Greg Katsoulotos has been a Respiratory Physician for more than 18 years. Here he shares with the Woolcock's Professor Sinthia Bosnic-Anticevich some impressions from his experience as an Asthma Specialist.
There have been huge changes, particularly in severe and mild asthma over the last 18 years.
I think we are able to assist our patients more holistically and this is mainly through the evolution of multidisciplinary care - I think it has been a really exciting development. I have really enjoyed working with colleagues for the better assessment and 'work up' (management) of patients.
I also think the pandemic has brought us some good things as well, with the ability to do electronic scripts and telehealth. There have been new and good ways to provide better access to care, especially to remote patients for whom physically visiting a Lung Specialist is a challenge.
I think novel treatments have really been welcomed by patients. Often patients stick to the same treatment because they think it is the best that is available for them. Once they are informed of new treatments they are often relieved to think that someone is willing to think outside the box and offer them a new alternative treatment.
I also think patients really appreciate multidisciplinary care and that you are willing to speak to other healthcare professionals in order to prepare the best possible care plans which are individualised for each patient, not just relying on your own judgment. I have found patients are very willing for me to share their case with other healthcare professionals – they almost always will say yes, and with real appreciation.
With regards to telehealth, in my experience, it has had a mixed response. Often city people – especially last year – were quite sceptical of telehealth, whereas people in rural or remote areas embrace it: they're more familiar with telehealth. That has changed over time however with increasing acceptance. Telehealth will form a key part of our clinical management in the future for those who want it.
The challenges will probably remain the same relating to diagnosing asthma properly: the challenge of diagnosing asthma when someone's been put on medication for many years without any confirmed objective diagnosis; the problem of misdiagnosing asthma still remains.
From my perspective, the long length of time that it takes for a patient to get referred to specialist care is another ongoing challenge. People come to me often after they have been on oral steroids for long periods of time for their asthma and then also have to deal with all the complications that result from long periods of oral steroid use. These people often say when we meet 'I wish I was referred earlier!'
And finally, over my years of practice I have learned to listen to patients, to see what they want from their treatment and what their beliefs are about asthma. Because treatment needs to be individualised or tailored to that individual.
For someone with confirmed asthma, it's just not OK to be using your short-acting reliever (eg Ventolin) all the time. That should ring an alarm bell that something is not right. You should see your doctor to review your asthma. There are better treatments out there.
It's also not OK to be on oral steroid tablets all the time. It's an important emergency treatment, but once again you should see your doctor to review your asthma. Seek the best treatment and stay well.
Dr Greg Katsoulotos is a Respiratory, Allergy and Sleep Medicine Physician with over 18 years of experience working in hospitals and clinics across the St George and Sutherland Shire. He is an Honorary Affiliate of the Woolcock Institute of Medical Research.
Greg is recognised as a Severe Asthma Specialist who is passionate about improving care for all asthmatics regardless of where they live. He is also Senior Lecturer with UNSW Sydney, a member of the Guidelines Committee of the National Asthma Council and completed a PhD in asthma immunology followed by further allergy studies.
This is the fourth in our series of interviews for Asthma Week 2021. See the other interviews in Reflections from the asthma front line.
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