1 February 2024
Q&A with Dr Kathleen Tymms AM
Rheumatologist and Clinical Associate Professor Kathleen Tymms was appointed Member of the Order of Australia (AM) for significant service to rheumatology and to professional associations in this year’s Australia Day honours list.
Following her medical degree at the University of Tasmania in the 1970s, she moved to Canberra as an intern in 1977. There she met her mentor, Dr Andrew Brook, who inspired her to become a rheumatologist.
Working with adults and children in Canberra since then, she also runs a two-day monthly clinic at surrounding south coast NSW.
Now aged 70, though with no immediate intention of retiring, Dr Tymms talked to us about her career thus far and what the AM award means to her.
As a junior resident medical officer in Canberra Health Services, I really liked the rheumatology term. I knew I wanted to be a physician, and they rotated us through different terms. I got to the rheumatology term, and Dr Andrew Brook was there. He was the first rheumatologist in Canberra and a wonderful man. He told me that finding a job and falling in love with that job was a key to happiness. And I just knew that rheumatology was the one thing I wanted to do and specialise in.
What areas do you specialise in?
I have been giving care to adults and children with predominately inflammatory and autoimmune rheumatic conditions for 40 years.
I really have liked looking after the children. Some of the children that I started looking after in the late 1970s are now in their 40s so transitioned and still are with me.
I was a bit worried, as I was getting older, that they would have difficulty replacing me in the hospital paediatric rheumatology clinic, so I gave notice and stopped consulting at this hospital clinic in December 2021, and took all the children involved to the rooms. However, in December 2023 the hospital appointed a visiting paediatric rheumatologist from Sydney, so I’m very pleased about that.
Some of the professional associations you’ve served include the ARA, Arthritis Australia ACT and the Scleroderma Association of NSW. There is also the Haemophiliac Foundation of Australia – what was your interest there?
Haemophiliacs get joint problems – they bleed into their joints. Every six months, there is a combined hospital meeting which the haemophiliacs attend. So, the haematologist involved asked if I could just come and give musculoskeletal advice with a physiotherapist. I did that for many years, though I did stop that about three years ago, because the hospital rheumatology department got so busy. But some of the haemophiliacs still come to the private rooms, which is nice.
What are the biggest changes in rheumatology treatment you’ve seen over the last 40 years and what would you hope to see in coming years?
There’s been a huge difference since 2003 in Australia with the advent of subsidised biological drugs. They’ve changed people’s lives so much. Before 2003 my patients with inflammatory arthritis were getting crippled. It was terrible. But really, since 2003, particularly if patients first developed their condition not long before 2003, you can stop or minimise joint damage and disability. That’s been amazing to experience.
New drugs continue to be developed, and we’d like to have a cure for many rheumatic conditions. Our scientists must at some stage work out the pathophysiology well enough to have a vaccine or a cure. I don’t see why not, because although there’s genetics involved, there also seems to be one or more triggers to each of the inflammatory arthritides setting off inflammatory pathways which are then blocked. So I’d love to see a cure for inflammatory arthritis in my lifetime.
And I feel so sorry for osteoarthritis patients. It’s so common, and we still do not have drugs to change the course of it, to stop it or slow down. So to me, unlike rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis or juvenile arthritis, I feel a little uncomfortable if I’m referred someone with osteoarthritis, because I’m advocating good lifestyle measures, allied health involvement and as needed, send some to the surgeon. I’d just love disease modifying anti-osteoarthritis specific drugs.
You have an interest in scleroderma – what do you think about some of the more recent developments in treatment, such as stem cells and CAR T cells?
Stem cell transplant is still a worry for me because in some centres 15% can die going through the procedure. So I do not refer many people for a stem cell transplant unless I think they will otherwise die.
But with the CAR T cells, that’s exciting and promising and is a reason I do clinical work with scleroderma patients and stay linked with the Australian Scleroderma Interest Group based in Melbourne. They have been great at producing Australian research and combining with other groups around the world.
What do you see as the challenges ahead for rheumatology?
As we all know, there’s a shortage of rheumatologists. Older rheumatologists are starting to retire, and not enough younger people are coming in. My workload is increasing, even though I try not to take many new patients because I’ve got 40 years of accumulated patients to continue looking after. In Canberra we need probably another five rheumatologists now. Then in the rural/regional country area some rheumatologists visit to consult, but hardly anyone lives and works there so patients have to travel long distances to see a rheumatologist.
You’ve been involved in teaching at the Australian National University since 2006. Are you seeing more interest in a potential rheumatology career from your students?
They seem to enjoy the lectures/tutorials; they ask lots of questions. Career wise, they probably start to make up their life direction as an intern, so I think we really have to get them inspired by first year out, get them interested and try and involve them in projects as well – before someone else interests them in another specialty!
What are some of your career highlights?
Looking after children has been a career highlight, as mentioned, and that they’ve transitioned with me into adulthood. Looking after someone from about two into their 40s, that’s been good. Also the big change since 2003 has been that children are rarely getting damaged joints because of the biologic and new drugs being used and the strategies how we use them.
I’ve enjoyed the predominately patient-centred clinical research I have been involved with which I believe has optimised patient outcomes for rheumatic conditions.
Supervising many advanced rheumatology trainees including a PhD student has been always stimulating.
The Australian Rheumatology Association has been always supportive with great colleagues and friends. Being given in 2014 the Distinguished Service Award was an honour.
Can you tell us about your interests outside of work?
Mmmh, what perhaps different to other folk? Corgi dogs. I’ve had corgis all my life. I’ve had seven corgis, currently have two and a new puppy!
Photo supplied by Dr Kathleen Tymms
What does the AM mean to you?
I love my work, so to me it’s not a service. Rheumatic and musculoskeletal conditions are interesting. I also enjoy seeing my patients and sharing what is happening in their lives. This AM is also shared recognition for those working in the field and those living with these conditions.