12 DECEMBER 2025 2 NEWS ausdoc. com. au
12 DECEMBER 2025 2 NEWS ausdoc. com. au
Code of silence on GP isotretinoin prescribing
ANALYSIS Heather Saxena
IT is one of the big issues in medicine, an issue that touches directly on the scope of practice of GPs.
Following an application by the RACGP, a TGA committee is about to decide whether to expand prescribing rights for isotretinoin to GPs with additional training.
The college has argued that living with significant acne has psychological harms for patients, but treatment is hard to access as it is restricted to physicians and dermatologists.
With issues like this, there are usually two sides, so a few weeks back Australian Doctor approached the Australasian College of Dermatologists for its view.
There seemed to be plenty to discuss: the drug’ s teratogenicity and continued debate over whether it has a link to depression and suicidal ideation, and, with that, the potential risks of GP prescribing. The response was not particularly informative. It mentioned how it shared concerns about access but stressed“ any changes to expanding prescribing rights must be balanced carefully against the potential for patient harm”. Yes, obviously. However, the spokesperson said the college would outline its position“ in further detail” via the TGA’ s public consultation on the RACGP proposal. Still, it was“ not comfortable” sharing until after the closing date for submissions. This date was 17 October. After 17 October arrived, Australian Doctor contacted the college again for a copy of the submission. We were told that this would not be possible, but that the college was“ happy to engage further … once we have an update to share”.
Eventually, after more questions, the college revealed it had in fact reached“ a mutual
agreement with the RACGP to refrain from public commentary while the TGA process is underway”.
Given the importance of informed public debates about any issue touching on patient safety— and the need for medicine to embrace openness and transparency— this seemed slightly strange.
Remember the TGA decision to upschedule codeine to prescription-only a decade ago: a decision debated at incredible length in the medical press and across the front pages of daily newspapers, with the RACGP in the thick of it.
Asked about this apparent agreement to keep silent, and not promote its own proposal, we expected a full response from the RACGP. But it refused to comment.
So when will we find out what the dermatology
It has argued that living with significant acne has psychological harms.
college thinks about GP prescribing?
If we are dependent on the TGA publishing the college’ s submission— the regulator usually publishes most of the submissions it receives— this will likely not occur until the Advisory Committee on Medicines Scheduling is about to make its decision or has made it.
An interim decision is not due for release until February 2026.
The dermatology college said its arrangement with the RACGP would“ enable both colleges to continue to meaningfully engage”. But given we do not know whether the college is for or against GPs prescribing isotretinoin and the reasons why, meaningful engagement for everyone else seems difficult.
Is this the open society?
Professor Michael Kidd’ s plea
Jamie Thannoo THE chief medical officer has branded Australia’ s congenital syphilis rates unacceptable following his decision to declare syphilis a communicable disease incident of national significance.
Between January 2023 and August this year, doctors reported 41 cases of congenital syphilis and 18 related deaths.
In a heartfelt speech at the RACGP’ s annual conference in Brisbane in November, Professor Michael Kidd said his choice to make syphilis a communicable disease of national significance was one of his first major decisions since taking over as chief medical officer in August.
“ Please, every time you see a person who is pregnant, please ensure that they are receiving antenatal care and the three syphilis tests which are now recommended as a standard during pregnancy,” he added.
“ It’ s unacceptable that, in this country at this time, babies are dying from congenital syphilis or being born with totally preventable and devastating disabilities.”
The former RACGP president said the new disease status meant more resources being allocated to increasing the number of patients receiving antenatal care.