Practice Philosphy

Our calling is helping patients suffering from the effects of surgical endocrine disorders. We work in both the public and private health systems and ensure that we provide safe and effective treatment of thyroid, parathyroid, adrenal and other neuroendocrine conditions (see the section on the conditions we treat).

In our practice there is a supportive and respectful collaboration between our office and clinical staff and we have a patient centred work ethic. We find that our long working relationships mean we can shepherd our patients through the complexities of the health system. Our staff have enjoyed working together for between 5 years and more than 20 years so it is likely we have collectively seen and dealt with most problems and circumstances. When we accept your referral we are determined to see your problem through to its conclusion. 

Successful surgery depends on thorough assessment and preparation of patients with careful attention to detail so that when a procedure is performed the scope for surprise discoveries and unplanned changes in treatment is minimised. We aim to have our patients fully informed and confident of the treatment plan. As a result we place a strong emphasis on the pre-operative work-up and education of patients when they first see us. Central to this is a detailed medical history and examination. We use nasendoscopy (vocal cord examination) and ultrasound in our rooms to assist in the examination. 

We work closely with our medical endocrinology colleagues who have particular diagnostic and therapeutic skills and a range of other imaging and diagnostic specialists to make sure that we offer a useful surgical procedure that will realistically deal with the clinical problem and improve the patient’s quality of life

As the population ages we need to place their surgical procedure in the perspective of other illnesses and similarly in the younger population think about the impact of treatment on work and family life. We endeavour to provide safe and lasting surgical solutions to surgical problems, and carefully follow up and support our patients during recovery, and in the case of cancer during post treatment surveillance. When a patient has other medical problems we make sure that these conditions are stabilised and that the risks are acceptable for surgical treatment. We will often advise against operating when we feel the benefits of surgery are outweighed by other risks, or if surgery is not the correct treatment.

We are very dependent on our working relationship with our anaesthetic colleagues, and the scope of what we can achieve with an operation is often only possible due to their high level of expertise. They can in many cases make anaesthesia which was previously a bad experience for a patient very much more pleasant this time around. They make the post operative experience much less troubled by pain.

We provide the most modern technology when we know it will help treat your condition, but avoid adopting new techniques until we know they are useful and safe in our practice. When an established surgical technique achieves the same result with less risk we choose proven results over novelty. We continue to review and fine tune our techniques to remain current. As a result we consider education and retraining both here and overseas to be critical to the success of our practice.

Since I commenced consultant general surgical practice in 1991 we have progressively limited the scope of the conditions that we treat to exclusively endocrine surgery, so we are familiar with a very wide range of unusual variations and presentations of endocrine disorders, and with the problems that might arise following surgery. When we have a very unusual case we consult with our network of trusted local and overseas colleagues before making decisions regarding management.

We see and treat patients referred from other surgeons, and from around the state, interstate and overseas. We provide second opinions on difficult cases, and perform technically challenging revision surgery.

When a condition impacts on other areas of expertise such as thoracic surgery, vascular surgery, gastrointestinal surgery or head and neck reconstructive surgery we consult and work closely with the right person in that specialty to deal with difficult and advanced cases. We enjoy a close working relationship with our preferred colleagues in cytology and pathology to ensure that the microscopic diagnosis is accurate.

When it assists in planning and co-ordinating cancer therapy we consult with our nuclear medicine, radiotherapy and medical oncology colleagues at Multidisciplinary meetings. We are indebted to our medical endocrinology colleagues in the challenging areas of stabilising and replacing hormonal imbalances in thyroid, bone metabolism and adrenal hormonal dysfunction. 

We consult regularly with our endocrine genetics colleagues when there is a genetic component that might affect more than just the one person in a family, and contribute to the research effort that is rapidly changing the management of inherited illness.

We see the pervasive nature of "spin" in personal, political and commercial life. Our surgical results are very good and rank with similar highly specialised services around the world, but we avoid superlatives and "never" or "always" when we describe complications and cure rates. We do have complications and not every problem is solved; we would delude ourselves if we thought we were perfect. We are pleased with the results of our work in this practice.