Traditionally held around the saint’s day of St. Luke the Evangelist, St. Luke’s Symposium sees RCPI become a conduit for world health leaders, with a programme seeking to reshape healthcare.
Held on 22 October, the symposium began with a session by early-career physicians sharing discoveries about medicine as a career.
Dr Bearach Reynolds (HST Infectious Diseases trainee) spoke of a year posted at the HSE Chief Medical Officer’s office which gave him an understanding of how health policy works, and showed him new ways of being involved in the healthcare system. Dr Paul O’Brien (BST General Internal Medicine trainee) shared his path into medicine, which began with him teaching English in China during the 2010s, where he studied medicine, and later ended up helping organise teleconferences connecting Irish healthcare professionals with frontline doctors in Wuhan during the early days of the COVID-19 pandemic. Dr Rachel McNamara (HST Public Health Medicine trainee) spoke of how she found a passion for a specialty to do with service design and inequity. Dr Mary T. O’Neill (RCPI ASPIRE Fellow) presented on a new national review of hospital doctors’ wellbeing, to compare the findings with that of a previous national survey conducted in 2014.
A keynote by Dr Robert Harrington (dean, Weill Cornell Medicine New York) encouraged the thinking of medicine as a data science as well as a bio science, and made connections between late-century projects that combine disparate forms of data – such as the Framingham Heart Study, and Duke University Medical Centre’s “prognostigram” – with contemporary applications of Artificial Intelligence.
A panel dedicated to digital health and Artificial Intelligence began with Prof Cathy Quinlan (RCPI Clinical Lead on Artificial Intelligence) speaking of the need to think about scaling Artificial Intelligence as infrastructure, and for there to be a “clear line-of-sight, from European law to the bedside.” Derek Tierney (secretary general, Department of Health) spoke of the HSE’s “Digital Health Strategic Implementation Roadmap” as not simply a digital strategy, but as a healthcare-reform strategy. Damien McCallion (HSE Chief Technology and Transformation Officer) spoke of progress made in the two years since publication of the roadmap, such as launch of HSE Health app and work begun on digitised patient records.
A panel dedicated to HSE Health Regions, and perspectives from within the recently restructured health service, featured Dr Eamon Doyle and Sara Long from HSE Dublin and North-east, Dr Pat Nash and Tony Canavan from HSE West and North-west, and Dr Rose McNamara from HSE Clinical Reform office. Their discussion touched on the importance of clinical directors like Dr Doyle and Dr Nash being on the ground in clinical sites, and of the importance of building on the experience of regional executives like Ms Long and Mr Canavan, all while moving towards new structures that integrate care and replace previously-siloed models of care.
In a final “Clinical Pearls” session, Dr John Fitzsimmons (RCPI Quality Improvement director) spoke of how the image of the doctor transformed in the 20th century, from being involved in the community, as famously depicted in Luke Fildes’s 1890 painting The Doctor, to being located somewhere more remotely clinical, due to improvement in services. He spoke of the need for doctors to remain compassionate leaders, and drew on research conducted on “kindness” as a method to broach uncomfortable issues. Prof Joseph Keane (respiratory physician, St James’s Hospital) presented a series of recent cases where tuberculosis mimicked community-acquired pneumonia and mycobacterial bulla conditions. Dr Aoife Laffan (neurologist, St James’s Hospital) spoke of diagnostic delays for patients with functional neurological disorder, and encouraged doctors to validate their symptoms. Dr Bairbre McNicholas (nephrologist, University Hospital Galway) advised on physical examination in the management of shock.
A keynote by geriatrician Dr Paula Rochon (Centre for Mature Women’s Health, Mount Sinai Toronto) spoke of the need for research infrastructure that includes age and gender, referencing high rates of “potentially inappropriate” prescriptions for women aged over 85-years-old as one reason why drug safety should be viewed through lens of age and sex.