Which doctor?—Dr Malcolm Davison

Dr Malcolm Davison is a cardiologist whose specialist interest lies in ischaemic heart disease, valvular heart disease, echocardiography, stress echocardiography and coronary angiography. He is located on Level six, Mater Medical Centre, 293 Vulture Street, South Brisbane. His rooms can be contacted by telephoning +61 7 3163 1700.

What is your training and experience?

I graduated from The University of Queensland in 1981. I then joined Mater Adult Hospital as a medical intern between the years of 1982–1984 and then a medical registrar for a period of two years (1985–1987). I competed my advanced training in cardiology at The Prince Charles Hospital (1988–1990). I then moved to The Cleveland Clinic Foundation USA in 1991 to complete my sub-specialist training in echocardiography. From 1991 until 2001 I was a staff cardiologist at Mater Adult Hospital (1991–1996) and The Prince Charles Hospital (1991–2001). It was also in 1991 that I commenced my private practice consulting in cardiology.

Why did you choose to specialise in your area of specialty?

The 1980s were a most exciting time in cardiology. Before the early 1980s cardiologists largely observed cardiac disease and had little capacity to alter disease progression. Few therapies were available and most diseases progressed rapidly towards their conclusion. Suddenly, there was a remarkable confluence between a rapidly advancing arsenal of pharmacologic therapies (thrombolytic, anti-platelet, beta blocker, ACEI, Statin therapies), revascularization options (thrombolytic, PTCA, CABG), and remarkable diagnostic tools (echocardiography, trans-oesophageal echocardiography, angiography, electrophysiological studies). Furthermore, this was the beginning of the era of the first landmark, worldwide multi-centre clinical trails which led to an amazing growth of clinical knowledge.

All this created an unparalleled realization that for the first time, very significant and sustained benefit could be achieved for the majority of patients with heart disease, that previously might have seemed miraculous and unattainable. As a medical registrar at that time, it was impossible not to be swept up in the enthusiasm. I particularly was intrigued by echocardiography and frequently “played” with the only available machine at Mater Adult Hospital—a retired M-mode scanner (single dimension scanner). Looking back, it remains remarkable that such primitive machines spawned the marvellous devices available today. So I think cardiology found me, not me it! Luckily, it still has that “wow factor” for me.

What is the most interesting/exciting area of your work, and why?

The ability to precisely and non-invasively diagnose cardiac conditions remains the most exciting part of my practice. Today, a thorough clinical evaluation backed up by appropriate imaging tools, rarely leaves room for any diagnostic surprises, so that patient and doctor alike can have supreme confidence in both the diagnosis and the ensuing therapy. In particular, the growing applications of echocardiography (transthoracic echocardiography, trans-oesophageal echocardiography, intra-operative echocardiography, stress echocardiography, contrast echocardiography) have transformed clinical cardiology, and continue to provide me with significant personal satisfaction as the technology is applied to my patients. Perhaps, once the joy and excitement of my work lay in one's capacity to manage an acute medical problem.

Perhaps strangely, I now find that the greatest pleasure comes from the relationships that have developed over many years and even decades of managing patients with stable yet slowly progressive disease. If you don't like people, cardiology is not for you. These days, your patients tend to survive a long time!

What has been your greatest professional achievement so far?

I don't recognise any single milestone or specific achievement. I think the fact that I still love what I do, despite the stress, the hours, the call ins, the phone calls in the middle of the night and the rising expectations of patients and the community, it is the greatest professional achievement of my career so far. I hope it remains so.

What is the most challenging thing about working in your specialty?

The hardest part of my work is not the medicine. Generally, that's the easy part. The most difficult aspect is in being able to adequately communicate very complex medical issues to the patient, who may be in denial, or may be resistant, biased, misinformed, medically ignorant, frightened, or feeling coerced and manipulated. So deciphering just what is the patient's special needs, beyond just the “science”, is for me the “art” of consultative medicine. This I continue to work towards perfecting. On a more personal note, the challenge to find the right balance between commitment to one's work and patients, and to one's family and personal needs remains the “holy grail”. As I walk the hospital wards late at night, I am impressed by how few of my colleagues have managed to achieve the balance.

Do you have a passion besides medicine? If yes, what is it?

My family, skiing, boating, and fast cars (driven slowly and sensibly I might add).