Shoalhaven Medical Association – Important Update

Planning is well underway for the next Conference to be held on 23rd October 2021 at the Nowra Golf Club. Please note the change of date.

Together with some medical and surgical updates, we are focusing on Psychiatry and Mental Health with presentations, panel discussions, and Q&A. This is considered high priority.

We are excited in preparing for this conference, so will immediately post our speakers and program, when confirmed.

Warren Bruce
Chairman, Shoalhaven Medical Association

SMA March Medical Update 2021

March Medical Update Conference, Saturday March 20, 2021


Welcome to Country
The Dr Bill & Dr Pat Ryan Founders’ Session – chaired by Dr Jenny Woods
9:10 – 10:15am Dr Khan MBBS, FCPS(Pak), FRACP (Consultant Nephrologist)Chronic Kidney Disease Early identification & Management at Primary Health Care level
The purpose of this topic is to facilitate timely testing and intervention in patients at-risk for chronic kidney disease (CKD). There will be discussion on how to apply appropriate clinical measures to manage risk and increase patient safety in CKD and emphasis on the strategies of co-management and timely referral to nephrology specialists, when appropriate, in order to improve outcomes in CKD.
Dr Johanna Kohlhagen MBBS (Hons) FRACP MD (Nephrologist)Management of Chronic Kidney Disease and its Complications
A practical approach to the management of CKD and its common complications, with reference to the CARI guidelines where relevant. Strategies to delay the progression to ESRD, when to refer, and important issues around managing hypertension, dialysis, and transplant populations will also be covered.
Debbie Pugh RN, MCN (Master of Clinical Nursing), and Narelle IllicRenal Supportive Care
10:30 – 11am Panel Discussion – chaired by Dr Jenny Woods, who will present cases for discussion
11:05 – 11:20am Morning Tea
11:25 – 11:45pm Alan Clark AM Local historian and life member of Shoalhaven Historical SocietyThe 1919 Influenza Epidemic in the Nowra District
Based on research which Alan undertook for his book, Nowra District in Mourning, on the 1919 Pneumonic Influenza Epidemic, he will tell of how the epidemic came to Nowra, how little was known in its treatment, and the difficulties faced by doctors. With no public hospital in the town, the primary school was used as a temporary hospital, while meals were prepared by Red Cross and other community members.
11:45 – 12:05pm Dr Bill Pratt MBBS, MPH&TM, FRACP (Infectious Diseases Specialist)An update on COVID-19
Dr Pratt will deliver a much anticipated update on COVID-19 – this is a follow-up from his presentation at the October 2020 Conference, and there will be considerable interest in what has changed in the intervening five months. Dare we hope that the vaccine will allow a return to “normal”, or will it always be a “COVID normal”?
12:10 – 12:30pm FascinomasCase presentations by Medical Students from the University of Wollongong
12:35 – 1:10pm Dr Damian Jiang MBChb FRANZCR (Radiologist)Introduction to PET CT in the Shoalhaven
Dr Jiang obtained his medical degree at the University of Otago in Christchurch followed by completing a Fellowship in MRI / Sports Imaging. In 2015, he completed an Advanced Oncology Fellowship at the Peter Mac Oncology Centre. In 2016, Damian joined South East Radiology, and has a special interest in MRI and Oncology. His lecture to the SMA is sub-titled “Hot or not? The how and why of PET CT”.
1:20 – 1:45pm LUNCH
1:50 – 2:10pm Dr Dylan Mordaunt BHB MBChB PGDip(Data Science) FRACP FAIDH (Director of Medical Services at Shoalhaven Hospital)Hospital and Community: How do we work together?
Dr Morduant is a metabolic paediatrician and clinical geneticist by background, and currently works as the Director of Medical Services at Shoalhaven Hospital Group.
2:15 – 2:55pm Dr Chad Todhunter B Med Sc. MBBS (Hons) FRACS FAOrthA (Orthopaedic Surgeon)The Dodgy Knee
Dr Todhunter will provide a work-up algorithm for suspected knee arthritis and appropriate treatments. The aim of this is to streamline the referral process and prevent costly investigations. He will also provide an evidence-based summary on the results of knee arthroscopy and the use of robotics.
3 – 3:40pm Honorary Clinical Professor Martin Jones MB BS FRACS (General Surgeon)Changes to General Surgery in 2021 and Beyond
The Global status of medicine is epitomised in General Surgery. The involvement in MDT, Data, and Audit collection has seen the growth of science backing surgeons – ERAS, imaging, and laparoscopy. Zoom. COVID-Safe and Vascular Access are the buzzwords, but how do they affect surgical patients? Robotics are here, but is this the way of the future?
Pre- and Post-Operative Management
3:45 – 4:05pm Dr Tony Fitzpatrick MBBS (Hons) FANZCAPost-Operative Cognitive Dysfunction (PCOD) and Anaesthesia
Dr Fitzpatrick is a Senior Specialist Anaesthetist based in the Shoalhaven since 1996, and he is presently a VMO at the two local hospitals. His presentation will examine the incidence and aetiology of POCD and the how, why, and if anaesthesia may be contributory, addressing such questions as “Doctor, I’m worried about my memory since the surgery and anaesthetic” or “my husband was never the same after his op…”.
4:10 – 4:30pm Alex Stronach MClinExPhys, BAppSc (Sp&ExSc), ESSAM AEP (Accredited Exercise Physiologist)Using Exercise as Medicine in Perioperative Care. How to prescribe the right dose to optimise patient outcomes
The benefits of exercise for rehabilitation have been well promoted for some time, but what does the research recommend for prescribing exercise? What is the correct dose? And more importantly, how do we ensure our patients actually engage in exercise and achieve the most optimal outcome following surgery?
Lectures are free for all members of the medical fraternity. RACGP & ACRRM CPD points available.
Venue: Zoom Online Meeting & Nowra Golf Club.

Registration & Membership

Please register your attendance by sending your printed Registration Form by email to conference@shoalhavenmedical.com.au by Friday, March 12, 2021. For catering purposes, it is essential that we know numbers.

Membership is only $300 per annum and is tax deductible!!

Direct Deposit details – Shoalhaven Post Grad Medical Committee;
Commonwealth Bank, Nowra Branch: BSB 06 2585 Account Number 28037627.

Cheque payment: please include copy of this invoice with your cheque and send both to:
67 Waldegrave Crescent,
Vincentia. 2540

Your receipt will be forwarded to you after payment.
Queries or concerns? email membership@shoalhavenmedical.com.au

SMA Chairman’s Newsletter: 1st February 2021

I will take this opportunity to wish everyone a better and brighter 2021.

Whilst 2020 may have been memorable for all the wrong reasons, the evidence that 2021 will be better is inconclusive at this stage. Evolution of COVID impact is ongoing, effective vaccination is yet to reach Australia, and the trauma of the 2019-2020 bushfires is settling, but not resolved. The Shoalhaven has dodged several COVID bullets over the last year, and in terms of COVID caseload, has seen surprisingly little – strong evidence that the Australian and NSW strategies are effective.

We are still governed by these strategies which affect the way we conduct ourselves in terms of everyday life, medical practices, meetings, and our SMA conferences.

Our October 2020 SMA Conference was held in Zoom format with a hub of presenters and IT support at the Nowra Golf Club. Surprisingly, there was strong support for this format with little negative feedback, and a majority of attendees very supportive.

We managed to record most of the October Conference, with the aim of making content available to our members (just another perk of SMA membership) via secure access YouTube presentations. This should be available soon via the shoalhavenmedical.com.au website.

Our plans for the March 20, 2021 Conference remain a little dynamic. We are acting on Infectious Diseases advice to plan the setup. At this stage, the plan is to conduct a hybrid Conference with either a Zoom option or face-to-face option at the Nowra Golf Club available. COVID guidelines will be adhered to.

The SMA Committee is excited by the prospect of this March 20 Conference, and hope to see you there or on-screen.

Warren Bruce
Chairman of Shoalhaven Medical Association

Lecture Notes
Controversies in COVID. An overview of the viral pandemic and areas of contention – DR WILLIAM PRATT (INFECTIOUS DISEASES SPECIALIST)

There is a herarchy of interventions to control COVID-19. The least effective of these is relying on masks and PPE – it works, but it isnt perfect. More effective measures include using telehealth, engineering controls [HEPA filters and high rates of air flow, perspex barriers], administrative controls [contact-free payments], and having appropriate sick leave so that staff do not keep working when sick. When wearing a mask, wear it properly and don’t touch your face!

There seems to be a wide spectrum of illness from very mild to very severe. Deterioration tends to happen most often in the second week of illness. Several treatments have been found ineffective, including hydroxychloroquine. Remdesivir and dexamethasone are still being investigated.

There is an emerging idea that this may be a Syndemic, not a pandemic. A Syndemic is where two categories of disease interact within specific populations, i.e. socioeconomic disadvantage and chronic disease is intersecting with the viral infection leading to worse outcomes.

Locally there has been a huge amount of work done to plan for the response in the aged care facilities. [As previous, see HealthPathways for the latest guidelines.]

Lecture Notes
Gender Dysphoria for GPs – DR DAN TAIT (PAEDIATRICIAN)

Gender diverse young people face many challenges in health care. There is a severe shortage of available services. GPs can help by providing respectful and affirming care, especially holistic care addressing all of their physical and mental wellbeing.


  • Make sure to use their preferred name (and change to this name in practice software) and their preferred pronouns (i.e. he/him for a trans male). If in doubt, ask the patient what they prefer.
  • Psychological support is essential.
  • Not everybody wants hormonal treatment, but for those that do there are still access issues unfortunately.
  • Changing a birth certificate is also a difficult process.
  • Refer to a paediatrician initially (children / adolescents).


You can read more about the management guidelines here.