Universal Telehealth in Australia Begins Today - Here's What You Need To Know

"Universal Telehealth" was announced by Australian Federal Health Minister Greg Hunt yesterday. That means from today, we're all eligible for bulk-billed Medicare telehealth consults in Australia.

Telehealth = over the phone, or over video call eg. Skype, FaceTime, Zoom, WhatsApp. This is really useful for things like appointments to follow up on blood results; counselling; referrals; anything that doesn't require a physical examination. You may be already using Telehealth, whether you’re a clinician practicing it for remote patients; or as a patient who’s received care online or over the phone.

You may still need to attend in person if the doctor needs to examine a lump, excise a melanoma, or other condition.

GPs, Specialists, Midwives, Psychologists, Aboriginal and Torres Strait Islander Health Workers, Social Workers- a range of providers are able to do this (if they choose to), saving you the visit to a clinic, and saving the healthcare worker the added exposures from them going to clinic or seeing more patients in person in an era when we're all social distancing and at risk of bringing #COVID19 home to our loved ones (and lacking Personal Protective Equipment to protect ourselves).

This also helps vulnerable healthcare workers #workfromhome or from other safe, protected premises so the 70-year-old specialist with diabetes for example could continue working safely if they wish.

The ABC has a great article for patients.

Many providers are also offering privately-billed Telehealth consults for those items that are not covered by Medicare, such as Physio and Dietitian consults for non-eating-disorder-related conditions. Your clinic or provider will be able to inform you.

Healthcare workers, check your indemnity covers Telehealth- it should. A phone call or visit to your indemnity provider's website will help.

Also, be aware of the privacy of free software. As mentioned on Avant: "The Department of Health has noted that free versions of these applications (i.e. non-commercial versions) may not meet applicable laws for security and privacy. You should check whether the platform you wish to use complies with Australian privacy and security laws. You can do this by asking the vendor or checking the vendor’s website."

Grateful to the Australian government and to EVERYONE who campaigned hard for this, including the Australian Medical Association​, RACGP, RACP, RACS and other colleges, and healthcare workers and community groups nationwide.

For insights from the Australian Telehealth Conference; read our post here!

For insights from New Zealand healthcare workers from telehealth, including Virtual Ward Rounds, read our article here.

Preparation, Not Fear: Tips For Working and Living in Isolation during COVID-19

Hit the news right now and you’ll see almost nothing but sadness and negativity about COVID-19. Rightly so; it’s a pandemic; it’s a rapidly accelerating #globalhealthemergency, and not enough seems to be done by many leaders til it’s too late.

As we mentioned, it’s easy to feel despondent and helpless about the future. We can’t fix everything, but we can focus on the things we can. The current projections are that this will be around for at least a few months, if not, longer; and decisions on working, studying, travelling, and socialising are changing rapidly literally overnight. If you’re not used to working, studying or living in isolation or confined quarters, what can you do?

How are some ways to prepare for home isolation or working from home:

1) Keep up your exercise, eating and daily health routines

It’s absolutely vital that we keep up our immunity, whether we have access to gyms and sports groups in normal life, or steps, water bottles, exercise bands and barbells at home. Download a fitness app (such as this one, which has home exercises you can do without gym equipment!); watch YouTube for free fitness classes; do some starjumps, pushups, lunges, and squats every hour; do a few walking laps or light jogs within the confines of your home every hour; take a break from the screen every hour so your eyes can adjust. And yes, it’s okay to let the sunlight in (though wear sunscreen if you sit in direct sunlight); no one’s said that COVID-19 seeps through windows at present!

Obviously, if you’re in quarantine because you fit the criteria for recent overseas travel or immediate contact with a confirmed COVID19 case, which is what the current Australian Government guidelines are for testing, you will need to take it easy and self-monitor more closely for signs of symptoms, rather than exercising yourself through respiratory failure in the worst case scenario. But, you have good judgment; use it.

And, of course, use the chance to cook (or learn to cook!) some delicious, nutritious healthy meals for yourselves

2) Keep up your daily hygiene routines as though you’re still going to the office/uni/school

Seems like a silly thing to say, but it’s quite common when working from home to be tempted into staying in pajamas without a shower all day! The WHO Handwashing recommendations for preventing COVID-19 is not just for handwashing; taking a shower obviously will help wash off any germs just like washing your hands will. We were befuddled to see the local supermarket handwash shelves stripped bare, yet creaking with 1-litre bottles of shower gel right next to it!.

Plus, keeping your daily hygiene routine also helps reset your “home” mindset for “work/study”, and thus help you with your productivity.

3) I’m unemployed/a casual worker unpaid during isolation/unable to do my usual job at home because I’m a mechanic or otherwise

We’re not going to make light of this; it’s a huge issue for millions of people around the world, and there is a LOT that needs to be done by Governments, employers, insurers and other structures to help protect you in times like these. And, it is scary.

Instead of focusing on the negative, let’s think about the positive. The time off may just be for two weeks. Or even a month in some cases, or longer, which is daunting, and in the realm of what you CAN’T control. But think about the following, which you CAN control:

  • Is there some skill or unique knowledge I have that I can turn into a product or service offering online or over the phone? Could you be a coach? A tutor? Write and sell an eBook? Sell an online course? Platforms like Teachable and Thinkific provide free classes on how to plan, create and launch an online course, simply with your laptop. It can take time, but it can be as simple as you need. You don’t necessarily need to film with your face in front of the camera if it doesn’t suit you. The best thing is, once COVID-19 is over, or even beforehand when quarantine is over, your product or service can still be there, running along in the background when you return to work, or when you hit the ground running looking for other jobs. That’s basically your side-hustle helping you with an additional income stream, no matter what your employment situation is at any stage in your life; no matter how small the income may be at first; and during isolation, it helps to keep your mind active and focused on a goal and outcome to prevent worrying about the unknown.

  • What have I always wanted to do or wished for more time for, but couldn’t because I was working/studying? Barring the ones like “travel to Europe” or “hike Kilimanjaro”; perhaps you’ve wanted to spend more time with your children; organise your photo albums; learn to paint; reorganise your home; learn to dance; or other things that you could do at home. In fact, “travelling to Europe” could still be done, kind of, virtually, with a decent VR headset and travel film- search online for suggestions. Buy eBooks or read free travel blogs stacked with photos upon photos of Greece, Venice, the Caribbean… or write up your own travel memoirs into a blog or book yourself.
    And in terms of learning to dance or paint - online class portals like Skillshare and CreativeLive have thousands of free or low-cost classes you can take to pick up a new skill.

  • Speak to your local welfare sources; to your employer; to your bank; to your service providers (electricity, etc) about what sort of assistance they can provide, if any. Some may be willing to defer or freeze payments temporarily while you’re in sudden hardship, though this may be more difficult when the rest of your country is in lockdown. But if you don’t ask, you don’t know. And some employers in Australia have committed to paying their casual staff if they are suddenly isolated or quarantined due to COVID19.

4) Keep your mind healthy. Meditation; mindfulness; yoga; deep breathing; and other calming techniques are useful in all kinds of situations, and for all ages and demographics. Isolation can be tough; you may miss the everyday social interactions you didn’t realise you get from the workplace or school or study institution; learning a meditation technique can be incredibly helpful for keeping your mind and body strong. Yes, meditation has significant health effects on the body, including lowering blood pressure, preventing illness, and improving your immunity. It may not prevent you from falling sick (including from coronavirus, unfortunately), but can help your mindset and physical health if you do happen to fall unwell, or if a loved one falls ill.

5) Keep social. Home isolation doesn’t mean you have to switch off your phone! Make time to call a friend each day. If you’re home with family or friends, make time for just having your usual meals together; exercising together; learning a fun new activity together; or playing board games together. An interesting article in the BBC recently showed some unexpectedly positive benefits from working from home and spending more time with loved ones in forced isolation in Wuhan and other parts of China.

6) Talk to someone for help. It’s also okay to speak to a phone or telehealth counsellor over Skype, Facetime or other platforms if you’re having trouble coping. If your employer offers an Employee Assistance Program (EAP) or other free confidential counselling service for their workers, you can access this over the phone or video call as a benefit of your employment. The Australian Government has finally approved funding for Medicare-enabled telehealth consults for GPs to see possible coronavirus and chronic illness patients remotely without having to physically come into the clinic, where they may be exposed to coronavirus or potentially infect others. There are numerous online psychologists and counsellors, with varying fee structures (mostly private out-of-pocket funding in Australia at the time of writing); and other telehealth services in other specialties including Psychiatry, Endocrinology, Rheumatology, Dietetics, Physiotherapy, and other specialties, which, if you see a current Specialist, you may be able to access. All it takes is a quick phone call or email to find out.

7) Your temporary quarantine/isolation is a gift that others don’t have. It may not seem like it immediately; but if you think about the poor doctors who died in Wuhan during the initial outbreak, while the world was trying to figure out what this mysterious new virus was; what the incubation period was; and how to prevent its spread; if you think about the several months’ head start you and your country have in identifying the cause and knowing more about what to expect from COVID19; we are truly, incredibly fortunate, and if we all act together with #compassion and #kindness, we still have time to fight this and stop this horrible disease from spreading and worsening its effects on the world.

These are just some tips to start out with; we may well add more but for now, enjoy this post, let us know if you found it helpful!

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Book Review: "Rest: Why You Get More Done When You Work Less" by Alex Soojung-Kim Pang

Many of us in medicine struggle to justify why we should slow down and give ourselves a break.

We’re used to putting others’ needs before our own.

We’re used to unrelenting unrostered overtime; oncall callbacks at 3am; weekend shfits trickling into birthdays and holidays; and working through illness.

If only there was a book that helped us justify to our evidence-based selves WHY we need to rest.

Alex Soojung-Kim Pang does this brilliantly in his easy-to-read manual, “Rest.

Alex is a Silicon Valley consultant used to seeing that other modern group of trophy chronic overworkers - tech workers.

No longer is “hustling,” “crushing” and “burning it” a badge of honour for your work.

And no longer are you badgering yourself for not “working hard enough”. You probably already are. This book teaches you how to work SMART.

Doctors know well (or should know!) that as physiologic stress hormones, chronic raised adrenaline and cortisol (which are essential hormones that help regulate our daily functions in normal health, not an evil in themselves!), can lead to raised blood pressure; heart disease; higher stroke risk; obesity; cancers; some thyroid disorders; some autoimmune conditions; and other conditions. As part of the body’s natural homeostasis/resetting, we all need sleep; good nutrition; regular exercise; and unregulated downtime- sitting and doing nothing, allowing ourselves to drift to boredom and creativity. (They say having bouts of boredom in our lives actually helps fuel creativity and innovation- hence why people struggle when they try to find a “job they love” that never bores them 24/7- the fact is, those peaks and troughs even in your dream pursuit, help you stay stimulated, curious and engaged with your passion!)

When we set that homeostasis out of whack due to shift work; chronic long hours (and everyone has a different set point for when they feel tired after a certain number of hours - your 40-hour week may be someone else’s 100-hour week!); irregular sleep habits; poor diet; and basically being “on” all the time; eventually, our bodies catch up and physically can’t take it anymore without an even longer rest, if it ever recovers.

Workplace burnout has recently been recognised by the World Health Organization as a “workplace syndrome” classified by the International Classification of Diseases (ICD)-11. This makes it even easier for us, whether we’re in medicine, tech or otherwise, to recognise signs of burnout, and the need to switch off and rest as part of our work/life routine.

Alex’s book gives tips from his research and work on this subject, and illustrates it with anecdotes from scientists who’ve raised productivity through napping; Stephen King’s writing routine; the benefits of walking; and other simple, inexpensive and time-effective measures for longevity in your work-life continuum. Like most books we recommend, it’s easy to read on the train, in bite-sized pieces, or all at once during your favourite reading time.

So, no more excuses. You deserve to Rest!

(The Medical Startup is an affiliate for Book Depository.)

Your Creativity-Filled Holiday in New York City with Creative Cities 21

A few years ago, I embarked on two creative exploration visits to New York City.

I attended an Italian shoemaking course; a music industry summit; several shows on Broadway and off; a hackathon; and a talk by the Man Repeller herself, Leandra Medine.

For me, it was life-changing, and not long after the first trip, I was inspired to create The Medical Startup.

The memories from these trips still inspire me. But it took time to find these events, and curate my own retreat.

Creative Cities 21 would have made this a lot easier.

Jeremy and Angie Stone discovered this on a long-service leave trip to New York City. Inspired by one of the world’s most creative cities, the couple designed their own creative holiday, filled with activities such as painting and acting with Broadway actors, and came back from their trip not only rejuvenated, but fuelled with the desire to bring others along on this experience. Hence, Creative Cities 21 was born.

This year, CC21 will be held again in NYC, from Sunday 25th August. The five-day program includes art, communication and other experiential classes taught by local professionals, with ample time for exploring the Big Apple each day. Exclusive social events have been curated with local creatives, and classes with the best New York teachers who are professionals in their own right, so you don’t need to do the hard work yourself planning your own escape.

Why is creativity so important?

Studies worldwide have shown the many benefits of creativity and creative thinking in business and innovation. Harvard teaches Creative Thinking in many of its own courses, and creativity is widely recognised as an essential skill for the 21st century; perhaps an antidote to increasing automation and “the robots will take our jobs” fears.

As Jeremy says, “Creativity is identified as the third most required skill by the World Economic Forum. An IBM survey of 5,000 CEOs lists creativity as the No. 1 required skill for their role.”

He knows this first hand, having come from an extensive background in mechanical engineering and advising ASX-listed companies.

Whether you’re in healthcare or not, having a one-week break exploring your creativity while surrounded by the best New York has to offer will no doubt reenergise you when you bring your experiences home with you. And, quite likely, you’ll make new friends, too!

To register and for more information, visit creativecities21.com and instagram.com/creativecities21

*TheMedicalStartup.com is an affiliate for Creative Cities 21; we earn a small fee from the CC21 team if you mention TMS19 upon registration.

All images in this article courtesy of CreativeCities21.com.

Life As Usual - Managing Illness And Grief While Running Your Startup

The thing about illness is, it just hits you.

It’s unpredictable, it follows no rules (not always anyway, despite our best work as clinicians and scientists, biology is unique and will play its own role in each of us), and it hits you when you least expect it.

It’s damn frustrating, because our daily lives are built around routine, around schedules for work and appointments and goals and personal life. But illness doesn’t follow a schedule. The world doesn’t sit still while you suffer.

So what can you do?

You try to pace yourself, and take time off.

You limit your commitments; you rest; you take a break.

Then, when you feel better, you return to work, to your startups, to your passions - to your life as usual - and BAM! It hits you again. Or some other calamity related to the illness.

Whether it’s an illness hitting you, or your loved one; your life is disrupted again.

And think about the emotional trauma of impending bereavement; grief; or other foreshadowing..

Imagine this happening again, and again, and again, and again…..

This is reality for millions of people around the world.

And if it’s not cancer, child-related, or pregnancy-related, often the people affected are suffering in SILENCE- the kind where no one understands what’s going on with you.

How on earth can you live #lifeasusual while fighting something that’s bigger than you, that has no rule book, that pays no heed to your wishes, that doesn’t reward you for good rest and nutrition and self care?

You can recognise the things you can control.

All you can control is right in this moment.

The present.

Being mindful of your surroundings; of your circumstances; of the thoughts, fears and hopes in your head.

You can control your breathing; whether you take a step forward or back (literally); whether you choose to sit in stillness, or with a book and pen, or with headphones on the train, or holding your loved one’s hand.

You can accept that things aren’t right for now, and possibly won’t be ever again, instead of trying to hide those feelings; and that makes it easier to take your next step.

It’s tough while running the startups in your life, tough trying to keep all the wheels in motion while trying to be there for yourself and others who are most important to you.

Allow yourself to not listen to those who don’t understand- because there are many, unfortunately, who will choose not to.

Remember, you’re doing your best.

You deserve to be kind to yourself.

To be continued…

This week: AMA Queensland's Junior Doctor Conference

Coming up this weekend is AMA Queensland’s annual Junior Doctor Conference.

There will be many sessions available to help boost your career and friendships in Medicine, whether you’re from Queensland or interstate; working as a doctor, or as a medical student.

I’m looking forward to Chairing the Tech in Medicine panel on Sunday; we’ve been busy preparing and rehearsing our questions and sessions, and I’m excited to see the other sessions, too!

(Image courtesy of AMA Queensland)

(Image courtesy of AMA Queensland)

There is tons on Career Planning; variations on this year’s theme of Crossroads, including Alternate Career Paths in Medicine; how to land that College place of your dreams; Clinical Skills workshops; medicolegal issues; and other current topics that junior doctors face in Australia and around the world.

Tickets are still available; there’s also a Cocktail night on the Saturday night; and you’ll get to make new friends and enjoy Brisbane while at it! Previous conferences have been fantastic for building new skills and knowledge to set you up for the wards. #whattheydontteachyouinmedschool

For the full program and tickets, please visit AMA Queensland’s website.

Fear is the Enemy of Creation

Something I’ve been thinking of recently.

Is Fear synonymous with Perfectionism?

Fear of screwing it up?

Fear of not getting it right the first time?

Fear of looking like a fool (a usually unjustified concern)?

Fear you’ll launch and sell not one item?

Fear you’ll screw up your job interview and miss out on your dream job?

Are you fearing what others might say and think about your choices?

Does it really matter?

As long as you’re choosing something you’re passionate about, and believe in, by action you can convince yourself.

It’s all about learning along the way.

And acknowledging your fear.

Seth Godin says here to “acknowledge” the fear and shame. Don’t fight it. “I listen to it and do it anyway. And that is where we’re going to make the impact.”

It’s being mindful of it.

And recognising your power to conquer your fears.

What are you scared of most?

Is it really that bad?

Write down three actions you can take to challenge it.

Empowerment through eLearning in Medicine

You may have noticed on Instagram- I’ve been working on developing online courses.

The courses will have a difference to what’s existing already. There are literally thousands of fantastic courses online that will help you learn to code, sew, speak Spanish, and more.

But nothing out there exists specifically for medical workers and the entrepreneurially-minded out there, from a medical perspective, from real experiences.

How does startup thinking apply to you as a doctor, nurse, physio, engineer and so forth?

Where do you start when a great idea comes to mind?

What’s the truth about how clinicians really feel at times- burnt out, exhausted, demotivated, self-loathing even? How is this similar to how entrepreneurs in other industries feel? And how can all of you learn from these experiences and overcome them, or at least start to tackle them when you’re on the go, on rotation in the middle of nowhere, a busy parent on night shift, or taking a gap year overseas?

I realised that, by exploring all these topics the last three years, even when it wasn’t clear to me at first (this whole blog started by accident, after all!), the whole journey has helped me in my own personal and professional life.

I went through all of this myself, was burnt many times, and know what lies are out there, what superficial constructs have been built supporting the “Silicon Valley mindset”, how toxic this can be to you as a compassionate person who works in healthcare or wants to start in healthcare, and how the medical world is similar to this.

And also, what’s changing about these worlds, to accept more human elements, more authenticity, more vulnerability, and more real sharing of experiences and ideas.

Thinking of your path as your own Startup is one way to start healing yourself, to build resilience, and to encourage yourself when you’re alone, when you feel misunderstood, and things seem tough. Even if you never start your own tech company, it doesn’t matter. We can all learn from startup thinking, even if your pursuit is actually in art or music or sport.

And that’s the thing. From Day 1, I was keen to feature people who are like me- creative as well as in STEM- to help transform the dialogue in medicine, that we are just what our job roles say- RMO, RN1, Dietitian, and nothing else beyond that. What happened to the extracurricular activities we loved in school, and how they were promoted as part of our curriculums there?

I felt ridiculed and even stupid for having a strong creative passion from childhood, and trying to marry this with medicine, which I also enjoy. Really, we all use creativity to some extent in our daily lives. From showcasing interviews with photographers, magicians and jewellery designers, to gaining confidence for my own journey in the creative industries, and to being approached to help start other ventures, this journey has been incredible and taught me a lot that I can share with you, too.

I’ll keep you posted- best is to sign up to the Mailing List at the bottom of this page, and/or follow on social media; if any questions about what particularly you’d like to learn or are struggling with, please send me an email at info (at) themedicalstartup.com.

Thank you for being part of our journey throughout, can’t wait to share more!

Cheers,

Louise

Success At All Costs?

I touched on this briefly in my New Year’s post.

What saddened me when I dug deeper into medical startups in 2016 was that, quite often, success was seen as something to achieve at all costs, with no respect for customers, colleagues, or the wider community.

Even if a brand has a carefully constructed facade, it will all fall apart behind the scenes if you don’t genuinely care.

Coming from the similarly ruthless world of physician training, I found it very disappointing, especially when startups and the entrepreneurial world are trying to attract more clinicians.

Most clinicians are attracted to healthcare because of the caring aspect. They genuinely want to help make a great contribution to people’s lives, through direct patient-clinician contact.

That compassion and vulnerability can be misused by unscrupulous individuals and companies, and even with a strong Corporate Social Responsibility (CSR) program, the WHY behind the company can be lost.

Is any industry safe from this?

No.

But it’s up to us, the individuals, to keep our values in mind, and live them.

For real.

Are you living your Mission Statement?

Thank you, 2018 :)

It’s strange sitting here, 1.5 hours before midnight in my home city, 2.5 hours til 2019 in my current one.

But it’s a great time for reflection, particularly when you and your other half saw the Early fireworks as he’s oncall tonight.

2018 was a huge year for me.

One of my faves, Ariana Grande herself said it best- “I find it interesting that this has been one of the best years of my career and the worst of my life.”

I guess personally, it wasn’t the absolute worst it could have been for me, but it definitely had a huge amount of challenges that really rocked me- but also gave me the extraordinary chance to reset and reframe the difficult situations in my personal life.

You can dread each day and its challenges, or you can reframe it to be uplifting for someone else who’s going through a hard time.

Every day counts.

I really believe that, no matter what challenges your career throws at you, you and your loved ones come first.

They’re your anchor, they’re your reason, your “Why” in most cases.

And you should never be ashamed of putting your wellbeing first.

Because no matter how big your career gets- and I believe that your career is your startup - you’ll enjoy it more when you respect yourself.

If you need more time before saying “Yes” to a project, ask for it.

If you feel pressured to work weekends and public holidays because that’s “the startup way,” but you’re actually more productive just working on odd weekdays, go ahead and set your boundaries.

If your personal circumstances mean it’s more favourable for yourself and your family if you work a bunch of part-time and casual freelance roles, go ahead and do it.

If you feel your co-founder’s doing something dodgy, reassess and consider trusting your instincts.

If someone’s being two-faced, don’t be afraid to call it out.

If you love doing several other things along with medicine, allow yourself to do it.

Give yourself permission.

And many more examples like this.

Everyone will be better off for you owning your power.

—-

Someone wise I met recently gave me that wonderful piece of advice.

“Own Your Power.”

Own your decision-making capability, your strengths and skills, your relationships, your identity.

People will try to take advantage of your vulnerability.

So-called “friends” and “partners” in startups and medicine will show their true colours to you, even when the rest of the world can’t see it immediately.

It’s disheartening. It can be isolating, and you can question yourself and your perception, wanting to believe you’re wrong.

It’s okay, because questions are healthy, and I’ve learnt how valuable it is to be mindful, and become more self-aware.

It’s a great defence mechanism, mindfulness. I’ve found it’s a great decision-making tool, productivity booster, and mental health balm. (Ooh, I should package that! Next to the lip balm jars!)

But I guess my rambling here right now is to say,

THANK YOU.

Thank you, 2018, for teaching me even through my weaknesses and dark times this year.

Thank you for giving me the chance to grow stronger.

Thank you for helping me to speak my truth.

Thank you to every single one of you who stumbles across my page; who reads my articles from way back when; who follows and likes (for real) my stuff on social media; who has become a true friend from this crazy journey; who has bumped into me at some event or clinic somewhere around the world and said hello; who believes in me even when I don’t; who believed in me even when it doesn’t all make sense.

I can’t wait to share 2019 with you all.

Have a wonderful New Year and enjoy the celebrations :):):)

*I think I am serious about the mental health balm!