Lecture Notes
Who you gonna call? Decision-making at end-of-life – Dr Joel Rhee

Person Responsible Hierarchy

If a patient cannot consent to their own treatment then the practitioner should seek consent from the patient’s ‘person responsible’

  1. An appointed guardian
  2. Most recent spouse/de facto/same sex partner who person has close and continuing relationship with the patient
  3. Unpaid carer who is providing support to person
  4. Relative/friend/neighbour who has a close personal relationship with the person

You can find out more about consent and substitute decision makers here (also summarised here).

SMA October Medical Update 2020

October Medical Update Conference, Saturday October 17, 2020

The Program

8:30am Welcome Cup of Coffee/Tea
Acknowledgement Of Country
The Dr Bill & Dr Pat Ryan Founders’ Session
Aged Care – Smoothing Out Some of the Wrinkles
9:10 – 10:15am Dr Joel Rhee (General Practitioner)“Who you gonna call? Decision-making at end-of-life.”
Justine O’Reilly (Solicitor)“Keeping Older People Financially Safe & driving safely”
Dr Sundhar Balu (Staff Specialist in Geriatric Medicine)“Managing Behavioural and Psychological Symptoms of Dementia (BPSD) in Nursing Homes”
10:20 – 11:15am Panel Discussion
11:20 – 11:30am Morning Tea
11:35 – 12:15pm Dr Dan Tait (Paediatrician)“Gender Dysphoria for GPs”
12:20 – 1pm Dr William Pratt (Infectious Diseases Specialist)“Controversies in COVID. An overview of the viral pandemic and areas of contention.”
1 – 1:20pm Lunch
1:25 – 2:05pm Dr Ed Danson (Cardiologist)“Interventional Cardiology in the Illawarra and Shoalhaven in 2020”
2:10 – 2:30pm Fascinomas“Presented by students from Graduate Medicine, University of Wollongong”
2:35 – 3:10pm Superintendent Mark Williams (NSW RFS District Manager)“Currowan, Shoalhaven Burns”
3:15 – 3:35pm Commander Vince Di Pietro (Former Fleet Air Commander)“Shoalhaven Local Recover Coordinator perspective of Recovery, Readiness and resilience”
3:40 – 4pm Dr Shane O’Neil (Plastic Surgeon)“Plastic Surgery – Now & Then: A brief history and some recent cases”
4:05 – 4:30pm Dr Anthony Barker (Specialist Plastic, Reconstructive & Aesthetic Surgeon)“Clinical Diagnosis and Initial Management of Acute Hand Trauma”
Lectures are free for all members of the medical fraternity. RACGP & ACRRM CPD points available.
Venue: Zoom Online Meeting.

Meet the Lecturers

Dr Joel Rhee

BSc(Med) MBBS(Hons) GradCert(ULT) PhD, FRACGP
Dr Rhee is an Associate Professor of General Practice at the University of Wollongong and a practising GP. His research has focused on decision-making around end-of-life, improving Advance Care Planning in community and hospital outpatient settings and optimising palliative care in the community setting. He is a current chair of the Royal Australian College of General Practitioners Cancer and Palliative Care Specific Interests Network.

Justine O’Reilly

Justine O’Reilly is the Principal Solicitor of Shoalcoast Community Legal Centre in Nowra and is a Family Dispute Resolution Practitioner. Since 2007 Justine has worked with in and around the South Coast with Shoalcoast Community Legal Centre, Legal Aid and the Family Relationship Centre.

Dr Sundhar Balu


The tragic consequences of the pandemic in Aged Care facilities in Victoria has highlighted the need for this issue to be addressed openly in the interests of patients and their families.

Dr Dan Tait


Dr Dan Tait is a paediatric endocrinologist and general paediatrician who after graduating from the University of Sydney, undertook specialist training through the Sydney Children’s Hospital Network (Randwick and Westmead). He is employed as a staff specialist at Shoalhaven and St George Hospitals and specialises in Type 1 diabetes, disorders of growth and puberty along with thyroid, adrenal and pituitary disease.

Dr William Pratt

Dr Pratt will provide an insight into the COVID 19 pandemic and the controversies which surround it.
A much anticipated talk addressing the virus which is devastating lives, livelihoods, and lifestyle around the world.

Dr Ed Danson

Dr Edward Danson is a Consultant Interventional Cardiologist and Senior Lecturer at the University of Wollongong. He is trained in coronary and structural heart conditions and offers some of the latest and most innovative treatments to the area.

Superintendent Mark Williams

As the face of the RFS response to the Currowan fire in Dec and Jan, Mark Williams became a household name through his briefings to media and local communities.
He is the RFS Shoalhaven District Manager and he will share a rare insight into the bushfire disaster and the organisation of the response.

Commander Vince Di Pietro

As Shoalhaven Local Recovery Coordinator and Chair of the Recovery Committee for the 2019/20 bushfire, Vince will share his first-hand experience and perspectives of the Recovery from the Bushfire Emergency which affected 80% of the Shoalhaven’s 4,600 square kilometers.

Dr Shane O’ Neill

FRACS(Plast); Dip. Hand Surgery
Dr O’Neill is general plastic surgeon with an interest in skin cancer and hand surgery. He completed his final plastic surgery exams in 2012 after having trained predominantly at Royal Prince Alfred and Royal North Shore Hospitals. He then completed a Fellowship in Dublin at St Vincent’s Hospital for further training in breast reconstruction and hand surgery.

Dr Anthony Barker


Dr Barker has extension clinical and research expertise in Plastics and Reconstruction, having worked in academic units in Melbourne and Sydney. His passion for innovation and patient care drive him to apply the best techniques to optimise patient care. Dr Barker is an Honorary Clinical Senior Lecturer at Macquarie University and available to consult at Park Medical Clinic Nowra.

Registration & Membership

Please register your attendance by sending your printed Registration Form by email to conference@shoalhavenmedical.com.au by Thursday, October 15, 2020. For catering purposes, it is essential that we know numbers.

Membership is only $250 per annum and is tax deductable!!

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

Shoalhaven Medical Association Update: October 2020

Important Information regarding SMA Conference Saturday 17th October 2020.

ZOOM Meeting to replace face to face Conference.

Hi to all members and associates of the Shoalhaven Medical Association,

COVID19 has forced change in how we function normally. After discussion with Dr Bill Pratt (Infectious Disease) the recommended position is;

  • No large indoor gatherings can be supported.
  • Dinner to be postponed.
  • Mingling around feeding/coffee stations and trade displays is seen as a real risk.
  • Conference can be held by video format (Zoom or similar).
  • Conference hub will be at the Golf Club with a small number of people, the organising committee and those presenters who would prefer to present from the hub with more control over their Powerpoint or content. Those involved in the panel session may wish to be present. Those presenters who would otherwise need to travel may wish to present remotely. There will be IT support at the Golf Club.

Program Brochures will be distributed with Registration Details in the next few weeks.

Registration for the SMA Conference will be via email or phone.

An invitation to join the Zoom meeting with identifier and password will be sent in the week before the Conference.

Free Zoom activation is recommended via – https://zoom.us and click on (sign up, it’s free) for those not currently using Zoom.

The potential for interactive questioning or comments will be maintained by video or type-in.

CPD points are available.

If you know of colleagues who aren’t associated with the SMA please let them know of this event as it is free to all health professionals and they may wish to establish contact.

With a little under two months to the Conference we are looking forward to adapting to change whilst realizing there may be real opportunities involved. ‘Tis a brave new world.

Hope to see you there.


Warren Bruce


SMA    www.shoalhavenmedical.com.au

COVID and Type 1 Diabetes Late Diagnosis

The Australian Paediatric Society is a special society of the Royal Australasian College of Physicians and the voice of rural child health.

While supporting the Government measures to limit spread of COVID-19, we are concerned about the potential impact that late or non -attendance of a sick child to a general practitioner or emergency department may have on the lives of many children.

In particular, we are concerned about the potential late diagnosis of Type 1 Diabetes. Diagnosis in a toddler is particularly difficult.

Symptoms of:

  • thirst,
  • excessive wetting (including starting to wet the bed again),
  • vomiting,
  • tiredness and /or
  • weight loss

may be attributed by a parent or in a phone consultation as “gastro”, the “flu” or urinary infection. Delayed diagnosis of Type 1 diabetes may result in death or permanent damage.

Please distribute this message to your members to remind them to think “is it Type 1?”

Check a blood (or urine) glucose immediately and refer to the nearest Emergency Department immediately if positive or if in doubt.

Newly diagnosed Type 1 diabetes is a medical emergency.

Dr Peter Goss FRACP (Vic)

On behalf of Dr Tim Warnock FRACP (Qld), Dr Joanne McCubbin FRACP (Vic) , Dr Mark DeSouza FRACP (NSW) Dr Allan Kerrigan FRACP (NSW) Paul Bauert FRACP(NT) Nigel Stewart FRACP (SA)
Australian Paediatric Society Committee