In an era where modern public healthcare is increasingly driven by waitlists and high patient turnover, local specialist general surgeon Dr Adrian Aitken believes the core element of medicine — personal, longitudinal care — is at risk of being lost.
Reflecting on a recent locum stint at a Queensland hospital to maintain his acute care delivery skills, Dr Aitken noted that many public hospital patients wait months or even years for surgery, only to meet their operating doctor moments before entering theatre and never see them again.
Post-operative follow-up, he observed, is routinely delegated to junior doctors or general practitioners who may only be involved fleetingly before moving on.
“Personal care and longitudinal care are very important,” Dr Aitken said.
“I simply think that patients should be treated as if they are family. All patients referred to me — regardless of whether they aself-funded — are treated in the exact same manner.”
During his recent locum work, Dr Aitken performed an appendectomy on a severely unwell three-year-old girl, utilising a time-honoured open technique rather than keyhole surgery.
He noted that many junior doctors had never witnessed the classic open approach, which uses a single small incision in the lower right abdomen rather than the three incisions required for laparoscopic procedures.
“Not all keyhole or laparoscopic procedures are done better, nor are they necessarily more successful than a simple open procedure,” he said.
“It is sound clinical judgment that remains of paramount importance.”
Following the procedure, the young patient recovered smoothly and returned home the next morning on oral antibiotics.
Dr Aitken also recently returned from Prague in the Czech Republic, where he presented a novel surgical reconstruction technique for nasal skin cancers at the 22nd European Association of Dermato-Oncology (EADO) congress — one of the world’s premier skin cancer forums.
While acknowledging that general practitioners competently manage most skin cancers on the limbs and torso, Dr Aitken emphasised that lesions on the head, neck, hands and feet warrant specialist surgical referral. These delicate anatomical sites require advanced technical expertise and specialised theatre equipment typically unavailable in general practice settings.
Dr Aitken continues to accept referrals for all general surgical matters, including second opinions, across East Gippsland with minimal wait times.
