Professor Murrell is Head of the Dermatology Department at St George Hospital since 2004.  Professor Murrell graduated from Oxford University Medical School and trained in medicine and dermatology in the UK and USA as well as in Sydney.  She holds doctorates from UNSW and Oxford Universities for her research.

Professor Murrell runs a clinical trial centre for skin diseases and lectures globally on autoimmune and genetic skin diseases.

Dr Lara-Rivero is an overseas-trained Dermatologist fully qualified by the Australasian College of Dermatologists and the Australian Health Practitioner Regulation Agency who works as a consultant dermatologist in private practices across Sydney and the public practice is based in St George Hospital. He is involved in educational activities for medical students, overseas-trained dermatologists and post-graduate medical officers.

Dr Lara-Rivero has published articles in local and international peer-reviewed journals and has also presented at local meetings for fellow dermatologists and GPs. His areas of interest include medical dermatology, urticaria, eczema, contact dermatitis and patch testing, and male genital dermatology.

 

Wednesday Afternoon:  13.00 - 16.00 (a paediatric dermatology clinic occurs once a month)

Friday Morning: 08:00 – 12:00 (alternating between outpatient clinics and clinics for biopsies run by the trainee)

 

Conditions treated at St George Hospital include, but may not be limited to:

• Moderate to severe inflammatory acne (when the lesions are numerous, leaving bad scarring and / or post-inflammatory pigmentation)
• Hair loss (excepting male or female pattern hair loss). Intralesional corticosteroids for alopecia is not currently performed in our department
• Eczema / dermatitis: including atopic, seborrhoeic, contact (irritant and allergic). Patch testing for allergic contact dermatitis is not being currently performed in our department
• Chronic urticaria (>6 weeks of symptoms)
• Psoriasis
• Pigmentary disorders such as vitiligo
• Skin cancers (basal cell carcinoma, squamous cell carcinoma, melanoma, Merkel cell carcinoma). Please attach of the corresponding biopsy report to the referral
• Nail disorders (except for tinea / fungal infection) - a negative nail fungal microbiology report must be attached to the referral for this purpose
• Genital rashes where a sexually-transmitted infections has been ruled out (a negative STI screening must be attached to the referral)

Exceptions – conditions or patients not managed by the department

This service does not offer treatment for the following:

• Patients being treated for the same condition at another NSW hospital (special arrangements can be made for children under 18 years of age via CARS - Children Acute Review Service)
• Routine skin checks (only provided for high-risk patients e.g. solid organ transplant patients or with more than 5 skin cancers). Refer to the NSW Health and SESLHD supported skin cancer service at Integrated Specialist Healthcare Service: https://ishc.org.au/find-a-service/skin-cancer/
• Venous ulceration and venous ulcers (refer to Vascular Surgery)
• Sexually transmitted diseases (refer to ID)
• Cosmetic Conditions and Treatments (post-acne scars or pigmentation, post-inflammatory pigmentary changes, facial rejuvenation, superficial varicose veins, wrinkles, lipodystrophy or lipoatrophy, among others)
• Seborrhoeic keratoses
• Laser Dermatology
• Warts (for warts that have persisted for more than 6 months despite treatment, please specify in the referral the number and type of treatments that has been used)
• Blistering diseases (to be referred to Prof Murrell Bullous Diseases clinic in her Kogarah private rooms)

Please keep in mind that due to a very high demand of our services, failure to attend to the appointments more than once will make the patient to be discharged back to their treating GP. If the patient's condition requires it, the referring doctor will re-send a new referral and the referral will be re-triaged. For the same reason, unless the patient has multidisciplinary care at SGH, we are no longer accepting patients outside of our catchment area

The process for referring a patient is:

1. GP/referrer to send through referral via Fax 02 9113 2297 or Email seslhd-stg-opd@health.nsw.gov.au
2. The referral will be checked to ensure it is valid. If not valid then extra information will be sourced from the referrer
3. If valid the referral will be triaged by dermatology clinic doctor
4. Appointment made as per doctor's recommendation
5. Patient notified by confirmation letter as well as a text / call 1 week prior to appointment

A valid referral requires:

1. Written by a medical practitioner in a private practice or an SMO
2. Written to a named doctor within the clinic
3. Signed and dated by referring practitioner and include their Provider Number and place of practice
4. Include length of referral, unless it is a 12-month referral
5. Patient to have signed financial consent form
6. If an interpreter is required
7. If it is for further follow up, please specify the condition for which the patient has been attending our department

All referrals are prioritised and allocated according to criteria.

You can contact us by telephoning the Translating and Interpreting Service (TIS) on 131 450.

Tell the operator what language you speak, and then ask the interpreter to set up a telephone conversation between you, an interpreter, and us on 02 9113 2513.

 

Our Physicians:

• Dr Wei Lai Vicky Chang
• Dr Shu Han Emily Liu
• Dr Anthony Byrne

Our Specialised Nurses:

• Joshua Banner – Nurse Unit Manager
• Mei Qi He – Acting Clinical Nurse Consultant

• All referrals should be sent via fax to (02) 9113 1948 or via email to SESLHD-StGeorgeChestClinic@health.nsw.gov.au  
• Referrals can be accepted from GP’s, Specialist’s, hospital in patients (teams) and Chest Clinic staff where all referrals will be triaged according to clinical need
• Immigration referrals are referred via BUPA
   

• Proof of identification
• Insurer details (workers compensation, public liability or third party)
• Any previous Chest X-Rays, CT scans, blood tests or doctors’ letters (if available)
• Adult vaccination card for pre-employment screening
• Activities to keep you entertained while waiting (for example, a book, music player with headphones, crosswords)

Please let us know if you need an interpreter.

You can contact us telephoning the Translating and Interpreting Service (TIS) on 131 450. Tell the operator what language you speak and then ask the interpreter to set up a telephone conversation between you, an interpreter, and the healthcare professional you want to speak with.

We are a teaching hospital and student doctors or nurses may be involved and supervised by senior staff during your visit. You have the right to say no. If you do so, this will not impact in any way on the services we will provide.

Phone

(02) 9113 2430

Fax

(02) 9113 1948

Email

SESLHD-StGeorgeChestClinic@health.nsw.gov.au 

Monday to Friday, 9.00 am – 4.30 pm

 

Lower Ground floor 

Prince William Wing

Belgrave Street

Kogarah NSW 2217

What is Tuberculosis (TB)?

• TB is an infectious disease caused by the bacteria Mycobacterium tuberculosis and usually affects the lungs but can be found in other parts of the body such as lymph glands, kidneys, gastrointestinal etc. TB is preventable and curable

How do people become infected with TB?

• TB is spread through the air when a person has active TB disease in their lungs or throat. It is spread when that person is talking, coughing, sneezing or singing near other people. Most people will get TB after spending a lot of time with a person with active disease.
• TB is not spread by household items such as cutlery, crockery, toilet seats or telephones

What is the difference between latent and active TB?

• Latent TB is when TB bacteria is in your body but sleeping i.e. not making you sick
• People with latent TB do not have any TB symptoms and cannot spread TB
• Once you are diagnosed with latent TB it is lifelong and is always a chance you can become active
• Active TB is when the bacteria causes infection and makes you sick with symptoms
• Without treatment TB can be spread from one person to another if disease is in the lungs or throat

What are the signs and symptoms of TB?

• Persistent cough for more than 2-3 weeks and not responding to other treatment
• Coughing up blood
• Fevers
• Night sweats
• Unexplained weight loss
• Feeling of tiredness and loss of appetite
• TB that is not in lungs will have different symptoms relating to the area it is present

What does it mean to be contact of TB?

• You may have been identified as a person who has had contact with someone while they were infectious with active TB. If you are contacted by the Chest Clinic, we will commence TB screening which involves a blood test and possibly a chest X-Ray. This is preventative healthcare to help identify latent TB before developing to active TB and provide preventative treatment or monitoring

Is it safe for me to continue working and be with others?

• As a contact of a person with active TB disease, you are not infectious and cannot pass TB onto anyone else. If your screening test is positive, it still does not mean that you are infectious
• If you are diagnosed with active TB disease in your lungs or throat you will not be able to work or socialise until cleared by the Chest Clinic
• If you develop any TB symptoms do not delay in seeking medical attention

Our Department offers a wide range of services and treatments guided by Policies and Procedures in line with best evidence based practice. Any treatments that involve patients receiving a medication, the patient must obtain the medication prior to their appointment. The DMIC department does not provide medications for treatments unless otherwise stated to the individual.

• Monoclonal Antibodies infusions and injections
• Blood and Blood product administration
• CT Hydration (pre/post)
• Immunotherapy (for non-malignant cancer related conditions)
• IV fluid infusions (including IV electrolyte replacement)
• Intravenous antifungals, antibiotics, and antiviral medications
  • Other Intravenous medications given also include Actrema, Biphosphonates like Zoledronic acid and pamidronate and Avastin Infusions
• Subcutaneous Immunoglobulin therapy initiation and ongoing follow-up
• CVAD management
• Venesections (for those who are not suitable to have this done at Lifeblood)

Procedures:

• Renal Biopsy
• Tracheostomy Changes
• Complex acute wound dressings – including VAC dressings
• Bone marrow Biospy or BMAT procedures
• Ascitic Taps (abdominal paracentesis)
• Anti spasticity Treatment conducted by the Rehabilitation Team
• Lumbar Puncture procedures
• Synacthin Test/ Saline infusion Test for investigations

DMIC prioritises treatment for cohorts of individuals that require support from a hospital setting. Services that can be completed within the community for example, a General Practitioner Practice, are not appropriate for the DMIC department.

Our service is a Nurse led unit, and our team is made up of experienced and skilled professionals, such as Registered Nurses and Administrators. Medical support is provided by the General Medical Team, or respective Haematology Team if patients are receiving care for their Haematological condition.

Exclusion Criteria:

• Residing outside of SESLHD catchment area, with no need for tertiary level care.
• Residing within SESLHD, but outside of the St George catchment area (click here for catchment area) and care is able to be provided at patients SESLHD catchment hospital.
• Patient is not medically clear for discharge or is currently an inpatient
• Children under 16 years cannot be treated in DMIC, children between the ages of 16-18 years MUST be accompanied by a parent or legal guardian for duration of treatment.
• Patients that require treatment exceeding 8 hours
• Invalid referrals
• Administration of cytotoxic drugs for a malignant cancer indication
• Chronic wound management

Please note the following whilst completing the referral:

• Name, DOB, Address (MRN if internal hospital referral)
• Patients contact details
• Clinical treatment required – clear instructions of what treatment is being requested
• Medication Information (Drug, dose, route, frequency and time)

Referrals that do not meet the above criteria will not be processed by our team and will be sent back to the referrer.

We accept referrals from Specialist Consultants or General Practitioners. A referral completed by a Specialist will last 3 months and a one completed by a GP will last 1 year. Indefinite GP referrals are accepted only for the subcutaneous immunoglobulin (SCIg) program only.

Our administration team will call the patient or referring employee if the patient’s referral is expiring.

Please use this referral form and send to this email address SESLHD-STG-DMIC@health.nsw.gov.au or fax to 9113 1923.

Please ensure that all the mandatory information is completed on the form. The referral form ensures that you do not miss any important information to enable a timely and appropriate referral. External referrals that are sent in with a letter head from the MO clearly stating all essential clinical information (as indicated in the referral criteria section above) may also be accepted.

A member of our administration team will contact the patient with an appointment date once your referral has been triaged. If you have not heard from anyone from our team by [two weeks or even 4 weeks] please call 9113 2333 to follow up with your referral.

If an appointment is missed or cancelled, we will reach out to the referring medical officer by letter.

Monday to Friday – 07:30 to 17:30 (For the public 08:00 to 17:00)

Saturday – 08:00 to 16:30 (For the public 08:30 to 16:00)

We are closed Sundays and Public Holidays

DMIC contact details are:

Phone: (02) 9113 2333

Fax: (02) 9113 1923

We are currently located in the Day Medical Infusion Centre on Level 2 East in the Tower Ward Block at St George Hospital.

We are a Medicare service and your treatment will be bulk billed if you have Medicare. If you do not have Medicare you will incur a service fee in addition to extra charges depending on your treatment. If you have Private Health Insurance, you will need to pay the service and additional fees, and then liaise directly with your insurer to ascertain what can be reimbursed to you.

In the event a patient presents to DMIC feeling unwell they will be referred for medical review by their GP/Treating specialist or Nursing Staff may escort them to the Emergency Department prior to initiating treatment and the booking will be rescheduled. It is recommended that if you are feeling unwell prior to your appointment to follow up with your referring doctor and advise DMIC admin staff to reschedule your appointment.

• If you need to reschedule or have missed your appointment, please contact our department as soon as possible. Please note that if we are unable to reach you within 14 days, your referral may be returned to your referring doctor.
• Upon your arrival, kindly check in with the administrator at the front desk. You will be asked to wait in the waiting room, and a nurse will come to escort you when they are available.
• To ensure a smooth flow of appointments, we kindly ask that you arrive close to your scheduled appointment time, neither too early nor too late.
• We recommend bringing your own food and beverages, as our department has limited food options available.
• Due to space constraints and safety considerations, we advise that relatives wait in the waiting room during your treatment or return to pick you up afterward.

Thank you for your understanding and cooperation.