Skin Cancer Medicine and Surgery with Dr Nick Mouktaroudis at Partridge Street General Practice

Dr Nick Mouktaroudis is a GP and co-owner at Partridge Street General Practice. He’s  passionate about health education, has a special interest in Skin, and a lot of expertise to share when it comes to helping people cope with and improve Skin Conditions. We recently had occasion to have a think about how we started Skin Cancer Surgery and Medicine at Partridge Street General Practice and we have a little story below.

 

Imagine a perfect day in a perfect General Practice. Focus on a busy yet unrushed GP, consulting with another valued patient. The flow of the consult is perfect, the communication great, everything is as it should be. 
 
We have to imagine days like this because they very rarely occur. Flow is fleeting and perfection is often aimed for and seldom reached. 
 
Going back to that consult, we can see that the GP is busy – but is definitely not unrushed. You can feel the pressure in the room as the patient seeks answers and closure and the GP senses the minutes ticking by. The consult comes to a close and both stand, the patient heading towards the door, the GP wishing them well, the patient’s hand is on the door and then. It happens. 
 
‘By the way Doc, what do you think of this?’
 
The GP turns away from the flashing screen and sees, across the room, a spot on the patients leg. 
 
Should we get the patient back at a later date? Offer reassurance we don’t feel confident giving?
 
Or, as the GP in this story does, do you reach for the dermatoscope, call the patient back, and look. There’s no such thing as a quick look and so the light comes out, the gel is applied, and a good thorough look is had. 
 
It’s an ugly duckling, a chaotic little mishmash of colours and globules. 
 
It would turn out to be a nasty – a nasty better appreciated in the pathologist’s dish than in the patients bloodstream.
 
A good result.
 
At the end of the day, the GP sat and wondered how this could be avoided in the future – how could we improve and be better. These challenges see us but we do not always see them.
 
This was our practice and so we had to change. 
 
Plan
Do 
Study
Act
 
Patient safety is paramount. We decided to solve for quality improvement and patient safety at the same time and made the decision to upskill one of our GPs, Dr Nick Mouktaroudis. He undertook multiple courses and extensive study in Primary Care Skin Cancer Medicine, Surgery, Therapeutics, and Dermatology. Following this we spent time and money upgrading our procedure facilities, equipment, and systems to support Dr Nick. We then allocated time for dedicated skin checks and adjusted our online booking and reception protocols. 
 
These were the first steps and in conjunction with our most recent AGPAL accreditation we have repeatedly run through this cycle, improving every time. We now have dedicated times for skin checks and skin cancer surgery, as well as protocols, systems, and education supporting Dr Nick and the other GPs in the practice. Patients enjoy seeing a GP they know and trust who can deliver appropriate care at a Primary Care level and price point. We receive great feedback from patients and local sub-specialists. It’s a clear win for patients, GPs, and our practice – and the mindset of continual quality improvement that we share with AGPAL was the way to get there. 
img_1955

 

 

 

img_2998

 

 

 

What is a Skin Check?

 

 

A Skin Check is a Comprehensive Skin History and Examination which is done at Partridge Street General Practice.

 

Your GP will ask you questions to assess the extent of Your risk/exposure to UV radiation and Your risk of solar related cancers.

 

They will examine you head to toe, examining the skin surface, focusing on any areas of concern (including the eyes, mouth, and anywhere else you may have noticed any spots, lumps, or bumps).

 

 

 

Are there any tools used for the Skin Check?

 

 

A proper examination needs proper equipment and we use handheld LED illumination with magnification as well as polarised light and clinical photography.

 

skin check dr nick mouktaroudis light

A dermatoscope is used to examine specific skin lesions. This is a particular type of handheld magnifying device designed to allow the experienced examiner to further assess skin lesions and determine whether they are suspicious or not.

 

 

 

Who should have a Skin Check?

 

We encourage all Australians over the age of 40 to have a Skin Check annually. Australians have one of the highest rates of skin cancers in the world.

 

Australians who have above average risks should be having Skin Checks before the age of 40 and sometimes more than annually.

 

You should have a Skin Check at any age if You are concerned about Your skin or particular skin lesions/areas.

 

img_2746-1

 

 

We ask You to identify any lesions of concern prior to the Skin Check wherever possible.

 

These may include new lesions that You have noticed or longstanding lesions that may be changing in some way or that You are concerned about. If You are worried – Ask!

 

Skin cancer check risk dr Nick Mouktaroudis

Risk factors for skin cancer

 

 

 

People at higher risk of skin cancer are those who:

 

have previously had a skin cancer and/or have a family history of skin cancer

have a large number of moles on their skin

have a skin type that is sensitive to ultraviolet (UV) radiation and burns easily

have a history of severe/blistering sunburns

spend lots of time outdoors, unprotected, during their lifetime

actively tan or use solariums or sunlamps

work outdoors

 

 

 

 

Does My GP take photos of My Skin?

 

 

 

During a skin check at Partridge Street General Practice Your GP will ask Your Specific Consent to take photos if they are concerned or want to make note of a particular skin lesion.

Photographs are useful as an adjunct to description of the lesion and act as a reference to position and comparison if required.

The photos will be uploaded onto Your Private Medical Record at Partridge Street General Practice.

 

 

 

What if My GP finds something?

 

 

 

This will depend on what Your GP has found.

 

If they are concerned about a particular skin lesion they may suggest a biopsy to clarify the diagnosis.

 

A biopsy is a surgical procedure during which they take an appropriate sample of tissue from the lesion of concern and send it to a pathologist for review.

 

Generally pigmented lesions (coloured spots), will be biopsied in their entirety whereas non pigmented skin lesions may be sampled partially if the lesion is too large to sample in its entirety.

 

The results of the pathology report will guide further treatment.

 

Your GP may elect to treat without a biopsy if they are confident of the diagnosis.

 

This may include freezing/cauterising a lesion, cutting it out (excising), or offering topical treatments such as creams.

 

Biopsies are scheduled in the Partridge Street General Practice theatre and our Practice Nurse will assist Your GP.

 

 

img_2745

 

 

 

What do I wear for a Skin Check?

 

 

 

Comfortable clothing.

 

Your GP will ask to examine you down to your underwear.

 

A sheet or towel will be provided for you to preserve your comfort and dignity.

 

A chaperone (Our Practice Nurse) is always offered.

 

Please avoid makeup or nail polish as the Skin Check involves the face and skin under the nails.

 

 

 

 

How long is a Skin Check?

 

 

Allow half an hour for Your GP to perform a thorough history and examination.

 

 

 

 

Do I need to see My GP or should I see a dermatologist?

 

 

GPs are Primary Care Physicians on the front line of Skin Cancer detection.

All GPs can check your skin, though not all GPs have formal training or a specific interest in skin cancer medicine and dermatoscopy.

Dr Nick Mouktaroudis has trained extensively in General Practice, Skin Cancer Medicine and Surgery, and has formal qualifications in Skin Cancer Medicine.

Dermatologists are sub-specialists in all skin conditions including Skin Cancer Medicine and Surgery although some will focus on other skin conditions.

 

 

 

 

Can I do more than a Skin Check?

 

 

 

You can Reduce Your risk by:

Avoid unnecessary exposure to the sun

Wearing sunscreen regularly and on all sun exposed areas.

Wear Hats and Sunglasses when appropriate.

Be aware of Your skin – both You and Your partner can check at Home.

 

 

 

525436572488

 

 

 

Book Your Skin Check Right Here.

 

 

 

Need more information? Leave a comment or see us in person. We’re Here to Help!

 

 

 

img_8445-2

 

 

You can see any of our Great GPs right here:

 

 

Dr Gareth Boucher

 

 

Dr Penny Massy-Westropp

 

 

Dr Monika Moy

 

 

Dr Katherine Astill

 

 

Dr Nick Mouktaroudis

 

 

Dr Nick Tellis

 

 

The Evidence For Sugar

IMG_1791

How do we get to the left side of this image rather than the right?

 

Probably not with sugar!

 

See the evidence – and read more here

 

IMG_1792.JPG

 

 

You can see any of our Great GPs right here:

 

Dr Gareth Boucher

 

Dr Penny Massy-Westropp

 

Dr Monika Moy

 

Dr Katherine Astill

 

Dr Nick Mouktaroudis

 

Dr Nick Tellis

Five People Who Need To See Their GP (But May Not Realise It)

The Runner

 

img_3050

 

Whether you’re already an experienced runner or a complete novice, setting goals — like running a half marathon — can provide the motivation to lace-up those runners each day. But when you’re tackling longer distances and putting your body under more strain than usual, it’s worth keeping in mind that checking in with your GP can ensure you reach the finish line injury free. “A GP might say, ‘let’s have a look at you, what’s your height and weight? Is your time frame realistic?” says Dr Tellis. “They might advise you to look out for shin splints, or what to do if you’re experiencing shortness of breath or chest pains.” And let’s be real, we’re not all just born with a runner’s physique. So if you are concerned about getting in better shape for the big race, it’s worth raising with your doctor. “For a half-marathon, we’d also be advising what you should be eating and drinking and how many calories you should be consuming on a daily basis,” Dr Tellis says.

 

 

The Soon-To-Be Traveller

 

IMG_7934

 

Whether you’re planning a tour of Europe, a week partying in Bali or a volunteering trip to Africa, your GP can offer you a wealth of advice. That includes options for travel vaccinations, food safety measures to take abroad, and what to include in your first-aid kit. “I also recommend to everyone get the best travel insurance they can afford and to take a close look at the exclusions in there,” says Dr Tellis. “For example, if you go to Bali and get on a scooter after drinking beers, you may not be covered by travel insurance — the cost of medical repatriation from Bali to Australia could be as high as six figures.”

 

 

 

The Couple Planning A Family

 

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You don’t need to wait until you fall pregnant for a trip to the GP — their advice can assist all couples with a healthy conception and pregnancy, by looking at your lifestyle and what might need changing from diet, to sleep, smoking, alcohol and drug consumption. “For women, you want to be taking vitamins with the right amount of folate. You want to be making sure your cervical screening (the new term for the old pap smear test), dental checks and rubella vaccination is up to date and that you’ve had your flu shot,” says Dr Tellis. “For guys, you want to be sure you’re not smoking dope or drinking too much, you want to be looking after your weight and your partner as well.”

 

 

The Exhausted Gym Rat/Bunny

 

BDB2A62F-DA16-4819-AB26-BE2CC49EF397

 

What happens when you think you’re healthy — and hitting the gym regularly — but still feeling exhausted or in pain? A trip to the GP can help pinpoint the cause, and advise on how you can change your training regimen to avoid injury. “A lot of men will hit the gym and do things likely to cause an injury or problem down the track… or they’ll find that big guy at the gym who has some interesting pharmaceuticals of his own. Again, that’s something we can give advice on,” says Dr. Tellis. Meanwhile, women may be suffering from undiagnosed mineral deficiencies, leading to tiredness. “A lot of women can be iron deficient,” explains Dr Tellis, who says he’d ask: “How much sleep are you getting, what are you doing in the gym, is it sustainable to be working 50 hours a week and getting up at 5am daily for Crossfit? Is your thyroid okay, are you getting enough calories in?”

 

 

The Stressed Out Comfort Eater

 

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When you’re working long hours and feeling stressed, it can be easy to find yourself regularly turning to unhealthy fast food lunches or indulging in sugar-filled snacks. While it may be something you feel reluctant to bring up, there are plenty of lifestyle suggestions, resources and referrals that a GP can provide, as well as simply lending a supportive ear. “Part of the skill of being a GP is picking your moments to start a conversation about delicate subjects. Some people come in ready to talk about their weight, some do not. I generally take a weight as part of my routine clinical review/examination, and discuss as I, and the patient, feel appropriate,” says Dr Tellis. He explains there are plenty of ways a GP could assist someone with issues stemming from stress and over eating. It may be a discussion about healthy diet — including good food choices, a better routine and when to eat — or stress management advice, and if necessary, a psychology or counselling referral. “What I would like to say as a doctor is that the door is open. Come in and say hello. You set the agenda as the patient.”

 

*Originally published here

 

You can see any of our Great GPs right here:

Dr Gareth Boucher

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Katherine Astill

Dr Nick Mouktaroudis

Dr Nick Tellis

Sore Throats at Partridge Street General Practice

Spring is here but it has been a big flu season at Partridge Street General Practice!

 

 

 

What should you do when you have a cough, cold, or sore throat?

 

Flu-Shot-logo
This may have helped before getting ill…

 

 

Here’s some information:

 

 

Do I have the flu?

 

 

 

Should I be on antibiotics?

 

 

 

My ear is sore?

 

 

 

Should I be immunised?

 

 

 

How do I stay healthier?

 

 

Any other ways to stay healthier?

 

 

Got anything else?

 

 

 

And, of course, What should I do instead?

 

 

There’s a new paper, at the link, saying this:

 

 

 

steroids in sore throat at Partridge Street General Practice

 

 

 

Need more information? Leave a comment or see us in person.

 

 

 

We’re Here to Help!

 

 

 

img_8445-2

 

 

You can see any of our Great GPs right here:

 

 

Dr Gareth Boucher

 

 

Dr Penny Massy-Westropp

 

 

Dr Monika Moy

 

 

Dr Katherine Astill

 

 

Dr Nick Mouktaroudis

 

 

Dr Nick Tellis

 

 

Check Your Skin with Dr Nick Mouktaroudis at Partridge Street General Practice

Dr Nick Mouktaroudis is a GP and co-owner at Partridge Street General Practice. He’s  passionate about health education, has a special interest in Skin, and a lot of expertise to share when it comes to helping people cope with and improve Skin Conditions. Let’s hand over to Dr Nick!

 

img_2998

 

 

 

What is a Skin Check?

 

 

A Skin Check is a Comprehensive Skin History and Examination which is done at Partridge Street General Practice.

 

Your GP will ask you questions to assess the extent of Your risk/exposure to UV radiation and Your risk of solar related cancers.

 

They will examine you head to toe, examining the skin surface, focusing on any areas of concern (including the eyes, mouth, and anywhere else you may have noticed any spots, lumps, or bumps).

 

 

 

Are there any tools used for the Skin Check?

 

 

A proper examination needs proper equipment and we use handheld LED illumination with magnification as well as polarised light and clinical photography.

 

skin check dr nick mouktaroudis light

A dermatoscope is used to examine specific skin lesions. This is a particular type of handheld magnifying device designed to allow the experienced examiner to further assess skin lesions and determine whether they are suspicious or not.

 

 

 

Who should have a Skin Check?

 

We encourage all Australians over the age of 40 to have a Skin Check annually. Australians have one of the highest rates of skin cancers in the world.

 

Australians who have above average risks should be having Skin Checks before the age of 40 and sometimes more than annually.

 

You should have a Skin Check at any age if You are concerned about Your skin or particular skin lesions/areas.

 

img_2746-1

 

 

We ask You to identify any lesions of concern prior to the Skin Check wherever possible.

 

These may include new lesions that You have noticed or longstanding lesions that may be changing in some way or that You are concerned about. If You are worried – Ask!

 

Skin cancer check risk dr Nick Mouktaroudis

Risk factors for skin cancer

 

 

 

People at higher risk of skin cancer are those who:

 

have previously had a skin cancer and/or have a family history of skin cancer

have a large number of moles on their skin

have a skin type that is sensitive to ultraviolet (UV) radiation and burns easily

have a history of severe/blistering sunburns

spend lots of time outdoors, unprotected, during their lifetime

actively tan or use solariums or sunlamps

work outdoors

 

 

 

 

Does My GP take photos of My Skin?

 

 

 

During a skin check at Partridge Street General Practice Your GP will ask Your Specific Consent to take photos if they are concerned or want to make note of a particular skin lesion.

Photographs are useful as an adjunct to description of the lesion and act as a reference to position and comparison if required.

The photos will be uploaded onto Your Private Medical Record at Partridge Street General Practice.

 

 

 

What if My GP finds something?

 

 

 

This will depend on what Your GP has found.

 

If they are concerned about a particular skin lesion they may suggest a biopsy to clarify the diagnosis.

 

A biopsy is a surgical procedure during which they take an appropriate sample of tissue from the lesion of concern and send it to a pathologist for review.

 

Generally pigmented lesions (coloured spots), will be biopsied in their entirety whereas non pigmented skin lesions may be sampled partially if the lesion is too large to sample in its entirety.

 

The results of the pathology report will guide further treatment.

 

Your GP may elect to treat without a biopsy if they are confident of the diagnosis.

 

This may include freezing/cauterising a lesion, cutting it out (excising), or offering topical treatments such as creams.

 

Biopsies are scheduled in the Partridge Street General Practice theatre and our Practice Nurse will assist Your GP.

 

 

img_2745

 

 

 

What do I wear for a Skin Check?

 

 

 

Comfortable clothing.

 

Your GP will ask to examine you down to your underwear.

 

A sheet or towel will be provided for you to preserve your comfort and dignity.

 

A chaperone (Our Practice Nurse) is always offered.

 

Please avoid makeup or nail polish as the Skin Check involves the face and skin under the nails.

 

 

 

 

How long is a Skin Check?

 

 

Allow half an hour for Your GP to perform a thorough history and examination.

 

 

 

 

Do I need to see My GP or should I see a dermatologist?

 

 

GPs are Primary Care Physicians on the front line of Skin Cancer detection.

All GPs can check your skin, though not all GPs have formal training or a specific interest in skin cancer medicine and dermatoscopy.

Dr Nick Mouktaroudis has trained extensively in General Practice, Skin Cancer Medicine and Surgery, and has formal qualifications in Skin Cancer Medicine.

Dermatologists are sub-specialists in all skin conditions including Skin Cancer Medicine and Surgery although some will focus on other skin conditions.

 

 

 

 

Can I do more than a Skin Check?

 

 

 

You can Reduce Your risk by:

Avoid unnecessary exposure to the sun

Wearing sunscreen regularly and on all sun exposed areas.

Wear Hats and Sunglasses when appropriate.

Be aware of Your skin – both You and Your partner can check at Home.

 

 

 

525436572488

 

 

 

Book Your Skin Check Right Here.

 

 

 

Need more information? Leave a comment or see us in person. We’re Here to Help!

 

 

 

img_8445-2

 

 

You can see any of our Great GPs right here:

 

 

Dr Gareth Boucher

 

 

Dr Penny Massy-Westropp

 

 

Dr Monika Moy

 

 

Dr Katherine Astill

 

 

Dr Nick Mouktaroudis

 

 

Dr Nick Tellis

 

 

Do I have the flu Doc?

flu
bah humbug

 

 

 

A very common question so HealthDirect (check your symptoms here) have put together an infographic.

 

 

flu1

flu2

 

 

Infographic courtesy of
Healthdirect Australia

 

 

Remember, you probably don’t need antibiotics, but if you’re worried, we’re all here to help at Partridge Street General Practice!

 

DR NICK TELLIS

 

 

Your Specialist In Life

DR NICK MOUKTAROUDIS

 

 

DR GARETH BOUCHER

 

 

Dr Gareth’s Cycle of Care

DR PENNY MASSY-WESTROPP

 

 

Dr Penny Massy-Westropp

DR MONIKA MOY

 

 

Dr Monika Moy

DR KATHERINE ASTILL

 

 

Dr Katherine Astill 1

 

 

The Government provides the flu vaccine FREE* for the following groups:

 

people who get the government subsidised flu vaccine
*Free – the flu vaccine is free but a fee may apply for your GP’s consultation

 

 

 

5 Things about Winter Colds

 

 

Winter is Coming! Everyone has a sniffle and they all want to give it to you. Why?

 

 

 

  • Colds are more likely in Winter. The cold temperature seems to affect your immune system, making it more likely that you’ll suffer more viruses you might otherwise brush off.

 

  • That snotty cough doesn’t always require antibiotics! Read more here.

 

 

  • Have you had your flu shot yet? It’s especially recommended for those at risk. Check with our practice nurses here.

 

 

 

  • Viruses can be spread by fomites (objects or materials which are likely to carry infection, such as clothes, utensils, and furniture) and direct contact…disinfect your hands, cover your mouth when coughing, and stay away from work if you’re unwell.

 

  • See your GP if you need to. If you’re feeling more unwell than you think you should, if you’re not getting better, or if you’re worried, the Good GP is here to help.

 

 

Get well soon or better still, don’t get unwell in the first place! How can you get healthier? Come in and find out…

 

DR NICK TELLIS

Your Specialist In Life

DR NICK MOUKTAROUDIS

DR GARETH BOUCHER

Dr Gareth’s Cycle of Care

DR PENNY MASSY-WESTROPP

Dr Penny Massy-Westropp

DR MONIKA MOY

Dr Monika Moy

DR KATHERINE ASTILL

Dr Katherine Astill 1

10 tips to stay healthy on a cruise

  1. Travel Insurance

  2. Vaccines

  3. Healthy Eating

  4. Healthy Drinking

  5. Exercise

  6. Read

  7. Good Company

  8. Wash your Hands

  9. Did I mention the Eating?

  10. Enjoy yourself!

 

 

Full disclosure : 2 time cruise attendee – still working off the extra weight

 

 

You can see any of our Great GPs right here:

Dr Gareth Boucher

Dr Penny Massy-Westropp

Dr Monika Moy

Dr Katherine Astill

Dr Nick Mouktaroudis

Dr Nick Tellis