Multidisciplinary Ambulatory Consulting Service (MACS)

The Multidisciplinary Ambulatory Consulting Service (MACS) provides care to patients living with chronic conditions including hypertension, diabetes, heart failure, arthritis and lung diseases. 

MACS combines evidence based clinical guidelines, patient centred practice and a shared care approach with general practitioners to enable patients to optimise their health and wellbeing and reduce hospital admissions. Types of patients we see include:

• frequent acute exacerbations of chronic conditions, that potentially results in emergency presentations and /or hospital admissions
• patients with complications related to polypharmacy
• young adults transitioning from paediatric chronic care management to the adult system.
• When treatment of one condition affects the treatment of another
• patients who are experiencing suspected Long COVID syndrome, when symptoms have not resolved after 12 weeks.

The Clinical Pharmacology Department/MACS are located on Level 8 of the RAH. 

Outpatient appointment locations

Ground Floor
18 North Terrace (building opposite side of the road to the RAH)

CALHN East
137 East Tce (entry through door to the right of the premises)

MACS is a multidisciplinary service consisting of physicians specialising in medication management, nursing, pharmacists, and a psychologist supporting patients who are at risk of being hospitalised from their chronic conditions, including, but not limited to, patients with polypharmacy and multiple chronic conditions.

You need a referral letter from your GP or medical practitioner to access this service. 

Once referred, we will contact you within clinically recommended times, depending on the waiting list length. If there is no waiting list, you will receive an appointment booking letter, or we will contact you to arrange a suitable time.

MACS clinics can provide you with access to a team of health care professionals who will work through your health concerns and problems with you. 

The team may include senior doctors (consultants and senior registrars) who specialise in different areas of medicine, a registered nurse, specialist nurses, and a pharmacist. Your individual needs will be assessed by the team and, in consultation with you and your general practitioner (GP), they will develop a management plan. 

By attending the clinic you will benefit from:

• understanding more about managing your condition
• understanding more about the medications you take
• knowing how to manager yourself if your symptoms get worse
• knowing when to see your GP if symptoms get worse
• knowing more about your illness.

The aim is to keep you well, improve your quality of life and keep you out of hospital.

• Limbs 4 Life
• The national Disability Insurance Agency (NDIA)
• Polio Australia
• MACS Clinic pamphlet for young people transitioning from the WCH to RAH (PDF 1MB)

We accept GP and specialist referrals to this service. 

eReferrals preferred. Alternatively, fill out the referral form and send a copy via email or fax.  

Named referrals are accepted. Please state the reason for referral.

Comprehensive referrals including medications and a problem list assist with triaging

• Triage categories include:
  • Immediate appointment (please call if the referral is urgent)
  • Category 1 (<4 weeks)
  • Category 2 (1-3 months)
  • Category 3 (>3 months)

Bulk bill clinics: (named referral / or colleague required) eg Dr Rami Tadros or colleague

• Dr Sepehr Shakib
• Dr Rami Tadros
• Dr Josephine Thomas
• Dr Tam Le Cong
• Endocrinologist (please phone the clinic number for the Dr ‘s name)
• Cardiologist (please phone the clinic number for the Dr ‘s name)

Patients that have one or more of the following:
 

• medication optimisation and or review of medication related complications
   
• require medical management due to multimorbidity
• would benefit from holistic care management with multidisciplinary input
   
• coordination of care, as they see multiple medical specialists and would benefit from case management.
• further health education and support for effective self-management.
   

Some examples of the type of patients we see, include:

• frequent acute exacerbations of chronic conditions, that potentially results in emergency
• presentations and /or hospital admissions
   
• patients with complications related to polypharmacy
   
• young adults transitioning from paediatric chronic care management to the adult system.
   
• When treatment of one condition affects the treatment of another
   

For patients in residential care facilities please contact our team directly to discuss the most suitable follow-up options which may include discussion with other services.