Clinician Profile - Dr Tony Rahman, Director of Gastroenterology and Hepatology at The Prince Charles Hospital

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CKN recently spoke with Dr Tony Rahman, Director of Gastroenterology and Hepatology at The Prince Charles Hospital, and heard about some of the innovative programs being run by his team.

Dr Tony Rahman (left) with The Prince Charles Hospital CURE-IT team, winners of the 2017 Staff Excellence Awards for Excellence in Integrated Care

Prior to his arriving in Brisbane in 2012 in Brisbane, for ten years Dr Rahman was a Consultant Gastroenterologist, Hepatologist & ICU physician. He was also Senior Lecturer at St. George’s Hospital & Medical School in London.

He graduated in Medicine and Physiological Sciences from Christ Church, Oxford University, UK in 1992. He was awarded Membership of The Royal College of Physicians (UK) in 1995, appointed as a Fellow of the Royal College in 2008 and is now a Fellow of the Royal Australian College of Physicians. In 2003 he was awarded Doctor of Philosophy in Medicine at Imperial College, London, following three years researching mechanisms and novel therapies in acute liver failure at the Royal Postgraduate Medical School (Hammersmith) & Royal Free Hospitals, London. 

His further specialist training included, Institute of Liver Studies & Transplantation, King’s College, St. Thomas’ London, where he was involved in new and innovative treatments of liver diseases, complex reflux disease, inflammatory bowel disorders and functional bowel disease.

In Australia Dr Rahman has been instrumental in a number of innovative patient-centred and research programs, with a focus on improving equity and access to make the lives of patients with hepatitis, bowel cancer and rural patients significantly easier.

My training in the UK was in Gastroenterology, Hepatology, Intensive Care medicine and Adult Internal Medicine. Prior to leaving the UK I spent my time equally split between Critical care and Gastroenterology with a research interest in gastroenterology and liver diseases in patients who were very unwell, and the impact that ICU has on those organs, for example, bleeding, liver dysfunction and nutritional difficulties. The area is vast and yet undiscovered, so a great place to start!

Since coming to Australia in 2012 I have been fortunate enough to be involved in senior positions within The Prince Charles Hospital, Metro North and the State. More recently have been appointed as a Health Advisor to the Department of Home Affairs.

I normally work fairly long days, but rewarding days. I split my time between performing endoscopies, colonoscopies, seeing patients in clinic (patients have tummy complaints or may have liver problems) and time administering the department - making sure that we work efficiently and to high standards. Maintaining a happy team is paramount!

We have done amazing things at The Prince Charles Hospital. They have all been possible due to an equally amazing team which I have been fortunate to work with. This has allowed us to increase the provision of endoscopy and colonoscopy with marked increase in quality of procedures, making us one of the busiest and efficient units in Queensland. We’ve also been innovative in developing new and novel clinical care pathways to facilitate treatments of Hepatitis B and C. Through generous funding by NHMRC, the Prince Charles Foundation and Gastroenterology Society of Australia we have been able to develop a research program. We have been involved in pioneering work examining novel treatments for Coeliac Disease, diagnostics for hepatic encephalopathy and best practice treatments for cirrhosis of the liver. And we will also be embarking on further collaborative work with James Cook University looking at colon polyps, colon cancer, fatty liver disease and inflammatory bowel disease.

This has all led us to be one of the only departments to have received Excellence Awards from Metro North and Queensland Health for Innovation, Team Performance and Connecting Health.

I try my very best to make sure that every encounter I have with a patient or relative is the best that I can do. In healthcare we are in the privileged position to be able to see patients at their most vulnerable and therefore they require us to be at our best. 

Our patients face challenges coming from a range of issues. That can be right from the very start in just being able to see a GP. Financial problems or lack of transport can make it very difficult. Once patients get referred to use the hospital visit itself can be a barrier. Patients have to not only contend with the concerns about their health, but then also getting to and from the hospital, the costs involved in getting there, and of course the anxieties associated with sharing personal details with a complete stranger! Ultimately patients can be scared about what is going to happen and what maybe wrong with them. Some will already have an idea of what may be wrong and this may raise their anxieties.

Queensland as a whole has unique challenges for the provision of healthcare. An increasing population and the changing face of industry and the workforce means that many more people are in regional and remote places. Healthcare still needs to be delivered, and we have tried to facilitate healthcare to all. 

City dwellers have huge advantages over people living in rural and remote areas, as doctors and health care workers are easily accessible if and when required. It’s much more difficult in the bush. 

Telehealth has been adopted in a major way so that all of our clinics can be delivered to patients who live anywhere in Queensland. We are not restricted to the traditional model of seeing people in clinic, however there are occasions where this is required. 

With the help of Queensland Health, we have tried to extend the expertise seen in the cities to the regional communities, and a good example of that is facilitating the training of GPs in performing endoscopy and colonoscopy. We have tried to enhance these initiative with national training days where the GPs can be trained and upskilled by the best colonoscopists in Australia. We had such a day in August at The Prince Charles Hospital. This was very well received by the GPs who work all over rural and regional Queensland. Patients in those remote areas now have access to a practice of excellence in their local communities. 

I’m keen to provide care locally to patients and make sure that the health care delivered is delivered by the best person to deliver that care. We developed the CURE-IT program for hepatitis C patients in Metro North to help do just that. The program allows patients to avoid the traditional visits (often multiple visits) to hospital. We liaise with the GP when we receive a referral and provide the GP with all the information and clinical support to allow them to prescribe the medications to the patient at their local surgery. This is really important for people who live in regional or remote Queensland. So far we have been involved in facilitating assessments and treatments approximately 500 people, many of whom are now cured of a disease that was only a few years ago deemed to be incurable.

Bowel cancer is the second most common cancer in Australia and thousands of Queenslanders will get colon cancer this year. It is however, preventable in 90% of cases. The national Bowel Cancer Screening Program has now become a 2-yearly screening invitation, where patients over the age of 50 will be posted a poo testing kit. The big challenge for Queensland is that the number of people all around the state who get involved with this free life-saving screening test is still only 38-40%, so this could be vastly improved! The attitudes of rural patients towards being ‘unwell’ are also very different. That tends to be multifactorial, involving family, community and financial issues, which may influence their likelihood of investigating an episode of required healthcare. We need to become a little bit more relaxed about talking about these sensitive issues to maintain good healthy long life in Queensland!

Rural doctors too face immense challenges both clinically, personally and educationally. I think that the CURE-IT program, telehealth and telehealth endoscopy / colonoscopy advice is a great step forward in the provision of support for our rural doctors. It is only a small step but we are slowly trying to provide equity of access to both the patients and their GPs.