With great sadness we learnt that Dr Phil Tideman AM (pictured left) lost his brave battle with cancer on Wednesday 26 July.
He showed enormous courage and strength in the last 2 years during his treatment and returning to work in rural South Australia, despite very significant physical hardship.
RDASA feels it is important that all members are aware of some of his achievements that led to him being awarded an Order of Australia Medal earlier this year. This was due to be presented to him in August.
It is a very sad day for all his friends, work colleagues and family.
We will miss his drive, his energy and enthusiasm, and his great sense of dry humour.
He was a very close friend and mate of many rural clinicians and health staff across the state.
Phil was an outstanding Australian. He was a mentor, educator and friend of many rural doctors and nurses across the country as well as being an innovator for change. He provided the highest quality clinical services for thousands of rural South Australians.
Phil was recognised for his tireless efforts and outstanding leadership to ensure that those living in rural Australia are provided with equal access to high quality cardiovascular care and benefit from the best clinical outcomes equal to those patients living in the city.
He was a great contributor to the work of the Rural Doctors Association of Australia (RDAA) and Rural Doctors Association of South Australia (RDASA). He was a leader in our state RDASA Executive, serving as a Vice President of RDASA for the past 5 years as well as chairing RDAA’s national Rural Specialists Group for many years.
He provided key advice to our Associations with regards to improving rural health services to communities through his work with the South Australian Clinical Senate and as Chair and Clinical Lead of the SA Health Commission on Excellence and Innovation in Health.
While working as a cardiologist in 2000 at Flinders Medical Centre, Phil undertook a study to look at the survival of patients presenting at Flinders Medical Centre with an acute coronary syndrome (ACS). He found that people from rural South Australia had a far lower chance of survival after ACS than those from metropolitan Adelaide. Phil set about trying to work out why and then developed a complete system to help to reduce that survival gap. He succeeded, kept records, conducted ongoing research and showed that no gap now exists.
A new revolutionary cardiac model of care provided a solution to the problem. Phil was the key driver of the integrated Cardiovascular Clinical Network (iCCNet) system that links clinics to hospitals to provide a healthcare model that leverages new technologies and cardiac markers to improve rural access to quality healthcare for heart disease patients.
iCCnet provides rural clinics with the ability to test, monitor and manage rural patients so that the care of patients suffering heart attack in rural areas could be equal to those in the cities. It is exciting and extraordinary to see the degree of success his vision has made and will make to the lives of rural South Australians.
Phil approached his work unlike most metropolitan specialists; he did not merely visit the rural areas and return to the city. Instead, he built a system that encompassed many different levels:
- He brought fellowship candidates out from Finland to undertake primary research into risk factors for cardiac disease in rural areas, and identified for the first time the differences in risk factors between rural areas and the city.
- He developed detailed wall charts for hospital treatment rooms that are personalised for every rural hospital across South Australia (as well as for a few doctors in small towns without hospitals).
- He provided regular training and updates for doctors and nurses in the guidelines he had laid down for the management of cardiac emergencies.
- He ensured that equipment provided for each rural hospital in South Australia for the management of cardiac emergencies is standard. This includes ECG machines that connect back to Flinders Medical Centre so that the ECG of a critical patient in a remote location can be instantly examined, if necessary, by several experts.
- He trained staff and provided equipment to do exercise testing and echocardiograms in several major rural centres, so that patients can be provided with more advanced testing closer to their homes to determine who really needs to travel to the city for the most advanced investigations.
- He employed scientists through grants that he sought and won, to develop and maintain a biochemical point-of-care system throughout rural South Australian hospitals. This has ensured that the two-thirds of heart attacks that cannot be diagnosed on ECGs alone but only through the rapid access to such biochemical testing, can indeed be identified and rapidly and safely treated. His point-of-care network is well recognised and respected across the world.
- He ensured the deployment of thrombolytic drugs in small hospitals and even a few remote medical centres, so that patients who are critically ill can be immediately treated rather than waiting for them to reach Adelaide.
- The scientists he employed maintain quality control systems to ensure the safety of the point-of-care system. And they train, examine and accredit the personnel who operate that equipment in all the smaller country hospitals and medical centres across rural South Australia.
- Phil recruited cardiologists to staff his after-hours call system to receive calls from rural doctors when they need help most, when the patient has just presented, no matter what hour of the day. And he measured the response times of those cardiologists to ensure they provide the help to rural doctors that they need.
- He developed and implemented an alternative cardiac rehabilitation system that does not rely on patients travelling great distances. This has shown to improve patient admission and completion to the program, reduce cardiac readmissions to hospital and be a cost effective model of care.
- He developed and maintained a remote monitoring system for those patients living in rural areas with chronic disease, so that they are constantly being monitored from their homes.
- He made the time to personally check up on his long list of patients, ensuring that pacemaker checks were provided for those who need them, for instance, in centres close to their homes.
- He developed a database that collects ECG and Point of Care Pathology information and allows it to be shared across all health professionals using their computer or smartphone, wherever they are working from.
iCCnet’s innovative approach has been proven to reduce re-admission rates as well as to reduce both in-hospital and pre-hospital death rates. An evaluation of the network reported in the Medical Journal of Australia that implementation of the iCCnet model of care in rural hospitals was associated with a 22% reduction in 30 day ACS mortality.
Phil’s talent and vision was fundamental in creating rural cardiac clinics across rural South Australia including Cleve, Kimba, Wudinna, Naracoorte, Kingston, Robe, Millicent, Mount Gambier and Bordertown.
Phil’s personalised approach to his work meant he constantly reminded rural GPs to call his mobile at any time for their patients or to ask clinical questions.
To ensure ongoing, progressive cardiovascular training for rural doctors, Phil hosted the biennial ‘Weekend Update on Cardiovascular Management’. The event brings rural doctors and nurses together to build their capacity to best manage heart attack, blood pressure, arrhythmia and stroke cases. It is offered to all rural clinicians at no cost.
While Phil attained his Bachelor of Medicine and Bachelor of Surgery at The University of Adelaide, his academic and professional leadership extended far beyond South Australia where his Cardiology practice and cardiovascular research program at Flinders University gains ongoing recognition. Phil emerged as an inspirational leader in his field and is often recognised by his peers for his academic and research contributions including:
- The Royal Australasian College of Physicians Medal for Clinical Services in Rural and Remote Areas
- Inaugural SA Health Award for Building and Sustaining Partnerships, South Australian Government (Individual and Team)
- SA Health Awards Enhancing Primary Care (Team)
- Australian College of Rural and Remote Medicine Distinguished Services Award 2011
- Inaugural SA Health Award for Building and Strengthening Partnerships, South Australian Government (Team)
- SA Health Awards Minister’s Health Award – Virtual Clinical Care Service (Team)
- For the last three years, his research papers published in the Journal of the AMA have won, each year, recognition by the Victorian Branch of the AMA as the best papers published for the year.
- SA Health Awards Out of Hospital Strategies and Care – CATCH – Telephone Cardiac Rehabilitation (Team)
- He was a Finalist in the SA 2017 Australian of the Year Awards
Phil will continue to be recognised as a national and internationally leading cardiovascular specialist whose ongoing research, innovative projects and continuing studies have furthered South Australia’s position as the national industry leader in rural cardiac health.
His vision, leadership and personal effort which started out as a research project in the South East of South Australia in 2000 has been successfully translated into clinical care and is saving countless South Australian lives.
And as his model of care continues to grow and gain recognition throughout regional Australia and internationally, his work will be saving the lives of not only those living in rural Australia but those living in remote communities throughout the world.
Phil has been an outstanding South Australian and an enormous contributor to rural and remote healthcare.
He will be sorely missed by us all, and his legacy will never be forgotten.
Dr Peter Rischbieth
on behalf of the RDASA Executive and membership