Letters
TWEET OF THE WEEK
GP advertising a fraught issue
Letters
Your Views
EDITOR There is so much medical advertising in WA— in the newspapers, at the cinemas, even on billboards(‘ Promoting your practice’, Smart Practice, 4 August). Some GP practices tout for patients as they go into pathology or radiology from other practices. I don’ t see AHPRA doing anything much about it.
Dr Mary Cadden GP, Perth, WA
EDITOR This is very fraught area when you consider we are wearing two hats.
As medical practitioners, we are bound by strict regulations to protect patient safety. But we are also businesses in competition with each other for patients.
With the increase in the supply of doctors hitting the market in the coming years, there is going to be greater pressure in this area, testing the boundaries. Dr Justin Dooland GP, Adelaide, SA
EDITOR In 1980, 29 doctors from four adjacent suburbs decided to set up an after-hours service for their patients. We hired an advertising company and appraised them of the medical board’ s regulations about medical publicity. They were a bit
FROM THE WEB
TWEET OF THE WEEK
“ And * only * seeing complex stuff is really tiring. Having a few“ simple” consultations is often how you get through a morning clinic.”
— Dr Tim Senior @ timsenior
Follow us at @ australiandr cute and put an advertisement in the local weekly paper with our names in the form of a crossword puzzle with some doctors’ names being black on white( which was permissible) and others being white on black( which was not).
The board received a complaint from another after-hours service some 12km distant and with a different catchment area from ours.
We received a long and offensive letter from the chairman of the board detailing the complaint against us and demanding an immediate reply, to which we succinctly complied.
Those were the days when medical
Best feeding
( Don’ t stigmatise mums for formula feeding: AMA, 1 August) I agree completely. As the studies suggest, with 96 % of mums starting breastfeeding, this is something most mums want to do, but there are many reasons why it doesn’ t work in the long term. Families that use formula should be supported to ensure they are not misled by false information from friends and media, and know how to choose and use formula correctly. As a side issue, I think that without the support of several days in a private hospital, breastfeeding might not have worked out for my family( both children did end up breastfed until almost 12 months). It is a shame that public patients are discharged quickly with little support in establishing breastfeeding. I wonder if there is any research into breastfeeding rates in public vs private hospital deliveries?
Chris Hmmm. Some would argue an intervention that bestows great health benefits, such as reduced asthma rates, reduced diabetes and improved immunity, should be promoted vigorously.
Personally, I feel breastfeeding is up there with immunisations in importance to overall child health. If our immunisation rates were at 15 %, then I think we would all be pretty fired up.
Dr Dan
If you don’ t look...
( Ignore Gwyneth Paltrow and limit thyroid tests to highrisk patients, RCPA says, 1 August) In 40 years of general practice, I have found sub-clinical Hashimoto’ s disease is rampant and I suspect chronic inflammation of the thyroid causes symptoms of fatigue. We have 170 active patients with Hashimoto’ s noted on their record, 70 of whom are on T4. I suspect there are many more, but we are pressured not to order thyroid antibodies test routinely. T4 is
boards had difficulty distinguishing between ethics and etiquette. The current regulations on self-promotion seem very liberal and no one, nowadays, seems much concerned about etiquette. Dr Max Kamien GP, Perth, WA
Have your say
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a very cheap drug and it takes months to get the metabolism back to normal from prolonged hypothyroidism. If you don’ t look, you don’ t find.
PeterCStephenson Here we are, trying to fight an obesity epidemic— and they are asking us to not act on one of the most common correctable causes and wait until they become hyperlipidaemic?
Iliya Englin How can one describe the unforgettable sight of a patient whose hypothyroidism had been undiagnosed for so long that they had gradually developed a life-threatening myxoedema coma— and are then admitted to the ICU? The symptoms can creep up on a person and present as depression, dementia, etc.
Dr Poo
AHPRA’ s decision may fuel vexatious actions
EDITOR A patient who made a formal complaint about their psychologist has been refused access to the psychologist’ s response to AHPRA(‘“ Aggressive” patient denied access to AHPRA complaint defence’, 31 July). The outcome seems fair enough but there is the issue of the imagined being more injurious than the truth.
If I were the psychologist, I would probably have sent a copy of what I had said to AHPRA to the complainant. If it was the absolute truth— and the complainant would know that deep down— it would explain why I could no longer work with them and, hopefully, result in a better understanding of why AHPRA took no action. If I were the patient, I would naturally be wondering what the psychologist had said, and whether their version differed from mine substantially— a reasonable concern, one would think.
In the above case, the complainant is left imagining they were impugned in some way, concerned that the psychologist’ s version might well be exaggerated and unfair. Thoughts like that can eat away at a person and, before you know it, you have a vexatious stalker on your hands. Dr Peter Bradley GP, Brisbane, Qld
australiandoctor. com. au
Storm in a teacup
( Female surgeons lance journal’ s sexism, 3 August) I tend to respect my colleagues,( male, female, straight, gay, etc) based on competence, punctuality, attitude and general things looked for in employees / friends. By the time I realised some were not straight, white, middle-aged males, I had already decided whether they were worthy of my respect. The cluttered dust storm raised by equity issues tends to distract from the real issues.
Rural GP
Own up
( Guild gets creative with scheduling, 1 August) I’ m a pharmacist working in an opioid dependence program. Hopefully, this latest attempt by the Pharmacy Guild of Australia will be shot down. However, it needs to be acknowledged the medical profession is not much better at managing opioid risk. More than 500,000 Australians used over-the-counter codeine for non-medical use last year but around the same number used prescription opioids.
Tim Griffiths
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www. australiandoctor. com. au 18 August 2017 | Australian Doctor | 31