Taking a breath with our paediatrician rep

When did you first know you wanted to be a doctor?  

My childhood memories were of regular and fond visits to our family doctor. When that GP moved to a different practice, my family drove a significant distance to continue that relationship. That was my earliest exposure to the profession, and it left a lasting impression.

Why did you join the AMA?

In my training years, I found myself on the wrong side of a hospital policy change made by medical management. Effectively, nobody wanted to hear my perspective, and they wouldn’t even make time to talk. Bullying seemed  to be the default response. It was a big wakeup call. I realised the need for representation, and I’ve been a member ever since.

Why did you join the AMA (WA) Council?

I currently work across several organisations – in paediatrics at Perth Children’s Hospital and Fiona Stanley Hospital; at Asthma WA, which is a non-government organisation; and I previously ran private rooms. I see different issues that affect each setting. With wider exposure as a councillor, I thought I may be better placed to represent and comment on paediatric issues.

What would you most like to achieve as a councillor?

I would like to have more resources in place to implement the Sustainable Health Review findings (2019). Although this seemingly provided a roadmap to better community care and better integration, in reality, there are few resources in place to rethink or change current services.

I’ll give you an example, which also doubles as a shameless plug for the Children’s Asthma Hub at Asthma WA (asthmawa.org.au/services/childrens-asthma-hub). This service came about as we identified a large gap in paediatric asthma service, particularly the lack of community lung function services for kids. We established a free holistic community asthma service as a one-stop shop for concurrent paediatric lung function, asthma education and specialist review. It continues to grow, and now runs in West Perth, Cockburn, and soon in Joondalup. We would like this service to become a discharge pathway from ED to support families by giving education and diagnostic clarity as they move back to GP care.

The service is only able to be run from limited charitable grants (Channel 7 Telethon Trust and Stan Perron Charitable Foundation), as there are no obvious government funding streams to establish or support community partnership programs. If funding barriers were removed, I could see others rethinking other chronic disease models, with likely overall cost savings in the end.

What do you see as the main issues facing paediatricians?  

This is probably not exclusive to paediatrics, but we’re seeing an increase of at least 15 per cent in service demand over the last five years, without a proportional increase in staffing. We are seeing wait times balloon across the board. There is record demand in services, particularly in developmental paediatrics where this problem is proportionally worse, and it has prompted the formation of a Parliamentary Enquiry and the formation of a Select Committee into Child Development Services. This committee’s interim report was released in November 2023, making explicit that there has been a 52 per cent increase in referrals to Child Development Services since 2013-14, and the last meaningful increase in staffing was in 2010.

Are there any new innovations in paediatrics that you’re particularly excited about? 

For cystic fibrosis, we now have modulator therapies that target and fix the protein problems from genetic abnormality. We are seeing some of our sickest patients going from barely able to breathe, to winning dance competitions. It’s giving these kids their childhood back.

In your opinion, what’s the one innovation that has changed paediatrics over the past 10-20 years?

Humidified high flow. We’ve gone from putting babies with bronchiolitis in these gigantic, relatively immobile Perspex head boxes to now giving them better respiratory support, with high-flow nasal prongs that allow parental cuddles and easier feeding.

Do you have any heroes or mentors who have guided your path so far?  

I am inspired by John West, who is famous for writing one of the great respiratory physiology bibles. He tells a story of how he started his career. Sir Edmund Hillary had just climbed Everest, and the next planned expeditions were for him to take a respiratory physiologist to altitude to conduct experiments on how respiratory gases behaved at altitude. John West, a newly minted scientist, signed on – having never climbed a mountain in his life. The whole endeavour seemed incomprehensibly difficult. His work is gospel and has never been replicated.

What’s the one life lesson you’ll always remember? 

I am a second-generation immigrant, and I thought I grew up with challenges. When I started seeing patients, I realised for the first time how hard life is for some, and that their problems are truly insurmountable. It was my first realisation that I’ve never had a hard life, and where I am now is largely the product of privilege.

What’s something your parents impressed on you? 

All their decisions were for the betterment of their children. I hope I can do the same for mine.

What would you tell a young doctor looking to specialise in paediatrics? 

Kids are the best (but I’m biased).