chemo@home

There are few of us who escaped the news coverage of what happened when the Australian  government wanted to boost the economy back in 2009, by funding the installation of “pink batts” into homes. Tragically, four young men died, from what was found to be a lack of oversight by the government resulting in massive system failures.  Simply put, the government provided the money, but did not ensure that there was the appropriate legislation, regulation or training available to make it safe.  And where there is money to be made, there will always be some who will want to profit from it.  Some of these people will have no regard for the safety of the product they are supplying, some will be ignorant of what is needed to make it safe.  The result is the same. When people ask me, “is giving chemo in the home safe?”, I find it difficult to answer.  To be honest the answer is both yes and no. I have worked managing a “home chemo” service for just unde...

Recent media reports have highlighted the somewhat complex and hidden costs associated with health care.   The Four Corners report “Mind the Gap” focused on out-of-pocket expenses and hidden fees from surgeons.   Whilst the ABC medical report on “Secret Pacemaker Payments Boosting Private Hospital Coffers” focused on the hidden rebates hospitals receive for using various medical devices. The two issues are separate, but very much related.  Both point to the lack of transparency of financial interactions between specialists, hospitals and a variety of other stakeholders in the health care market. The first media report highlighted the issue around “informed financial consent”.   It is mandatory for all patients receiving care from a specialist in a private hospital to sign a document stating that they agree to the charges related to the procedure or care for which they are being admitted.   But how “informed” is the financial consent?   At a vulnera...

In 1997 a study was published in “Blood”, arguably the most respected medical journal on blood cancers on planet earth.   The study was about the effect of exercise on treatment related fatigue after a type of bone marrow transplant called a peripheral blood stem cell transplant.   The study peaked my interest, not just because of the positive benefits of exercise on reducing fatigue, but because it also showed a benefit in other somewhat more unexpected areas.   It also reduced the length of time a patient’s white blood cell count is low after transplant, the severity of diarrhoea and the severity of pain.   Of these the one that interested me most at the time, was the effect on the white blood cell count.   The white cells are the part of your blood system which fight infection; without them the body is more prone to getting nasty bugs and less able to fight them off. So, what was so interesting about this finding?   In the early 80’s a medicat...

Have you ever believed in something, something you thought everyone else believed in as well; only to find out that in fact nothing could be further from the truth? Just after we started chemo@home 5 years ago, a very high up health executive said to us during a meeting, "It's not about the patients, don't bring emotion into this".  It was possibly the first time (but definitely not the last time) that such a jaw dropping statement like this was said to us. We had started chemo@home on the entire principle that treatment WAS ALL ABOUT THE PATIENT.  For us, the patient and their family are at the centre of everything we do.  Their choices, about their treatment, is what matters most. To find out that there were health managers and executives who put other concerns before the patient was, for us, mind blowing.  What are these concerns you might ask.... well let’s just say that a lot of emphasis is placed on a health services "activity", the nu...