AusDoc 31st Oct | Page 17

ausdoc. com. au 31 OCTOBER 2025

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VIEWS FROM YOUR ONLINE COMMUNITY

It’ s not us versus them

The specialist shuffle:

Take over, step back, leave the GP to pick up the mess

I hate this argument. All it does is inflame old grudges and lean into the tired old narrative of GPs feeling disrespected by specialists and vice versa.

This is an unfair and purely onesided opinion from either side.

I have found that, over time,( and I am also a rural GP) I have built a great relationship and rapport with my local specialists.

I rarely have trouble getting them on the phone; many have given me their personal mobile numbers, and I feel very supported to interrupt them out of cycle for questions and issues related to our patients.

The criticism of their wait times and failure to see acute problems is also unfair. Many GPs these days do not do this either, hence the need for the government’ s new urgent care clinics.

Perhaps a better opinion piece to write would be one that provides advice for those GPs struggling with specialists as you have described.

Dr Rowan Purtell GP, Bright, Vic

My recollection of the‘ old days’ is that they were not always‘ good’. After hospital residency, I spent four years working as a GP before qualifying as a cardiologist and cardiac electrophysiologist and then working for 30 years in a public hospital.

Those four years as a GP gave me persistent insight into, and understanding of, the difficulties of general practice. As a teacher and mentor to a large number of specialist trainees, I have always tried to impart respect for the GP role.

I have also always rejected specialists taking over outpatient care. Even if I ever had the time to do that personally, it has always been clear to me that, for a variety of obvious reasons, a successful outcome for the patient depends heavily on GP involvement in shared care, characterised by accurate, timely communication in both directions.

This view is not exceptional among specialists.

Professor John Hill Cardiologist, Brisbane, Qld

I do not think it matters what type of doctor you are— GP or specialist.

Just like in other professions, there are good doctors and bad doctors.

The hand-writing is on the wall

Judge orders doctors to write prescriptions in capital letters because of bad handwriting

Although most prescriptions are now computer generated( thank goodness), I work in rural hospitals where progress notes are often written by hand, a trend that hopefully is decreasing.

The doctor, often a locum, has usually departed for some unknown destination, leaving me to try to decipher his or her important notes. Frequently, this is impossible. Surely someone who is capable of getting a medical degree can learn to write! It is sheer conceit to use the glib excuse of“ doctors’ handwriting”. Errors due to this laziness can be catastrophic and certainly waste time as I run around asking:“ What does this say?”

Dr Vivienne Tedeschi GP, Bowraville, NSW

As a specialist, I love working with good GPs, but at the same time, I also get referrals with nothing but“ please kindly review”, and I have to guess what I need to see the patient for.

I also get fellow specialists who decide to stop my medications for a patient without any type of phone call or communication, only for me to pick up the mess.

So the label does not matter. It is actually the care factor that matters.

Dr Teresa Lam Endocrinologist, Sydney, NSW

I think the narrative given by Dr Craig Lilienthal is bidirectional. I get many‘ legacy’ patients who have been receiving industrial doses of opioids for 20 years, and then their GP retires or dies and the next one does not want a bar of them.

Associate Professor Cornelius Nydam Physician, Bundaberg, Qld

I saw a patient with hip pain who was told by her orthopod to see three different orthopaedic surgeons: one for her labral tear, one for her gluteal pathology and another for the joint itself.

We looked at each other, and she said,“ I think I will go back to Pilates.” I concurred.

A few years later, she remained pain free.

Limited practitioners. Sometimes it is a bit ridiculous.

Dr Jane Ralls GP, Perth, WA

Feverish fallacy over magic drug

Misogyny masquerading as evidence-based medicine

Excellent article, Dr Rachel Glasson! I am grateful for my laidback attitude to pregnancy and child rearing; it would have been so much more difficult if I were rigid in my thinking.

I remember eating sushi and soft cheeses when no other suitable food was available( coeliac). I figured starving or intense vomiting was not crash hot for fetuses.

I went into preterm labour with my second child around 30 weeks. The hospital gave me two paracetamol, and the whole thing stopped. Apparently, I had the world’ s smallest fever.

That drug is magic in pregnancy, and women should not be made to feel guilty for taking it.

Dr Peta Fairweather Pathologist, Brisbane, Qld

Financing a losing battle

’ A mind shift for the dementia field’: Would you pay $ 40,000 to delay Alzheimer’ s by five months?

Considering that we often withhold more meaningful treatment options from young people with a potential of a meaningful life ahead, I find such bizarre spending on a patient’ s last years of life without any hope for recovery just plain horrible.

It probably reflects the personal fears of the decision-makers more than any rational, let alone ethical, thinking.

Dr Horst Herb GP, Cooktown, Qld

I would spend the $ 40,000 on some holidays and let it rip for the sake of five months.

Dr Lee Drury GP, Newcastle, NSW

He is a cut above the rest

’ Dear GPs, it was nothing to do with my clinical care’: Respected surgeon pens letter after hospital sacking

Dr John Stuchbery is a wonderful doctor. Thankfully, for me, the ED registrar called John at about 7am one Friday morning during the COVID-19 tide.

I had turned up at the Albury ED with severe epigastric pain and vomiting. The ED was full, and they saw and treated me promptly in the cramped conditions.

I knew I had gallstones after a previous isolated episode of pain three months before.

The registrar was able to settle my pain and vomiting. But early Friday morning, John added me to his afternoon list at the local private hospital. He saw me on the ward before going to theatre, and I was feeling reasonably well.

A couple of hours later, he removed my necrotic gallbladder, and I was discharged Sunday afternoon.

John is a great clinician and surgeon.

Dr Christian Fandrich GP, Albury, NSW

Crossing the red( ink) line?

Patients can now see their pathology results instantly— but what problem is it trying to solve?

I still remember a patient from my student days( this was 1975) who woke from an operation to the news that he had a treatable cancer and that more details would be given the next day.

He only heard the word‘ cancer’ and, later in the day, discharged himself, went home and suicided.

Associate Professor Chris Hogan GP, Sunbury, Vic

So many patients were afraid when they saw red ink on their results, but their ranges were just outside the 95th percentile.

I am all for the information to be available, but how many will now google their results and resort to quack remedies?

Dr John Davis GP, Warwick, Qld

If this has raised issues for you or you are concerned about someone you know, call Lifeline on 13 11 14 or contact your local doctors’ health advisory service.