Rounded life in rheumatology

Cate Swannell
Med J Aust || doi: 10.5694/mja17.2003C1
Published online: 20 March 2017

Dr Sharmayne Brady combines research into back pain, clinical practice providing holistic care for her patients, and a balanced family life …

DR SHARMAYNE Brady is exactly where she wants to be.

At 33 years old, Dr Brady is an up-and-coming rheumatologist, partway through her PhD, mother to a 1-year-old, married to an Ob/Gyn, about to join a flourishing private practice, and enjoying every second of life. In 5 years’ time, she’d like to be the mother of two, with a finished PhD, and more clinical experience under her belt.

It’s a good life.

“I was always going to end up in a healthcare field,” Dr Brady tells the MJA. “I always liked the idea of making a meaningful difference in peoples’ lives.”

Halfway through high school she set her sights on medicine, and it was in her third year at Monash University that she settled on rheumatology as her specialty of choice, thanks to “great experiences with mentors” in the field.

“One of the things that struck me early on was that rheumatologists all seemed to be happy,” she says. “They all had good work/life balance, and that was important to me.

“Rheumatology lends itself to a 9 to 5 workday, and there is not as much after-hours work, emergencies and procedural work as in other specialties. That struck me as being an advantage.

“Even now, as a mother, and with a husband who is an ob/gyn, we needed at least one of us to be working more reliable hours. Rheumatology definitely has more kid-friendly hours.”

After graduating in 2007, Dr Brady has stayed close to her roots at the Alfred Hospital. Shortly she will be joining a private practice in Endeavour Hills, in Melbourne’s southeast.

Also important to Dr Brady’s happiness is the ability to make research a significant part of her professional life. Her PhD, undertaken through the Alfred, is on the modifiable risk factors for back pain in women.

“Back pain affects just about everyone at some point,” she says. “The mechanisms involved are not clearly understood – why do so many people have back pain? Why are some people very disabled by it, and some people not?”

Back pain’s ability to stop someone in their tracks is infamous. Combine that with patient expectations about what doctors should do about their pain, and treatment can be a frustrating enterprise.

“There’s heavy reliance on imaging to provide the answers, and that’s eating into the budget,” Dr Brady says. “Often the images don’t correlate with the patient’s back pain symptoms.

“Patient expectations are significant. They can think that there’s something wrong with the doctor if you don’t send them off for an x-ray.”

Education and reassurance are important. So is getting the patient back into an active life.

“We’re trying to change practice,” Dr Brady says. “That slogan – ‘don’t take back pain lying down’ – that’s important. Being active provides better outcomes for patients. We’re also moving away from prescribing opioid medications. We don’t have a quick cure, but we can help people manage their back pain.”

Like many clinician-researchers, Dr Brady believes being regularly involved in research makes her a better doctor.

“Definitely. With research, you can help many people at once. In the clinic, I can help the person in front of me. Me being able to combine the two approaches is helpful to my patients, no question.”

There is a bonus with research work, she says.

“I can understand the literature better. I like being able to read an article and working out for myself what I can take from it and what to bring in to my practice.”

It’s not just the hours that recommend rheumatology as a medical career, Dr Brady believes.

“It’s an ever-changing, exciting field, that seems to be going through a particularly fertile time at the moment,” she says. “There’s a stream of new, exciting medications to become familiar with.

“In the last 5 years, there has been a tremendous increase in the number of drugs being studied and given PBS approval, which is very good for patients. It’s very satisfying to be able to offer them so many choices in treatments.

“One of the beauties of rheumatology is that it is a field that isn’t restricted just to one organ, or structure. We have the ability to treat someone holistically, and that’s very gratifying.”

  • Cate Swannell



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