NEWS 9
ausdoc. com. au 22 AUGUST 2025
NEWS 9
Inpatient psychiatry faces‘ perfect storm’
NIKOLES COLEMAN © 2025 ABC
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* Trimbow is the only triple therapy PBS listed for severe asthma in two strengths and COPD( 100 / 6 / 10) 2
Rachel Carter A 58-BED private psychiatric hospital closed its doors for good this year.
Toowong Private Hospital in Brisbane moved to a wind-down plan after administrators received no“ viable” interest from potential buyers in the face of rising costs.
However, doctors say that is only part of the tale and the bigger story is the decline in admitting psychiatrists, which threatens the availability of private treatment.
“ If you need to come into hospital but they cannot arrange an admitting psychiatrist, you are likely to sit on their waiting list, getting progressively more desperate— just hoping someone will pick up your file,” psychiatrist Dr Josh Geffen says.
“ And we will be sitting at the hospital with 20 empty beds.”
Dr Geffen worked at the Toowong hospital for 25 years and first observed the trend during school holidays.
“ There are no fewer depressed people during the holidays, but there are fewer doctors in town.
“ I ran the neurostimulation team, and we would be half as busy. It was clear that the key rate-limiting step on admission was the availability of admitting doctors.”
The turning point came during the COVID-19 pandemic, when psychiatrists were generally not allowed to do inpatient work via telehealth, Dr Geffen said.
“ It became an even harder climate to work in, and some of the adjustments that were made for outpatient medicine did not really work for inpatient medicine.
“ The economics of the hospitals got worse; they found themselves in the terrible position of having waiting lists and empty beds simultaneously.
Ciara Seccombe THOUSANDS of medical students who had not attended lectures for 17 months as part of a protest have finally returned.
The impromptu gap year started in February 2024 when
“ It was the perfect storm.”
At the same time, according to psychiatrist Professor Brett Emmerson, outpatient psychiatry transformed.
“ A lot of psychiatric practice before the COVID-19 pandemic involved a patient who went to someone’ s rooms, waited in the waiting room, spent their time with the doctor and then left,” said Professor Emmerson, chair of the Queensland branch of the Royal Australian and New Zealand College of Psychiatrists.“ Now, lots are doing telehealth.“ You practise from your home office, see more people and the remuneration is
‘ They were in the terrible position of having waiting lists and empty beds simultaneously.’
far greater than for an inpatient.”
The financial rewards of private outpatient practice made it harder to attract younger psychiatrists to inpatient roles, Professor Emmerson said.
“ Inpatient work is not easy. These patients are generally a lot more acute than what you would see in community practice.“ You see them probably every day for the two or three weeks they are in hospital.
“ So, psychiatrists are in the position where it is uneconomic to look after private inpatients. The rebates are no longer acceptable to the profession.”
In 2021, Dr Geffen relocated his outpatient practice to Toowong Private Hospital to alleviate pressure from the admitting psychiatrist shortage.
“ I negotiated with the hospital that, if they could get me a half-time registrar, I could train that registrar and together we could pull some people off the
the South Korean Government announced it would increase the medical student intake from 3000 to 5000 a year. The Korean Medical Association claimed this would lower standards.
It rallied students to strike
Dr Josh Geffen.
waiting list and fill beds,” he said.
It failed to save the hospital, but he said more private sector training places remained part of the solution.
“ Seeing as 55 % of the psychiatric workforce is going to work partly or completely in private practice, I think we should do more training in that setting.
“ If I have got a registrar, I can get through about three times as much work, so it makes existing admitting doctors more efficient.
“ Private training places relative to public places are still few and far between.”
Another option was persuading the Federal Government to vary or lift the moratorium on IMGs, Dr Geffen said.
“ It sounds a bit odd to class the private hospital system as an area of need.
“ But if you could give overseas doctors the opportunity, I think they would be keen to take up metropolitan work. That would be a relatively quick solution.”
However, he said there was no fix without federal policy.
In the meantime, Queensland was down 58 inpatient beds.
Dr Geffen believed that, of Toowong Private Hospital’ s roughly 50 admitting psychiatrists, 25 had not sought recredentialing in another hospital.
“ People are sitting on the waiting list looking for an admitting psychiatrist because they are seriously ill,” he said.
“ They are already close to despair and effectively feel rejected that there is no help for them.
“ Their only other option is to show up at ED to advocate for themselves to be admitted to a public psychiatry unit that is already overfilled.”
Medical students back after strike
until the government abandoned the plan, which it finally did in March 2025.
However, it took until July for the union to call off the strike.
More than 8000 students will reportedly have to repeat a year.
Trimbow 100 / 6 / 10 & 200 / 6 / 10 are indicated for maintenance treatment; in adults with asthma not adequately controlled with a maintenance combination of medium dose or high dose ICS / LABA respectively, and who experienced ≥1 exacerbation( s) in the previous year. Trimbow 100 / 6 / 10 is indicated in adults with moderate to severe COPD who are not adequately treated by ICS / LABA or LABA / LAMA. 1
PBS Information: Authority required( STREAMLINED). Severe Asthma. Chronic Obstructive Pulmonary Disease( 100 / 6 / 10 mcg presentation only). Criteria Apply. Refer to PBS for full information.
Please review Product Information before prescribing. Product Information is available by scanning the QR code.
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Abbreviations: COPD: chronic obstructive pulmonary disease; ICS: inhaled corticosteroid; LABA: long-acting beta 2 agonist; LAMA: long-acting muscarinic antagonist; PBS: Pharmaceutical Benefits Scheme; pMDI: pressurised metered dose inhaler. References: 1. Trimbow Approved Product Information. 2. Pharmaceutical Benefits Scheme( PBS). www. pbs. gov. au. Chiesi Australia Pty Ltd, Hawthorn East, VIC. 3123, Australia. Tel: + 61 3 9077 4486; Fax: + 61 3 8672 0792; Email: medinfo. au @ chiesi. com. Copyright © Chiesi 2025. All rights reserved. Date of preparation: January 2025. AU-TRI-2500008. CHIE00211C.
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