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Richard Harris: An Australian Endovascular Surgeon’s Perspective on Healthcare

We’ve gone Down Under to get an Australian endovascular surgeon’s perspective on healthcare from Richard Harris on this episode of the Perspectives on Healthcare Podcast with Rob Oliver. He is a member of the baby Boomer generation and is in Sydney, Australia. Additionally, he is an author.

Here are 3 things that stood out as Richard Harris gave us an Australian endovascular surgeon’s perspective on healthcare:

· Healthcare is a human right, it is not based on financial eligibility
· The Australian healthcare system is a hybrid of both socialized medicine and private health insurance
· Australia has only had 1500 deaths from the COVID pandemic

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Here is the transcript of Richard Harris: An Australian Endovascular Surgeon’s Perspective on Healthcare

Rob Oliver: Thank you and I appreciate you being with me today. I’m very excited because I’m bringing a perspective to you that literally comes from the other side of the world. My guest today is Richard Harris. He is from the land down under, land of Sunshine and Sharks is what I’ve been told. But he is a vascular surgeon down in Australia. He is a member of the Baby Boomer Generation and located in Sydney, Australia. Richard, welcome to the show.

Richard Harris: Thanks so much, Rob. Great to be with you.

Rob Oliver: Wonderful. Of course, being from Sydney, Australia, you wouldn’t happen to know where P. Sherman at 32 Wallaby Way is?

Richard Harris: No.

Rob Oliver: Okay. I’m sorry. It’s a reference to finding Nemo.

Richard Harris: Yeah, right.

Rob Oliver: Then let’s jump into the actual reason why I have you on the podcast. Tell me about yourself and your role in health care, please.

Richard Harris: Yeah. We call ourselves into vascular surgeons these days because the role of the vascular surgeon has just changed enormously in the last 25 years, as have so many specialties and particularly surgical specialties have gone toward minimally invasive ways of doing things. So where I was attracted to this massive specialty where you’re operating and making huge cuts in people all over their bodies. And nowadays we can often access them through little tiny punctures and groans and basically operating on people on TV screens. So it’s just such an incredible revolution in the way we do things compared to 25 years ago when I was training. So, yeah, it’s a life of technology using that in combination, we’re trying to maintain the holistic approach to the patient that I’ve always tried to maintain. And, yeah, I set aside some time in my life to be a writer as well. So that’s another joy of my life. I have two wonderful careers, really medicine and writing.

Rob Oliver: Wonderful. As a fellow author, I celebrate your creativity and you’re doing something that’s way more difficult than me. You’re writing fiction. I’m writing non fiction. Nonfiction is a lot easier because you don’t have to make things up. And if you do make things up, then you get in a lot of trouble for that. But for the creative side of writing, it very impressive. And I celebrate that for you. What does quality health care mean to you?

Richard Harris: I like to look at healthcare on a world basis, and I think the most important things is the actual ability to access a standard care that’s excellent. And you’d like to think that that could be applied worldwide, but also equity and the ability to get to that. So I’ve had the pleasure of working in the NHS in England. I’ve had the pleasure of understanding the American health system fairly closely, somewhat in shock. And I’ve had the pleasure of working in my health care system, which is kind of a hybrid between the small socialistic NHS and the more privatized American healthcare system. So I kind of like our balance to a certain extent, where public patients have universal access and pretty promptly in most cases and good quality. So being an advocate for the highest quality and easiest access for everyone, I see it more as a human right. That’s something that has to be shared out by monetary opportunity.

Rob Oliver: Okay. So talk to me then a little bit about the Australian healthcare system, if you don’t mind, you mentioned it kind of being a hybrid. What would you say are the strengths of the system and what are areas that you might see as being detrimental in the system?

Richard Harris: Absolutely private. There is private medicine, so you can insure. And about 42% of the Australian population has private insurance, and that does vary by demographics a fair bit. But on the background of that, we have universal healthcare, which was introduced in the 970s. And there was a lot of controversy about that now. But people in Australia now completely embraced that as the backstop and the underlying backbone of Australian health. So even private medicine is subsidized by the government. If you do a procedure, you’ll get a fee or the patient’s episode will be partly paid by the government, partly paid by insurers. And it worked relatively seamlessly. We’re kind of frightened of the insurance companies having more of a say in how that’s delivered and then making the decisions for patients rather than the best advocates, which I think are the health professionals to do that. So we’re trying to maintain that advocacy on one hand versus how it’s modeled on the other. I think we have quite good efficiencies in our system, and there’s competition almost between the public and the private sector who can provide the better service. There’s a lot of pride in the public hospital system here. I work in both. I work in a public hospital and a big private hospital as well. And there’s definitely who’s going to actually have the best vascular hybrid suite to operate on in a modern way for people. And that’s great that there is this sense that the public hospital can keep up with and even sometimes surpass what the private hospitals can offer. So I think that’s only good for the patient ultimately negative things. I don’t know. I see that when I look back on working in England and you had these clinic with 1000 people and there’s 20 doctors in the clinic seeing people over four or 5 hours, and they could be sitting there in that horrible chair in the clinic for 2 hours with breast cancer, and they’re seeing some anonymous doctor. I don’t think that’s an ideal sort of setting for health care or quality healthcare. On the other hand, I’ve seen American vascular surgeons pondering, can they use that wire? Because that wire is going to be $150, and that’s going to come out of their budget. Whereas we kind of say, well, we need that wire to get through that particular blocked artery, and we do it. There’s a couple of breaks on our system as well, but some are normal is, but it generally works pretty well. That kind of combination of public and private medicine.

Rob Oliver: Okay. It sounds like in the States, when my kids were little ten years ago, there was Hannah Montana, and she was all about the best of both worlds. Can you give me an example of quality health care?

Richard Harris: Well, I think Australia’s approach to COVID in general was quality health care. We had the ability as an island nation to shut our borders. That’s pretty tough. I haven’t been out of the country in two years. It’s a massive radical thing, but we’ve only had about 1500 deaths and in the whole country in the whole time. And now we’ve got a very highly vaccinated, very highly compliant population. We’re up to 99% in one territory where my particular state is greater than 94% vaccinated already. And we didn’t start for a couple of months after America, so we can now open up fairly safely. And we’re doing that even in that sort of macro public health measure. We’ve done well. On a micro level, early on. I had a beautiful 91 year old lady with COVID, and she survived. Six of the people in her residence did not and 45 days out from COVID she’s there, and she then sends an embolism to her legs. We were able to sort of fish that out and get her home a couple of days later, just sitting on the side of the bed chatting to her and said, how do you feel about the people that you lost and in the nursing home? And she kind of just stared and she couldn’t come and she was totally mentally with it. But she just really couldn’t handle that. But I think those sort of moments where you’ve got doctor and patients reaching for each other. I think they’re the real great moments of health care.

Rob Oliver: Yeah, very powerful experience, even in just being with a patient who is having trouble verbalizing the feelings that they have and just to be able to be there for them. What do you wish people understood about your role in health care?

Richard Harris: I like the idea of educating people, and I’m not afraid of expressing myself in many different forums about where I see the positive way that we can deliver health care and not just health care, but all sorts of social justice issues. So I’m happy to get out there. I think a lot of surgeons are a little bit more hermitlike, and they’re within themselves, and they just do their job and get on with it. And they do a good job. But they don’t necessarily and they don’t get the message out about what they’re achieving, why they do things. So I think being able to express yourself and explain what you’re doing to people, particularly when they’re in front of you and you’re trying to tell them why they might want to have a procedure or not have a procedure is a huge thing. I think also the balance that you get with experience about not doing things to people. That’s another very important factor. I think some young doctors tend to overdo things when they feel too confident or to copy and are doing procedures that they probably shouldn’t be doing. So I think that comes a bit with experience when to hold back as well. It is an art still, to a certain extent, how you communicate with people, how you explain procedures, what they can expect from procedures and not to overcall and not to overexaggerate things.

Rob Oliver: It’s so interesting to hear what you just said because I’ve used the analogy on the show before, but when you’re a hammer, everything looks like a nail. And so I would imagine that when you’re trained as a surgeon, there’s an initial instinct to think, I know how we can address this through surgery, but you’re saying, let’s take a step back. And before we talk surgery, let’s talk about other options. Is that properly understanding what you said?

Richard Harris: Yeah. And I think it’s not just the surgery part of it, but it’s also one other alternative programs, exercise programs or dietary things that you can look at to prevent recurrence. Smoking is a great thing. I mean, I have stopped many people from smoking over the years, which is, I think, a pretty good achievement, even just in one person. But it’s definitely not all about I’ve got to just go and book this person for another operation. That’s a ridiculous approach to surgery. You’ve got to be able to appreciate the person as a whole. I’ve always disliked some surgeons attitude. It’s just about the procedure, and they don’t want to know about the medical side of things. They want to know about all the other issues. And I think that’s a really silly way to approach surgery. But surgery is very rewarding in the sense that it’s an instant gratification. A lot of the time. There are some things that are so obvious, like if somebody comes in with appendicitis and you take the appendix out in the olden days, that would have died us. But now we can fix them up and they go home the next day. So there is a lovely instant gratification, too. Surgery quite a lot of the time.

Rob Oliver: Although with surgery, it’s interesting because the only person that is not aware that doesn’t receive the instant gratification is the patient, right, because as the surgeon, as the members of the team, you’re all there and you’re seeing what’s going on, you’re able to say yes, we were able to do this. And yet the only person who doesn’t participate in that fully, for the most part, would be the patient themselves.

Richard Harris: That’s very true in the old days of horrible surgery. So I had a person who had an ischemic leg. In the old days, we’d have to do a fence pop bypass. That’s such a huge operation, all these cuts on the legs and these wounds and coming through the pain of that. But nowadays I can do a puncture in the groin and fix them with a balloon or a stent or an atherectivity device. And they go home the next day. They don’t notice they’ve had a punter in the groan, and they can walk as far as they like, whereas the day before they couldn’t. So there is some things for the benefit of the place really quickly.

Rob Oliver: Sorry. My idea was that once they wake up, they’re seeing the results very quickly. When they are under anesthesia, they are not participating. That was kind of where I was going with that. What excites you about the future of health care?

Richard Harris: I’ve got a son who’s a Med student, so that excites me that I’ve got a quality man coming through to take over, not me, but just in the field of medicine. I know he’s just a fantastic guy, and I know that some of his friends are as well that are doing the course with him. So I feel that there’s still great people coming through to push medicine forward. So that’s a wonderful knowledge. But also, as technology comes through, more and more, it’ll be less invasive, more successful. I think the artificial intelligence is going to aid in diagnosing things quicker and more accurately. And it’s kind of sad to think that the pathologist isn’t going to be looking down the microscope to work out what sell that is. But, yeah, I think those things are exciting. Even in basketball surgery, there’ll be imaging techniques that will take the wire through. I won’t have to sort of guide it or use an angiogram. It’ll just work its way through like a Tesla in traffic. I see these things that are very obvious will come to medicine. Technology applied to what we do, but they’ll still need to be their caring and skilled people to guide that technology. So I think we’ve got a long way to go.

Rob Oliver: Absolutely. What is one thing medical professionals can start doing today to improve the quality of health care?

Richard Harris: Yeah. I’m a great advocate for not putting your hand on the doorknob of a consulting room before you’ve made sure that you’ve finished a conversation with the patient. So there was a wonderful speech, actually given by a President of the Vascular Society in the States once, and it was documented in one of the journals, and it was just a beautiful description of what not to do and what to do as a doctor. That was one thing that always stuck with me is that don’t stand up, don’t finish a conversation until it’s finished and you’ve had the opportunity of the patient having to ask for all the questions they want to have. And it doesn’t matter if you’ve got a room full of cranking patience out the front. The important thing is the person in front of you and connecting with them properly and getting them to understand what you’re on about.

Rob Oliver: Yeah, I think it’s a very powerful message that you’re saying handle the patient that’s in front of you and let the rest of it get handled when it gets handled. So very interesting. Wonderful. Listen, I really appreciate you being on and real quick. If people are looking for your book, what’s your book called and where can they find it?

Richard Harris: So this is it. Imagine a novel by Richard A. Harris website is or you can just Google “Imagine a novel” and you can get it on Amazon and get it in any good bookshop if you ask them. And it’s a great read. There’s a bit about healthcare in there. There’s quite a bit. It’s a vision about… Well, it’s taking John Lennon’s song, John and Yoko’s Song as in a novel form. So it’s envisioning a change of heart, a change of the world order. If you like to enable that kind of world to exist with no borders, no war, no crime. It was a joy to write, but there’s so much in the equity of world health care and education, health care, and the way that skills are distributed in the world that could be instantly changed if there was an imaginary and everything changed that day. That’s one aspect of the book. But it’s a series of love stories and part of Love is getting proper health care out for everybody. I reckon in the world.

Rob Oliver: Yeah. Part of love is not losing the ones that you love. Richard Harris, thank you so much for being with me today. I appreciate your perspective on healthcare.

Disclaimer: All opinions expressed by guests on the Perspectives on Healthcare Podcast are solely the opinion of the guest. They are not to be misconstrued as medical diagnoses or medical advice. Please consult with a licensed medical professional before attempting any of the treatments suggested.

This Post Has One Comment

  1. Alicia Ready

    The only book I have read in a long time.

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