NEWS 5
ausdoc. com. au 19 SEPTEMBER 2025
NEWS 5
Privileges of the profession?
Professor Kwame Anthony Appiah.
FRONTEIRAS DO PENSAMENTO / CC BY / bit. ly / 46aLhcB
Dr Ranjana Srivastava.
Dr Michael Steiner.
Dr Ranjana Srivastava discusses the dilemmas of professional courtesy.
Carmel Sparke A GENERATION ago, offering a professional courtesy— say providing advice or free healthcare to doctor-patients and their families— was commonplace and largely unquestioned.
But we live in different times, where the ethics can get complicated.
The topic was raised last month by Melbourne oncologist Dr Ranjana Srivastava, who wrote about the times she had leant on colleagues when her family were sick.
In one case, she drove past two children’ s hospitals so her three-year-old son with urinary retention could be seen at her own institution.
There she was met by the emergency doctor and eventually sent home with an“ in-and-out catheter” as well as reassurance from a paediatrician.
Another time, her father was taken by ambulance to her hospital after collapsing. He underwent the usual triage, but later that night was visited by the head of cardiology, who offered reassurance.
More recently, Dr Srivastava’ s mother was in acute pain. Dr Srivastava phoned a surgeon who diagnosed the problem and advised staying at home rather than
undertaking a hospital dash.
“ For a worried parent to have immediate access to paediatricians. For a worried daughter to have specialists as friends,” Dr Srivastava wrote in her column in The Guardian.
“ You would have to be possessed of a special kind of imperviousness to not admit the privilege of this position, especially in an era of fragmented healthcare and long waitlists.”
Her reflections had been prompted by a letter to philosopher Professor Kwame Anthony Appiah, in The New York Times, about a woman whose ED ordeal for a fall only lasted 70 minutes, rather than the more typical five hours, owing to her being the mother of a doctor.
In Dr Srivastava’ s own case, she said she was comfortable that her actions had not compromised any other patient’ s care.
She also said that in the numerous doctors’ chat groups, requests for favours on behalf of a( non-doctor) patient far outweighed professional courtesy asks.
“ If you have a doctor in your family, you are privileged. But if you don’ t, rest assured, we have your back,” she told Guardian readers.
Back in 2021, Australian Doctor wrote about another doctor with ethical
‘ If you have a doctor in your family, you are privileged.’ concerns— Dr Michael Steiner.
But in this case, the chair of AMA NSW’ s ethics committee was worried professional courtesies were fast disappearing but needed to be preserved, arguing that the tradition of waiving fees for other doctors was a mark of professional respect.
“ All medical practitioners have a responsibility to look after the health of colleagues,” he said.
“ It’ s also not about money, but about showing mutual respect for one another’ s commitment, training and expertise as a medical professional.”
Doctors were split about the“ embarrassing and unnecessary minefield” as one GP described the issue.
Dr Tibor Konkoly, retired, wrote in a comment:“ I have never charged a doctor, specialist or their family members and never will … We make enough money, and we will not go broke for being considerate and kind.”
But Canberra GP Dr Merson Mathew was firmly against the practice, saying it was“ immoral and perverse” not to charge colleagues who could easily afford the fees.
“ For when they are sitting in front of you as a patient, they are a patient to you, not [ a colleague ]. It helps [ to ]
reinforce the doctor – patient relationship and maintain boundaries.”
A small 2024 Australian study interviewed 26 GPs on the topic, finding 73 % bulk-billed all doctor-patients, 8 % bulkbilled most doctor-patients and 19 % never did.
Their reasons cited for bulk-billing included collegiality, to promote good healthcare, to meet a professional expectation and an expectation of reciprocity.
But what of the mother with the doctor-son who had had a great experience of ED owing to her offspring’ s profession— right or wrong?
In summary, the ethicist Professor Appiah had a bet each way, as many philosophers do.
The doctor seeking the favour for his mother was acting correctly, he said, as family relationships were important. But the treating institutions should not have placed that patient ahead of others in the queue.
“ The staff members should have politely pushed back,” wrote the professor of philosophy and law at New York University.
“ I don’ t fault him for wanting special treatment. I fault them for delivering it.
“ But not very much. A hospital’ s staff [ are ] a community of people who must manage their relations with each other under trying conditions.” BMC Prim Care 2024; 16 Sep.
Nurses need botox training
Carmel Sparke AHPRA has now enforced additional training requirements on nurses who want to perform cosmetic procedures, including botox injections.
The watchdog’ s new guidelines mandate extra training and demand that nurses who administer cosmetic injectables have at least
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12 months’ nursing experience. Updated advertising regulations also require advertisers of“ higher-risk” non-surgical cosmetic procedures— such as cosmetic injectables, injection lipolysis, thread lifts, sclerotherapy and microsclerotherapy— to only use real pictures. |
‘ Dignified death’ for sex offender
Carmel Sparke THE death of a sex offender through NSW’ s voluntary assisted dying scheme has outraged victim support groups.
Daniel Hume, who was diagnosed with terminal cancer, had served seven years of a 30-year sentence for various sex crimes before being administered a lethal drug at
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a hospital facility.
“ Why are we giving convicted … rapists and murderers an easy way out when they are meant to serve out their full term and [ be ] punished in prisons?” victims’ advocate Howard Brown told The Daily Telegraph.
“ Good, decent people should be able to access voluntary assisted dying( VAD), not those who are convicted of vile crimes.”
Convicted paedophile Malcolm Day was believed to be the first Australian prisoner to die under VAD laws when he died in South Australia in 2023, aged 81.
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