Monday 28 September 2020 @ 7.30 pm featuring
North Coast Dermatology
Come join the North Coast's three newest dermatologists for a review of the current management of psoriasis and a peak at the latest options for severe cases.
The case presentation with Q&A gives attendees the chance to ask questions about those difficult cases.
Key Learning Points
- psoriasis and its subtypes
- psoriasis co-morbidities
- pre-immunosuppression screening
- monitoring drug side effects
Presenters from North Coast Dermatology
Sign up for this the second of the NorDocs webinars on on Zoom.
Thanks to our sponsors Janssen Immunology
by Scott Monaghan, Andrew Black, Marion Tait, Hannah Visser
Bulgarr Ngaru Medical Aboriginal Corporation (BNMAC) was established in 1991 to provide health services to the Aboriginal communities of the Clarence Valley, and now operates a regional network of comprehensive primary health care services covering the traditional clans of the Yaegl and Gumbaynggirr Nations and a large proportion of the Bundjalung footprint.
BNMAC provides services to communities from Tweed Heads to Grafton, including Grafton, Baryulgil, Malabugilmah, Yamba, Maclean, Casino, Box Ridge, Muli Muli, Tabulam, Kyogle, Tweed Heads South, Chinderah, Fingal Heads and Banora.
The emergence of the global pandemic necessitated BNMAC, like society at large, to respond to unprecedented circumstances. The extensive media coverage, the incessant social media postings, even conspiracy theories, heightened the confusion and anxiety felt by many in the Aboriginal community. The economic situation of disadvantaged communities added to this anxiety.
From the start we knew that access to reliable and timely information about the virus was important. Soon BNMAC took on the role of trusted information broker in regard to the virus. Facebook proved a viable platform for disseminating accurate information to the community. This was supplemented by BNMAC health workers communicating important information through their networks.
In developing a response to the new circumstances, social and cultural matters relating to the Aboriginal community were thought through carefully and consulted upon with the community and the Aboriginal staff at BNMAC. We recognized that the Elders had to be protected, given their custodianship of community knowledge and their role in Aboriginal community life.
On 1 July 2020, North Coast General Practice Training (NCGPT) launched CAPE Institute, continuing to deliver quality education for clinicians but now expanded to include practice teams as well. CAPE's systems simplify tracking education and training records, a new burden for health professionals, now necessary under AHPRA's updated CPD requirements.
NCGPT was known as a not-for-profit organisation that has always had quality general practice at its heart. NCGPT was faced with the prospect of operating without a grant from a major funder, following an unexpected decision from the Primary Health Network to establish an in-house team to develop and deliver clinical education in their catchment. This role was previously undertaken by NCGPT on their behalf.
The Board of NCGPT has been encouraged by feedback from clinicians in the region and had already been considering strategies to build a sustainable future. After talking to local clinicians we realised there was a significant appetite for affordable, reliable, unbiased, independent education.
GPs, Nurses and Allied Health Professionals reported unmet education needs and expressed frustration about the cost and inconvenience of meeting their CPD requirements. GPs felt ‘swamped’ with education about national priorities and COVID-19, but said it was harder to find independent, practical and sponsor free education that was relevant to regional general practice.
- Written by Dr Chris Ingall with Dr Austin Curtin
Dr Chris Ingall talks to recently retired Lismore surgeon, Dr Austin Curtin AM
I’m enjoying a cup of tea with Austin Curtin, looking out at the huge fig trees that define his garden. It strikes me how their deep roots and strength allow such reach across the lawn, and how that is mirrored in Austin’s approach to his vocation over nearly 40 years here in Lismore. He tells me of his decision to leave Sydney’s Royal North Shore Hospital in the early 1980s and how it was viewed with bafflement by his peers, who saw no advancement in serving ‘the bush’.
You use the word ‘serving’ quite a bit. Does that come from your formative years?
Well I was Jesuit trained, and one of the Jesuit mottos is ‘Men for Others’, which articulates the idea of service developing self-worth. I’m also a third-generation doctor and I guess I was inculcated with medicine as a vocation rather than a job. I have always seen rural and remote medicine as needing a voice, deserving of more attention from what is still a strongly metropolitan-based health system. Indigenous health stands to gain from taking this perspective, and I have always thought it a privilege to represent both rural New South Wales and indigenous communities.
- Written by North Coast Dermatology
by Claudia Curchin, David Jenkins and Hsien Herbert Chan, all from North Coast Dermatology
Kim Kardashian West, Cyndi Lauper and Art (Bridge Over Troubled Waters) Garfunkel are some of the world’s famous psoriasis sufferers, but lest the condition be thought to disproportionately affect singers, others in the celebrity club include author John Updike and golfer Phil Mickelson.
If the disease doesn’t target occupations it does tend to run in families – KKW’s mother is also a sufferer – but fortunately treatment options for patients with psoriasis have evolved considerably in recent years. Advances in dermato-immunology have been especially encouraging, with targeted “biologic” treatments for severe psoriasis.
Nine monoclonal antibodies are now available on the PBS for patients who have failed some of the more traditional treatments, and have a persistently high Psoriasis Area and Severity Index (“PASI score”). In this article we review the treatment options available, as well as aspects that are of particular interest to the general practitioner.
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