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Surgery in Modern Models of Care
 

Surgery in Modern Models of Care

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A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, to the RACS Annual Scientific Congress 4 May 2010

A presentation by Australia's Chief Medical Officer, Professor Jim Bishop AO, to the RACS Annual Scientific Congress 4 May 2010

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    Surgery in Modern Models of Care Surgery in Modern Models of Care Presentation Transcript

    • “ Surgery in Modern Models of Care ” Royal Australasian College of Surgeons Annual Scientific Congress Tuesday 4 May 2010 Professor Jim Bishop AO Chief Medical Officer Australian Government Department of Health and Ageing
    • Australia compares well among OECD
    • Broad cause mortality trends Australia
    • NSW Population Age Distributions, Males (1977-2036)
    • Burden of major disease groups, 2003
    • Cancers with reducing death rates 1997 to 2006 – all ages
    • All Cancer- Mort ality/Incidence ratios 2002 for selected countries
    • CANCER Milestones in Survival Improvement
          • Preventions – Tobacco control
          • Early detection
            • Screening
            • Interventions
          • Better treatments – medical research
          • Clinical trials of better approaches
          • Evidence based standard practice
    • Breast cancer mortality NEJM 2005 SOURCE: N.ENGL. J MED: 353:17
    • WHAT IS THE SURGEON’S ROLE ?
      • Well oriented to patient needs and unmet needs
      • Diagnosis/first advice following diagnosis
      • Multi-disciplinary team leader/member
      • Disease expert/International models of care
      • Teacher, mentor to new wave of graduates
      • Advocate for prevention and early detection
      • NSW CANCER PATIENT
      • SATISFACTION SURVEY 2008
      • Courtesy of Doctors 95.5%
      • Risks benefits explained by Surgeons 90.0%
      • Patients received right amount of pain
      • medicine 89.6%
      • Cancer Institute NSW Patient Satisfaction Survey (8,800 cancer patients participated)
      • LOW LEVELS OF PATIENT SATISFACTION
      • Choice of Admission dates 28.9%
      • Patients having enough say about treatment 57.3%
      • Patients being given enough information 58.6%
      • Patients given enough emotional support 61.1%
      • Source: Cancer Institute NSW 2008
      • BETTER INFORMED PATIENTS
      • NSW Patient satisfaction survey:
      • Comfortable asking medical staff questions about their condition or treatment (73.1% satisfaction)
      • Evidence based questions given to the patient increases understanding, retention and reduces anxiety
      • Medical Psychology Unit: Butow, Tattersall et al
    • The difference between localised and regional extent of disease at diagnosis
    •  
    • Base: 2006 – n=14, 2008 – n=16
      • OPPORTUNITIES FOR TRAINING AND
      • MENTORING – HEALTH REFORM 2010
      • COAG AGREEMENT
      • 60% Australian Government funding for Hospitals including teaching and research
      • 100% funding for primary care
      • Local Hospital Networks including Lead Clinician Groups
      • Three new National Agencies including Australian Commission of Quality and Safety
      • HEALTH REFORM: SPECIFIC MEASURES IN WORKFORCE
      • Over all immediate COAG package $5.4 billion from 1 July 2010
      • Additional $632m – 5,500 places for GPs
      • - 5,400 pre-vocational GP Places
      • - 680 Specialist places
      • Health Workforce Australia established
      • Initial emphasis on Clinical training places
    • CONCLUSIONS
      • Understanding our patient’s unmet needs
      • Training – in areas of future burden
      • Treatment – role in prevention, screening early intervention, initial counselling
      • Leadership –work with multi-disciplinary teams to develop and implement best practice
      • Review and promote high standards of care in areas of expertise
      FUTURE ROLE OF SURGEONS