Public and Private

You may be referred to my office or the St Vincent’s Head and Neck Cancer Multidisciplinary Team (MDT) at The Kinghorn Cancer Centre. Head and neck cancers are highly aggressive. Our goal is to get patients diagnosed and treatment started as quickly as possible.

Head and neck cancers are highly aggressive and my goal is to get patients diagnosed and treatment started as quickly as possible. When I receive your referral I assess how urgently you need to be seen. I brief my clinical and admin staff to schedule your consultation accordingly. I also advise which medical investigations may need to be completed before your consultation.

The speed with which you are seen depends a lot upon your referring doctor. They need to provide a referral and forward relevant reports and investigations before your consultation can be organised.

Patients with a suspected malignancy are typically offered a consultation within seven working days. To help fast track your consultation we need a valid referral from your doctor. It is important that you or your referring doctor forward all relevant reports and investigations.

There are no out of pocket costs for patients attending the St Vincent’s Head and Neck Cancer MDT.

Patients are advised of the cost of the consultation at the time of booking. Consulting fees are listed on my website in the FAQ section.

Your referring doctor or a member of the St Vincent’s Head and Neck MDT may refer you for imaging or other investigations before you attend the MDT.

My admin team book and coordinate your consultation in conjunction with any imaging or other investigations you may need before you see me. Investigations typically include PET scan (Positron Emission Tomography), CT, MRI, and/or blood tests.

It is important that you advise us of what investigations you have had done so that the Head and Neck team can help organise any further investigations. In extenuating circumstances a social worker may help coordinate your care. You may be referred by your GP to your Local Health District (LHD) Integrated Care Coordinator or you may be eligible for help from your local Can Assist office.

My staff arrange as many of these medical appointments investigations as they can. Most practices expect you to make your own medical imaging appointments. My team works hard to minimise the amount of time regional patients spend away from home. You may be referred by your GP to your Local Health District (LHD) Integrated Care Coordinator or you may be eligible for help from your local Can Assist office.

If you are traveling more than 100km for treatment you are eligible to access the Isolated Patients Travel and Accommodation Assistance Scheme (IPTAAS) and St Vincent’s Open Support Country Care Link.

If you are traveling more than 100km for treatment my staff will provide you with information regarding the Isolated Patients Travel and Accommodation Assistance Scheme (IPTAAS) and St Vincent’s Open Support Country Care Link. My staff will also help you with paperwork to support IPTAAS claims and arrange medical certificates.

Your initial consultation routinely takes place at the St Vincent’s Head and Neck Cancer Multidisciplinary Team (MDT) meeting at The Kinghorn Cancer Centre, 370 Victoria Street, Darlinghurst.

My Nurse Practitioner attends your consultation. She is a second point of contact for you and your family throughout your cancer journey.

A junior medical officer such as the ENT registrar will take your history. Once the head and neck MDT commences you will be examined. You will be examined by a Junior Medical Officer (JMO) or an ENT Registrar (a doctor training to be a specialist) or a senior doctor in the Head and Neck Service. Senior doctors are also known as specialists, consultants or VMOs (Visiting Medical Officer).

After taking a history I may need to examine you with a flexible video telescope. This takes a moving image of the inside of your throat which you can also see on a monitor.

Examination may require the use of a flexible video telescope. This is a minor procedure which provides a magnified, high definition, live action review of your larynx, throat and nose. It is called a video nasolaryngoscopy.

Direct video nasolaryngoscopy is a minor procedure which gives me a magnified, high definition, live action view of your larynx, throat and nose. The great advantage of videoscopes over standard flexible fibreoptic telescopes is that they provide a superior (4K) magnified image on a wide screen. I originally used fibreoptic telescopes in my practice but I changed over to video in 2013. This was because I recognised that the superior image offered by video significantly improves my ability to identify pre-cancerous and cancerous changes in the lining of the throat and voicebox. I pioneered the use of this equipment in Australian consulting rooms and know of only a handful of head and neck and otolaryngology surgeons who use it.

This is the only time video nasolaryngoscopy is used during your treatment. Long-term follow up in the Outpatient Department uses direct fibreoptic endoscopy.

I use video nasendoscopy because I consider it the best way to document your lesion. I compare the still and video images I collect at each consultation in order to monitor your response to treatment. This is important for long term follow up. The majority of head and neck oncologists (surgeons, radiation oncologists, medical oncologists) do not do this.

The video nasolaryngoscopes are individually cleaned and sterilised on-site at the Kinghorn Cancer Centre according to Australian/New Zealand standards. This is performed by appropriately trained sterilisation staff.

All reusable equipment used during your examination is cleaned and sterilised according to Australian/New Zealand Standard AS/NZS 4815:2006 Office-based health care facilities – Reprocessing of reusable medical and surgical instruments and equipment, and maintenance of the associated environment. We use a steam steriliser, also known as an autoclave, and the Tristel medical instrument disinfection system. Our Melag Premium Steam Steriliser meets international sterilisation standards and is validated annually. All practice staff are trained in infection control.

Both public and private patients attend the weekly St Vincent’s Head and Neck Cancer Multidisciplinary Team Meeting (MDT). The meeting runs on Tuesdays at The Kinghorn Cancer Centre. The MDT includes a range of doctors, nurses, dentist and allied health workers from different specialties including doctors who specialise in radiotherapy and chemotherapy.

The vast majority of my patients attend the weekly St Vincent’s Head and Neck Cancer Multidisciplinary Team Meeting (MDT). The meeting runs on Tuesdays at The Kinghorn Cancer Centre which is less than 300 metres from my practice in St Vincent’s Private Hospital and is part of the St Vincent’s Integrated Healthcare Campus Darlinghurst. The MDT includes a range of doctors, nurses, dentist and allied health workers from different specialties including doctors who specialise in radiotherapy and chemotherapy.

Public and private patients are reviewed at the St Vincent’s MDT in exactly the same way.

At the MDT your history will be taken by a junior medical officer (JMO) and presented to the MDT. You will then be examined by a member of the Head and Neck Service in an adjoining private examination room. The examination will be relayed by video link into the MDT meeting room where it will be watched by the MDT team. Your scans, X-rays and other investigation results are reviewed and your case discussed. A management plan, also referred to as a treatment plan, is created. We then meet with you to tell you our recommended treatment plan including the purpose, benefits and potential risks of treatment. Your treatment plan includes your recommended primary treatment as well as any adjuvant treatment if it is required. Adjuvant treatment is extra or further treatment which typically follows surgery. Primary treatment may include surgery radiotherapy, chemotherapy, immunotherapy or referral to clinical trials. Adjuvant treatment for surgical patients may include radiotherapy, chemotherapy or immunotherapy. Patients will also meet our Social Worker and Cancer Care Coordinator. A record is kept of the discussion and treatment plan and sent to your treating and referring doctors.

You may also require a Dental Review which involves a dental examination with the St Vincent’s Head and Neck Cancer Service dentist and an orthoptomogram (OPG) also known as a dental x-ray. This is usually done on the same day as your visit to the MDT. The x-ray is taken at St Vincent’s Hospital Medical Imaging and is bulk-billed.

You may also require a Dental Review which involves a dental examination with the St Vincent’s Head and Neck Cancer Service dentist and an orthoptomogram (OPG) also known as a dental x-ray. This is usually done on the same day as your visit to the MDT. The x-ray is taken at St Vincent’s Hospital Medical Imaging and is bulk-billed.

If you require surgery and choose to proceed as a public patient you will attend a Pre-Admission Clinic at St Vincent’s Hospital. At the Pre-Admission Clinic you may undergo some tests and an anaesthetic review to ensure you are fit for your operation. This is also an opportunity to ask any questions you may have about your procedure and to plan your discharge after your admission.

If you require surgery and choose to proceed as my private patient you will return to my rooms after the MDT. We will have a follow up consultation to confirm that you understand the treatment plan, answer any questions you may have, and discuss next steps.

Public patients will be placed on the St Vincent’s Hospital public surgical waiting list and prioritised according to clinical need. You will be contacted by a St Vincent’s Hospital Waiting List Manager or admissions team. This is usually by phone or post. More information can be found about SVHS Pre-admission procedures here.

During that discussion we will review your recommended treatment plan. This is another opportunity for you to ask questions and for me to make sure you understand the purpose, benefits and potential risks of surgery. If you are happy to proceed you will be given formal consent and hospital admission paperwork to complete before you leave. We may also discuss a potential date for surgery.

Your point of contact is the ENT Registrar or Cancer Care Coordinator.

In the days immediately after your first consultation my Nurse Practitioner will check to see if you would like a phone or video consultation (Telehealth) with her to answer any questions.

There is no fee for Australian citizens in the public health system.

In the days after your initial consultation my Practice Manager and I will discuss the date for your surgery. Once this has been agreed my staff will contact you to discuss the logistical details of your surgery including fees. You will be sent a customised Informed Financial Consent (IFC) which details my fee and your out of pocket expenses. The IFC also includes advice about how to research other costs associated with your care such as the anaesthetist’s fee and intensive care expenses. The level of cover provided by private health funds for in-hospital services varies between funds and between policies. Only patients can check with their funds to confirm their level of cover. My staff cannot do this for you due to government privacy legislation.

There is no fee for Australian citizens in the public health system.

If, after receiving your Informed Financial Consent, you are concerned about the costs associated with your care, please discuss your options with my Practice Manager. You always have the option of going through the public system as a public patient. You may also want to learn more about how I determine my surgical fees and financial resources for surgical patients.

Patients are placed on a waiting list and triaged according to clinical need. A date will be allocated for your surgery. You will be contacted by the St Vincent’s Waiting List Manager once the date of your surgery has been determined.

Surgery is typically scheduled as soon as possible. As a private patient you are actively involved in this process of selecting the date and timing of surgery with my Practice Manager.

While you wait for surgery you have a couple of points of contact at St Vincent’s. Clinical questions should be directed to the Ear, Nose and Throat (ENT) – Head and Neck registrar (the technical name for doctors who specialise in ENT is Otolaryngology – Head and Neck Surgeon). Transport, accommodation and other non-clinical questions should be directed to the Cancer Care Coordinator or Social Worker.

You have access to myself, my Nurse Practitioner and practice team to answer any questions.

If you are on medications your anaesthetist and the ENT Registrar will manage these in conjunction with your regular treating doctor.

If you are on medications my anaesthetist and I will manage these in conjunction with your regular treating doctor.

There is no fee for Australian citizens in the public health system.

You are asked to pay your surgical fee prior to your surgery.

A Visiting Medical Officer (VMO) surgeon in the St Vincent’s Head and Neck Cancer Service supervises your surgery. Some, if not all, of your surgery is performed by training registrars. St Vincent’s Hospital is an accredited teaching hospital for the Royal Australasian College of Surgeons (RACS).

I perform your surgery.

Surgery performed by less experienced surgeons typically takes longer than surgery performed by experienced surgeons. This means you will be under anaesthetic for a longer period of time as training surgeons are learning how to operate.

You will spend a minimum amount of time under general anaesthetic. I am a fast and efficient surgeon. This is a reflection of my skill and experience. I am one of only a handful of surgeons in Australia who performs head and neck cancer surgery on a weekly basis.

A senior VMO anaesthetist will supervise a trainee anaesthetist.

My surgical team includes anaesthetists who have special expertise in managing patients requiring airway surgery.

I often work with a team of highly experienced theatre sisters who are experienced in head and neck and otolaryngology surgical procedures.

I always work with a team of highly experienced theatre sisters who are experienced in head and neck and otolaryngology surgical procedures.

Transoral robotic surgery (TORS) is currently available at St Vincent’s to public patients.

If you require transoral robotic surgery (TORS) the operating team includes a theatre nurse who trained with me in the USA in 2011 and has worked with me extensively on the da Vinci robotic platform.

Co-surgeons such as Plastic and Reconstructive Surgeons supervise junior co-surgeons.

If additional surgeons are needed to help me perform your operation I will choose my preferred co-surgeon(s) or assistant surgeon.

You may require admission to the Intensive Care Unit (ICU).

You may require admission to the Intensive Care Unit (ICU). This usually incurs additional fees which may or may not be covered by your private health fund.

After surgery patients are transferred to Xavier 8 South which is a dedicated Head and Neck ward. You are cared for by the ENT Registrars.

After surgery patients are transferred to Level 10 at St Vincent’s Private Hospital. The nurses on Level 10 have extensive experience in caring for patients with complex head and neck disease. The ward has 24/7 telephone access to me if they have any questions or require my presence in an emergency.

The ENT-Head and Neck registrars round on you daily. The VMO who supervised your surgery will round on you typically once or twice a week.

Typically I and my Nurse Practitioner visit you daily, depending upon the stage of your recovery. We are available to answer any questions you and your family may have about your care.

Pathology results are updated daily and checked by junior doctors in the Head and Neck Cancer Service.

Your pathology results are updated daily and forwarded to my practice where they are reviewed and filed by practice staff.

If you require a consultation with another medical specialist this will be organised by the junior doctors managing your care. You may also be seen by a dietitian or speech pathologist. These services are free of charge.

If you require a consultation with another medical specialist I will organise for you to be seen in hospital. I may also arrange for you to be seen by a dietitian or speech pathologist. In-hospital allied health consultations are usually covered by private medical insurance.lts are updated daily and forwarded to my practice where they are reviewed and filed by practice staff.

There is no option to extend your stay in hospital for non-clinical reasons.

Some patients ask to stay in hospital longer than clinically necessary in order to have nursing care and support. This is discouraged as it incurs an additional daily fee from St Vincent’s Private Hospital which is not covered by your health fund.

Your points of contact remain the same as before your surgery. Clinical questions should be directed to the ENT Registrar. Transport, accommodation and other non-clinical questions should be directed to the Cancer Care Coordinator or Social Worker.

I will give you my mobile phone number. You will also be given my Nurse Practitioner’s mobile phone number.

Your contact is the ENT Registrar.

After leaving hospital, if you have pain, wound management, swallowing, diet or psychological concerns you or your carer can directly contact myself or my Nurse Practitioner.

You will need to see your GP if you require further post-operative prescriptions.

My Nurse Practitioner can write and issue prescriptions relating to your post-operative management.

Any routine follow up care will be scheduled on a Wednesday afternoon during the St Vincent’s ENT Outpatients Clinic. This clinic runs once every four weeks.

Your first post-operative consultation will be scheduled at a time convenient to you and within an appropriate clinical timeframe. Post-operative consultations in the period immediately after your surgery are included in the cost of your surgery.

A summary of your hospital stay is sent from St Vincent’s Hospital to your referring doctor.

At your first post-operative consultation, or soon after, you will be given a copy of a Hospital Discharge Summary prepared by my Nurse Practitioner. This is a summary of information about your hospital stay which includes medications, next steps, and follow up appointments. A copy of this will also be sent to your General Practitioner and other doctors involved in your care.

The majority of public patients receive adjuvant treatment at no charge, especially if all their treatment takes place on the St Vincent’s Integrated Healthcare Campus Darlinghurst. If a public patient receives adjuvant treatment from a medical centre which is not affiliated with the St Vincent’s Health Campus then charges may apply.

There is no fee for Australian citizens in the public health system.

If you require radiotherapy, chemotherapy or immunotherapy I will be kept informed about your care by your treating doctor. Please note – there are costs associated with being a private radiotherapy patient. These costs are best advised by your treating physician. Chemotherapy is typically covered by your private health fund. Immunotherapy may or may not be covered.

The Multidisciplinary Team (MDT) approach to your treatment continues after surgery. Pathology and intra-operative findings are discussed with other doctors and your treatment plan adjusted accordingly.

The Multidisciplinary Team (MDT) approach to your treatment plan continues after surgery. Pathology and intra-operative findings are discussed with other doctors and your treatment plan adjusted accordingly.

You can call the Registrars or Cancer Care Coordinator to discuss.

You can call me or my Nurse Practitioner at any time for advice.

Your point of contact is the ENT – Head and Neck Registrar. If they are unavailable then you will need to call for an ambulance or present at the Accident and Emergency Department of your nearest hospital.

If there is an emergency I can arrange to have you re-admitted to St Vincent’s Private. I will attend in person. If I am away I will organise a senior Head and Neck surgical colleague to be available to attend.

If you need to be re-admitted to hospital you will be admitted to St Vincent’s Public Hospital.

If you need to be re-admitted to hospital I will arrange for you to be admitted to St Vincent’s Private (bed availability permitting).

If, after speaking to the ENT Registrar, you are advised to attend the nearest Accident and Emergency at a hospital which is not St Vincent’s Sydney, doctors involved in your care will hopefully contact the ENT Registrar.

If, after speaking to me, I advise you to attend the nearest Accident and Emergency at a hospital which is not St Vincent’s, Sydney, I will speak directly to the doctors involved in your care.

Side effects from surgery are common. You may be referred to a St Vincent’s Hospital Head and Neck Service speech pathologist, specialist physiotherapist, dietitian, dentist, or oncology psychologist. These consultations are limited.

Side effects from surgery are common. You may require referral to a speech pathologist, specialist physiotherapist, dietitian, dentist, or oncology psychologist. I or my Nurse Practitioner will organise a referral to a member of our extended Head and Neck care team. Alternatively I may speak to your GP in order to arrange a local referral.

Head and Neck cancers are rare. The further you live from a high volume centre such as St Vincent’s Sydney the harder it is to access allied health professionals who are experienced in treating patients recovering from head and neck cancer.

Head and Neck cancers are rare. The further you live from a high volume centre such as St Vincent’s Sydney the harder it is to access allied health professionals who are experienced in treating patients recovering from head and neck cancer.

Your care will be managed by the ENT – Head and Neck Registrars in consultation with senior doctors in the Head and Neck Cancer Service.

If complications arise I will take direct responsibility for your care. There will not be additional charges for post-operative complications, including additional surgeries required to manage post-operative complications.

Your ongoing treatment will take place at the St Vincent’s Head and Neck Outpatients Clinic in keeping with the Australian Optimal Care Pathway for People with Head and Neck Cancers. The Outpatients clinic occurs one Wednesday every four weeks.

We will arrange an ongoing series of review consultations for at least five years. This is in keeping with the Australian Optimal Care Pathway for People with Head and Neck Cancers. You can call my practice any time to discuss concerns relating to your treatment which may arise between consultations.

For two years post treatment you will require a review consultation every three months. This takes place in Outpatients and is free of charge. Outpatients is held one Wednesday every four weeks. At Outpatients you may be reviewed by junior members of the ENT-Head and Neck Service who will consult senior members if required.

For two years post treatment you will require a review consultation every three months. This takes place in my private rooms and is billed as a Review Consultation. My Nurse Practitioner and I will see you during your consultation. If I am unavailable a senior colleague from the St Vincent’s Head and Neck Service will review you in order to ensure timely monitoring of your treatment. The consultation will be scheduled at a time convenient to you and my staff will liaise with you to coordinate additional tests, investigations or other medical appointments with your visit to the campus.

If you’ve received adjuvant treatment typically the Radiation Oncologist will share the long term follow up with me.

If you’ve received adjuvant treatment typically the Radiation Oncologist will share the long term follow up with me.

Typically a PET CT scan is performed at regular clinical intervals. You will be provided with a referral request form to arrange your PET imaging appointment.

Typically a PET CT scan is performed at regular clinical intervals. My practice staff will coordinate with you to arrange any medical imaging or other investigations required prior to your consultation.

In year three you will be seen every four to six months. In years four and five you’re seen every six to twelve months.

In year three you will be seen every four months. In years four and five you’re seen every six months. If I am away when your routine follow up is due you may see another senior member of my clinical team. This ensures your review is not delayed.

There are no charges for patients attending Outpatients.

You will be charged for each of these visits as a Review Consultation.

You can contact your General Practitioner or the St Vincent’s ENT Registrar to discuss changes in symptoms.

You can contact my Practice at any time to discuss changes in symptoms. We will arrange an immediate consultation if it is considered appropriate.

Unfortunately, despite our best efforts, some head and neck cancer patients develop recurrent disease, a new primary cancer, or distant metastatic disease. This is why we monitor your progress for a minimum of five years. Patients with recurrent disease may need to return to the St Vincent’s Head and Neck Cancer MDT for a revised treatment plan. Patients with new or metastatic disease will be referred to appropriate oncologists.

Unfortunately, despite our best efforts, some head and neck cancer patients develop recurrent disease, a new primary cancer, or distant metastatic disease. This is why we monitor your progress for a minimum of five years. Patients with recurrent disease may need to return to the St Vincent’s Head and Neck Cancer MDT for a revised treatment plan. Patients with new or metastatic disease will be referred to appropriate oncologists.

The St Vincent’s Head and Neck Service is here to help and support you through your treatment.

My dedicated team and I are here to support you through your treatment however long it takes.