20 Jun 2018

Patient Satisfaction Survey

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If I looked after your pregnancy and the birth of your baby (or babies) since January 2017 I’d be very grateful if you could fill in my Patient Satisfaction Survey. It only takes 5 minutes.
The link is https://www.surveymonkey.com/r/X2YBW9N
Thanks so much for your time and your feedback
Rob

28 Feb 2018

Rockmelon and Listeria!

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I’ve just received notification that there have been a few cases of Listeria caused by eating Rockmelon in NSW!

So in addition to the usual precautions you must take regarding food we need to add that you must not eat:

  • Pre-cut melons of any sort, and
  • Pre-packed cold salads including coleslaw and fresh fruit salad

And throw out any rockmelons in your fridge.

Be safe

Rob

22 Feb 2018

Pre Pregnancy Genetic Carrier Screening

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I’d like to recommend that you consider genetic carrier testing before you fall pregnant or in early pregnancy. There are a small number of rare conditions that can be harmful to your baby but are not part of the usual pregnancy genetic testing. The main focus of our testing during pregnancy is Down Syndrome and a number of other genetic and structural problems (e.g. cleft lip or spina bifida).

Conditions like Cystic Fibrosis (a severe disorder that mainly affects the lungs), Fragile X Syndrome (a cause of intellectual disability) and Spinal Muscular Atrophy (a cause of muscle weakness) are not routinely tested for during your pregnancy.

The thing about these conditions is that you or your partner could be carriers for these conditions without being affected yourselves or even having a family history of them. However if you are both carriers (e.g. Cystic fibrosis) or the mother is a carrier (Fragile X) it is possible for the baby to be affected. If one or other of you is a carrier we can then offer you appropriate testing of your baby relatively early on in your pregnancy (or even before the pregnancy if you are going through IVF). Before you fall pregnant is by far the best time to do this testing.

As these tests are of your own genetic makeup, you only need to do them once in your life.

Obviously we can now recommend such testing because it is available although Medicare does not help out with the cost.

Please also remember there is a number of what we call autosomal recessive conditions (e.g. Tay Sachs Disease) that affect members of the Jewish community so it is very important that if you and your partner are Jewish at least one of you has undergone testing for these conditions prior to pregnancy.

Please remember:

I recommend that you have testing for your carrier status for a number of conditions before your pregnancy if possible

These conditions are rare but devastating if they affect your child

You can be a carrier for these conditions without any problems yourself and without a family history of them

If you and / or your partner are carriers your baby may be

Affected by the condition, or

Unaffected by the condition, or

Another carrier for the condition (and unaffected).

If we are aware of your carrier status we can offer relevant testing early on in your pregnancy although this is done via a “needle” test (a CVS or amnio) which carry a very small risk of causing a miscarriage

With the best will in the world there are conditions we cannot test for – Cerebral Palsy and Autism are good examples – but it is worthwhile testing for the things we can test for (if you know what I mean).

I can organise these tests for you – all it involves is a simple blood test at one of the Douglass Hanly Moir labs.

The bad news:

These tests cost $400. I don’t think Medicare chips in at all.

Rob

Feb 2018

12 Jan 2018

Weekend Cover Changes

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Dr Natalie Shaw and I have pretty much covered each other’s weekends, study leave and holidays on a one in two roster (12 days on and two days off) now for ten years.

This is an unusually onerous out of hours roster (many obstetricians work in groups of up to four or five doctors) although working in this way has enabled us to provide our patients with a very personalised service. Unfortunately we aren’t getting any younger and we both face a number of challenges including ageing parents and – in my case – a wife that works in Melbourne.

Anyway we have taken the step of gradually including a third obstetrician into our weekend roster over the course of this year. This is not a step we have taken lightly and indeed we have waited until a suitably qualified, experienced obstetrician could help us out. This doctor is Justin Tucker who has trained in Melbourne and Sydney at RPA Hospital. Justin is also a Fertility Specialist working at Monash IVF next door to my office. Justin will be seeing patients in my rooms so – as with Natalie – you will have a chance to meet him before the birth of your baby to continue with our “no strangers” policy.

I know this is a big change. I spent the first 5 years of my private practice life pretty much doing all of my weekends prior to Natalie and I getting together (professionally, that is) and then we have covered each other for the last ten but to be truthful doing so has become exhausting even though both of us have smaller practices than many other obstetricians.

Keep an eye on the Whiteboard in my office for our weekend and leave roster and remember I always strive to continue to provide the highest standards of care

Rob

07 Dec 2017

MY FEES

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I know that seeing a private obstetrician is expensive, I really do. I’m also aware there is a sizeable out of pocket component to these fees that is driven by relatively low Medicare and Health Fund rebates for maternity care. I have not increased my fees for a number of years but I am now faced with increasing medical indemnity costs along with significant operating costs (rent, parking etc). However I have not increased my fees but am adopting a “no discount” policy. In the past I used to discount my fees for returning patients, medical colleagues and various others. I can simply no longer afford to do this and have taken this step to try not to increase the already significant financial burden of private maternity care. Please check out my fee schedule in the “Services” section of my website.

Rob

09 Apr 2016

Former Patients Only

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Things are really ramping up with Aquamamma. We have signed manufacturing, distribution and marketing deals for the world with a couple of companies – unfortunately for tiny royalties not millions of dollars! While this is very exciting Aquamamma is taking up more of my time than it has done previously – over the past three years it has just been something to fill my spare time (Ha Ha).

 

Anyway unfortunately I need to further cut down my private obstetric work such that for the remainder of 2016 I will only be able to accept former patients of mine for obstetric care. I hope this will only be a temporary change and hopefully you will understand my wish to maintain the quality of my care.

 

In the Eastern Suburbs I highly recommend my weekend and holiday partner (if you know what I mean) Dr Natalie Shaw and also Drs Rahul Sen, Bobby Teoh, Steve Coogan, Wendy Hawke and Jan Dudley.

 

Of course if nobody buys Aquamamma in the next six months I will be back to my usual booking numbers after Christmas!

 

Rob

05 Feb 2016

Of Salads & Salmonella

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Of Salads and Salmonella

As you no doubt know there is an issue with respect to Salmonella infections in pre-prepared salads that can be purchased in plastic bags, usually from supermarkets. A couple of patients have already contacted me having consumed such salads.

Now first things first. Salmonella is an extremely unpleasant infection and well worth avoiding but it does NOT specifically cross the placenta and target babies (unlike Listeria, CMV, Parvo – “slapped cheek” –  and Toxoplasma). Babies can only come to harm if their mothers become dehydrated from the infection. This means that if you have no symptoms your baby is fine.

Secondly however – and I thought I did tell people this at their first visit – I would NEVER consume a pre-prepared salad in pregnancy anyway because of the risk of Listeria infection. (Actually I’m not pregnant and I would never eat a pre-prepared supermarket salad myself). A salad made the same day in a restaurant, café or salad bar should be ok.

 

So the food rules are simple:

  • Anything that is fully cooked through and served hot is fine
  • Food that has been cooked OR pre-prepared IN ANY WAY, refrigerated and served cold is NOT ok.

 

Have a safe weekend

Rob

03 Feb 2016

The Zika Virus

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The Zika Virus

 

You cannot have missed the media coverage of the Zika virus outbreak in latin America along with the very disturbing news that this infection appears to cause birth defects.

There appears to be a link between maternal infection with Zika and babies suffering from microcephaly. Microcephaly literally means “small head” and the small head in these cases is due to abnormalities in brain development. This means that babies with microcephaly have a very high likelihood of suffering significant developmental delay. The earlier in pregnancy the infection occurs, the greater the likelihood of microcephaly occurring.

Zika virus infection appears to cause no symptoms so people are not aware they have caught it. There is no vaccine for the virus.

Zika virus is spread by the Aedes aegypti mosquito. This mosquito is found in latin America (ie all of America south of the USA and the Caribbean), the Pacific Islands and North Queensland. I know that Health Authorities in Australia are being very reassuring we need to consider the possibility that this mosquito – and the Zika virus – may become more prevalent in Australia.

My strong advice is for pregnant women – or those even considering pregnancy – NOT to travel to countries in which there is a Zika virus outbreak. Currently that means the entirety of latin America, the Caribbean and some Pacific Islands including Samoa and Tonga although I expect that list to increase with time.

Whenever you are in the tropics be meticulous about mosquitoes – use repellent (yes, it’s safe), long sleeves if possible, insect screens or nets.

 

So while Peter Allen said “When my baby smiles at me I go to Rio” right now I wouldn’t.

18 Jan 2016

Email issues

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I’m now receiving quite a few e mails from patients about urgent clinical concerns.

I’m really uncomfortable about this as my e mail goes down from time to time and on occasions it has been down for a few days.

PLEASE text me if you have an urgent concern about yourself or your baby – do not e mail me.

Rob

17 Nov 2015

New Patient Booking Procedure

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New Patient Booking Procedure

It’s a bit of a first world problem – and one I definitely do not take for granted – but we’re struggling to keep a lid on our numbers of births per month. In order to retain what I hope are high standards of pregnancy care it is necessary for me to continue to limit the number of pregnancies I take on per month. I am resisting the temptation to increase my fees to try and mange my numbers as truthfully I think I am expensive enough. With this in mind we are instituting a new booking in procedure for new pregnant patients at Rob Buist Obstetrics:

If you are pregnant and wish to seek my services please e mail me at rob@robbuist.com letting me know:

  • The date of the first day of your last period OR your due date if you have undergone a dating ultrasound scan
  • The name of your GP or referring doctor
  • Any complex medical reproductive or pregnancy history that may be relevant (this information is treated with the utmost confidentiality)

Priority will be given to women who:

  • Are previous patients of mine – I value loyalty above all else,
  • Are patients of the GPs and referring doctors who have supported my practice over the past decade (they know who they are),
  • Have significant medical problems or who have experienced previous reproductive or pregnancy problems

In the absence of a reason for a very early visit most first visits will occur at 8 to 9 weeks gestation  and will include an ultrasound scan of your baby

The required documentation for your first visit is:

  • A valid referral from your GP or referring doctor
  • A full set of Pregnancy Booking Bloods (Bloods Group, Rubella etc). Your referring doctor will know what these are.
  • I’m sorry but you will not be seen if you do not provide this documentation and it is your responsibility to do so.

Rob