AusDoc 19th Sept | Page 15

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Trapped in a dysfunctional membership
Nice guys finish last in aged care
ausdoc. com. au 19 SEPTEMBER 2025

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VIEWS FROM YOUR ONLINE COMMUNITY

believed that the college represented

Airing their dirty scripts in public

excellence in the care its members provided to the community, that it had a mission.
It is distressing to learn that egodriven dissent has reduced it to a typical modern political entity.
Is patient privacy not a thing in pharmacies?
Dr Ludomyr Mykyta Retired doctor, Adelaide, SA
Pharmacists do have an important
role, but let’ s be honest, the retail model puts profits for owners ahead of patient welfare.
Confidential consultations are happening in public spaces, records are questionable and

Cheque, please, AHPRA!

pharmacists themselves often don’ t seem fully aware of their professional responsibilities.
If a GP did this, they would be in front of AHPRA immediately.
Maybe the only way change will come is if these pharmacy‘ consultations’ start being reported— because privacy and accountability in healthcare aren’ t optional extras.
Dr Alan Tse Anaesthetist, Melbourne, Vic
I’ ve witnessed these public consults many times and, on one occasion, felt I had to step in— both with a suggestion of privacy and the correct medical advice.
I felt a bit awkward doing it, but I just couldn’ t let it go.
I was also approached by some pharmacists to help them‘ train’ by running through case studies with them.
No formality, no insurance and no remuneration, but they would“ buy me a coffee”.
I thought perhaps my time would be better spent seeing patients in my surgery and making sure they got advice and treatment based on a proper medical degree and years of experience.
Dr Siobhan Wills GP, Sunshine Coast, Qld
I love this article. I am always horrified to see people walking to the check-out desk from the dispensing area with their packets of Prozac or Viagra, so everyone knows exactly what is going on in their lives.
It is hard in small towns, especially where you usually know the check-out kid because they live on your street.
Dr Penelope Figtree GP, Port Macquarie, NSW
I’ m not against pharmacists( or any other allied health discipline for that matter) expanding their scope of practice if appropriate. But two things have long concerned me. I, too, have observed the appalling lack of privacy while waiting in pharmacy queues, where patients are grilled loudly about their symptoms.
If I did this in my own waiting room, I would expect a call from
the complaints unit sooner rather than later.
Then there is the indemnification for the advice and treatment provided. All doctors pay a very high level of indemnity insurance and know that other disciplines do not. The traditional indemnity providers have been happy to maintain the status quo because there is no incentive for them to argue for saving the premium burden with other discipline insurers.
But if pharmacists are treating, they should be taking the appropriate level of indemnity risk as well.
Professor Simon Willcock GP, Sydney, NSW

Getting a little long in the stethoscope?

I miss the days when patients told me I was too young to be a doctor
The greys have officially clocked in, and it’ s been a solid five years since anyone mistook me for a medical student fresh out of uni.
Hitting my 40s has flipped my world view in ways I didn’ t see coming, as it turns out I was only pre-wisdom before.
I still chase that youthful spark, even if the mirror insists that I’ m more‘ seasoned specialist’ than‘ fresh-faced intern’. The years may show, but hey, at least the stethoscope still fits.
Dr Divya Kannan GP, Darwin, NT
Most of my patients are anxiously asking how soon I am going to retire!
Dr Paul Webster GP, Port Macquarie, NSW

An unhealthy focus on diagnosis

’ NDIS reforms must end the culture of cash for diagnosis’
I agree with the problems raised about diagnosis-based assessment. The National Disability Insurance Scheme( NDIS) was supposed to be about disability and getting supports to help people lead dignified lives.
In my work with people experiencing homelessness, there are many individuals with very highlevel functional and cognitive disability who need specialised supports to get them housed durably, but they fail to get any NDIS funding because their disabilities are so multifactorial and accumulated across a lifetime of poverty, trauma and disadvantage.
This makes it impossible to make a precise diagnosis, even if we could get these individuals to complete a series of complex tests.
If someone has spent a decade rough sleeping, drinking heavily, getting head injuries from assaults and falls, probably never living in an actual house and potentially experiencing fetal alcohol spectrum disorder, how can a tidy diagnosis be made?
These severely disabled people get nothing from the NDIS and rot on our streets.
Dr Amanda Stafford Emergency doctor, Perth, WA
This article echoes many of my own concerns.
The issue is, if the NDIS provides treatment cover, then treatment for what? Not every symptom is diagnostic. And not every diagnosis requires intensive treatment.
I have specialised in the neurodevelopmental area for 35 years. The biggest issue I see is that there are
too few clinicians with experience to determine who and what requires treatment because too many offer diagnosis only.
Diagnosis by questionnaire is simplistic, and understanding what requires treatment involves taking the time to explore contexts.
There are primary and secondary symptoms, and the secondary symptoms( part B of DSM-5) are broad and really just comorbid( and not diagnostic).
Social media has turned these into the focus with a need for treatment, along with a demand for diagnosis and funding. It cannot go on indefinitely.
Derek Cohen Psychologist, Perth, WA

Trapped in a dysfunctional membership

The RACP’ s leadership needs life support as toxic culture tears it apart
The governance of the Royal Australasian College of Physicians is a disgrace and an embarrassment. The duty of an incoming elected official is to ensure they have cultivated positive relationships with staff and colleagues and to ensure they are acting in the best interests of the members. As a very reluctant and weary member, I fail to see how any of this is in my interest, and honestly, at this point, if I could make a living without the shame of holding membership of this terminally dysfunctional organisation, I would.
Associate Professor Michael Vagg Physician, Geelong, Vic
I am a retired life member of the college.
Becoming a member many years ago was a proud milestone. I
The 2687 hours spent escaping AHPRA’ s registration portal: AusDoc survey results
What a ridiculous roundabout. The AHPRA site said I needed a new password. A new password could be acquired by logging on to the website. But that needed a password.
Finally, I conceded I needed help and phoned AHPRA. After triage through the phone-automated process, I spoke with a helpful person who emailed me what I needed. It( only) took about 90 minutes of my life.
Retirement looks ever more attractive. Thank you, AHPRA. Yet again, I’ m not feeling the reciprocity of respect.
Dr Elizabeth Grey GP, Bicheno, Tas
I gave up and emailed them a request to mail me an invoice so I could send them a cheque.
Dr Paul Fitzgerald GP, Kettering, Tas

Nice guys finish last in aged care

’ Medicare trip-wires and quicksand’: GP stops seeing patients in aged care
I completely concur with Dr Nick Tellis’ experiences.
The new aged care incentive is less than transparent, inefficient and not sustainable. For practices that have registrars, it’ s not conducive to teaching aged care work.
I missed out on payments because the system was not able to identify that my registrar was the doctor providing the services in their very complicated system.
These are now being taken up by doctors who only provide services to aged care with various ways to‘ game’ the system.
For genuine GPs, it’ s a souldestroying exercise.
Charge a private fee for those who can afford it, and get out of the disincentive program.
Dr Aline Smith GP, Sydney, NSW