Australian Doctor 12th July Issue 2024 | Page 15

ausdoc . com . au 12 JULY 2024

15

VIEWS FROM YOUR ONLINE COMMUNITY

Shining a light on dark tactics

‘ My husband said it was not violence , it was domestic correction ’: A GP tells her shocking story

Dear Anonymous GP , thanks so much for sharing your story .

What you have written carries huge power , and you expose some of the many myths around domestic violence .

You are also shining a light on the coercive tactics used by perpetrators , including the threat of self-harm , which is so hard to deal with , in addition to the mixture of feelings that can be present : fear , love , shame and the desire to protect .

One of the only books I have read that adequately addresses these behaviours is called Why Does He Do That ?: Inside the Minds of Angry and Controlling Men by Lundy Bancroft .

It needs to be prescribed reading for psychologists and all of us who work in this area .

Dr Belinda Carne GP , Melbourne , Vic

A couple of decades ago , I listened to a young student ’ s research into intimate partner violence among high school students .

She found that very early signs of disrespect escalated when unchecked , as if the abuser was testing the ground to see how far he could go before being stopped .

The message I took was to end relationships as soon as there is a sign of disrespect or disregard for one ’ s own needs unless it is clearly a mistake and there is an apology and no recurrence .

This can be difficult for those of us who are forgiving and understanding of others ’ struggles .

Girls and women , in particular , are often taught to be accommodating and accepting of others ’ misbehaviour , trying to understand and support the person rather than protecting themselves from someone who is dangerous to their mental and physical health .

Jennifer Manson Psychologist , Canberra , ACT

Thank you so much for sharing and helping us all to see the experiences you endured as a pattern that repeats itself over and over in our communities .

I am so glad you escaped , thankful for the revelation you had and thankful you are now safe .

You have nothing to be ashamed of in your story . I hope sharing it makes you feel even stronger .

Dr Johanna Lynch GP , Brisbane , Qld

Reading your account of what happened to you was more enlightening than a hundred e-learning modules on the subject of domestic violence .

Thank you for your honest and painful description of the terror you suffered .

I wish you well in your recovery and am pleased you have found someone who shows you the love you deserve .

Dr James Courts GP , Gold Coast , Qld

Not living in the rural world

Pompous colleges , bow ties and pointless PhDs : Dr Colin McClintock on specialist training

Dr McClintock ’ s arguments against colleges and their reluctance to accredit training in regional hospitals are compelling but idealistic . I also don ’ t like the tertiary hospital – focused structure of the health system , but that is what we face .

I can ’ t expect junior doctors to want to work regionally when there is a multitude of disadvantages : fewer healthcare resources , fewer job opportunities for spouses , fewer social services for family , more dysfunctional employers ( the regional local health districts ) and minimal support for the challenges of living in rural areas .

Even more so than in the city , the rural hospital executives view the medical staff as a disposable utility .

All rural areas are disadvantaged compared with metropolitan areas — so how , in good faith , can I encourage junior doctors to move out of the city ?

In truth , I do encourage it , but I don ’ t brush over the negatives .

Last week , I decided not to renew my only rural contract because the local health district was so disorganised that a simple contract renewal turned into a major drama : a drama for me , not for them .

Rural areas will continue to struggle to recruit when their administrative processes are of a comparatively low standard .

Dr Julian Marshall Anaesthetist , Sydney , NSW

Thank you , Colin , for speaking up and telling it like it is .

The graft and corruption in the public system in rural hospitals are horrendous , and we are spending huge amounts on locum services ( doctors and nurses ) instead of supporting people to come to rural areas to live and work .

With regard to specialty training in rural areas , our registrars love it . But if they have not experienced it , how would they know ?

And with regard to the countrywide specialist shortage , if everyone worked for a couple of weeks a year in the country , which would not be a huge hardship or sacrifice for any one person , everyone would be exposed to life as a country doctor , and as a result , we would have much more service provision , more evenly spread .

And I love your idea of standardising pay rates across the country .

The higher rates paid in some states drain staff from others , particularly in areas close to the borders .

Please keep speaking out on behalf of all of us .

Dr Anne Malatt Surgeon , Alstonville , NSW

I ’ ve had the opposite experience as a specialist : I now live 320km from Melbourne , but there ’ s no public job in my subspecialty area ; private practice pays half what it pays in Melbourne .

I drive back to Melbourne to work there every second week , even though there is enough work to employ me full-time in my regional area . Go figure .

Dr Michael Block Psychiatrist , Melbourne , Vic

Dispensing with doctors ’ orders

It is meant to save billions , but just how many 60-day scripts are GPs writing ?

The question is not how many 60-day scripts we , as GPs , are writing , but how many are the pharmacists actually honouring .

I ’ m seeing countless patients where their 60-day scripts are getting amended to 30-day scripts , usually without their consent or knowledge , and without my permission .

Dr Elicia Rodas GP , Sydney , NSW

Weeding out fact from fiction

MDO restricts cover for medicinal cannabis prescribers

Desperate times call for desperate measures

Hospital malfunction : Orthopaedic patients handed service call bells to alert nurses

Shouldn ’ t all doctors be taught about the endocannabinoid system to allow us all to be aware of the potential benefits and risks of cannabinoid therapy ?

Currently , an experienced practitioner must refer to an inexperienced specialist to get approval for a therapy about which the specialist has little or no practical experience but has been influenced by non-factual and scientifically unfounded fears arising from decades of misinformation .

For example , cannabis is often internationally described as a narcotic , and that is patently untrue .

The beneficial effects ( in autism , for example ) are well known to experienced practitioners but remain either unknown or are deeply opposed by non-prescribers .

The concerns about unprincipled practitioners and irregular clinical practice are well founded .

But perhaps if the profession accepts the clinical need to consider cannabinoids more widely , we can then move to establish proper clinical , peer-reviewed pathways .

Dr Brian Walker GP , Serpentine , WA

My friend , with full private insurance , was once put into a four-bed room in one of Brisbane ’ s major private hospitals . His buzzer did not work , and so the nurse told him to shout when he needed attention . My late husband — who was hospitalised after passing 30-plus bowel motions a day as a result of his colitis — was once put into another of Brisbane ’ s prestigious private hospitals with four men sharing a bathroom .

Public health staffing and facilities are often better than what you get in the private sector .

Dr Maureen Fitzsimon GP , Sunshine Coast , Qld