Australian Doctor 18th July 2025

18 JULY 2025
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TWO IN THIS ISSUE
Otitis media in children
HOW TO TREAT, PAGE 23
Justice gone wrong?
NEWS REVIEW, PAGE 20
Doctors demand right to rebel NEWS, PAGE 7
Group A strep: a post-COVID threat
THERAPY UPDATE, PAGE 42

Doctors await fate of GP outpatient fix

Rachel Carter A PILOT of GPs working in outpatient clinics that successfully reduced waitlists has stopped for no clear reason, GPs say.
The Tasmanian pilot employed GPs with special interests on shortterm contracts to improve access to care.
The GPs worked in the highestdemand hospital outpatient clinics, including antenatal, breast, cardiology, gastroenterology, youth and paediatrics.
But the successful pilot had stopped suddenly, according to Dr
Tim Jones, who was employed in the paediatric neurodevelopment and behaviour clinic for 20 months.
“ With about three weeks left to run on my contract, I received an email stating that the contract would not be continued for any GP in the program past the contract end date,” he told Australian Doctor.
The email gave no explanation, he said.
“ The feedback from other GPs employed in the services was that we were making big gains in terms of efficiency and timeliness of outpatient clinic appointments.”
In the clinic, Dr Jones and a nurse colleague saw 208 patients, and the average wait time for an appointment plummeted from three years
‘ We were making big gains in efficiency and timeliness.’
to less than four months.
“ We also reduced the average number of appointments required to fully deal with a presenting
concern from about four or five to less than 1.5,” he said.
This was despite Dr Jones only working 0.1 FTE.
“ The cut, therefore, came as quite a surprise,” he said.
“ We don’ t have definite information as to why that happened, but we suspect that it was budgetary savings.”
He said there were“ mixed messages” about the pilot’ s evaluation.“ When I exited my role, I wrote to the state health minister seeking some honest feedback and information on how it had gone from their
perspective and what evaluation had been conducted.
“ I was told that the evaluation had been completed but was still being processed.
“ But the first time I was contacted about anything to do with evaluating the program was more than six weeks after that.
“ I was sent an email from one of the staff members attached to outpatient services asking for an interview to begin the process of obtaining evaluation and feedback.
“ My understanding is that there is a willingness to capture that PAGE 4

‘ Everything was white noise’

Dr Shabnam Gujadhur on her cancer diagnosis.
Rachel Carter“ WHEN I walked into my postop review, the look in my gynaecologist’ s eyes gave me the hint it was not good news.
“ I have had the same facial expression when I have broken news to patients.”
Physician registrar Dr Shabnam Gujadhur was 30 when, in May 2022, she was told of her diagnosis of mixed germ cell ovarian cancer.
“ Everything was just like white noise. I didn’ t know what to do or what to say.”
Suddenly, she was in the health system not as a doctor but as a patient, and the experience was confronting.
Since her childhood in Mauritius, where her parents are doctors, Dr Gujadhur had wanted to pursue medicine.
She moved to Melbourne in 2011 to study laboratory medicine, working as a scientist for several years before medical school on the Gold Coast.
“ I started experiencing symptoms shortly after my birthday. I was coming to the end of my first rotation in ED and was about to go rural for my second.
“ I was having some intermenstrual bleeding and cramps, but I did not think much of it because I was healthy.
“ Working for the first time as a doctor, I was full of ambition and passion for medicine, like anyone who has just graduated.
“ I kept working and took painkillers for the cramps.”
After a few weeks, a concerned friend encouraged Dr Gujadhur to visit her GP.
An abnormal ultrasound led to surgery to remove what had been identified as a potential cyst, but came back as cancer.
More urgent surgery followed, which took place on the same day Dr Gujadhur’ s aunt was dying of cancer.
Her final diagnosis took several months because of the rarity of the cancer.
“ That was the hardest bit because I did not know what was going to happen,” she says.
“ Would I need chemo or not? I went through the egg-freezing cycle just in case.
“ It was still at stage 1, so I was kind of lucky. It meant I had a choice in my treatment.” PAGE 3