My journey started years ago as a Geriatrician for the Continence service, I got the opportunity to become experienced in performing Video Urodynamics Studies. This procedure put me in regular contact with a journal club meeting with a group of local Urologists who subspecialise in functional urology and neurourology.
These urodynamics meetings opened my mind to the vision that we could have a joint service, working collaboratively side by side – Geriatricians and Urologists. I imagined a system where our patients can benefit from the best of both worlds, where a spectrum of surgical and non-surgical options are all accessible to achieve the best patient outcomes, and barriers to cross-specialty communication are removed. In my enthusiasm, I even put myself through a few months of learning to do flexible cystoscopies in the day procedure unit. Led by our Head of Urology Department at Eastern Health, we put together a business case for a new combined model of providing Video Urodynamics – this would be a significant upgrade from the current urodynamics set up in the clinic without videofluoroscopy.
However, the business case didn’t get the executive approval that we had hoped for. Everything went on hold during the pandemic.
Fast forward to late 2022. I was invited to come to join the Urology outpatients clinic. It took me about the time of a heartbeat to decide. There were some challenges with logistics of fighting for clinic space, but eventually my job as a Geriatrician in the Urology clinic started. The job description was written for me after I started working in it a few months later. When I told the news to my urodynamics mentor, he revealed to me that aside from himself, I am the only other Geriatrician that has been formally employed by the Urology Department.
I am collecting data as I go along. I am curious to find out what I don’t know, and gathering momentum with each patient that I have seen. In fact I even sorted out someone who failed to attend clinic, when I reviewed her medical notes, what she needed was a trial of void in a nursing home. This was managed by a rapid referral to residential inreach, and her son was extremely pleased that she voided and they did not need to attend the hospital in person.
Thanks for allowing me to share this story. My journey continues.