- Where are your practice locations?
- What are your business hours?
- Can x-rays be done in your rooms?
- Do I need a doctor’s referral to make an appointment with Professor Kohan?
- What are your fees?
- What are your accepted payment methods?
- Do I need Private Health Insurance?
- What should I bring to my first appointment?
- What hospitals does Professor Kohan operate at?
- When is the best time to have surgery?
- Why is it important to have an empty stomach prior to surgery?
- Can I smoke cigarettes before my surgery?
- Will I be in pain after surgery?
- Will physiotherapy be required after surgery?
- Privacy & Confidentiality of your medical records
- What is the National Joint Registry?
1Where are your practice locations?
The Bondi Junction office offers Professor Kohan’s main consulting rooms and the clinic administration.
Level 2, 99 Spring Street
Bondi Junction NSW Australia 2022
Ph: 02 9387 2877
Fax: 02 9387 5557
- Closest cross street: Bronte Rd
- Closest Parking Station: Eastgate Shopping centre (approx 100m from the office)
- Closest Train Station: Bondi Junction (approx 200m from the office).
Leichhardt Consulting Rooms
The Leichhardt office offers the patients in the western areas of Sydney easier access.
32 Norton Street
Leichhardt, NSW Australia 2040
Ph: 02 9560 8272
Fax: 02 9387 5557
- Closest cross street: Parramatta Rd.
- Closest parking: Station across the road from the office in the Forum. Entry via Norton St.
All correspondence: PO BOX 240 Bondi Junction, NSW 2022
2What are your business hours?
Our offices are open 8:00AM to 5:00PM. Monday through Friday (except holidays).
Appointments can be made by calling the rooms on 02 9387 2877 during office hours.
Professor Kohan consults at the Bondi Junction Rooms:
- Alternate Monday’s: 8:00AM – 5:00PM
- Every Tuesday: 8:00AM – 11:00AM
- Every Wednesday: 8:00AM – 5:00PM
- Three Friday’s out of the Month: 8:00 AM – 5:00 PM
Professor Kohan consults at the Leichhardt Rooms:
- Every Tuesday: 12:30PM to 5:00PM
3Can x-rays be done in your rooms?
There is an X-Ray centre walking distance from the Bondi Junction consulting rooms.
Bondi Junction Imaging Centre
Crn Spring & Bronte Road Bondi Junction, NSW 2026
Tel: 02 8305 7760
4Do I need a doctor’s referral to make an appointment with Professor Kohan?
The Orthopaedic Centre is a Specialist clinic so patients do need referral from their General Practitioner, family physician or other doctor to make an appointment with Professor Kohan.
Referral letters from a GP or Specialist will allow you to claim the medicare rebate for the consultation.
You can make an appointment without a referral HOWEVER you will not be able to claim a medicare rebate for the consultation fee or surgical fee.
5What are your fees?
The following is a guide to the fees charged by The Joint Orthopaedic Centre. Please do not hesitate to contact our staff on 02 9387 2877 if you require further information or assistance.
Generally our ‘Estimate of Fees’ is accurate however, on occasion unexpected events can occur during the operation which can alter the nature of procedure and necessitate changes in the fees. This will be explained to you after the operation should it occur.
Estimate of Fees
- Consultation Fees
Each consultation attracts a fee which is reimbursed in part from Medicare. The consultation fee will be advised to you at the time of booking your appointment.
Upon payment, you will be given a receipt so that you can claim part of the fee back from Medicare.
- Operation Fees
If you require a surgical procedure a detailed outline of Professor Kohan & his surgical team’s fees will be provided as well as an estimate of out-of-pocket expenses. You will meet with Dr Kerr, the anaesthetist before your operation so that you can obtain an estimate of his fees also.
Procedures vary in complexity, difficulty and duration and these are all factors that determine out-of- pocket expenses. Please check with your Private Health Insurer regarding whether an excess is payable to the hospital under your level of cover.
Please note: as with any surgical procedure there may be unforeseen circumstance in theater that changes the duration of your operation or type of procedure performed. These changes although rare would change the nature of your surgery and may impact on the final cost of your operation.
- Workers’ Compensation
If you have your claim number, your consultation and operation fees will be charged directly to your workers compensation insurer with no personal charge to you.
- Veterans’ Affairs (DVA)
If you have a valid DVA number, your consultation and operation fees will be charged directly to the Department of Veterans’ Affairs with no personal charge to you.
- Health-Care Financial Terminology
The Medicare Benefits Schedule (MBS) is a list of medical services subsidised by the Australian Government. Each service covered by the schedule has an Item Number. The MBS details how much Medicare will pay for each Item Number.
The Medicare Schedule Fee is what you can expect Medicare and your Private Health Insurer to pay for a particular Item Number.
A gap is the difference between the Medicare Schedule Fee and the fee charged by the doctor. It represents an ‘out-of-pocket’ expense for the patient.
No Gap (or Gap-cover) is an agreement between private health insurance companies and medical specialists whereby the health insurer covers the cost of the service with no out-of-pocket expense to the patient for the doctor’s fees.
The AMA Schedule is a list of recommended fees for medical services published regularly by the Australian Medical Association (AMA). These fees are generally higher than the MBS.
A Medical Item Number is a code which identifies a particular medical service. These numbers are used when generating accounts for patients, Medicare and insurance companies. A single operation may involve a number of different item numbers. If you need an operation, the relevant item numbers will appear on your “Estimate of Fees.”
6What are your accepted payment methods?
We accept cash, personal cheque, bank cheque, money order, VISA, MASTERCARD or EFTPOS
7Do I need Private Health Insurance?
If you wish to be treated in a private hospital, having private health insurance pays for your hospital, theatre and implant costs. It also helps fund your surgeon, anaesthetist and assistant’s fees. If you wish to be treated in a private hospital without health insurance then you will have to entirely self-fund your hospital stay.
Please note that Professor Kohan performs all his elective surgery in a private hospital only.
8What should I bring to my first appointment?
At your first appointment Professor Kohan will take a thorough history and perform a detailed examination of the hip and/or knee joint(s) to determine the impact your condition is having on your everyday life. You may be referred for further X-rays, an MRI or other tests to confirm the diagnosis.
To ensure that your first visit to see Professor Kohan is of maximum benefit, please remember to bring the following:
- Referral letter from your family doctor
- An up to date list of any medications you are on
- Any relevant operation records (in particular planned or past dental procedures) or physiotherapy reports
- Any relevant old or current X-ray films, bone-scans, MRI films or other relevant tests
- Contact details of your Cardiologist (if applicable)
- Wear clothes that will allow easy access to the affected joint during the clinical examination
- Your Medicare card and Private Health Insurance details
- Your current pension card if you are a pensioner
If your condition/injury is work-related, please bring your workers compensation details including your claim number, insurer, and case manager’s contact details.
9What hospitals does Professor Kohan operate at?
St Lukes Care Hospital
18 Roslyn St Potts Point NSW 2011
Prince of Wales Private Hospital
Barker St, Randwick NSW 2031
The Mater Hospital
25 Rocklands Rd, Crows Nest NSW 2065
Dalcross Adventist Hospital
28 Stanhope Rd, Killara NSW 2071
East Sydney Private Hospital (ESPH)
75- 85 Crown Street Woolloomooloo, NSW 2011
10When is the best time to have surgery?
This is probably the most frequent question asked by patients. There is no set time. For each individual patient, the decision that “something must be done”, is a decision that comes more from the heart than from the painful joint. However, there is no doubt that for each patient, when that time comes, the decision is accompanied by a level of certainty that leaves the patient in no dilemma that further treatment, a new level of treatment, is required.
The decision is the result of a combination of factors, including pain, limitation of function, and stiffness, all leading to a loss of quality of life.
While this development may take a long period of time to come about, often many years, once this trigger point has been reached, the level of suffering, and the progressive loss of quality of life needs to be addressed. It is at this stage that the option of joint replacement surgery is explored. My advice to most patients is that, “when the time is right, you will know”.
For most patients who develop osteoarthritis, symptoms can be managed for some time with non-operative measures. If this is enough to control the discomfort and to allow a reasonable quality of life to be pursued, enough for the patient’s needs, then surgical intervention is not a consideration. When the symptoms are too severe its time to seek advice from an orthopaedic surgeon.
11Why is it important to have an empty stomach prior to surgery?
You will be asked to fast from food and fluid before your procedure so that you have an empty stomach. This is because whilst under anaesthetic your body’s normal reflexes are relaxed. Therefore there is a risk that your stomach contents could enter your windpipe or lungs which can cause significant complications.
12Can I smoke cigarettes before my surgery?
It is important to avoid cigarettes for as long as possible before and after your operation, particularly the day of your operation. This will help reduce surgical and anaesthetic risks and help you have the best possible results from your surgery.
The nicotine in cigarette smoke increases your heart rate and blood pressure, making your heart work harder so that it needs more oxygen. Carbon monoxide in cigarette smoke competes with the oxygen in your blood. This makes it harder to get the oxygen you need for your heart and body. Chemicals in cigarette smoke make your blood thicker, stickier and more likely to clot.
If you continue to smoke, you will be more likely to:
- starve your heart of oxygen
- form blood clots in your veins
- have difficulty breathing
- increase you risk of infection
- impair the healing of bones, skin and wounds
- change the breakdown of certain drugs in your body
Quitting smoking completely is the only way to reduce surgical risk and ensure you are giving yourself the best possible outcome from your procedure.
13Will I be in pain after surgery?
Post-operative pain is one of the major outcomes of surgery and relief of the patient’s distress is an important goal in its own right. Severe pain often leaves the patient permanently scarred and terrified of even minor surgery.
Meticulous pain management is pivotal in achieving acute rehabilitation.
Our objectives are:
- No pain or low levels of discomfort for the entire peri-operative and convalescent period.
- Side effects limited or reduced to negligible levels.
- Acute rehabilitation and early discharge.
The Joint Orthopaedic Centre have developed a multimodal technique for the control of pain following knee and hip surgery, called The Kohan-Kerr “Local Infiltration Analgesia Technique” (LIA).
LIA is based on systematic infiltration of a mixture of ropivacaine, ketorolac, and adrenaline into the tissues around the surgical field to achieve satisfactory pain control with little physiological disturbance.
The technique allows virtually immediate mobilization and earlier discharge from hospital. It places meticulous pain management at the centre of immediate post-operative care and it is central to achieving our stated goals.
LIA adopts three pathways:
- The first pathway, involves the establishment of an effective local anaesthetic block at the time of the operation (The LIA Kohan-Kerr Technique). In essence, we try and numb all the parts which have been operated on and which may generate pain. After the operation the area involved usually feels numb. This is a feeling similar to that experienced at the dentist when a local anaesthetic injection is given
- The second pathway involves oral medications. These are prescribed to try and improve the pain control. Injections are also available if required
- Postoperatively, a pain controlling skin patch may be applied, which also contains a slow release analgesic
We have found this process to be extremely effective at controlling pain. We cannot say that you will have no pain, but rather, that manageable discomfort will be present. We aim for the discomfort not to reach a level, which would interfere with your ability to mobilise effectively.
14Will physiotherapy be required after surgery?
Major surgery on a joint may take two or three hours in the operating room. Getting full range of motion, strength and flexibility back in that joint after surgery usually takes months. That’s where pre-operative exercise and education and post-operative physiotherapy programs come in – to ensure you’re physically and emotionally prepared for surgery, and to maximise your recovery after surgery.
Together, such programs are among the most important determinants in the success of your surgery.
15Privacy & Confidentiality of Medical Records
The provision of quality health care requires a doctor – patient relationship of trust and confidentiality. Consistent with our commitment to quality care, The Joint Orthopaedic Centre follows a policy to protect patient privacy in compliance with The Australian Medical Association (AMA) Code of Ethics.
16What is the National Joint Registry?
The Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) was established in 2002 to improve and maintain the quality of care for individuals receiving joint replacement surgery.
Information on hip, knee, shoulder, elbow, wrist, ankle and spinal disc replacement is collected from all hospitals in Australia undertaking joint replacement surgery.
The AOANJRR is entirely funded by the Commonwealth Department of Health and aims to improve and maintain the quality of care of individuals receiving joint replacement surgery.
Your personal information is confidential and cannot be used outside the Registry. Procedures are in place to protect your information and to keep it confidential. When your details have been entered into the Registry your record will be given a specific Registry number. In addition you cannot be identified in any reports produced by the Registry.
There are no risks to you by having your details in the Registry. Your information is protected and the AOANJRR is not allowed to identify you by law. The Registry will produce general reports on a variety of factors that influence the success of joint replacement surgery. This will improve the quality of future joint replacement surgery.