Australian Doctor 13th Sept Issue

| THE | WOMEN ’ S AND MEN ’ S HEALTH SPECIAL
13 SEPTEMBER 2024
The country ’ s leading independent medical publication

| THE | WOMEN ’ S AND MEN ’ S HEALTH SPECIAL

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My patient ’ s cut penis
Genetic evaluation of male infertility
Breast surgery breakthrough
Dr Jana Pittman
OPINION , PAGE 18
HOW TO TREAT , PAGE 21
CASE REPORT , PAGE 36
NEWS , PAGE 5

A revolution for GP consults ?

Electric dreams : The rise of AI scribes .
Mohana Basu AMID the myriad dystopian futures resulting from the nervous embrace of artificial intelligence , there is a realworld promise of freedom for doctors . Since February this year , Best Practice Software has been offering an artificial intelligence ( AI ) medical scribe which records consults and then generates medical notes for doctors to review , edit and sign off .
It goes without saying that medical notes are fundamental to consultative medicine .
But their creation is time-consuming . So are AI scribes one of those promised revolutions GPs want ?
That was the view of one doctor on our website : “ I use an Australian-based AI scribe and have found it to be a game changer for documenting 20-30 [ minute ] psychiatric review consultations .
“[ Its ] ability to adequately output a full initial assessment in enough depth still needs work , but no other single intervention in my practice has done more to reduce my cognitive load across the day .” It is a big claim . The early adopters of this tech believe the specialty needs to jump in now to safeguard their patients ’
interests , as well as their own .
But what has been their experience ? Are the drafts being generated detailed enough ? Is it generating errors with drug doses and medications , the areas where the risks of
‘ I found some entries I can ’ t remember saying .’
patient harm are so very real ?
Melbourne GP Dr Ralph Audehm began using the Lyrebird Scribe app over a year ago , typing out his own notes to compare with versions it was creating .
“ I am a good touch-typer , so I don ’ t have to look away from the patient while taking notes ,” he said .
“ But what I found was that the AI gave me far more detail than with my own history taking .”
Where Dr Audehm was writing “ Feels well ”, the AI was writing “ No chest problems or trouble breathing . No shortness of breath during exercise . Energy levels generally good , but slower to get out of bed ”.
It was not perfect . Dr Audehm ’ s written notes had details of blood pressure readings for one patient , but the AI did not capture the results of the examinations in its account of the consult .
Dr Audehm also described
‘ hallucinations ’, where AI takes things a step further than it should , such as dreaming up sentences that were not actually spoken .
“ I found some entries I can ’ t remember ever saying or hearing . I would just delete those sentences ,” he said .
“ It wasn ’ t a particularly big thing for me , but I was surprised because this was a hallucination or dreaming where it ’ s putting in things that it expects to find .
“ But I want to stress that it was easy to manage , because when you look over the notes from the AI , you could see straight away ,” he added .
Dr Tamsin Franklin is another early adopter . She said Lyrebird PAGE 3

Return of the zombies

NEWS REVIEW , PAGE 40

No pelvic thrust : Judge says doctor was doing the haka

Heather Saxena A RADIOLOGIST sacked after being accused of pelvic thrusting at a female employee has been awarded almost $ 368,000 after a court found it was possible he was demonstrating the haka .
Dr Kevin Daynes was originally sacked in May 2022 by the corporate I-MED , three months after an independent workplace report “ substantiated ” allegations he had sexually harassed an employee at a staff Christmas party as well as bullied another .
At the time it was alleged he had suddenly performed a pelvic thrust at his colleague , who had come dressed in a foam holly leaf costume , while they were standing in a group of people .
In his claim for wrongful dismissal , Dr Daynes argued he had been responding to a comment about Kiwis .
“ He says that he responded by
‘ He responded by moving a little on the spot .’
moving a little on the spot and raising his hands to face level as if to demonstrate some form of haka ,” Justice Richard Cavanagh wrote in his Supreme Court of NSW judgement .
It was possible the witness who claimed to have seen him pelvic thrust towards the employee ’ s side had actually seen what he said he was doing — “ that is , attempting to imitate a haka ”, he added .
“ He was standing next to [ the employee ] at the time and did not actually come into contact with her or her costume in any way as the witness ultimately accepted .
“ The difficulty for [ I-MED ] is that there is nothing surrounding [ the ] conversation which provides any real explanation as to why [ he ] would have done a pelvic thrust .”
The judge said the doctor ’ s behaviour towards the other employee had been “ rude and abrupt ” but fell short of workplace bullying .
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