4 NEWS
4 NEWS
16 MAY 2025 ausdoc. com. au
Dr Glaucomflecken’ s American horror story
Dr William Flanary.
For Australian Healthcare Professionals
PAGE 1 surgery after outrage from doctors and patients.
The policy applied to children born with cataracts, to adults whose cataracts interfered with their ability to drive, and to people in need of emergency cataract surgery before vision-threatening retinal conditions could be treated.
The impact was swift and chaotic. More than 10,000 to 20,000 patients had their cataract surgery unnecessarily delayed in just one month before the policy was ditched.
Dr Glaucomflecken said on average, a physician in the
US submits 45 prior authorisations a week.
“ Think about that … You have to ask permission to do
TRELEGY Ellipta: One inhaler. One inhalation. Once daily. 1
for the patient whatever it is you are offering them.”
And who are the ones making these clinical decisions? They are doctors,
so-called medical directors, but Dr Glaucomflecken says some of them have not seen patients in 30 years, or they
COPD: TRELEGY Ellipta is indicated for the maintenance treatment of adults with moderate to severe COPD who require treatment with LAMA + LABA + ICS. TRELEGY Ellipta is not indicated for the initiation of therapy in COPD. 1
Asthma: TRELEGY Ellipta is indicated for the maintenance treatment of asthma in adult patients who are not adequately controlled with a combination of inhaled corticosteroid and long acting beta 2
-agonist. 1 are specialists in areas totally unrelated to the care treating doctors want to give.
“ You might get on the phone and you’ re talking to a radiologist about whatever surgery.
“ Or you’ re doing breast surgery and you’ re talking to, God forbid, an internist,” he says, injecting a bit of his intra-hospital banter into his depressing explanation.“ You want a picture?” He plays a clip from one of his most popular YouTube
TRELEGY Ellipta should not be used to treat acute symptoms for which an inhaled short-acting bronchodilator is required. TRELEGY Ellipta is generally well tolerated. Adverse Effects: Nasopharyngitis, headache, cough, oropharyngeal pain, pneumonia, upper respiratory tract infection, viral respiratory tract infection, influenza, pharyngitis, dysphonia, rhinitis, arthralgia, back pain, constipation, sinusitis, bronchitis, urinary tract infection, candidiasis of mouth and throat. Contraindications: Severe milk-protein allergy or hypersensitivity to any of the ingredients.
PLEASE REVIEW PRODUCT INFORMATION BEFORE PRESCRIBING. Product Information can be accessed at www. gsk. com. au / trelegy. PBS Information: Severe asthma( 200 / 62.5 / 25 mcg presentation only); Chronic obstructive pulmonary disease( 100 / 62.5 / 25 mcg presentation only). Authority Required( Streamlined). Criteria apply. Refer to PBS for full information. 2
SCAN QR CODE to see full TRELEGY Ellipta Product Information
‘ We have given power and decision-making to people who do not care about patients.’
Inhalers not to scale.
References: 1. TRELEGY Ellipta Product Information. 2. www. pbs. gov. au. Abbreviations: COPD, chronic obstructive pulmonary disease; ICS, inhaled corticosteroid; LABA, long-acting
beta 2
- agonist; LAMA, long-acting muscarinic antagonist. For more information on GSK products or to report an adverse event involving a GSK product, please contact GSK Medical Information on 1800 033 109. GlaxoSmithKline Australia Pty Ltd ABN 47 100 162 481, Melbourne, VIC. Trade marks are owned by or licensed to the GSK group of companies. © 2025 GSK group of companies or its licensor. PM-AU-FVU-ADVR-250002. Date of approval: April 2025. videos about a request for an MRI.
Doctor:“ I have a patient who might have a brain tumour.”
Insurer:“ Hold on, have you thought about an X-ray?”
Doctor:“ There are no bones in the brain— you need an MRI.”
Insurer:“ Have you explored other diagnostic modalities like palpitation?”
Doctor:“ You can’ t palpate a brain tumour; it is surrounded by the skull.”
The doctor in this parody secures permission for the patient’ s MRI; however, it is at an MRI machine in the back of a Texaco service station 150 miles away because the hospital nearby charges too much.
Insurer:“ There is a guy down there, bought himself an MRI … just knock on the door, ask for Mike. The patient’ s plan approves a walk-by.” Doctor:“ What is that?” Insurer:“ The patient just walks briskly past the MRI machine and [ tests ] and goes. Mike just gets whatever images he can.”
Okay, it is satire, but it points at deeper truths.
“ Why is it like this?” Dr Glaucomflecken asks.“ If I could sum it up in two words it would be: corporate greed.“ We have given power and decision-making to people who do not care about patients, right? That is the fatal flaw of US healthcare.
“ Even those of us who are the most greed- [ oriented ], we still have a piece of ourselves that got into medicine to help people, and that is still there. It’ s more prominent in some than others, but it is still there.
“ But these corporations are run by people who don’ t have any kind of duty to patients. They have a duty to shareholders. Care is secondary, tertiary.”
He says corporations like UnitedHealthcare are“ getting so powerful and so rich” that they are buying up every step of the health system, including the employment of 70,000 plus doctors. Dr Glaucomflecken says the tide can be turned.
“ People are fighting back, and I’ m doing my part. We have a whole army of Tik- Tokers. There is a lot of advocacy being done. I’ m trying to make as many videos as possible to get the word out.” However, this is clearly difficult.
“ These corporations... are so powerful, you can’ t put the toothpaste back in the tube.”
So, his prescription for Australia is not letting the toothpaste out in the first place.
“ Seriously, the health insurance thing, it can go sideways really fast.”