Australian Doctor 1st September 2023 AD 1st Sept Issue | Page 12

12 NEWS

12 NEWS

1 SEPTEMBER 2023 ausdoc . com . au

Locum a cost too big for GP

Dr Gundi Muller-Grotjan .
Carmel Sparke WHEN Dr Gundi Muller-Grotjan
told patients she would be forced to close one of her two clinics for a couple of days a week because of a desperate doctor shortage , the response was overwhelming .
“ Apart from all the scones , baked goods , bottles of wine and fresh fish , I actually found dinner on my doorstep the other day ,” Dr Muller-Grotjan said .
Patients had also contacted local media and written to MPs in
support of their local GPs .
But all the baked goods in the world will not solve the staffing problem — even in a place as beautiful as the far South Coast of NSW .
Dr Muller-Grotjan co-owns two clinics : one in Narooma and the other in Bermagui about a 30-minute drive away .
“ It all came to a head when we realised that , starting early August , we would have to close the Bermagui surgery regularly at least one day a week ,” she said .
“ I put it out on our social media and put a bit of a spiel on two big whiteboards we have at the practices .
“ It was just saying we have an acute doctor shortage . Please be patient . Please bear with us , and if you want to help us , please write to our local members .”
She managed to secure a locum , but the cost of $ 8500 for four days a week was too much for the long term .
“ The locum doctor was well loved and helped keep the surgery running , but the practice was running
at a loss employing her ,” said Dr Muller-Grotjan .
“ I have now decided to ask our local councils for better financial support so we can keep going a little longer .” She awaits their response . “ Almost every rural general practice is in the same boat . Our problem is not new ; it is just worse than ever .”
Despite having to “ work her arse off ” with 80-hour weeks , she still loves her work .
“ It is the best job in the world .”

Now blooming with living guidelines

More updates than ever before !

Therapeutic Guidelines regularly reviews content , responding to significant changes in evidence and practice .
Don ’ t have a subscription ? Visit tg . org . au to subscribe and support the continued development of your independent guidelines .

New PCOS guidelines released

Rachel Fieldhouse ELEVATED serum antimüllerian hormone can now be used as an alternative to pelvic ultrasound to aid diagnosis of PCOS , according to updated guidelines .
Although testing for anti-müllerian hormone ( AMH ) is not MBS subsidised , lead author and endocrinologist Professor Helena Teede says the cost of an ultrasound is “ comparatively ” higher .
The guidelines caution against using serum AMH in adolescent girls aged 10-19 because of poor specificity and the risk of overdiagnosis .
The authors also stress that AMH should not be used as a standalone diagnostic marker for the condition .
Professor Teede , from Monash University in Melbourne , explains that up to 70 % of women with PCOS can be diagnosed based on the presence of both menstrual irregularity and hyperandrogenism , which can include acne , female pattern hair loss or hirsutism . “ But if adults do not have one of those features , you can do an ultrasound , and now you can also do an AMH test .”
In other changes , cardiovascular disease is now considered a “ core feature ” of PCOS , with all women recommended to undergo a lipid profile at diagnosis regardless of age and BMI .
Similarly , the increased risk of type 2 diabetes with PCOS warrants a 75g oral glucose tolerance test at baseline and reassessment of glycaemic status every 1-3 years based on an individual ’ s risk factors .
The guidelines also recommend mechanical laser and light therapies for reducing facial hirsutism and associated depression or anxiety .
Guidelines : bit . ly / 44AZkFP