Broken system costing an arm and a leg ED doctors fear $ 259 million hospital software upgrade is a danger to patients
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It is sadly fascinating that the same error keeps happening all over the world , time and time again , with multiple very expensive examples of bad hospital IT systems .
They are designed by computer people to do what computer people think or are told is needed .
In some countries , these systems are explicitly about billing , not clinical care .
A clinical information system will only be functional if the focus is on the ‘ clinical ’ bit , and doctors are advising from day one on how to make the system functional for doctors .
Professor Ian Seppelt Intensive care medicine , Sydney , NSW
I am in NT primary health and have read-only access to Acacia — the software system that is worrying ED doctors — so I can see bloods and radiology performed at hospitals .
Yes , it is good to have access , but it is a very clunky system , and viewing pathology is a real process .
It is not simple to scroll through results ; you have to keep going back to the main page .
In one of the feedback sessions , I expressed that it was not fit for purpose and was essentially told : “ We cannot change those things ; that is the way they are .”
Dr Amy Rosser GP , Yuendumu , NT
Ready-made doctors are not reality GP says it ’ s almost impossible for IMGs to pass PESCI exam
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Standards need to be maintained , no question .
However , as far as I know , all IMG doctors who pass the pre-employment structured clinical interview ( PESCI ) work under supervision for a period of time , not independently .
It is impossible for a doctor who has never lived or worked in Australia to fully understand the Australian culture and healthcare system .
The aim of the PESCI should be to identify good candidates who understand their strengths and weaknesses and are capable and willing to do the hard work to bridge the gaps . The high failure rates may be due to the unrealistic expectations of finding ready-made candidates to fill barely supervised posts at no
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cost to the state .
Dr Pradeep Samarakoon GP , Adelaide , SA
Physician , silence thyself ? AHPRA changes social
Dr media guidelines after doctors reported for Gaza posts
I understand that a doctor ’ s opinion carries more weight for some people in the community than your average bystander .
However , I do not understand why our professional body should police our personal , political and religious views more so than other professional bodies , such as those governing the legal fraternity .
Are we not allowed to advocate for our personal views and lobby outside of the medical field for change — either domestically or internationally — in whatever area of life we want to take action in ?
If I want to protest against a country ’ s government that may have committed genocide against my ancestors in the past but refuses to acknowledge this fact , surely as a private citizen in a free society , I should have the right to .
Why am I denied this right because I also happen to be a doctor ?
Dr Thomas Shashian GP , Melbourne , Vic
In support of second chances ‘ I was a dead man
Dr walking ’: The story of a deregistered doctor ’ s quest for redemption
Thank you for sharing this , Dr Chen .
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The front windscreen is much larger than the rear-view mirror for a good reason .
The most important step now is for a second chance to be given so we can support our colleagues back into a job .
We cannot complain about workforce shortages and not have a culture that helps us to fix it .
I do hope someone offers him work .
Dr Jaycen Cruickshank Emergency medicine , Ballarat , Vic
I have great sympathy and admiration for this doctor ’ s stand against bureaucracy and his fight for survival .
I would have given it all away if I were in his situation — started a new business and said ‘ up yours ’ to all those who rejected me .
But I do think , in the context of the ketamine clinics he worked for , consumerism and medicine are a deadly mix , blinding us to the fact that we are a profession dedicated to healing .
While medicine supports us in earning our living , our prime object is to help people with their physical and mental health problems , not make money out of them .
Once we commercialise this relationship , as in corporate medicine , we become subject to consumer laws , where justice becomes not the spirit but the letter of the law .
Dr Mal Mohanlal GP , Redcliffe Peninsula , Qld
Skipping step may destroy the pathway The next big thing ?
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Let allied health refer directly to specialists
While there is some valid criticism in this opinion article by the AusDoc editor , I think there also
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needs to be some open-mindedness about how this approach could work with the right implementation .
As a psychologist , I have no interest or business in referring patients to , for example , endocrinology or orthopaedics , so it would be reasonable to prevent this with Medicare rules .
However , I am extremely well placed to judge whether my patient needs to see a psychiatrist and then to liaise with that psychiatrist regarding their management , with my psychotherapy input and their psychopharmacology input .
Are checks and balances necessary to prevent inappropriate out-of-scope referrals and wasteful government expenditure ? Of course .
But let ’ s not toss out the entire idea without exploring what a workable solution could look like .
Dr Daniel Sullivan Psychologist , Brisbane , Qld
A psychology referral to a psychiatrist appears sensible on the surface ; however , given I have never had a psychiatrist who checks blood pressure , weight , regular bloods or ECG for those on novel antipsychotics , I wonder who is going to manage the ‘ whole ’ patient when the GP is taken out of the loop .
Dr Charlotte Goodall GP , Adelaide , SA
After receiving new patients ’ records , I am often surprised at the inaccuracy of how they recollect their own history .
So I pity the specialist receiving referrals from allied health .
The patient does not know why they have been on methotrexate for 20 years ; the patient forgets their history of melanoma or the “ small MI or stroke ” that is better now .
One of my patients intentionally withholds his history of polio
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so he can “ test how good the new doctor is ”.
Dr Kieran Nixon GP , Hobart , Tas
I already receive referrals for colposcopy assessments from our excellent local sexual health nurses and colleagues .
If the patient is fit and well , it is no problem to follow the simple pathway .
However , if the patient requires treatment , the history provided by my colleagues is never complete .
These patients often have low health literacy and cannot provide a reliable verbal history .
Current medications ? Bleeding disorders ? Suppressed immune system ?
Dr Leigh Grant O & G specialist , Mackay , Qld
Suspension a bureaucratic sledgehammer Nurse suspended for two years after attempting to steal a cannula during hospital night shift
Hitting a new Australian with a sledgehammer like this is bullying and legal bureaucracy gone mad .
A kindly chat from her boss was all that was required .
Ruining people ’ s lives and self-esteem is not ethical , and this decision was cruel and could easily have had a much worse outcome .
Professor Max Kamien GP , Perth , WA
Butler suffers from case of foot in mouth ‘ Vote with your feet ’ if
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GPs are not bulk-billing : Mark Butler
Mark Butler is clearly clueless .
Does he want more patients to attend ED ?
Dr Eleanor Go GP , Bendigo , Vic
The shift away from bulk-billing is not a behavioural issue ; it is a survival issue .
It might be better for the Minister for Health and Aged Care to adopt a more conciliatory tone .
You are speaking about highly trained healthcare professionals who are in short supply because of government policy , not a class of poorly behaved kids .
Government policies have left patient rebates underfunded by 50 %.
If you do not fund general practice , it goes away .
Dr John Kennedy GP , Grafton , NSW
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