Don ’ t shift blame solely to the system ‘ Please don ’ t blame
6 psychiatrists for rejecting your referrals — the system is failing us too ’
Sorry , but I am a psychiatrist who has worked in the private and public systems , and I do not agree .
I think psychiatrists can contribute to the solution rather than merely blaming “ the system ”.
Some suggestions . Private psychiatrists charging a reasonable gap rather than hundreds or thousands of dollars for a consultation .
Private psychiatrists not opting for the easier option of seeing low-acuity patients regularly for years on end and instead treating new , more unwell patients .
Newly minted psychiatrists not immediately fleeing for the lucrative world of locuming or telehealth consultations and instead contributing to treating the most unwell and needy patients in the public system .
Dr Tanya Hall Psychiatrist , Newcastle , NSW
Yes , the system is broken . Of course there are psychiatrists with special interests , and that is fine .
My gripe is the need to write a referral to be read first without breaching patient confidentiality .
We should be able to ring the rooms and say something like , “ I have a 37-year-old patient with bipolar I disorder already on lithium who I need help with .”
Then , the receptionist should know if the age and diagnosis are appropriate for that psychiatrist and give a rough wait time .
If we could talk to the psychiatrist , give a brief story and ask for an urgent appointment in rare circumstances , that would help a lot .
I am not sure why psychiatry is so different from other specialties , where both of these things can often be done .
Dr Jane Ralls GP , Perth , WA
The unlucky brain catches the worm Python parasite
Dr removed from Aussie woman ’ s brain
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I live in southeast Queensland in a python-infested area near a forest . I also grow some of my own food . Yikes !
Dr Peta Fairweather Pathologist , Brisbane , Qld
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Woolworths , the fresh faux people ‘ McMedicine ’: Woolies
Dr flame-grilled over its naturopath consults
It is so sad that our society commercialises everything .
There is a huge conflict of interest in naturopaths offering free consults to Woolies customers .
No health practitioner should be allowed to make a profit from selling any item to a patient .
Dr Marcia Manning GP , Sydney , NSW
Let ’ s be honest , Australia is not the land of evidence-based medicine .
It endorses multiple treatments that do not stand up to the norms of a Cochrane-style evidence base .
It is why I can finance clients seeing chiropractors and osteopaths after creating a chronic disease management plan under the public system .
It is also why pharmacies sell all kinds of hocus-pocus alternative medicines without any sound evidence base but with plenty of untruths on the side of the packets .
It is also why , in Australia , we demonise codeine and yet , at the same time , push cannabis for everything and now want to give every Tom , Dick and Harry MDMA and ketamine .
We are deliberately being led down the non-evidence or poor evidence route .
So , is it a surprise that Woolies gets in on the action ?
Dr Anila Reddy GP , Cairns , Qld
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The diversion of patients ’ problems into quackery and away from real medicine is a serious issue .
I hope the naturopaths will be financially liable when their ‘ advice ’
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is shown to have delayed or compromised real treatment .
Dr Laurence Anderson GP , Southern Highlands , NSW
Fearing for their careers , not their lives The lesson we can learn
MO from the tragic death of the dementia patient tasered by police
Dr Sue Ieraci writes : “ Fearing for their lives , staff called their manager and were advised to send the lady to ED .”
I suspect a reasonable person would not fear a 43kg 95-year-old lady with a walking frame .
On the other hand , fearing getting into trouble for breaching guidelines and protocols is the root cause of this incident and so much of the wastage in our health system .
After all , no-one wants to be pursued by the media with headlines about patients physically and chemically restrained .
A young colleague this week showed me her quote for $ 73,000 for annual medical indemnity as an orthopaedic surgeon .
That is more than $ 1500 a week harvested from patients and given to insurers , lawyers and the occasional meritorious plaintiff who otherwise has National Disability Insurance Scheme cover as a fallback .
The only way to implement a rational plan A , as opposed to always calling ED , is with legislated tort reform .
Governments must also articulate that 100 % of patients in nursing homes will die there — on average , within two years .
For the minute , it is no wonder the residential aged care facility manager panics when called in — given the risks of facing a royal commission .
Dr Ian Hargreaves Surgeon , Sydney , NSW
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The pointy end of bad paperwork GP who treated up to
Dr nine acupuncture patients at once repays $ 360,000 in Medicare rebates
I do not see a problem with multiple concurrent treatments of this nature , but his paperwork ( with adequate medical notes ) let him down , it seems .
Dr Johannes Haasbroek GP , Cairns , Qld
I am going to presume , in this case , that these repayments are entirely justified .
But speaking more generally , do doctors misclaiming on Medicare experience anything like the public sanction that Dr Nick Carr received for his paperwork transgression ?
From a distance , many appear to have committed fraud . Their dishonesty makes it embarrassing to have them as peers and galling that they go back to work after a slap on the wrist .
Dr Owen Casson GP , South Gippsland , Vic
A deeply moving meal invitation Why discharge
MO summaries are failing to connect
Such true , wise words , Dr Anne Stephenson .
We absolutely need better investment in healthcare communication systems , especially in relation to timely multiway communication between tertiary and primary care .
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Collaboration is key !
Dr Elysia Thornton-Benko GP , Sydney , NSW
Many years ago , I had the privilege of being the GP for the patriarch , and four generations , of an Orthodox Jewish family .
Having left practice , I saw him later on a social visit — as a friend , not a doctor — where I learnt of his impending death .
Later , I received a phone call from his eldest daughter to invite me and my wife , Sue , to the first Sabbath meal after his passing , which was to be held at her home . Sue knew her well as she had provided antenatal physiotherapy care for her first pregnancy , and I delivered the baby .
I thought that , if we were invited , it would be a major event , involving his extended family and friends .
When we arrived , there was only immediate family at the meal — and us .
I must admit I struggled to maintain my composure ; I was deeply moved .
Dr Paul Nisselle GP , Melbourne , Vic
Consider us deterred , Victoria ‘ Bruising and unpleasant ’: Dr Nick Carr
Dr
speaks to AusDoc about his prosecution for VAD paperwork error
The tribunal argued that , in sanctioning Dr Carr , it needed to ensure “ general deterrence ”.
Well , for me , this has been a great general deterrence .
I will not be signing up to train for voluntary assisted dying despite my strong support and belief in dignified dying for my patients .
I am determined to advocate for my patients , always , but I am even more determined not to be complicit in an overly burdensome and broken , lawyer-designed system where paperwork gets you into trouble .
Well done , Victoria , on overcomplicating , over-regulating and overreaching yet again .
Dr Justin Osborne GP , Melbourne , Vic
I declare that the Victorian Voluntary Assisted Dying Review Board is guilty of regulatory misconduct .
It should be ashamed of itself , wasting so much time and money and burdening Dr Carr in such a fashion over a completely inconsequential detail .
It should also ask itself whether the harms it caused were proportionate .
Dr Simon Holliday GP , Taree , NSW
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