A total of AU$2.8 billion of the federal health budget is spent on wound care annually,1 so it seems a natural fit that the Australasian Foundation for Plastic Surgery (AFPS) should seek to improve the situation. As the majority of funds are spent out of urban centres we felt that we should ‘assess and improve where possible the wound care of people in rural and remote Australia.’ After all, wound healing is the very core of our specialty.
Our aim is to add value to existing care givers and not duplicate their work. To this end we have met with the Minister for Aboriginal Health, The Hon Ken Wyatt, and the Assistant Minister for Health, The Hon Dr David Gillespie, Top End Health Service officials, representatives of Aboriginal controlled health care centres, Wounds Australia and others. They are all extremely enthusiastic about the value we can add.
We have made pilot visits to Cairns, Darwin and Tiwi Islands and are looking to undertake a number of ongoing activities, including outreach visits to support remote health care workers, updating educational manuals, supporting local Plastic Surgeons and providing telehealth services for advice and education.
Mission Australia conducts an annual survey of young people aged 15–19 years. The report consistently highlights that body image is one of the top three concerns identified by those surveyed and with body image acting as the greatest predicator of self-esteem for young people. In its latest report in 2016, body image was again an important issue of concern for 30.6 per cent of respondents (extremely concerned: 13.0%; very concerned: 17.6%).2
A significant number of young people seek cosmetic surgery as the solution to their self-esteem problems. As plastic surgeons we regularly see young people seeking surgery and it is important that any decisions made are done with the best interests of the patient at heart. While appropriate surgery has significant benefits, to operate on a patient who has unrealistic expectations is never going to be successful and may well cause grief for both patient and surgeon. The AFPS feels strongly that we have a unique voice in this space and that we can be leaders in the debate.
We should get our house in order first and we have facilitated changes to the PRS training curriculum to include body image and self-esteem issues. We are planning to work with the Centre for Appearance Research, UWE Bristol, to develop an assessment tool for the use of health care professionals. We will also identify appropriate resources to which young people can be referred.
While the wound management and self-esteem programs form the bulk of our current workload and were a successful part of the 2017 Plastic surgery congress, the AFPS continues to provide assistance for regular educational and research activities. For example, we support the registrars’ annual conferences, an annual research grant, an annual registrar award in cooperation with Interplast, the BK Rank foundation lecture and several registries. The AFPS supported the development of the Australian breast device registry and its transfer to the custodianship of Monash University and we instigated, and are the driving force behind, the international collaboration of breast registry activities (ICOBRA).
The two company members of the AFPS are the Australian Society of Plastic Surgeons (ASPS) and the New Zealand Association of Plastic Surgeons (NZAPS). Our board has representatives of both organisations. The AFPS board is committed to being the philanthropic arm of our specialty. We work closely with ASPS and are very grateful for their support. While many of our activities are bi-national we will support appropriate activities particular to New Zealand.
We are a registered charity, achieved tax deductible gift status in 2016 and our inaugural fundraising appeal in 2017 was well supported by donations from plastic surgeons. We will look to obtain government and charitable grants, where appropriate, but the AFPS will always require the ongoing financial and in-kind support of the specialty.
The Australasian Journal of Plastic Surgery is a joint initiative of the AFPS and ASPS. We are extremely enthusiastic about it and committed to its future. It represents ‘a coming of age’ for our specialty in Australia and as it matures will rightly position us as an international voice for plastic surgery. I encourage everyone to get behind it.