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Should rheumatologists worry about Dr rating sites?


My mate, Dr Rob Russo, was asking me about negative comments on doctors made by patients on the web. He was wondering how these could be monitored.

I didn’t know how this could be done and my response was that I personally wouldn’t bother as there was nothing positive to be gained by finding out.

We then talked about doctor rating sites. I did not think these were really in use in Australia but I resolved to find out more.

I found ratemds.com and then searched rheumatologists in my city: https://www.ratemds.com/best-doctors/nsw/sydney/rheumatologist/

There’s only a small handful of my rheumatology colleagues on here and I was glad to see that the only review I had was positive.

(By the way, I didn’t write that review!)

A specific Australian Dr rating site is: http://www.doctoralia.com.au/healthpros/speciality/rheumatologists-1719

I can’t imagine rheumatologist reviews are that useful at the moment.

For one, there are so few of my colleagues that appear on these sites. And even when they appear, there are so few reviews.

I had thought that it would only be aggrieved patients who used these sites to vent but from this small sample, this does not appear to be the case.

One major issue is that the reviews are anonymous (which I can understand being done to protect a reviewer from exposing detail of their medical history). But, this does mean that these sites have less credibility than a site like TripAdvisor.

So, I’m interested to hear if any of you have actually used a Dr rating website? Does it provide useful information? Should we take them seriously?

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I can’t cure RA but here’s what we’ll achieve


A 6yo's interpretationIt’s Sunday just after 6am. Wet and cold outside. The house is quiet and it’s a great time to write.

I’m preparing a talk on rheumatoid arthritis and as I read through some source material, I’m contemplating how far we’ve come in improving the management of this disease. There’s still however a range of unmet needs or wants.

I think I know what my patients with rheumatoid want.


I can’t deliver that. No rheumatologist can.

But we can and will clearly improve treatment. Here’s a wish list:

  • To be able to achieve remission & sustain this remission in a higher percentage of patients.
  • To get the vast majority of patients into a low disease activity state.
  • In those who’ve achieved prolonged remission, to be able to discontinue the medication without a flare or return of disease.
  • To completely prevent damage and deformity.
  • To reduce the potential side effects of the medication we use. We want safer & safer options.
  • To be able to individualise patient therapy. We would love to be able to confidently pick the very best treatment for each patient.

The goalposts have clearly changed. Things have improved for patients with rheumatoid arthritis and for the rheumatologists who treat this condition.

While I know that list is missing the “C” word, I hope you can take some comfort in the improvements to come. Please feel free to share your thoughts.

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Our inaugural BJC Health Conference


IMG_5788It was an uplifting day! IMG_5760

We’ve been searching for a way to bring our entire team together, with the aim of helping the different groups working in our organisation develop a greater appreciation of what each team does.

The hope is that this will lead to better teamwork.

It’s not enough to throw together people with different skill sets into the same clinic & expect that they’ll work together effectively and efficiently.

A lot of lip service is paid to multidisciplinary care, but getting that care bit correct takes hard work to achieve.

So, we decided to close all our clinics on Friday 18th September and collect our team at Q Station at North Head to partake in our inaugural internal conference.

40-odd people. We wanted our receptionist and admin team there. We mixed our doctors with our exercise physiologists with our physiotherapists, massage therapists and dietitians.

The morning started with a photo essay to reflect our 12 year journey. We then heard from 2 patients invited to help us understand their journeys, their expectations and how we could improve our service. Many thanks to Maxine & Liz.

Our special guest was Jannine Jackson, CEO of Arthritis & Osteoporosis NSW. She provide us insight about the role of her patient organisation and discussed special challenges facing patients with arthritis in regards funding and disease awareness. It was a great call to action and BJC Health will be trying to help.

This was followed by the rheumatologists and the reception/admin teams having their own sessions in breakout rooms. It was a rare opportunity for people working in different clinics at different times to meet in one place.

The allied health teams who do regularly meet, instead involved themselves in a session of self-defence followed by an Ikea-building challenge. Team bonding they all seemed to enjoy!

Post lunch, we collected as a group. Every service was involved in a range of presentations. This session was based on what & how we’re currently doing things and how we can improve:

  • The Smorgasbord of Dietary Services by Monica & Kate
  • RIP Stick Figures by Tim
  • Reviewing our PRP experience by Andrew
  • Better Breathing by Walter & Sharnee
  • Unfolding the world of massage therapy by Vanessa
  • Massage & the Pysche: positive effects on anxiety & depression by Jodi
  • Hans-free Physiotherapy by Hans
  • What you need to know about Knees – KOOS Stats: Our results from the OA Knee Protocols by Belinda
  • How it feels to be a patient with inflammatory arthritis by Flora & Nick

IMG_5766   The late afternoon session was about Big Ideas. New considerations to move us forward:

  • Food as Medicine: the recipe book by Chloe
  • Boing Boing Ouch! by Rachael
  • What EPs plan to do with all this increased gym space? by Sarah
  • Massage Packaging & Blogging by Vanessa
  • Can changes in diet help fibromyalgia? by Chloe
  • The Office of First Impressions is changing: here’s how by Ashlee & Shivani
  • In-house Meditation: is this something BJC embraces? by Tom & Monica

IMG_5780 Diverse talks, with the common thread of improving service delivery and outcomes for our patients/clients.

It was lovely to see various team members appreciate what their colleagues in different disciplines do. An example of this was the insight gained by our receptionists on the patient’s journey. This will translate to how they interact with our patients at the front desk and on the phone.

I share this with you because the day really exceeded our expectations. Many do not get much chance to take the podium so it was a proud moment seeing hard work and meticulous preparation pay off.

We want a culture of curiosity, innovation & continuous improvement. This was an important step.

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Getting close to better rheumatology workspace


We started a search for extra space for our Parramatta clinic over 2 years ago. I asked then for some help in designing the rheumatology centre you’d like to attend in this post (click here).

I’d been inspired by RA Guy’s autoimmune wellness centre concept.

While we can’t actually afford something so grand as a private practice clinic, we have certainly been planning for a better workspace, as it will benefit both staff and our patients.

Well, we got the keys to a new suite in Parramatta recently! The existing fitout has been demolished and we’ve into a construction phase which will hopefully be complete in 2-3 months.

Over 400 square meters of sensible space.

Errol at the new site

Errol at the new site


We’ll all excited! There’s so much to do, with fingers crossed that we can make the transition go smoothly.

And, due to unforeseen circumstances, we’re also expanding at our Chatswood site. At Chatswood, our team are currently separated with space on the ground floor and consulting rooms on the 3rd floor.

We’ll finally be able to bring the whole team together at that clinic with over 400 square meters of space as well.


So, 2 fitouts! 2 site rejigs to manage before Xmas.

I’ll share with you floor plans and photos soon.

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Wishing doctors would change?


IMG_5706A couple of weekends ago, I was in Hong Kong to talk to a collection of representatives and leaders of various patient associations in the Asia-Pacific region.

These associations were from Korea, Hong Kong, Japan, Malaysia, Singapore and Australia. They cover autoimmune inflammatory disease ranging from Crohn’s disease. ulcerative colitis, psoriasis and psoriatic arthritis, to ankylosing spondylitis and rheumatoid arthritis.

The presence of simultaneous translations provided by multiple interpreters gave the event a bit of a United Nations feel.

My brief was to give overview of autoimmune inflammatory arthritis, management principles, the challenges we face and to give an idea about how we may engage with patients using web-based technologies as well as to describe how we provide multidisciplinary care at BJC Health.

I could have talked for hours but was only given 45 minutes as well as a place on an hour-long panel to answer questions from the floor.

I was looking forward to the panel discussion as there were so many interesting topics we could talk about in relation to how we may help empower and engage patients.

We didn’t get a chance to discuss any of that.


Instead, the panel discussion was “hijacked”. Patient association leaders, one after another, stressed and monologued about the importance of patient – doctor communication.

In essence, it was very clear from their patient-centred point-of-view, that doctors could do better.

Better in terms of time spent with the patient. Better in terms of helping patients come to grips with the disease, how these affect their lives and what treatments would mean. There was discussion about how to train doctors to be more empathetic and how to change the system to reduce the rushed consultation.

From social media, I’ve realised this is a global concern.

Unfortunately, I’m not sure doctors will change just because patient associations complain about it. Doctors are typically set in their ways and because most tend to be busy, with more than enough work, the incentive to change is also low.

The panel mentioned “doctor shopping” as a solution. That phrase makes me cringe a little but I appreciate the sentiment. Yes, do get a 2nd or 3rd opinion and find a doctor you feel comfortable with and who you can work with.

Sometimes, depending on location, there isn’t that 2nd or 3rd choice.

I still think that instead of wishing and waiting for the doctors to change, patients should become as educated about their diseases as possible, be empowered by their knowledge, to then have higher level discussions with their doctors.

In the private sector, in areas where there are options, you may be able to demand better service as a paying customer.

If enough patients do this, you’ll get doctors to take notice and change is more likely to occur.

Have you ever considered this?

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