Australian Doctor 19th April issue | Page 16

16 OPINION

19 APRIL 2024 ausdoc . com . au

Why are more than 8 / 10 Australian women with severe menopause symptoms not receiving effective , approved therapy ? 1

Insight

The Gaza medical

catastrophe

Menopause management should do more than just mask the symptoms .

By treating the underlying hormone deficiency , patients can find relief for vasomotor symptoms and urogenital atrophy , while reducing their risk of osteoporosis . 2 , 3

Learn more by watching Dr Terri Foran on managing menopause symptoms .

Scan here .

References : 1 . Davis SR , Magraith K . Med J Aust 2023 ; 218 ( 11 ): 500 – 502 . 2 . The Royal Australian and New Zealand College of Obstetricians and Gynaecologists . Managing menopausal symptoms , September 2020 . 3 . Hormone Therapy Position Statement of the North American Menopause Advisory Panel . Menopause 2022 ; 29:767 – 794 .

Besins Healthcare Australia Pty Ltd ABN 68 164 882 062 . Suite 5.02 , 12 Help Street , Chatswood NSW 2067 . Office phone ( 02 ) 9904 7473 . For medical information call 1800 BESINS ( 237 467 ). www . besins-healthcare . com . au EPR-EST-PRM-1994 March 2024 .

Dr Jon Fogarty GP on the NSW Central Coast .

Doctors speaking out deserve more support .

THE horror of the war in Gaza is almost too hard to watch . The temptation is to look away . I certainly need to look away at times to preserve my own mental health . It is not the only horror on the planet at the moment , but watching the gross destruction of the health system in Gaza — the hospitals and clinics , medicine ’ s essential infrastructure — is a public health and humanitarian nightmare .

I am appalled by the destruction of the lives of the very people attempting to give medical care to those caught in the very worst of times .

It has been estimated that more than 300 doctors , nurses and other health workers have been killed since the conflict began .

Médecins Sans Frontières says the entire healthcare system in the territory has been rendered inoperative .

A population of half a million jammed into one corner of land no more than 13km wide and 41km long is under siege . Half a million . That is the population of Tasmania . Every day in Tassie , and in every big Australian city , thousands of medical issues are dealt with : complicated obstetric deliveries are managed , appendixes are removed and burns and broken legs are treated .

Imagine Tasmania with no medical care — or all but none . Every day . Nowhere to hide , and no help to be had . No reliable source of food . Day after day . For every Tasmanian .

The UN ’ s secretary-general , António Guterres , described the Gaza Strip being reconstructed as “ a graveyard for children ”.

What will become of those who survive ?

What mental and physical health legacy has been delivered to them ?

I am not writing to argue who is right or who is wrong in this conflict .

Doctors in Australia with connections on either side of the war will hold passionate views .

Many will be intimate with the suffering that the wider world sees only through the media .

Jewish families in Australia will grieve for those who were murdered on 7 October and for those taken hostage and who must be living a nightmarish existence few of us could imagine . Those families are outraged and angry .

Those with connections to Palestine will grieve for the death and destruction that has been inflicted upon their family , friends and colleagues . They too will be outraged and angry .

Doctors with no personal connection also hold passionate views . Many are

GETTY IMAGES

Nasser Hospital , Gaza Strip , following Israeli strikes on 3 December 2023 .

outraged and angry . How can we respond ? How can we talk to each other when emotions are stripped raw , when so much is at stake and so much already lost ?

Some have argued that raising a voice on these issues is counterproductive , that it is not the core business for doctors , that it divides communities rather than unites them , that we become political .

But silence cannot be the response either .

To advocate for medical care for those who are denied it is implicit in the ethos of medicine . Access to safe medical care is a universal human right and one not limited to periods of peace .

Chapter 7.3 of the Medical Board of Australia ’ s code of conduct for doctors states :

“ Good medical practice involves using your expertise and influence to identify and address healthcare inequity and protect and advance the health and wellbeing of individual patients , communities and populations .” That seems pertinent here . I know doctors in Australia who have spoken out about the destruction of medical services in Gaza and have faced abuse and threats . The abuse may come from inside and outside their own communities .

Some face doxxing and toxic threats on social media .

And with that abuse has come the lodgement of vexatious complaints to AHPRA and the Health Care Complaints

Commission , triggering unnecessary and inappropriate investigations .

I know we do not face an early and unexpected death in an Arctic prison because we speak out , but a letter from a regulatory body can keep the best of us awake at night and impair our confidence in public advocacy .

Regulatory bodies need to take a clear position on such complaints .

While they are obligated to assess all complaints , those that carry blatant vexatious intent need to be disposed of expediently .

The complainant , and the doctor subjected to the complaint , needs to know speedily that the complaint will

A letter from a regulatory body can keep the best of us awake at night and impair our confidence in public advocacy .

not be pursued .

The perpetrators of this form of bullying need to face appropriate consequences for the distress they inflict and the time they waste .

Doctors are familiar with difficult and challenging conversations . We are , or should be , good listeners .

We are also used to offering our view to patients in the knowledge that it is not the only one .

When required , we can sustain our position in a robust manner , without resorting to personal attacks .

Despite the pain and emotion , or perhaps because of that , there is a need for us to talk and to listen to each other .

We need to be free to clearly express strongly held views and to do so without facing threats or abuse .

We need to value the intellectual and social space that is destroyed by all war .