Tego Profile: Dinesh Patel
Specialty: Urological surgeon – private and public
Medical School: University of New South Wales
Internship, residencies and advanced training: Sutherland Hospital, St George Hospital, Prince of Wales Hospital, Concord Hospital, Gosford Hospital, Westmead Children’s, St Vincent’s Sydney
Significant other: My supportive wife
Enjoys: Music, travel, running, good food and wine
Urological surgeon Dinesh Patel enjoys the camaraderie in the operating theatre.
“I’m a fairly social person, so I enjoy the environment where you are interacting with your colleagues and teaching your registrars,” he says.
He also enjoys the feeling of being single-mindedly focused on one task with no distractions. “When it is all going well, and you can see that you are making a difference. That can be really satisfying.
“You decide to become a surgeon because you want to help people – find immediate solutions to their medical problems. You enjoy the challenge of operating. So, whether it’s a day surgery procedure or a major operation, you enjoy the planning, you enjoy the clinical decision making, and then you find it fulfilling to successfully perform the procedure,” says Dr Patel, whose father is a surgeon.
He discovered early in his medical training that he was most interested in doing things of a practical nature. “I enjoyed the specialties where we got more immediate results. Another big attraction was being able to do things with my hands,” says Dr Patel, who immigrated to Australia from Singapore with his family when he was a pre-schooler.
Urological surgery has turned out to be a good fit for him. He enjoys the emphasis on new technology and the variety: minor procedures, endoscopic procedures and a lot of major surgery.
The hours are also relatively family-friendly, says Dr Patel, whose wife, Louise, is a partner in a law firm. They have three teenaged children, so the relatively predictable hours help him find his life/work balance.
One of the most significant changes in urological surgery has been the introduction of robotic surgery over the past 10 to 12 years, says Dr Patel, who consults in private practice and operates in both public and private hospitals.
“It is very much a new set of skills. In private hospitals, it’s become the standard way of performing prostate cancer surgery, and it’s becoming more predominant in public hospitals.
“The robot allows a greater range of movement than can be provided by the human hand. It can improve precision, provides a magnified 3D view and aids in retraction of tissues.”
The advantages include a shorter hospital stay for most patients and less post-operative pain, he says. It also assists the surgeon to achieve a gentler dissection and to better protect the nerves which supply erections.
One of the most rewarding parts of Dr Patel’s work is achieving good oncological and functional outcomes in prostate cancer surgery. “It’s a great feeling to cure someone of their cancer, but even more satisfying when they have excellent urinary continence and retain sexual function.”
However, relatively minor procedures can also be gratifying. “I remember one patient in his mid-60s who had quite severe prostatic obstruction and put up with terrible symptoms for many years. After much deliberation, he decided to go ahead with surgery. Three months later, he said I had changed his life, as he could now do all the activites he wanted, without having to hunt for a toilet all the time.”
Dr Patel says clinical decision making about whether or not to perform the operation, can be more important than the procedure itself.
“Whatever procedure you do, whether it’s minor or major, it has to be with the expectation that your patient is going to experience an overall benefit.
“The patient has to be fully informed, fully consented, understand the risks and benefits and understand the post-operative course. By the same token, you can’t let a patient dictate to you what treatment they specifically want if you don’t agree with that.”
“I have a pretty big multicultural population of patients and frequently use interpreter services when I’m preparing people for procedures.”
He says medico legal risk is not something that keeps him up at night, but “we always have to be conscious that patients may take issue with some aspect of their management, and we have to take all complaints seriously.”
He says he has never had a significant complaint but has been “very happy” with the support and care he has received from Tego in terms of medicolegal advice.
Dr Patel says anyone deciding on whether urological surgery is right for them should speak to as many consultants as possible.
“Speak to them about clinical and non-clinical aspects of the work, including how they manage their lifestyle.
“It is also becoming increasingly important to try to develop a sub-interest within the specialty you choose.”
Dr Patel sets a good example. His sub-interests are: prostate surgery, urinary tract stones and minimally invasive treatment for benign prostatic hyperplasia.