Thinking too much inside the box The dehumanising
MO nature of modern medicine makes me scream
I agree totally , Dr Pam Rachootin .
Today , we pathologise normal
human emotions resulting from life challenges .
We measure and diagnose instead of listening .
Yet we know from decades of research that what is most effective in dealing with emotional or mental health challenges is not the technique used but the relationship with the practitioner .
A human being who listens , who seeks to understand and who portrays a genuine interest and compassion is more important to the person seeking help .
They are also much more effective in understanding what is really going on and recognising causes , process and aetiology .
Ratings discard rich and valuable information , leaving a skeletal number that tells little about the person or their issues .
They are for risk managers , like lawyers or accountants focused on managing legal or financial risks , not for health practitioners focused on helping people with their human needs .
Jennifer Manson Psychologist , Canberra , ACT
Well written , Dr Pam . Life is not a process line of categorical information .
I ’ m with you , a rebel on behalf of generalism against this ever-increasing ridiculous reductionism .
Why ? Because those who have a counting fetish now manage healthcare , I suspect we are decreasing the range of human experience into understandable and fixed columns .
This helps the fetish of measurement measure the task so it is acceptable to pay it .
In a lifetime of patients ’ narratives in mental or complex health presentations , you and I know it is a totally wrong paradigm of value applied to generalist healthcare .
It is driving good doctors out and failing to attract the young in . Adjunct Clinical Professor
Karen Price GP , Highett , Vic
I sense that the next mandated step in GP mental health services will be orders from above to direct our patients to ChatGPT in a dedicated booth in the waiting room .
Dr Dianne Moses GP , Gold Coast , Qld
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A sorrowful systems failure Footage of police
Dr tasering 95-year-old aged care resident ‘ confronting ’
I am saddened by this story — not just by the fact that an old lady has been severely injured but also by the vitriol emerging from so many people who were not there . I have some insight here . As a previous head of department of a major ED , I was constantly bombarded by people criticising our service through their ‘ retrospectoscopes ’.
People loved to tell me what they would have done after already knowing the outcome and without ever having to manage the complex situations involved .
We worked in an underresourced , volatile environment , as residential aged care facility staff do .
We had many junior staff on the front line , as the police do .
We can all think of things that should have happened , and hopefully , lessons will be learnt from the investigation .
A mature approach would be to limit our armchair assessments until all the facts are known .
No strategy is effective in 100 % of cases .
Outside the context of this particular case , many elderly people with dementia have falls and hit their heads without any force being used , and every strategy for restraint — whether physical or chemical — carries some degree of risk .
Dr Sue Ieraci Emergency medicine specialist ,
Sydney , NSW
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I cannot respond in anger to a situation so filled with sorrow .
It is a systems failure , where the largest contributors to tragedy are very poor community health literacy , with subsequent bizarre expectations of health personnel ; lack of resources for aged care ; and lack of therapeutic autonomy for aged care clinicians .
Violence against health personnel is getting worse , but communities and legislators limit our actions to prevent injury to us .
‘ No chemical restraint ’ is a mantra of the deluded .
It is sometimes needed , and as this tragedy reveals , it is a lot safer than a taser .
When I lecture to registrars on psychiatric and delusional emergencies , I always remind them of the severe dangers of these situations .
Associate Professor Chris Hogan GP , Melbourne , Vic
Backing down from up above GPs win back PBS
Dr prescribing rights for kids ’ asthma drug
I don ’ t think the PBAC did it for us . Someone living in an ivory tower has been advised that seeing these specialists is expensive , involves long wait times and is beyond the financial reach for many . And that , in turn , puts pressure on the ambulance services .
The cost of a visit to ED and hospitalisation is much higher than the medicine cost .
And the last time I checked , we had 700 asthma deaths a year .
GPs don ’ t prescribe to those who don ’ t need it .
Any parent who can afford it
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will want a second opinion from a specialist before their child ‘ goes on steroids ’ anyway .
Dr Nermana Gradisic GP , Melbourne , Vic
A ray of sunshine for the specialty I ’ m a young GP — here ’ s
MO my story about the specialty I love
I am a specialist in a small singleorgan specialty and have an even narrower subspecialty interest .
I see thousands of patients a year and unfortunately remember very few of them because I generally fix one problem and move on to the next straight away .
Most of the time , I have no idea who my patients are when I meet them on the street .
My wife is a GP , and her professional life is very different .
She has a loyal following of patients with whom she has walked through life ’ s ups and downs .
They would swear allegiance to her .
I don ’ t think I would cope with her work , as the breadth of knowledge required to do her job is simply daunting .
Fortunately , medicine has many different pathways to accommodate all our diverse personalities .
Dr Sunny Patel , I am glad you have found a pathway you are passionate about .
Keep up the enthusiasm . And value yourself : a good GP is worth more than gold .
Don ’ t let anyone ( specialists , bureaucrats , etc ) put you down .
Dr Joe Li Ophthalmologist , Mackay , Qld
Well done , Sunny . You are a ray of
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sunshine to the profession . I ’ ve been in beautiful Shoalhaven in NSW for 37 years now .
It ’ s a harder specialty than when I started — more complex with more consulting work every day .
We need to share patient responsibilities and embrace the activities that refresh us , whether teaching , supervising , assisting in theatre or running a skin clinic .
We need something beyond the slog of consulting .
Dr Victoria McCartney GP , South Coast , NSW
Dear Sunny , I am a 74-year-old GP — now retired for five years .
There was not a day in my 35 years I did not enjoy .
I feel privileged to have had the experience of working in general practice , never once waking with the feeling of not wanting to go to work .
Dr Colin Dolling GP , Adelaide , SA
Will costly creep become a stampede ? Psychedelic clinics to
6 offer $ 20,000 treatments for severe depression from July
As someone who has experienced treatment-resistant chronic depression for 25 years , the possibility of something that may help is like a beacon in the dark .
But I would also hope that more established psychiatric units would investigate it before the door opens .
I have my fingers crossed .
Dr Richard Johnston GP , Inverloch , Vic
I ’ ve just checked the outcome statistics for our practitioners in treating depression : 74 % improved , 53 % significantly so , with 0 % significant deterioration .
This was an average of seven sessions .
So people will be paying $ 20,000 for this as-yet unproven treatment , yet we can ’ t get an extra 10 psychology sessions on Medicare .
Julian McNally Psychologist , Melbourne , Vic
The ones who don ’ t improve are the ones who need the help . Those with a true biological depression are probably not in the group you get a response , not cure , for .
Dr Richard Johnston GP , Inverloch , Vic
I fear that the therapeutic creep will become a therapeutic stampede .
Dr David Ringelblum GP , Melbourne , Vic
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