

A P R I L 2013


CLINICAL SERVICES DIRECTORY

ORTHOPAEDIC SURGEONS

ORTHOPAEDIC SURGEONS ORTHOPAEDIC SHOULDER & UPPER EXTREMITY

Mr David R J Gill .#$I# '3"$4 Mr Michael Ledger .##4 68" '3"$4 0SUI

wishes to announce he has joined the Hollywood Orthopaedic Group.

Specialist interests include: t arthroscopic reconstructive techniques t BMMTQPSUTLOFFJOKVSJFT t shoulder instability t TIPVMEFSSPUBUPSDVGGDPOEJUJPOTBOEiBMMBSUISPTDPQJDwSFQBJS t joint replacement t orthopaedic trauma $POTVMUBOUPSUIPQBFEJDTVSHFPOBU3PZBM1FSUI)PTQJUBM+PPOEBMVQ )PTQJUBM$POUJOVFTUPPQFSBUFBU.FSDZ)PTQJUBMSFHVMBSMZWJTJUT1PSU )FEMBOE,BSSBUIB)PTQJUBMT Private practice: Hollywood Orthopaedic Group 4VJUF)PMMZXPPE.FEJDBM$FOUSF .POBTI"WFOVF /FEMBOET For Appointments: Phone: 9389 3811  'BY9389 3899 Email: info@hogwa.com.au

0SUIPQBFEJD4VSHFPO %BWJEDPNQMFUFEIJT6QQFS&YUSFNJUZ Orthopaedic fellowship at the Mayo Clinic Rochester Minnesota. Special interests include: t Shoulder- All Arthroscopic reconstructions and stabilisations t Elbow & Wrist Arthroscopic reconstruction t Joint Replacement: Shoulder, Elbow Hip & Knee 1SJWBUF %7"8PSLFST$PNQFOTBUJPOQBUJFOUTXFMDPNF $POTVMUJOHBU4VJUF )PMMZXPPE4QFDJBMJTU$FOUSF .POBTI"WF /FEMBOET8" "MTPDPOTVMUJOHBU.BOEVSBI (MFOHBSSZ.JEMBOE "MMBQQPJOUNFOUTQMFBTFQIPOF9386 3477'BY9386 5979 *BNBWBJMBCMFPONZNPCJMFGPSBEWJDF0439 863 477 Mr Tao Shan Lim.##4 68" (%JQ4VSH"OBU '3"$4 0SUI

0SUIPQBFEJD4VSHFPO *IBWFSFUVSOFEGSPNQPTU'3"$4GFMMPXTIJQUSBJOJOHJO BSUISPTDPQZBOETQPSUTTVSHFSZBUUIF6OJWFSTJUZPG#SJUJTI $PMVNCJB 7BODPVWFS $BOBEB *BNQMFBTFEUPBOOPVODFUIFDPNNFODFNFOUPG Joondalup Orthopaedic Group, and welcome referrals in my areas of interest:

Consult and operate privately at St John of God Murdoch Hospital and a member of the Murdoch Orthopaedic Clinic. .ZTQFDJBMJTU*OUFSFTUBSF Surgery of the hip: QSJNBSZBOESFWJTJPOBSUISPQMBTUZSFTVSGBDJOH GFNPSPBDFUBCVMBS impingement, the young hip, hip dysplasia, alternative bearings and minimally invasive surgery. Surgery of the knee: primary and revision arthroplasty including uni-compartmental surgery. BSUISPTDPQZ OBWJHBUJPO LOFFQSFTFSWBUJPOTVSHFSZBOEPTUFPUPNZ Trauma surgery: upper and lower limb, pelvic and acetabular orthopaedic trauma malunion and non-union surgery Offer a no gap cover for all health funds. .7*5BOE%FQU0G7FUFSBOT"GGBJSTQBUJFOUTBSFXFMDPNF "MTPDPOTVMUBOEPQFSBUFBU'SFNBOUMF 0TCPSOF1BSL BOE,BMFFZBIPTQJUBMT

Shoulder surgery: BSUISPTDPQJDUSFBUNFOUPGSPUBUPSDVGGUFBST JOTUBCJMJUZBOEGSP[FO TIPVMEFSSFQMBDFNFOUBSUISPQMBTUZ Hip surgery: arthroscopic labral repair, treatment of femoro-acetabular impingement and trochanteric bursitis Knee surgery: BSUISPTDPQJDUSFBUNFOUPGNFOJTDBMBOEMJHBNFOUPVTJOKVSJFT realignment osteotomy. 1VCMJD 1SJWBUF %7" 8PSLFST$PNQFOTBUJPOBOE.7*5QBUJFOUTBSFXFMDPNF For all appointments and enquiries: Joondalup Orthopaedic Group 4VJUF 4QFDJBMJTU$FOUSF +PPOEBMVQ)FBMUI$BNQVT 4IFOUPO"WF +PPOEBMVQ8" Phone: 08 9467 6388'BY08 9200 5748 Email: admin@jogwa.com.au Website: www.jogwa.com.au .PCJMF BMMIPVST

'PSBQQPJOUNFOUTQMFBTFQIPOF 9312 1135 PSGBY 9311 4183

ORTHOTICS Prof Markus Kuster.% 1I% '3"$4 0SUIPQBFEJD4VSHFPO My main areas of interest are: t )JQBOE,OFF3FQMBDFNFOUT4VSHFSZ t 3FWJTJPO4VSHFSZ t Joint preserving osteotomies *IBWFBOBQQPJOUNFOUBU3PZBM1FSUI)PTQJUBMGPSQVCMJD patient referrals and at Hollywood hospital for private QBUJFOUT*BNIBQQZUPCFDPOUBDUFEGPSBEWJDFSFHBSEJOH IJQBOELOFFDPOEJUJPOT For appointments or advice please contact: 1FSUI0SUIPQBFEJDBOE4QPSUT.FEJDJOF$FOUSF 0VUSBN4USFFU 8FTU1FSUI Phone: 9212 4200 FBY9481 3792

Orthotic Computer Technology Of Western Australia Pty Ltd Kevin McCarthy, Orthotist o%JQ .01 *410 "01" $POTVMUJOHBU.D$PVSU4USFFU -FFEFSWJMMF8" 4QFDJBMJTJOHJODPNQVUFSEFTJHOFEDVTUPNNBOVGBDUVSFEGVODUJPOBMGPPU PSUIPUJDTVTJOHUIF4XJTT$PNGPSU$BE$BNTZTUFN 8FBMTPTVQQMZBOEmU t $VTUPNNBOVGBDUVSFEBOLMFGPPUPSUIPTFTBOE6$#-GPPUPSUIPTFT t ,OFFCSBDFTGPSQPTUTVSHFSZ PTUFPBSUISJUJT  t "OLMFCSBDFTTQPSUJOH t $BNXBMLFSTBOE%SPQGPPU"'0T t $PSSFDUJPBOE1BWMJLIBSOFTTFTGPS%%) 'PSBMMBQQPJOUNFOUTFORVJSJFTQMFBTF Phone: 9382 4845PS'BY6380 2451 Please browse our website @ www.perth-orthotics.com.au and video on assessment measuring and manufacture of the cad cam foot orthotics.

A P R I L 2012

medic alFORUMwa

73


CLINICAL SERVICES DIRECTORY

PAEDIATRIC & ADOLESCENT RHEUMATOLOGY Associate Professor Prudence Manners .% .##4 '3"$1 Paediatrician, Rheumatologist 1SJWBUF3PPNT$IVSDIJMM"WF4VCJBDP1IPOF9381 6744, 'BY9388 2789 and PMH for paediatric and adolescent autoimmune, SIFVNBUJDEJTFBTFTBOEDPOEJUJPOTPGNVTDVMPTLFMFUBMTZTUFN

Dr Senq J Lee .##4 %JQ$) ($13IFVN '3"$1 Paediatrician, Paediatric & Adolescent Rheumatologist. 4FORJTMPDBMMZUSBJOFEJO1FSUIBOEDPNQMFUFEUSBJOJOHJO )PTQJUBMGPS4JDL$IJMESFO 5PSPOUP)FDPWFSTBMMBTQFDUT PG3IFVNBUPMPHZ BOENPTUPG(FOFSBM1BFEJBUSJDTFYDFQU DPNQMFYEFWFMPQNFOUBMCFIBWJPVSBM For appointments or advice, please contact: $FOUSBM"WFOVF.FEJDBM$FOUSF 4PVUI4U #FBDPOTmFME Tel: 9335 9884 'BY9430 8728 Western Rheumatology, -FNOPT4U 4IFOUPO1BSL Tel: 9380 9944 'BY9380 9481 Email: senqlee@gmail.com

PAEDIATRIC RESPIRATORY & SLEEP PHYSICIAN Dr Veena Judge, .##4 8" '3"$1 1I% 4QFDJBMJTUJO1BFEJBUSJD3FTQJSBUPSZBOE4MFFQ%JTPSEFST 4QFDJBMJOUFSFTUTBSF t Obstructive sleep apnoea - pre and post adenotonsillectomy assessment . t #FIBWJPVSBMTMFFQQSPCMFNTJODMVEJOHEBZUJNFTMFFQJOFTTOJHIU XBLFOJOHT t "TUINB t Chronic cough t Recurrent respiratory infections 4IFQSPWJEFTBsleep studyTFSWJDFBU4+0(4MFFQ$FOUSFBOE1.) "ENJUUJOHSJHIUTUP4U+PIOPG(PE)PTQJUBM4VCJBDPBOE.VSEPDI  3FTQJSBUPSZ4MFFQ.FEJDJOF6OJUBU1.)+PPOEBMVQ)PTQJUBM Consults at Suite 305, SJOG Clinic , 25 McCourt St, Subiaco All appointments Telephone: 9382 9462 Fax: 9382 9463 For urgent advice phone: 0403 126 569 Dr Anne Oâ&#x20AC;&#x2122;Donnell .##4 )POT '3"$1 1I% 4QFDJBMJTUJO1BFEJBUSJD3FTQJSBUPSZBOE4MFFQ.FEJDJOF t snoring and obstructive sleep apnoea t OJHIUXBLJOH t GSFRVFOUOJHIUUFSSPSTTMFFQXBMLJOH t FYDFTTJWFEBZUJNFTMFFQJOFTT t behavioural sleep problems t asthma t chronic cough t recurrent respiratory infections

PAEDIATRIC SURGERY Mr Colin Kikiros, .##4'3"$4 1BFEJBUSJD4VSHFPOBOE 6SPMPHJTUTQFDJBMJTFTJO t General paediatric and neonatal surgery t Minimally invasive (Laparoscopic and Thorascopic) surgery t Thoracic surgery t Correction of chest wall deformities t Treatment of hyperhidrosis t 1BFEJBUSJD6SPMPHZ t Burns .S,JLJSPTDPOTVMUTBU 8/10 McCourt Street, West Leederville (phone 9388 0606 BOEBUUIF4QFDJBMJTU.FEJDBM$FOUSF +PPOEBMVQ)FBMUI Campus (phone 9400 9800). He is also appointed to Princess Margaret Hospital. He can be contacted on mobile number 0411 477 754 for emergencies or advice.

PAIN MEDICINE FOR ALL CHRONIC PA P IN MANAGEMENT

Dr Michael Kent, '"/;$" "OBFTUIFUJTU$POTVMUBOUJO1BJO.FEJDJOF has commenced consultation at: .D$PVSU4USFFU 8FTU-FFEFSWJMMF 'PSBQQPJOUNFOUT1IPOF9388 8929'BY9388 8168 Continues to consult at: t )BSEZ4U 4PVUI1FSUI 'PSBQQPJOUNFOUT1IPOF9367 2255'BY9367 2299

PODIATRY SERVICES

UWA Podiatry Clinic Comprehensive range of reduced fee podiatric services: t Routine foot care for elderly patients t Paediatric assessment and treatment t 'PPU BOLMFBOEGPPUSFMBUFETQPSUTJOKVSJFT t %JBCFUJDBTTFTTNFOUXPVOENBOBHFNFOU t Minor podiatric surgical treatments t 'PPUPSUIPUJDEFWJDFT 'PSBQQPJOUNFOUTFORVJSJFT6488 4522, Email: clinic-podiatry@uwa.edu.au -PDBUFEBUUIFDPSOFSPG1BSLBOE$SBXMFZ"WFOVFT $SBXMFZ Web: www.podiatry.surgery.uwa.edu.au

PSYCHIATRY

4IFQSPWJEFTBpaediatric sleep studyTFSWJDFBU4+0(4MFFQ$FOUSF 4VCJBDPBOE1.) $POTVMUTBU4VJUF 4+0(.FEJDBM$MJOJD .D$PVSU4USFFU 4VCJBDP 'PSBMMBQQPJOUNFOUT1IPOF9382 9462'BY9382 9463 'PSVSHFOUBEWJDFQIPOF0402 424 849

PAEDIATRIC SURGERY Jill Orford .##41I%'3"$4TQFDJBMJTFTJO(FOFSBM1BFEJBUSJD BOE/FPOBUBM4VSHFSZ

"SFBTPGøJOUFSFTUøJOHVJOBMBOEVNCJMJDBMIFSOJBF  infantile hydrocoeles, undescended testes, hypospadias, laparoscopic surgery, hepatobilary and gastrointestinal TVSHFSZ TLJOBOETVCDVUBOFPVTMFTJPOT

Sentiens Day Hospital 1MFBTFSFGFSBMMQSJWBUFNFOUBMIFBMUIQBUJFOUTUP4FOUJFOT%BZ1SPHSBNT 0VSQBUJFOUTVTVBMMZIBWFEFQSFTTJPO BOYJFUZ CJQPMBS ESJOLJOHQSPCMFNT  SFMBUJPOTIJQQSPCMFNT TUSFTT 154% 0$%BOETPNFUJNFTFBUJOHEJTPSEFST BOETDIJ[PQISFOJB8FPGGFSHSPVQQSPHSBNTJO$#5 BMTPFWFOJOH %#5 TLJMMT DSFBUJWFUIFSBQZ BMDPIPMNBOBHFNFOU NJOEGVMOFTT DBSFSTTVQQPSU  self-esteem, health focus, recovery, stress management and drug related metabolic problems. Refer to Dr Dennis Tannenbaum $MJOJDBM%JSFDUPS$POTVMUBOU PSEJSFDUMZUP 4FOUJFOTWJBQIPOFGPSSFGFSSBMBEWJDF9481 1950PSGBY 9481 1952. 4FF4FOUJFOTDPNGPS1%'SFGFSSBM

Hospitals:1SJODFTT.BSHBSFU 4+0(.VSEPDI 4+0( 4VCJBDP .FSDZ4XBO%JTUSJDUT Practice Locations: Murdoch Medical Centre, Murdoch Mercy Medical Centre, Mt Lawley "MMBQQPJOUNFOUT5FM9370 9840 'BY9370 9678 'PSBEWJDFQMFBTFDPOUBDUNFEJSFDUMZ 0409 844 201

74

medic alFORUMwa

A P R I L 2013


CLINICAL SERVICES DIRECTORY

PSYCHIATRY

REPRODUCTIVE HEALTH

REFERRALS MADE EASY

PRIVATE FERTILITY CONTROL CLINIC

*GZPVWFCFFOTUSVHHMJOHXJUIIPX to best help your patients, ring our GP Hotline on 0430 709 459 "TLVTBCPVUPVSTQFDJBMJTFEBOE TVDDFTTGVM*OUFOTJWF"OYJFUZ%FQSFTTJPOQSPHSBNT Our day patient group programs are diverse, dynamic and seamlessly blend traditional and alternative approaches for the treatment PGEFQSFTTJPO BOYJFUZ USBVNB CJQPMBS BOEESVHBOEBMDPIPMBEEJDUJPOT -PDBUFEJO8FTU-FFEFSWJMMF -PPLJOHBUUIFXPSME "CCPUTGPSE1SJWBUF)PTQJUBMo$BNCSJEHF4USFFU8FTU-FFEFSWJMMF General Enquiries

Phone: 08 9381 1833'BY08 9381 7681

info@abbotsfordhospital.com.au

Termination of Pregnancies - Medical and Surgical /BOZBSBJTUIFmSTUGSFFTUBOEJOH1SJWBUF'FSUJMJUZ$POUSPM$MJOJDTFU VQJO8FTUFSO"VTUSBMJBJOUPQSPWJEFTBGF BDDFTTJCMFBOEBGGPSEBCMF abortion for all women, not only for those who are able to pay. Patients who cannot afford to pay will not be turned away. 'PSQFSTPOBMDBSJOHTFSWJDFBOEDPOUJOVBM"GUFS$BSFGPSZPVSQBUJFOUTCZ Dr Victor Chan and nursing staff. 1MFBTFQIPOF IST  Other services are: *OTFSUJPO3FNPWBM*6$%*OTFSUJPO3FNPWBM*NQMBOPO$POUSBDFQUJWF"EWJDF 45%DIFDLT Referral Pads and further information are available on request. Licensed Day Care Facility Nanyara Medical Group, 2 Cleaver Tce, Rivervale 6103 Telephone 9277 6070 TERMINATION OF PREGNANCIES & CONTRACEPTIVE COUNSELLING

The Marian Centre is pleased to announce that Dr Richard Madtengaard has commenced practice at the Marian Centre consulting rooms. Dr Richard Madtengaard   

 FOFSBM"EVMU1TZDIJBUSZ ( %FQSFTTJPO "OYJFUZ .PPE%JTPSEFST

Address: $BNCSJEHF4USFFU 8FNCMFZ Referrals: Phone: 9486 7399PS'BY 9381 2612

RADIOLOGY Envision Medical Imaging $BNCSJEHF4USFFU 0QQ4+0()PTQJUBM4VCJBDP

T: 08 6382 3888 '08 6382 3800 W: www.envisionmi.com.au W: www.envisionreports.com.au 8FC1"9Â&#x2122;POMJOFJNBHFTBOESFQPSUT

%BZ)PTQJUBM-JDFOTFECZUIF%FQBSUNFOUPG)FBMUIPG8FTUFSO"VTUSBMJB and Accredited with ISO 9001:2008 and working towards the National Safety and Quality in Health Service Standards The Womenâ&#x20AC;&#x2122;s Clinic has contracts with all major health insurance funds which cover the privately insured patient for their hospital admission The Womenâ&#x20AC;&#x2122;s Clinic provides:t $FSWJDBMDBODFSTDSFFOJOHQBQTNFBS t 5FTUTGPSTFYVBMMZUSBOTNJUUFEJOGFDUJPOT JODMVEFE$IMBNZEJB t "EWJDFPODPOUSBDFQUJPOJODMVEJOHJOTFSUJPOPGDPOUSBDFQUJWFEFWJDFT  FH*NQMBOPOJNQMBOUTBOE*6%BOEWBTFDUPNZXJUIPVS$POTVMUBOU  6SPMPHJDBM4VSHFPO.S3PCFSU%BWJFT t Termination of pregnancies (GP referral required by law), Medical and 4VSHJDBM Quality care is provided by Dr Judith Nash and her dedicated professional team. 'PSBQQPJOUNFOUTQMFBTFUFMFQIPOF9440 0044 for personal assistance from PVSBENJOJTUSBUJWFTUBGG'PSGVSUIFSJOGPSNBUJPOWJTJUPVSXFCTJUFXXX thewomensclinicwa.com.au or Email: admin@thewomensclinicwa.com.au

Envision Medical Imaging is an independent Radiology practice, located EJSFDUMZPQQPTJUF4U+PIOPG(PE)PTQJUBM4VCJBDPPO$BNCSJEHF4USFFUXJUI free parking behind the building. Services include: t 6MUSBTPVOEJODMVEJOHJOKFDUJPOT t .3*(1SFGFSSBMTBDDFQUFE t 9SBZMPXEPTF t CT: general and cardiac imaging t /VDMFBS.FEJDJOFTDBOT t %FOUBM$POF#FBNBOE01(

Our experienced Dr Marieâ&#x201E;˘ team provides caring and non-judgemental support and services. "VTUSBMJBTPOMZ/P$0BDDSFEJUFE .FEJDBM*NBHJOH1SBDUJDF

RENAL MEDICINE

Freecall 1800 003 707 DR0196

Imaging Specialists include: t #SFOEBO"EMFS t -BXSFODF%FNCP t #FSOBSE,PPOH t Conor Murray t &BNPO,PI t Jeanne Louw t .JDIBFM,SJFTFS t Tonya Halliday

â&#x20AC;&#x153;Unplanned pregnancy & family planning servicesâ&#x20AC;?

Part of the Marie Stopes International global partnership

8 Sayer St Midland WA 6056 www.drmarie.org.au Surgical & medical abortion Contraceptive inserts STI checks Vasectomy Decision-based counselling 24 hour aftercare

Dr Simon Wei, .##4 ..&% '".4 '3"$1 $POTVMUBOU/FQISPMPHJTUQSPWJEJOHDMJOJDBMTFSWJDFTUP*O hospital and consultation patient care in all aspect of adult renal medicine at: 4VJUF 4U+PIOPG(PE 4VCJBDP 4QFDJBMJTU$FOUSF  .D$PVSU4U 4VCJBDP8" "QQPJOUNFOUT 5FM9382 9462  'BY9382 9463 Mobile: 0401 289 276

A P R I L 2012

medic alFORUMwa

75


CLINICAL SERVICES DIRECTORY

RESPIRATORY & SLEEP MEDICINE SLEEP MEDICINE

Dr Scott Phung .##4 )POT '3"$1 4MFFQBOE3FTQJSBUPSZ1IZTJDJBO 1SPWJEFTBDPNQSFIFOTJWFTFSWJDFJO4MFFQ.FEJDJOF  including diagnostic investigations and management of all sleep disorders. 4QFDJBMJOUFSFTUTJODMVEFTMFFQBQOPFB JOTPNOJBBOE narcolepsy. He consults at: t 4+0(.VSEPDI4VJUF.VSEPDI%SJWF  .VSEPDI t 4+0(4VCJBDP4VJUF.D$PVSU4USFFU 4VCJBDPøøøøøøøøøøøøøøøøø For all appointments, Telephone: 9388 8875 and Fax: 9381 9052 )FBMTPDPOTVMUTBUUIF3FTQJSBUPSZ4MFFQ%JTPSEFST$MJOJDBU4$() Dr Richard Warren, .##4 '3"$1JTB4MFFQBOE3FTQJSBUPSZ1IZTJDJBO 1SPWJEFTBGVMMTFSWJDFJO4MFFQNFEJDJOFXJUIBTQFDJBMJOUFSFTUJO t 4MFFQBQOPFB t 4MFFQEJTPSEFSTSFMBUFEUPOFVSPNVTDVMBSEJTPSEFST t Obesity related sleep hypoventilation "MTPQSPWJEFTBTFSWJDFJOHFOFSBMSFTQJSBUPSZNFEJDJOF $POTVMUTBU0YGPSE$MPTF 8FTU-FFEFSWJMMF8" 'PSBQQPJOUNFOUQIPOF9388 8804PSGBY9388 8806 Dr Sina M. Keihani .##4 )POT '3"$1 Respiratory Physician 4MFFQ4QFDJBMJTU .VSEPDI4QFDJBMJTU$FOUSF 'BSSJOHUPO3E -FFNJOH Ph: 6161 7647 'BY 6162 0547 %S,FJIBOJXPVMEMJLFUPBOOPVODFUIBUhe has relocated to his new practice, providing consultation as well as inpatient care in all aspects of general respiratory medicine and sleep health. His special interests are in the evaluation of: t %ZTQOPFB MVOHGVODUJPOUFTUJOH BTUINBBOEMVOHDBODFS t 4OPSJOH TMFFQBQOPFBBOESFTUMFTTMFHTZOESPNF t 'VMMMVOHGVODUJPOUFTUJOH

RESPIRATORY & SLEEP MEDICINE Dr Michael Prichard, .##4 '3"$1 All GP referred sleep patients are seen by the consultant. $POTVMUBOUQIZTJDJBOXJUIFYQFSUJTFJODMJOJDBMSFTQJSBUPSZ BOETMFFQEJTPSEFST4QFDJmDJOUFSFTUTDPNNPOBJSXBZ disorders, occupational lung diseases, obstructive sleep BQOPFB FYDFTTJWFTMFFQJOFTTBOEJOTPNOJB Diagnostic services offered since 1995: t Portable (home based) and supervised sleep monitoring. t 'VMMQVMNPOBSZGVODUJPOUFTUTJODMVEJOHDBSEJPQVMNPOBSZFYFSDJTF UFTUJOH QSPWPDBUJPO HBTFYDIBOHF t Bronchoscopy. Allied Services: t /BTBM$1"1FEVDBUJPOBOEUIFSBQZ t Cognitive behaviour therapy for insomnia. t &YFSDJTFSFIBCJMJUBUJPOGPSDISPOJDMVOHEJTFBTF Consultation locations: 1FSUI.PVOU.FEJDBM$FOUSF.PVOU)PTQJUBM %VODSBJH(MFOHBSSZ)PTQJUBM.FEJDBM$FOUSF .VSEPDI4+0(.FEJDBM$FOUSF Inpatient management: .PVOU)PTQJUBM 4U+PIOPG(PE4VCJBDP 'PSBMMBQQPJOUNFOUT 59481 2244 ' 9481 2255 E admin@perthsleep.com.au 1FSUI3FTQJSBUPSZ4MFFQ$MJOJD 4VJUF.PVOUT#BZ3PBE 1FSUI8" W: perthsleep.com.au

Sleep / CPAP Services Perth, Applecross, Joondalup and Leeming 1FSUI$1"1PGGFSTUIFGPMMPXJOHTFSWJDFT t $1"15SJBMT4BMFT3FOUBMT-FBTFTBOEGVMMQBSUTJOWFOUPSZ t 8FXPSLDMPTFMZXJUICPUITQFDJBMJTUTBOE(1TUPFOTVSFQBUJFOUTBSF JOJUJBUFEBOENBJOUBJOFEPOFGGFDUJWF$1"1UIFSBQZ t -PDBUJPOTJO"QQMFDSPTT +PPOEBMVQBOE-FFNJOH Phone: 1300 744 441'BY9433 2830 1PTUBM"EESFTT$BOOJOH)XZ "QQMFDSPTT

Patients can be referred DIRECTLY for studies. SleepMed Sleep Laboratory: "UUBEBMF1SJWBUF)PTQJUBM Home Based Sleep Studies: 5FMFDPOGFSFODJOHGBDJMJUJFTOPXBWBJMBCMFUPTVQQPSUSVSBM BOESFNPUFDPOTVMUBUJPOT www.sleepmed.com.au 6SHFOUBQQPJOUNFOUSFRVFTUTPSBEWJDFBSFBMXBZTXFMDPNFPO 0401 800 197 (Mobile) or sina@sleepmed.com.au

Dr Jack Philpott .##4 '3"$1 3FTQJSBUPSZBOE4MFFQ1IZTJDJBO Hollywood Hospital Medical Centre 4VJUF .POBTI"WF /FEMBOET 8" Telephone: 1300 570 700 or visit www.sleepwa.com.au $POTVMUJOHJO/FEMBOET %VODSBJH 3PDLJOHIBNBOEWJB5FMFDPOGFSFODJOH XJUIZFBSTPGFYQFSUJTFJOBMMBTQFDUTPGTMFFQBOESFTQJSBUPSZNFEJDJOF 4QFDJBMJOUFSFTUTJODMVEFNBOBHFNFOUPGJOTPNOJBXJUIOPOESVHUIFSBQJFT BOENBOBHFNFOUPGGBUJHVFJONJOJOHBOEPDDVQBUJPOBMTFDUPST%S1IJMQPUU JTUIFBMTPUIF.FEJDBM%JSFDUPSPG4MFFQ8" PGGFSJOH t  t t  t  

76

/PXBJUMJTUGPSUFTUJOHBDSPTTTMFFQSFTQJSBUPSZDFOUSFT SFQPSUTQSPEVDFEXJUIJOCVTJOFTTEBZT %JSFDUSFGFSSBMGPSUFTUJOHXJUITFBNMFTTUSBOTJUJPOUPUIFSBQZ JF$1"1

&YQFSUJTFJOSPVUJOFDPNQMFYTMFFQBQOPFB PCFTJUZIZQPWFOUJMBUJPO OBSDPMFQTZ SFTUMFTTMFHT JOTPNOJBBOETIJGUXPSLEJTPSEFS )JHIRVBMJUZUFTUJOHUSFBUNFOUQSPUPDPMTDPNQMJBOUXJUIUIF"VTUSBMBTJBO 4MFFQ"TTPDJBUJPO "4" JODPOKVODUJPOXJUIUIF/BUJPOBM"TTPDJBUJPOPG 5FTUJOH"VUIPSJUJFT /"5"

medic alFORUMwa

SLEEP & RESPIRATO R RY CENTRE R

CPAP Specialists 8FOPXPGGFS)PNF4MFFQ4UVEJFTXIJDI NFBTVSF&&(&$(BTXFMMBTCPEZQPTJUJPOJOH and movement. Refundable by Medicare and accepted by Private Health Funds for purchase of equipment. 0VS4FSWJDFT t $1"1#*-&7&-JTTVFTBOEUSJBMT XPSLJOHDMPTFMZXJUI1IZTJDJBOTBOE providing appropriate patient care in order to achieve optimum results) t )PNFIPTQJUBMWJTJUT t Home diagnostics studies t Equipment rental t 4BMFTPGFRVJQNFOUJOHFOFSBM t )PNFPYZHFOTFSWJDFT )BNQEFO3PBE/FEMBOET8" Tel: 6389 1199  'BY6389 0707 &NBJMGPSFORVJSJFT"-8"TMFFQ!BJSMJRVJEFDPN

$1"18FTUQSPWJEFTBTQFDJBMJTFE$1"15IFSBQZ4FSWJDFXJUIBTUSPOHGPDVT on delivering quality care, focusing on patient comfort + adherence in order to optimise success with therapy. Allied Services: t 4VQFSWJTFE1"1#JMFWFM"47FRVJQNFOUUSJBMTSFOUBMT t 5IFSBQZ&EVDBUJPOBOE4VQQPSU5SPVCMFTIPPUJOH.BTLmUUJOH t 4BMFTPGFRVJQNFOUJOHFOFSBMBOETQBSFQBSUT t Close collaboration with sleep physicians and GPâ&#x20AC;&#x2122;s (doctors referral required) Tel: 9481 2244'BY9481 2255 Mobile: 0422 390 646 Email for enquires: admin@cpapwest.com.au

A P R I L 2013


CLINICAL SERVICES DIRECTORY

RHEUMATOLOGY

SEXUAL HEALTH

Rheumcare 1SPWJTJPOPGBMM"EVMU3IFVNBUPMPHJDBMTFSWJDFTCZ$POTVMUBOU Rheumatologist Eugene Ang with provision of ultrasonagraphic BTTFTTNFOUGPSJOnBNNBUPSZKPJOUEJTFBTFBTQBSUPGSPVUJOFDPOTVMUBUJPO 4FSWJDJOH%7"BOEBQQSPWFE.7*58$DBTFTBTXFMM Tel: 08 9226 3228'BY08 6161 2820 4VJUF7FOUOPS"WFOVF8FTU1FSUIBOE,BMBNVOEB Dr Jack Edelman .##4'3"$1 Consultant Physician in Rheumatology. 4VCJBDP3IFVNBUPMPHZ$MJOJD$IVSDIJMM"WFOVF4VCJBDPBMTPBU Midland, Wanneroo and Bunbury. 5SFBUNFOUPGBMM"EVMU3IFVNBUPMPHZQSPCMFNT PTUFPQPSPTJT DPOOFDUJWF UJTTVFEJTFBTF OFDLBOECBDLQBJO8PSLFSTDPNQFOTBUJPOBOE.7" assessment and treatment. "MMBQQPJOUNFOUT1IPOF9388 0399'BY9388 0499

Perth Rheumatology Dr Margaret Mazur .% 1PMBOE '3"$1BOE Dr Antonia Cole .#$I# '3"$1 XPVMEMJLFUPBEWJTFUIBUUIFZIBWFNPWFEUP Suite 16 / 95 Monash Avenue Hollywood Specialist Centre, Nedlands 6009 They continue to provide management of all adult rheumatology %S.BSHBSFU.B[VS problems including: t JOnBNNBUPSZBSUISJUJT t connective tissue disease t vasculitis t soft tissue rheumatic disorders t osteoporosis t osteoarthritis Dr Margaret Mazur provides musculoskeletal ultrasound. %S"OUPOJB$PMF Priority appointments for all inямВammatory arthritis. 'PSBQQPJOUNFOUTQMFBTFDBMM 9386 3066 PSGBY9389 6531 Dr Ai Tran .##4 68" '3"$1

Dr David Millar .##4 Dr Pam Quatermass .##4 Dr Denis Cherry Mentor 3FTFBSDI"EWJTFS .BOBHJOHBMMBTQFDUTPG'FNBMF BOE.BMF4FYVBM%ZTGVODUJPO BOE)PSNPOF*NCBMBODF 4VJUF )PMMZXPPE4QFDJBMJTU$FOUSF .POBTI"WFOVF /FEMBOET8" Phone: 9389 1400'BY9389 1411 &NBJMJOGP!XBTFYVBMIFBUIDFOUSFDPNBV 8FCXXXXBTFYVBMIFBMUIDFOUSFDPNBV

SPORTS MEDICINE & FOOT ORTHOTICS Dr Scott Isbel .##4'"$41 4QPSUT1IZTJDJBO 5SFBUNFOUPGBDVUFBOEDISPOJDNVTDVMPTLFMFUBMJOKVSJFT 4QFDJBMJOUFSFTUJO t ,OFF BOLMFBOEGPPUQSPCMFNTBOEDIJMESFOJO sport. t $PNQVUFS"JEFE%FTJHOGPPUPSUIPUJDQSFTDSJQUJPO and manufacture. t Compartment pressure measurement. t %FYBNFUIBTPOFJPOUPQIPSFTJT Consulting at: 4QPSUT.FE4VCJBDP 4+0(.FEJDBM$FOUSF Tel: 9382 9600'BY9382 9613 Email: sisbel@sportsmedsubiaco.com.au

THORACIC SURGERY

JOINTS WEST Rheumatology "JPGGFSTBDPNQSFIFOTJWFBOEDBSJOHTFSWJDF covering all aspects adult rheumatology including the VTFPG6MUSBTPVOEGPSNVTDVMPTLFMFUBMBTTFTTNFOU  diagnoses, and guided injections. Consults: Murdoch Clinic 4VJUF -FWFM4+0(.FEJDBM$FOUSF .VSEPDI%SJWF .VSEPDI Tel: 9366 1884 'BY9366 1882

Victoria Park Clinic 4VJUF"MCBOZ)XZ 7JDUPSJB1BSL Tel: 9472 1904 'BY9472 1082

Public locums 3PZBM1FSUI)PTQJUBM

'SFNBOUMF)PTQJUBM

Email reception@jointswest.com.au Dr Helen Keen .##4 68" 1I% -FFET '3"$1 "TTPDJBUF1SPGFTTPS68" $POTVMUBOU3IFVNBUPMPHJTU3PZBM1FSUI)PTQJUBM Helen is pleased to announce that she has recently commenced private QSBDUJDF NBOBHJOHBMMBEVMUSIFVNBUPMPHZQSPCMFNT JODMVEJOHJOnBNNBUPSZ arthritis, osteoarthritis, osteoporosis, crystal arthritis and connective tissue disorders. 'PSBQQPJOUNFOUTQMFBTFDPOUBDU Subiaco Rheumatology Clinic 142 Churchill Ave, Subiaco Tel: 9388 0399 Fax: 9388 0499

A P R I L 2012

Dr Sanjay Sharma .##4 68" '3"$4 $BSEJPUIPSBDJD 4VSHJDBM'FMMPX )BSWBSE.FEJDBM4DIPPM #PTUPO

$POTVMUBOU$BSEJPUIPSBDJD4VSHFPOPGGFSJOHBGVMMTFSWJDF in diagnosis and management of t 1MFVSBMMVOHNFEJBTUJOBMQBUIPMPHZ t )ZQFSIJESPTJT QBMNBSBYJMMBSZ DPOTFSWBUJWFBOE surgical management) t "EVMUDBSEJBDTVSHFSZ "MMVSHFOUSFGFSSBMT MVOHMFTJPOT XJMMCFTFFOXJUIJOUIF XFFL.PCJMF $POTVMUBU4VJUF MFWFM.PVOU.FEJDBM$FOUSF  .PVOUT#BZ3PBE 1FSUI Tel: 6162 0233'BY6162 0543

VASCULAR & ENDOVASCULAR SURGERY Mr Faraz Shakibaie consults at SJOG Murdoch and is alsoBQQPJOUFEUP"SNBEBMF)PTQJUBMXIFSFIFQFSGPSNT minor elective surgery on public patients. 4QFDJBMJOUFSFTUTJODMVEF t Minimally invasive endovascular surgery for aneurysmal and peripheral arterial disease. t 7BSJDPTFWFJOUSFBUNFOU t Carotid artery disease. 'PSBQQPJOUNFOUT QMFBTFQIPOF9311 4098 (Murdoch). 'PSNPSFVSHFOUNBUUFSTPSHFOFSBMBEWJDFBUBOZUJNF please call 0423857807.

medic alFORUMwa

77


CLINICAL SERVICES DIRECTORY

VASCULAR & ENDOVASCULAR SURGERY Dr Peter Bray .##4 68" '3"$4 7BTDVMBS

4QFDJBMJTU7BTDVMBS&OEPWBTDVMBS4VSHFPO )FBEPG%FQBSUNFOUPG7BTDVMBS4VSHFSZ4U+PIOPG(PE )PTQJUBM 4VCJBDP Offering a comprehensive service for the diagnosis and management of all vascular conditions utilising the most appropriate method for the individual (endovascular, TVSHJDBMBOEPSNFEJDBM  Consults at: Suite 39 Hollywood Medical Centre, 85 Monash Ave, Nedlands, Glengarry Specialist Centre & Amity Health, Albany 'PSUIFDPOWFOJFODFPGQBUJFOUTBOESFGFSSFST *OPXQSPWJEFBTQFDJBMJTU WBTDVMBSTPOPHSBQIZTFSWJDFBUNZDMJOJDTJO/FEMBOETBOE"MCBOZ /PHBQQSPWJEFS Telephone: 9386 4377. Facsimile: 9389 5477. Healthlink: drpebray (HL7) 0QFSBUFTBU4+0(4VCJBDP  )PMMZXPPE .PVOU #FUIFTEB 4$() 'PSQSPGFTTJPOBMBEWJDFPS emergencies, please do not hesitate to contact directly on 0412 006 191. Mr Brendan Stanley, #.#4 '3"$4, Executive Member ANZSVS, is in private practice at the Mount Hospital, and IBTTQFDJBMJOUFSFTUTJO&OEPWBTDVMBSSFQBJSPG"CEPNJOBM "PSUJD"OFVSZTNT """ BOE$BSPUJEJOUFSWFOUJPOT CPUI open endarterectomy and angioplasty with stenting. Brendan is interested in all vascular surgery, with a strong interest in interventional procedures because the techniques are less invasive and offer better recovery times. He still performs open surgery when appropriate GPSUSFBUNFOUPGDBSPUJEEJTFBTF """ QFSJQIFSBMWBTDVMBS disease, varicose veins and hyperhydrosis. Please direct all referrals, appointments, enquiries and correspondence to the main rooms at: 4VJUF .PVOU.FEJDBM$FOUSF .PVOUT#BZ3PBE 1FSUI Phone: 9481 0455 Fax: 9481 0045 Also consulting for both private & public patients at: Consulting Rooms Peel Health Campus 4VJUF-BLFT3PBE (SFFOmFMET No Gap Provider for privately insured patients for inpatient services. 'PSBEWJDFBUBOZUJNF QMFBTFDBMMPO VASCULAR SURGERY R

7BTDVMBS8FTUJTBEFEJDBUFE OPOJOWBTJWFWBTDVMBSJNBHJOHDFOUSF focusing on all aspects of vascular imaging including: t 1FSJQIFSBMBSUFSJBMTUVEJFTJODMVEJOH"#*T t 7BSJDPTF7FJOT t %75TDBOT VSHFOUJGSFRVJSFE

t Carotid arteries t """TUVEJFT t Renal and mesenteric arteries All patients will be bulk-billed. Three vascular surgeons (Mr Faraz Shakibaie, Mr Marek Garbowski and Mr Stefan Ponosh) are available for consultation as requested. Only stateof-the-art digital technology is used in our studies and all reports can be emailed to referring doctors if requested. Our centres are located at: West Leederville Murdoch Armadale

#$BNCSJEHF4USFFU 4+0()PTQJUBM.FEJDBM4VJUFT  .VSEPDI%SJWF 4VJUF (BMMJFST4QFDJBMJTU$FOUSF  "MCBOZ)JHIXBZ

VASCULAR & ENDOVASCULAR SURGERY

WA Vascular Centre WA Vascular Centre offers facilities for Non-Invasive Ultrasound Diagnosis of Arterial & Venous Disorders and advanced Minimally Invasive Treatment options. "MMQBUJFOUTo1SJWBUF 1FOTJPOFS 7FUFSBOT and Health Care Cardholders. WA Vascular Centreâ&#x20AC;&#x2122;s accredited modern GBDJMJUJFTPGGFSIJHIMZUSBJOFE7BTDVMBS4POPHSBQIFSTXIPVTFUIFMBUFTU %PQQMFSBOE%VQMFYFRVJQNFOU1IMFCPMPHJTU.FEJDBM1SBDUJUJPOFST who sclerose varicose veins using latest %VQMFYHVJEFEGPBN UFDIOJRVFBOE4QFDJBMJTFE7BTDVMBS/VSTFT Consults from: Perth â&#x20AC;&#x201C; Headquarters â&#x20AC;&#x201C; Bassendean (VJMEGPSE3PBE  NJOVUFTGSPN1FSUI$#%MPDBUFEDPOWFOJFOUMZDMPTFUP5POLJO 3FJE.JUDIFMM'SFFXBZ BNQMFQBSLJOHBWBJMBCMF

Fremantle 4IPQ 8PPETPOT"SDBEF $BOUPONFOU 4USFFU Joondalup6OJU $PSOFS1JNMJDP(SBOE#PVMFWBSE Mandurah"OTUSVUIFS3PBE Updates: Minimally Invasive Endovascular Surgery 0VSPWFSNPOUITFYQFSJFODFVTJOHUIFSFDFOU'SBSUFSJBMQVODUVSF system, for lower limb angioplasty or stents, has shown that morbidity JTNJOJNJTFEBWPJEJOHTJHOJmDBOUIBFNBUPNBTPSBSUFSJBMCMPPE loss, or need for any arterial closure devices with their associated DPNQMJDBUJPOSBUF BOEJUBMTPJODSFBTFTUIFMJLFMJIPPEGPSFBSMJFS discharge from hospital. Duplex Guided Foam Sclerotherapy of Varicose Veins (DGFS) &YQFSJFODFE1IMFCPMPHJTUT NFEJDBMQSBDUJUJPOFST VTJOH%('4  produce results that compare favourably with any other treatment method available, including surgery, laser or radioablation, but avoids UIFJSBTTPDJBUFEDPNQMJDBUJPOTBOEJODSFBTFEFYQFOTF BOEUIFTF NBZBMTPBMMSFRVJSFBEEJUJPOBMTDMFSPUIFSBQZ"MMUSFBUNFOUTIBWF comparable incidence of varicose vein recurrence, which can, if OFDFTTBSZ CFSFBEJMZUSFBUFEXJUIFBSMZNJOJNBMMZJOWBTJWF%('4

Dr Steve Baker '3"$4 %%6 consults at 4VJUF4+0(Subiaco 4VJUF4+0(Murdoch 8BJLJLJ1SJWBUF)PTQJUBMRockingham 'PS"QQPJOUNFOUTQMFBTFDBMM 'PSBEWJDFBOEFNFSHFODJFTDBMM Comprehensive care of vascular disorders is provided, with special interests in minimally invasive catheter treatment of arterial disease """ DMBVEJDBUJPO DBSPUJETUFOPTJT MFHVMDFST  and varicose veins, especially laser surgery.

VA S C

VEIN AND ARTERY SPECIALIST CLINIC

Dr Rick Bond .##4'3$4'3"$41I% Special interests: 4QFDJBMJOUFSFTUT7BSJDPTFWFJOT  Hyperhidrosis, vascular access surgery as well as carotid TVSHFSZ'VMMSBOHFPGPQFOBOEFOEPWBTDVMBSWBTDVMBS surgery. Provides both public and private services at: t $BOOJOH)JHIXBZ &BTU'SFNBOUMF t 8BJLJLJ1SJWBUF)PTQJUBM 3PDLJOHIBN t 4+0()PTQJUBM #VOCVSZ t %VDIFTT.FEJDBM1SBDUJDF #VTTFMUPO 'PSBMMBQQPJOUNFOUT1IPOFPS'BY9418 8377 Email: admin@vasc.com.au "MMDPSSFTQPOEFODF10#PY 4QFBSXPPE

'PSCPPLJOHTBUFJUIFSDFOUSF Phone: 9381 7772 PS'BY 9381 1040

78

medic alFORUMwa

A P R I L 2013


CLINICAL SERVICES DIRECTORY

VASCULAR & ENDOVASCULAR SURGERY

VASCULAR & ENDOVASCULAR SURGERY Mr Stefan Ponosh .##4 68" '3"$4 7BTDVMBS

7BTDVMBS&OEPWBTDVMBS4VSHFPO

Dr Kishore Sieunarine 7BTDVMBS&OEPWBTDVMBS(FOFSBMTVSHFPO .##4 '3"$4 '3$4& %%6

%S4JFVOBSJOFQSPWJEFTBDPNQSFIFOTJWFEJBHOPTUJDBOEUIFSBQFVUJDTFSWJDF to all patients with vascular and renal problems. %S4JFVOBSJOFPGGFSTWBTDVMBSBOEFOEPWBTDVMBSTFSWJDFTXJUI/P(BQTGPS QVCMJDBOEQSJWBUFQBUJFOUTBDSPTT8FTUFSO"VTUSBMJB 7BTDVMBS-BCUFTUJOHJODMVEJOHVMUSBTPVOETDBOQFSGPSNFEBU/FEMBOETPGmDF Specialising in: t Leg ulcers t Endovascular stents and grafting t Renal access t "OHJPHSBQIZ1FSDVUBOFPVTBOHJPQMBTUZ t 7BSJDPTFWFJOT t Carotid disease: endarterectomy and stenting t Hyperhidrosis t %JBCFUJDGFFU t "OFVSZTNBMEJTFBTF For all appointments please contact (08) 9386 9855 or reception@westcoastvascular.com.au.

-PDBMHSBEVBUFGSPNUIF6OJWFSTJUZPG8FTUFSO"VTUSBMJB  'FMMPXPGUIF3PZBM"VTUSBMBTJBO$PMMFHFPG4VSHFPOT BOE)FBEPG7BTDVMBS4VSHFSZ%FQBSUNFOU4JS$IBSMFT Gairdner Hospital. My private practice is located at: Suite 39 Hollywood Medical Centre, 85 Monash Avenue Nedlands 6009 *QSPWJEFBcomplete management service for all arterial and venous vascular conditions offering open surgery, minimally invasive endovascular surgery as well as conservative medical therapies. *BNBTUBGGTQFDJBMJTUBUSir Charles Gairdner Hospital and operate privately at Hollywood Private Hospital, SJOG Subiaco, Mercy Hospital and Bethesda Hospital. *DPOTVMUBUHollywood Medical Centre, Sir Charles Gairdner Hospital & Albany. 'PSBMMBQQPJOUNFOUTQMFBTFDBMM9386 6200PSGBY9389 5477. 'PSBOZBEWJDFBOEFNFSHFODJFTQMFBTFGFFMGSFFUPDPOUBDUNFEJSFDUMZPO 0403 239 956. *BNB no gap provider for privately insured patients.

For advice or emergencies contact 0417 927 611.

Dr Marek Garbowski .##4'3"$4 7BTD  Vascular & Endovascular Surgeon $POTVMUTPQFSBUFTGSPN t 4+0(.FEJDBM$MJOJD .D$PVSU4USFFU Subiaco t 4+0(4QFDJBMJTU$MJOJD Bunbury t 4+0(4QFDJBMJTU$MJOJD Geraldton t Joondalup Health Campus, Hampton House Joondalup t Glengarry Private Hospital, Duncraig t 1VCMJD"QQPJOUNFOUT4$() 31) +)$ Appointments: Tel 9382 9100 Fax 9382 9101 %S(BSCPXTLJQSPWJEFTBMMBTQFDUTPGEJBHOPTJTBOENBOBHFNFOU PGBSUFSJBMWFOPVTEJTFBTFT Special Interests: t Minimally invasive management of peripheral vascular disease, BOFVSZTNTDBSPUJEEJTFBTF t 7BSJDPTFWFJOTPQFOTVSHFSZ TDMFSPUIFSBQZ FOEPWFOPVT MBTFSBOE3'BCMBUJPO t $PNQSFIFOTJWFDBSFPGMFHVMDFSTEJBCFUJDGPPUQSPCMFNT t "MMBTQFDUTPGWBTDVMBSBDDFTT "7' 1%$BUIFUFST $FOUSBM7FOPVT"DDFTT

t Hyperhydrosis

Mr Gregory (Chui) Then .##4 68" '3"$4 7BTDVMBS

7BTDVMBSBOE&OEPWBTDVMBS4VSHFPO Special interests t "PSUJDBOFVSZTNTNJOJNBMMZJOWBTJWFPSPQFOTVSHFSZ t Carotid artery disease t Peripheral vascular disease (claudication and foot ulcers) t 7BSJDPTFWFJOToSBEJPGSFRVFODZBCMBUJPOPSPQFOTVSHFSZ t Renal access Consults at t .BOEVSBI4QFDJBMJTU$FOUSF .JOJMZB1BSLXBZ (SFFOmFMET

Operates at t Peel Health Campus (private and public patients) t 4U+PIOPG(PE.VSEPDI 4U+PIOPG(PE4VCJBDP t Bethesda Hospital /PHBQQSPWJEFSGPSBMMNBKPSIFBMUIGVOET Welcome both public and private patients "QQPJOUNFOUTFORVJSJFT1I0432 241 187 EBZ 'BY08 9535 6892 'PSFNFSHFODJFTPSBEWJDF1I0401 415 577 (all hrs)

VASCULAR IMAGING/INTERVENTION

Mr Garbowski is a NO GAP provider with most Health Funds. )FBMUIMJOLESNBSFLH 'PSQSPNQUBEWJDFBOEFNFSHFODJFTQMFBTFDBMM Dr Patrice Mwipatayi ..FE 4VSH '$4 4" '3"$4 $FSU7BTD4VSH 4"

4QFDJBMJTFTJOBMMBTQFDUTPGWBTDVMBSTVSHFSZJODMVEJOH t Management of aortic aneurysmal disease. t occlusive arterial disease t cerebrovascular disease t hyperhidrosis t 3BZOBVET4ZOESPNF t varicose veins management t legs ulcers management t all aspects of vascular access. 1VCMJDBQQPJOUNFOUIFMEBU31) 4$()BOEBMM/PSUI.FUSPQPMJUBO)PTQJUBMT Prof Patrice Mwipatayi offers NO GAP COVER for privately insured patients.

Dr Sanjay Nadkarni - Endovascular specialist .##4 '3"/;$3 '3$3 '$1 .3$1 %"

www.endovascularwa.com.au P: 9284 2900'9284 2955 M: 0410 407 044 4UJSMJOH)JHIXBZ $MBSFNPOU Comprehensive endovascular management of varicose veins, peripheral arterial disease, uterine ямБbroids, varicocele, pelvic congestion syndrome and vascular ultrasound. "DVUFCBDLQBJONBOBHFNFOUCT guided facet joint, Nerve root sleeve and Epidural injections, CT guided facet joint rhizotomy.

Consults at:  4VJUF )PMMZXPPE4QFDJBMJTU$FOUSF .POBTI"WFOVF /FEMBOET  4VJUF +PPOEBMVQ4QFDJBMJTU$FOUSF 4IFOUPO"WFOVF  Joondalup. 'PSBQQPJOUNFOUBOEFORVJSJFT QMFBTF1IPOF9386 9588'BY9386 9599 'PSBEWJDFBOEFNFSHFODJFT QMFBTFDBMM

A P R I L 2012

medic alFORUMwa

79


80

medical forum

ANAESTHETIST WANTED MT LAWLEY Dynamic specialist anaesthetist(s) SFRVJSFEUPSFQMBDFSFUJSJOHNFNCFS Share rooms with long established hospital based group. There will be no joining fee. Accreditation at Mercy Hospital is mandatory. Computerised billing system with excellent administrative/secretarial support. 'PSGVSUIFSJOGPSNBUJPOQMFBTFDBMM-PSSBJOF on (08) 9370 9733

BOARD MEMBER WANTED BOARD MEMBER WANTED Fremantle Womenâ&#x20AC;&#x2122;s Health Centre seeks a female GP (VR) as a Board member. This is a voluntary position that would suit someone with expertise in womenâ&#x20AC;&#x2122;s health medicine and an interest in the governance of a not-for-profit organisation. FWHC is a community facility providing medical and counselling services, health education and group activities. The Board currently has 8 members who are responsible for the governance and strategic direction of the organisation and meets monthly. For more information check www.fwhc.org.au or Contact Diane Snooks 9431 0500 / director@fwhc.org.au

FOR LEASE NEDLANDS Hollywood Medical Centre â&#x20AC;&#x201C; 2 fully furnished consulting suites on first floor, available for lease. Some secretarial support available JGSFRVJSFE Phone 0414 780 751 MURDOCH Murdoch Specialist Centre Brand new stylish large rooms. Please email you interest to: admin@sleepmed.com.au NEDLANDS Medical Specialist Consulting Rooms Fully serviced rooms and facilities for Specialist Consulting are available in Suite 31, Hollywood Specialist Centre, 95 Monash Avenue, Nedlands. "OZFORVJSJFTDBOCFEJSFDUFEUP Mrs Rhonda Mazzulla, Practice Manager Suite 31, Hollywood Specialist Centre 95 Monash Avenue Nedlands, WA 6009 Phone 9389 1533 Email: suite31.hollywood@bigpond.com DAWESVILLE Opportunity for two GPâ&#x20AC;&#x2122;s t TRN.FEJDBM$FOUSF t *OOFX4IPQQJOH$FOUSF t $PNQMFUJPO+VMZ t $BUDINFOUQFPQMF t 6OTFSWJDFEBSFB Ross on 0409 887 641

ROCKINGHAM Sessional room for rent in specialist medical centre in central Rockingham. Choice of two rooms, medical or allied health with communal patient waiting room. Reception staff not available. Sessions are four hours and currently available a.m. and p.m. $120 plus GST per session for allied health room and $160 plus GST per session for medical consult room, negotiable. Contact Julie Neet, Practice Manager at julieneet@drbillpatton.com.au Telephone 9528 1511 (select option 0) Tuesday â&#x20AC;&#x201C; Thursday mornings after 9.30 am BANKSIA GROVE City of Wanneroo - WAâ&#x20AC;&#x2122;s fastest growing local government authority Opportunity for 3 â&#x20AC;&#x201C; 4 GPâ&#x20AC;&#x2122;s t 8JUIJOB%JTUSJDUPG8PSLGPSDF4IPSUBHF t TRN.FEJDBM$FOUSF t $PNQMFUJPO+VMZ"VHVTU t -BSHFDBUDINFOU Ross on 0409 887 641 YOKINE â&#x20AC;&#x201C; Suit a Medical Specialist Suite 10 DR 7 Medical Centre, 162 Wanneroo Road, YOKINE Quality Suite, well located in purpose built medical centre, on busy road & close to all amenities. Has a large established doctors surgery, pharmacy, physiotherapist, dentist and many more. The centre comprises 17 strata lots. 5IFTVJUFIBTBOBSFBPGTRN Completely fitted, carpeted and air-conditioned and will suit most medical purposes. Phone: Valma 0458 088 899

FOR SALE OR LEASE

Rare opportunity to secure a long term future in West Leederville. Property located on McCourt Street Subiaco â&#x20AC;&#x201C; Available 1/5/2013 Well Presented premises â&#x20AC;&#x201C; 113 m2 with ample off Street parking. "MMFORVJSJFTUP#SBE1PUUFSo 9315 2599 / 041118 5006.

FOR SALE MEDICAL SUITE(S) 10 McCOURT STREET WEST LEEDERVILLE 5IFTFXFMMMPDBUFETRNNFEJDBMTVJUF T

with two car bays each are opposite St John of God Hospital and ready for immediate occupation. GORDON TUCKER R/E 0408 093 731 gtrealestate@iinet.net.au

LOCUM WANTED PERTH -PDVNT"TTPDJBUFTXBOUFE Perth Medical Centre, Hay Street Mall. Busy accredited privately owned practice, private billing, flexible hours. Excellent remuneration for suitable candidates. Phone: 9481 4342 Mobile: 0408 665 531

RURAL POSITIONS VACANT MIDLAND Consultant Psychiatrist - Private Practice We have a fully serviced new room in an established clinic in Midland. We would like to have a Consultant Psychiatrist join our practice. The rooms are fully serviced and reception will collect fees and process patients. The lease of the rooms is negotiable and very reasonable so we can attract a specialist into a high need area. www.cygnetclinic.com.au Phone: 9467 7676 Fax: 9463 6311 Email: admin@cygnetclinic.com.au JOONDALUP Modern sessional suites available in Joondalup CDB. 4FDSFUBSJBMTVQQPSUBWBJMBCMFJGSFRVJSFE Phone 9300 3380

MARGARET RIVER -POHFTUBCMJTIFEBDDSFEJUFEGBNJMZ practice seeks GP or trainee to replace retiring Doc. Anaesthetics, Obstetric and surgical scope available but not essential. Some afterhours commitment - not onerous. Phone Sally 08 9757 2733 for more info ALBANY 73(1SFRVJSFEUPKPJOPVS%PDUPS CVTZ  friendly family practice. Full or Part time. We are Accredited, computerised, full nurse support, experienced Admin team. Excellent remuneration. Clinipath pathology on site. Phone Gaye - Practice Manager 9841 6711 Email: admin@hillsidefp.com.au

URBAN POSITIONS VACANT

MANDURAH SPECIALIST CENTRE Fully furnished consulting suites are now available on a sessional basis in the new Mandurah Specialist Centre. 3FDFQUJPOTVQQPSUBWBJMBCMFJGSFRVJSFE Phone: Graeme Dedman on 0413 065 009 Email: graemed@wacardiology.com.au

SOUTH PERTH 73(1SFRVJSFE'515 Excellent River location in South Perth. Non-corporate, private billing, fully computerised. Friendly and efficient support staff. F/T registered nurse and onsite pathology. For more information contact Paris on 9367 1185. Email: bhabibi@bigpond.com

WEMBLEY DOWNS Inviting an enthusiastic Female GP to join this long established, non-corporate, private billing practice with a huge well established patient load. Email: managerbmc@gmail.com

MURDOCH Doctor Required for Stress Testing Supervision WA Cardiology offers the most extensive cardiology testing services in Western Australia and is committed to providing the highest standards in patient care, diagnosis and GP support. Medical Practitioners who share in this vision are invited to join our team of Doctors supervising exercise ECGs, exercise echocardiograms and Dobutamine echocardiograms at our various sites. Training is provided and excellent remuneration based on a fee for service basis is offered. Applicants must possess valid unconditional registration with the Medical Board of Australia and working rights within Australia. To register your interest, please contact Graeme Dedman (General Manager) on 0413 065 009 or Email us at admin@wacardiology.com.au.

MT HAWTHORN Mt Hawthorn Medical Centre, a non-corporate accredited long established practice situated in a fast growing inner city suburb of Perth, seeks a part time or full time VR GP to join this highly desirable practice. Fully computerised, Nurse Assistant. Phone Rose 9444 1644 ARMADALE Wanted VR/Non VR Female Doctors DWS/Aon Area Outer Metropolitan Perth Phone: Kerry 9498 1099 Email: sevilledrive@medicalcentral.com.au HILLARYS Exciting Opportunity. Join us in our brand new General Practice located NOR. Non-corporate. 8FSFRVJSFBGVMMUJNFPSQBSUUJNF GP for our practice. Hours to suit. /PFWFOJOHPSXFFLFOEXPSLSFRVJSFE The practice is fully computerised and XFMMFRVJQQFE Private Billing and some bulk-billing Full-time Nursing support. Pathology on site. Please contact Practice Manager on 9448 4815 or Email: smc@westnet.com.au FREMANTLE (FOFSBM1SBDUJDFJO'SFNBOUMFSFRVJSFT73(1 FTor PT for privately owned family practice. Accredited, computerised with fulltime Nurse support available. 65% of billings. Phone: Practice Manager 9336 3665

MAY 2013 - next deadline 12md Monday 15th April - Tel 9203 5222 or jen@mforum.com.au


medical forum WINTHROP/MURDOCH Full time/Part time VR GPs needed to join Hatherley Medical Centre. No longer Corporate and reopening in March 2013 with very experienced GP. Had been open for over 20 yrs and become a successful 8 doctor practice. Services a large private billing underserviced area. 1VSQPTFCVJMUDFOUSF XFMMFRVJQQFEXJUI on-site procedural room, large nursing station, pathology, physiotherapy, pharmacy and dental. Please call 0400 364 901 and get in early. INGLEWOOD/BEDFORD (1SFRVJSFE"SFBEZNBEFQSBDUJDFUP walk into. Part-time and hours negotiable. Busy private billing, non-corporate practice on the Inglewood / Bedford border. Full time nurse and pathology on site. Friendly and generously staffed. Phone Steve, Carl or our practice manager Denise on 9271 9311 Email: salisburymed@iinet.net.au

LANGFORD Due to one of our long term GPs taking BOFYUFOEFETBCCBUJDBMJO -BOHGPSE Medical Centre is looking for a full time GP to commence now. 8FBSFBNPEFSO XFMMFRVJQQFE  accredited mixed billing practice. 4JUVBUFETPVUIPGUIFSJWFS -BOHGPSEJTPOF of the closest practices to the CBD that still RVBMJGJFTBTBEJTUSJDUPGXPSLGPSDFTIPSUBHF 'PSDPOGJEFOUJBMFORVJSJFTQMFBTFDPOUBDU PM Mariette on 9451 1377 BEACONSFIELD Well established, niche family friendly practice seeking VR Female GP to work flexible days and hours. Fully computerised and accredited. Good mix of private and bulk billing. 1MFBTFDPOUBDU1SBDUJDF.BOBHFS-JOEBPO 9335 9884 or Email: centralavenuemc@optusnet.com.au BENTLEY GP VR â&#x20AC;&#x2DC;with/without a viewâ&#x20AC;&#x2122; needed for privately owned family orientated practice. NJOTGSPN1FSUI$#% "(1"-BDDSFEJUFE  fully computerised using MD/Pracsoft. Private billing. Supported by clinical and CDM nurses operating from purpose built practice. We offer 65% of billings. Contact Alison on 0401 047 063 MT LAWLEY Edith Cowan University, Student Health 4FSWJDFT .U-BXMFZDBNQVT Part time VR GP with an interest in 8PNFOTBOE4UVEFOU)FBMUISFRVJSFE 8FMMFRVJQQFENFEJDBMDFOUSF BDDSFEJUFE  excellent work environment, Registered Nurse support, flexible work arrangements. For information: Dr Robert Chandler Phone: 08 6304 5618 E-mail: r.chandler@ecu.edu.au

FREMANTLE Fremantle Womenâ&#x20AC;&#x2122;s Health Centre SFRVJSFTBGFNBMF(1 73 UPQSPWJEF medical services in the area of womenâ&#x20AC;&#x2122;s health 1or 2 days pw. It is a computerised, private and bulk billing practice, with nursing support, scope for spending more time with patients, and provides recently increased remuneration plus superannuation and generous salary packaging. FWHC is a not-for-profit, community facility providing medical and counselling services, health education and group activities in a relaxed friendly setting. Phone: 9431 0500 or Email: Diane Snooks - director@fwhc.org.au or Dawn Needham clinical-manager@fwhc.org.au

BIBRA LAKE PT/FT VR GP with/without view to replace PT female Dr in a small privately owned 2 person accredited private billing practice JO#JCSB-BLF The practice is computerised, and has nursing and pathology support. For further information contact Ashley on 0417 181 070 Email: ashleyr@iinet.net.au WEMBLEY GP wanted for long established private, accredited Wembley Practice. Sessions are negotiable but ideally Thurs/ Fri am or Mon to Fri pm or part thereof. Our practice is fully computerised using Med Director/Pracsoft. Practice Nurse on site, pathology and theatre. Adjacent services include Physiotherapist, Podiatrist, Psychologist and Dietician including diabetic educator. Please phone Pauline on 9381 9010 Email: wembleygp@westnet.com.au

PALMYRA 1BMJO4USFFU'BNJMZ1SBDUJDFSFRVJSFTB full or part-time VR GP. We, at this privately owned fully serviced computerised practice enjoy a relaxed environment with space and gardens. Earn 65% of mixed billings. For further information call -ZOPO 9319 1577 or Dr Paul Babich on 0401 265 881.

JOONDALUP CANDLEWOOD MEDICAL CENTRE (1SFRVJSFEUPKPJOPVSGSJFOEMZUFBNGPS After Hours work immediate start Weekdays 6 â&#x20AC;&#x201C; 9pm and Saturday 12 - 5pm Very Attractive remuneration 1SJWBUFMZPXOFE "(1"-BDDSFEJUFE general practice Fully computerised Contact Michelle 08 9300 0219 SORRENTO V/R GP for a busy Medical Centre in Sorrento. Up to 75% of the billing Contact: 0439 952 979

PERTH CENTRAL 73(1'VMM5JNFPS1BSU5JNFSFRVJSFEGPS GP owned practice in an excellent location (centre of Town). 8FBSFGVMMZFRVJQQFEBOEIBWFFYDFMMFOU nursing and admin support. On site allied health, pharmacy and pathology. Mixed billing. Fully accredited. Contact practice manager Bili. Phone: 9419 2122 Email: chishamave@westnet.com.au DUNCRAIG DUNCRAIG MEDICAL CENTRE SFRVJSFT a female GP. Flexible hours, excellent remuneration. Modern, predominantly private billing practice with full time Practice Nurses. Open 364 days: M-F 7.30am/9pm, Sat/ Sun/PH 8am/6pm, Fully computerised. Please contact Michael on 0403 927 934 Email: Dr Dianne Prior: dianne@duncraigmedicalcentre.com.au DALKEITH 5IF%BMLFJUI.FEJDBM$FOUSFSFRVJSFTB'5 or P/T GP to join busy privately owned and operated General Practice in the beautiful leafy suburb of Dalkeith. We are fully computerised with Best Practice. We have a dedicated team of doctors and staff and we are predominantly a privately billing practice. 5IFSFJTOPBGUFSIPVSTPSPODBMMSFRVJSFE Flexible hours and excellent remuneration is offered to the accepted applicant. Please contact Trish at dalkmc@bigpond.com WHITFORDS GP - F/T OR P/T. 8FBSFGVMMZDPNQVUFSJTFE XFMMFRVJQQFE  accredited practice. Friendly practice Nurse and admin staff to support at all times, including Careplan/ Health Assessment Nurse. Medical Centre has on site pathology, pharmacy and physiotherapy. 1MFBTFDPOUBDU+BDRVJ 1SBDUJDF.BOBHFS on 9307 4222 Email: jmarkouloop@iinet.net.au BENTLEY Rowethorpe Medical Centre is a nonprofit, friendly practice seeking a part time GP to provide visits to our onsite residential aged care facilities. Practice-based consultations are also available. t 'VMMZDPNQVUFSJTFE t /FXMZSFOPWBUFEQSFNJTFT t .PEFSOFRVJQNFOU t 0OTJUFQBUIPMPHZ t )PVSTUPTVJUZPV 'PSFORVJSJFT QMFBTFDPOUBDU+BDLJFPO 6363 6315 or 0413 595 676 THORNLIE '515(1SFRVJSFEGPSBGSJFOEMZOFX rapidly growing medical centre. Computerised, non-corporate and no BGUFSIPVSTSFRVJSFE Outer-Metro area 17km from Perth. Pay 65% of receipts. $POUBDU%S+PIO,VPS%S4BOESB-PL on 9267 2888 or Email: thornliemedicalcentre@hotmail.com

81

MT LAWLEY Position for a full time GP, working as a selfemployed contractor in our accredited, fully computerised independent practice. Excellent working environment, with modern facilities. Quality nursing staff and an onsite diabetes educator/dietician. Adjacent to the practice we have a pharmacy, and allied services, consisting of audiology, pathology, physiotherapy, podiatry, dental, and cardiology. Visit our website: www.3rdave.com.au and if interested, ring us on (08) 9272 5533. Please ask for Practice Manager Rachael Hadlow. Alternatively, you may send an email to rhadlow@3rdave.com.au DIANELLA /PO$PSQPSBUFQSBDUJDFSFRVJSFT'5BOE P/T VR GPâ&#x20AC;&#x2122;s to join 6 female and 1 male doctor team. Our newly extended, long established, accredited, fully computerised practice is supported with 4 excellent nurses and 5 very friendly admin staff. Our practice is mostly private billing and we offer excellent remuneration. Please contact Practice Manager on 9276 3472 Email: dfmc@dianellamedical.com.au

INGLEWOOD Interested in trying skin cancer medicine? 6OJRVFPQQPSUVOJUZUPKPJOBCVTZOPO corporate skin cancer practice. Friendly atmosphere with strong emphasis PORVBMJUZBOEQBUJFOUTFSWJDF Flexibility to explore any area of skin cancer medicine, ranging from comprehensive skin cancer checks, dermoscopy, and minor to more advanced surgical procedures. Continuing education and training provided. Fully computerised, with modern facilities and nurse support. Suit part time VR doctors looking for reduced paperwork ,flexible hours and above average income. Please contact admin@skincheckwa.com.au MANDURAH (10CTUFUSJDJBOSFRVJSFEQBSUUJNF to join our friendly team with a view to partnership. Excellent location, close to hospital and train station. Midwife assisted. Fully computerised. Contact Practice Manager Vicki PH: 9535 4100 Email: practicemanager@mandurahobstetrics.com MIRRABOOKA 'VMMUJNF1BSUUJNF(1SFRVJSFEGPS a very busy practice in Mirrabooka. VR prefered. 75% Private and Bulk Billing Applications can be made via Email: mds@mirrabookadoctors.com.au or calling 0400 814 091

MAY 2013 - next deadline 12md Monday 15th April - Tel 9203 5222 or jen@mforum.com.au


82

medical forum AGED CARE SEEKING

Medical Practitioners for Aged Care Service - Compassion â&#x20AC;&#x201C; Efficiency Medical Practitioners for Aged Care (MPFAC) is seeking Medical Practitioners to join our expanding service to Residential Aged Care Facilities (RACP) throughout the Perth metro area. Our aim is to provide a compassionate and evidence based medical care to RACP. t .1'"$QSPWJEFTGMFYJCMFXPSLPQUJPOT t 3FNPUFMPHJOUPQBUJFOUSFDPSET and appointment scheduling t /VSTJOHBOE"MMJFE)FBMUI Care support t .1'"$NFUIPEPMPHZVUJMJTFTUIF doctorâ&#x20AC;&#x2122;s time and resources more effectively t &GGJDJFOUPQFSBUJPOBMTVQQPSUFOTVSFT rewarding outcomes for doctor For more information or confidential interview please contact Rollo Witton â&#x20AC;&#x201C; CEO Mobile 0417 921 632 Email: rollo@gpagedcare.com.au

BYFORD 'VMMUJNF(1TSFRVJSFE Byford is a rapidly growing area and is continuing to expand. 1SBDUJDFJTGVMMZFRVJQQFEXJUI consulting rooms, 2 treatment rooms & employs 2 nurses. Onsite Pathology, Podiatrist, Chiropractor, Masseur and Dentist Excellent terms and conditions are negotiable We are an area of unmet need with a district of workforce shortage. Contact: David Cowden Email: byfordfp@westnet.com.au Fax 9525 0093 Phone: 0413 273 778 BYFORD GPâ&#x20AC;&#x2122;s Afterhour Clinic (1TSFRVJSFEGPSOFX"GUFSIPVS$MJOJD in Byford area excellent terms and conditions hours are negotiable We are an area of unmet need with a district of workforce shortage. Contact: David Cowden Email: byfordfp@westnet.com.au Fax 9525 0093 Phone: 0413 273 778

MOSMAN PARK FREMANTLE Part time or Full time (preferably VR) GPs wanted. ELLEN HEALTH is a doctor-owned and managed General Practice operating from two locations in port city of Fremantle. Well established patient base, offering a broad suite of services including nutrition and lifestyle, specialised pregnancy and midwifery care, community mental health nursing and skin clinic consultations. If you were to join our team we will offer you: t "HSPXJOHEBUBCBTFPG1SJWBUF Billing patients t "QSPGFTTJPOBMBOEEFEJDBUFE support team t "MJGFTUZMFUBJMPSFEUPUIFMPDBUJPO t )PVSTPGXPSLUPTVJUPVSCBMBODFE lifestyle approach - Practice hours are Weekdays 8am-6pm, Saturday, 8am-4pm - No after hours, on-call or hospital work SFRVJSFEBUUIJTUJNF t)JHIMFWFMPGFBSOJOHT Contact Practice Manager Bridie Hutton 0413 994 484 Email: bridie.hutton@ellenhealth.com.au MOSMAN PARK A friendly, non-corporate, fully computerised practice in Mosman Park is looking for a GP to work part or full time. Hours and days flexible. Remuneration - 70% of gross billings. Tel: Jacinta on 9385 0077 EDGEWATER Outer Metro Practice. 1BSUUJNF73(1SFRVJSFEGPSPVSQSJWBUFMZ owned, well established, fully computerised, accredited, non-corporate practice. Fully supportive with practice nurse and friendly work environment. Please provide CV to: edgewatermedical@westnet.com.au (Donna Gaynor)

Fantastic opportunity in excellent area for F/T or P/T GP Close to beach, shops and trains. Ample space for your car, bike or surfboard. Flexible hours to suit your lifestyle. Baby-sitting service an option. This is a GP owned group practice with all support services. Freshly refurbished with all new computers and furniture. Contact David Mortley on 9384 4426 or Email: mpmg@bigpond.net.au

WEST PERTH GP sessions available at our privatebilling, accredited and fully computerised general practice. Our busy practice serves a young, professional demographic as well as providing specialist sexual health services. This represents an exciting opportunity for an enthusiastic practitioner to join our friendly team. Morning and afternoon sessions are available. Experience in family planning, sexual health and mental health would be an advantage. Contact Stephen on 0411 223 120 Email: stephen@westperthmedicalcentre.com.au WANNEROO '515'FNBMF(1SFRVJSFEGPSOPO corporate family practice delivering excellent healthcare to our local community in Wanneroo (Perthâ&#x20AC;&#x2122;s northern suburbs, approved DWS area). Our practice is fully computerised (Pracsoft and Medical Director), paperless and accredited. We have a wonderful reception team, professional Practice Managers, and full nursing support. Contact: Jody Saunders 0410 617 094 or Cheryl Barber 08-9405 1234 E-Mail CV to jsaunders.wthc@gmail.com or cbarber.wthc@gmail.com

PERTH APPLECROSS FT GP wanted. A rare opportunity to join Reynolds Rd 7 Day Medical Centre has just presented itself as a long term colleague moves out of general practice. Commencing now, donâ&#x20AC;&#x2122;t miss out on your chance to join this private billing, vibrant practice with immediate access to a full patient data base. $POGJEFOUJBMFORVJSJFTUPUIFQSBDUJDF manager 9364 6633. BAYSWATER Wanted General Practitioner (VR) F/T PS15SFRVJSFEXJUIJOPVSGSJFOEMZOPO corporate medical practice. We are a fully computerised, wellFRVJQQFE UFBDIJOH BDDSFEJUFEHFOFSBM practice seeking an enthusiastic person to join our team with a view in assisting our growing patient load. We are a proudly independent practice which offers a friendly environment, flexible working hours, pleasant rooms, great staff, with wonderful patients. Email resume to: manager@walterrdegps.com.au or Fax: 9279 1390

Australian Skin Cancer Clinics Specialise in Skin Health in Western Australia t $"//*/(50/ t -&..*/( .63%0$)

Great opportunities for experienced GPs to join these two busy Australian Skin Cancer Clinics. t 'MFYJCMFXPSLJOHIPVSTUPTVJU your lifestyle; t (SFBUFBSOJOHQPUFOUJBM t .PEFSOXFMMFRVJQQFEDMJOJD t 1SPGFTTJPOBMBENJOJTUSBUJPOBOE practice management staff; These are not DWS listed sites. For more information please contact Fiona James on 0447 006 846 or fiona.james@ipnet.com.au www.ausskinclinics.com.au WOODLANDS P/T or F/T VR GP wanted to join happy, non-corporate, mainly private billing practice. Good mix of patients, no weekends or afterhours. Great location, RN support. Would suit female GP. Contact help@thewoodsmedical.com.au or 9204 3900 MANDURAH Mandurah coastal lifestyle 40 minutes from Perth. 73OPO73EPDUPSSFRVJSFETIPSUUFSNPS long term. No weekends or after hours. Good remuneration. Clinic has full time nurses, pathology, psychology, hearing centre, dermatologist and orthotics. Contact practice manager Elaine 9535 8700 Email: elaine@mandurahdoctors.com.au

Become part of the Perth Bigger Picture! -POHFTUBCMJTIFEBOEQSJWBUFMZPXOFE  Perth Medical centre is centrally located, accredited, fully computerised and privately billing. We have recently renovated so come and join our team and you will be busy from day one. We have an interesting and truly diverse mixture of clientele; young and old, blue and white collar, travellers and residents. You will have plenty of opportunity to develop an interest in whatever branch of practice you choose with the backup of a team of locally trained colleagues. We also have a team of RNs leading our chronic disease management program. We are a social group who support one another, are flexible with hours and believe in maintaining balance to avoid the rush hour, reduce your carbon foot print and keep fit; bus, train or cycle to work. Check us out www.perthmedicalcentre.com.au Interested? Call our practice manager Anne on (08) 9481 4342 or Dr Phil A/H 0411 108 883

KARDINYA ,FMTP.FEJDBM(SPVQSFRVJSFT15BOE or F/T GP This long established privately owned and managed mixed billing practice offers great opportunity for doctor with interest in CDM and minor surgical procedures. -PDBUFEJO,BSEJOZBJOOFXMZSFGVSCJTIFE premises with onsite pathology and allied health with growing patient base. Currently supported by 7 GPâ&#x20AC;&#x2122;s and 3 RNâ&#x20AC;&#x2122;s . www.kelsomg.com.au Please call 0419 959 246 for further information. GOLDEN BAY 15GFNBMF(1SFRVJSFE Fully computerised, DWS, private/ bulkbilling, Fully accredited, Practice Nurse, onsite pathology. Contact: Sheelagh 08 9537 3738 Email CV to: pracman@eftel.net.au GREENWOOD Greenwood / Kingsley Family Practice We are seeking a full time/part time GP to join our growing team. We are a flourishing, non-corporate and predominantly private-billing practice with a strong focus on chronic disease management with a dedicated EPC nurse, podiatrist, chiropractor, pathology and pharmacy on site to facilitate the team care arrangement. The practice offers an excellent work environment and attractive remuneration. There is computerised dermoscopy and a GVMMZFRVJQQFEQSPDFEVSFSPPNPOTJUF For further information please ring 0402 201 311 or Email: kingsleypractice@gmail.com to arrange to visit us for a no obligation meeting and confidential discussion.

MAY 2013 - next deadline 12md Monday 15th April - Tel 9203 5222 or jen@mforum.com.au


medical forum

Enjoy the best of both worlds A unique FIFO or permanent opportunity exists for a general practitioner to become part of a medical practice in the Goldfields town of Leonora. Servicing a population of 1,500, you will have the opportunity to join an accredited, computerised practice. The position, which offers diversity, is flexible with the opportunity to work in a fly in/fly out capacity from Perth one week on/one week off or take a permanent role in the town. The package will include a salary of approximately $350,000, a fully furnished 5x2 house with pool and car. Hospital admitting rights are required as well as detention centre visits and some emergency work. For further information please contact Rural Health Select on 08 6389 4500 or email recruit@ruralhealthselect.com.au quoting RHWLEO1.

CVS are a leading cardiology practice that provides high quality diagnostic stress testing services. We are seeking medical practitioners who meet the following pre-requisites:  Â&#x2021; 5HJLVWUDWLRQZLWKWKH$XVWUDOLDQ0HGLFDO%RDUG  Â&#x2021; 0HGLFDO,QGHPQLW\,QVXUDQFH  Â&#x2021; /LIH6XSSRUW6NLOOVRUH[SHULHQFH  Â&#x2021; +LJKUHJDUGWRGHOLYHURXWVWDQGLQJSDWLHQWFDUH ,I\RXPHHWWKHVHSUHUHTXLVLWHVZHZHOFRPH\RXWRMRLQRXUWHDPRI VSHFLDOLVHG0HGLFDO3UDFWLWLRQHUV6WUHVV3K\VLFLDQV$VD6WUHVV3K\VLFLDQ \RXZLOOZRUNZLWKVWDWHRIWKHDUWGLDJQRVWLFHTXLSPHQWFRQGXFWTXDOLW\ VSHFLDOLVWWHVWLQJDQGLPSURYH\RXUGLDJQRVWLF(&*VNLOOV$QDWWUDFWLYH UHPXQHUDWLRQSDFNDJHZLOOEHRIIHUHGWRVXFFHVVIXOFDQGLGDWHVDVZHOODV H[SHULHQFLQJH[FHOOHQWMREVDWLVIDFWLRQDQGZRUNLQJFRQGLWLRQV CVS locations include: Joondalup, Karrinyup, Nedlands, Midland, Mt Lawley, Leeming, East Fremantle and Rockingham. 3OHDVHSKRQH$GDP/XQJKLWRGLVFXVVRSSRUWXQLWLHVDW&96RQ 1300 887 997 or 0402 825 570 RUYLDHPDLOinfo@cvs.net.au

Are you looking to buy a medical practice?

www.ruralhealthselect.com.au

Make a difference in country WA

As WAâ&#x20AC;&#x2122;s only specialised medical business broker we have helped many buyers find medical practices that match their experience.

You wonâ&#x20AC;&#x2122;t have to go through the onerous process of trying to find someone interested in selling.

z z

Travel and accommodation covered Administration support provided Upskilling available Locum subsidy available

For further information please contact Rural Health Select on T 08 6389 4500 | E locums@ruralhealthwest.com.au.

Suite 27, 782 - 784 Canning Highway Applecross WA 6153

Ph: 9315 2599 www.thehealthlinc.com.au

85% take home,

www.ruralhealthselect.com.au 8JUIBSFQVUBUJPOCVJMUPORVBMJUZ ality of service, Optima Press has the WKH resources, the people and the e commitment to provide every client y client with the finest printing and value DOXHIRU for money. 9 Carbon Court, Osborne Park 6017 Tel 9445 8380

Brad Potter on 0411 185 006

Weâ&#x20AC;&#x2122;ll take care of all the bits and pieces and youâ&#x20AC;&#x2122;ll benefit from our experience to ensure a smooth transition.

If you can help a rural and remote community, contact us today! z

To find a practice that meets your needs, call:

Youâ&#x20AC;&#x2122;ll get a comprehensive package on each practice containing information that you and your advisers need to make a decision.

Rural Health Select has vacancies for locums throughout Western Australia.

z

83

enjoy ďŹ&#x201A;exible hours, less paperwork, & interesting variety...

Equipment Provided - WADMS is a Doctorsâ&#x20AC;&#x2122; cooperative Essential qualifications: s General medical registration. s Minimum of two years post-graduate experience. s Accident and Emergency, Paediatrics & some GP experience. sĂĽ sĂĽ sĂĽ sĂĽ

Fee for service (low commission).sĂĽ Non VR access to VR rebates. 8-9hr shifts, day or night. sĂĽ Bonus incentives paid. 24hr Home visiting services. sĂĽ Interesting work environment. Access to Provider numbers.

Contact Trudy Mailey at WADMS

(08) 9321 9133

F: (08) 9481 0943 E: trudy.mailey@wadms.org.au www.wadms.org.au WADMS is AGPAL registered (accredited ID.6155)

MAY 2013 - next deadline 12md Monday 15th April - Tel 9203 5222 or jen@mforum.com.au

Supplement your income: Are you working towards the RACGP? â&#x20AC;&#x201C; we have access to provider number for After Hours work. Are you an Overseas Trained Doctor with permanent residency and working toward RACGP? - we have access to provider number for After Hours work.


84

medical forum FOR SALE

Brand New State of the Art Medical Centres opening May:

HIDDEN VALLEY FOREST RETREAT

Armadale & Cannington

Four standalone architect-designed lodges with an on-site ďŹ tness centre nestle on 110 acres in the beautiful Margaret River wine region, with outline permission to build six more and a design for a 9 or 18-hole private golf course.

Candiid Candidates idates must have FRACGP or equivalent. Centre rees are are lo ar oca c t in DWS areas. Centres located To ďŹ nd o out more ofďŹ ce@apollohealt ofďŹ ce@apollohealth.biz | 08 6142 9275

Contemporary lodges built with luxury in mind

The partially reticulated property boasts three vineyards, each producing wine grapes. Interested parties contact: Sally & John â&#x20AC;&#x201C; Hidden Valley Forest Retreat â&#x20AC;&#x201C; Tel: (+61 8) 9755 1066

www.yourhiddenvalley.com

Looking for a work life balance? GP Opportunities Available in WA

General Practitioner â&#x20AC;&#x201C; Street Doctor Perth Central & East Metro Medicare Local Ltd (PCEMML) operates a mobile medical service, known as StreetDoctor. This service provides primary healthcare to homeless and disadvantaged populations of Perth. We are currently seeking an experienced Vocationally Registered General Practitioner to work at one of our Street Doctor Clinics held at a youth drop-in centre, located in Northbridge. The clinic is held on Monday afternoons between 1.00pm â&#x20AC;&#x201C; 4.00pm. If you have an interest in working in community health and have a true passion for helping people in need we would like to hear from you. For further information please contact Tracey Snowden (08) 9376 9200. To apply please forward your current CV to hr@pcemml.org.au

s'ARDEN#ITY-EDICAL#ENTRE s+INGSWAY-EDICAL#ENTRE s-IRRABOOKA-EDICAL#ENTRE s.ORANDA-EDICAL#ENTRE s6ICTORIA0ARK-EDICAL'ROUP IPN is a highly diverse and collaborative service provider. You will enjoy: s#LINICALINDEPENDENCE s&REEDOMmEXIBILITY s6ARIABLECOMMERCIALTERMSTOSUITYOU s-ODERN WELLEQUIPPEDCLINICS Limited positions available. &ORAPOTENTIALPARTNERSHIPWITH)0. PLEASE CONTACTesther.mortimer@ipnet.com.au or 0418 371 724. !LLDISCUSSIONSWILLBECONlDENTIAL www.ipn.com.au

LIFESTYLE AND CAREER

!

BEAUTIFUL BUNBURY BUNBURY Opportunity awaits your practice. 1/138 Spencer Street South Bunbury t .$POTVMUBODZTQBDF8JUI$BSCBZT t ;POFENFEJDBMSPPNT t  QFSNPOUIQMVTWBSJBCMFPVUHPJOHTQMVT(45 t 1SFWJPVTMZPQFSBUFEBTB3BEJPMPHZDFOUSF t 5IFQSPQFSUZQSFTFOUTBTOFX t &RVJQQFEXJUI.BMF 'FNBMFBOETUBGGUPJMFUTBTXFMMBTEJTBCMFEGBDJMJUJFT t )BWFOFXDBSQFUTUISPVHIPVU #FRVJDLBTPQQPSUVOJUJFTMJLFUIJTEPOUDPNFBMPOHWFSZPGUFOJOUIF4PVUIXFTU regional City of Bunbury Phone: Patrick Williams on 0407 990 886 Email: pat@sdea.com.au Bunbury Office 13 Stirling Street, Bunbury WA 6230 Phone: 9721 3533

Specialist and allied health opportunities! A great opportunity for the right clinicians to own and operate their own practice or if preferred we can employ! We have a combination of single rooms with dedicated reception or individual tenancies available â&#x20AC;&#x201C; come and have a look and choose for yourself! Opens late April/early May Project Manager: Jill Riggall 0437 516 850 jill.riggall@breckenhealth.com.au GPâ&#x20AC;&#x2122;s are encouraged to contact Dr Brenda Murrison 0418 921 073 brenda.murrison@breckenhealth.com.au

MAY 2013 - next deadline 12md Monday 15th April - Tel 9203 5222 or jen@mforum.com.au


Sometimes, it feels like weâ&#x20AC;&#x2122;re living in a photo album. The alarm goes off, my H\HV RSHQ DQG , FDQ SLFWXUH WKDW ÂżUVW morning we moved in. Boxes strewn across the room, paper everywhere and oh, how weâ&#x20AC;&#x2122;d laughed. Âł:KRÂśVJRLQJWRÂżOODOOWKLVVSDFH"´\RX said, dancing around the room. ,QDEOLQNWKHQXUVHU\ZDVÂżOOHGZLWKWKH cries of a new baby and the playroom with the sounds of laughter. So many birthday parties in the kitchen, debates across the table, holiday dinners. That

time Bob, dropped the lamb roast on WKHĂ&#x20AC;RRUÂąLWERXQFHGWZLFHHYHU\RQH was certain of that. You and I sat on the back verandah, sipping wine and startled at the silence. Âł:KHUH GLG HYHU\RQH JR"´ \RX VDLG reaching out and squeezing my hand. The moment was brief, before laundry was brought home and meals were PDGH DQG WKH ZDOOV ZHUH ÂżOOHG ZLWK laughter. Friends passing through, the weekend visits and getting everything ready for our little girl to walk down

hamptonyork homes.com.au

1800 220 180

the aisle. The kids with their families, settling in for the holiday break. My eyes open and I see you watching me in the moonlight. â&#x20AC;&#x153;The babyâ&#x20AC;&#x2122;s FU\LQJ´ The bed creaks. Our daughter pads across the hall to the nursery. You reach for my hand and I smile, thinking of all that weâ&#x20AC;&#x2122;ve built along the way.


Medical ForumWA* 4/13 Subscriber Edition  

WA's Premier Independent Monthly for Health Professionals - Subscriber Edition