Australian Doctor Australian Doctor 12 May 2017 | Page 3

Dipsticks don’t work in uncomplicated UTI: study JOCELYN WRIGHT GPs could do away with tests for symptomatic uncomplicated UTIs and treat empirically with antibi- otics, a study suggests. Primary care researchers from Belgium have shown that most women who have negative bacte- rial tests after presenting with clas- sical UTI symptoms show signs of infection when retested with the gold-standard PCR testing. In their study of 220 sympto- matic women, traditional MSU culture tests found UTI pathogens in 81% of samples. However, 90% of women with negative results tested positive for Escherichia coli on PCR testing. This may have been due to the presence of low counts of E. Coli below the usual threshold or because the pathogen persisted as an intracellular ‘biofilm’, causing inflammation and symptoms, the researchers said. Their findings supported the idea that routine testing may be unnecessary for women with symptoms of an uncomplicated UTI, who could be treated empiri- cally with antibiotics, they said. “Instead of spending time and energy to prove an uncomplicated THE boss of corporate giant IPN has quit to become the new CEO of the company’s biggest rival, Primary Health Care. The shock move by Dr Malcolm Parmenter — the face of IPN for over a decade — was announced last week. He will be paid $1.65 million a year, with up to a million dollars more on offer in performance bonuses. Primary has been in the market for a new CEO since current boss Peter Gregg announced he would step down after being charged with the falsification of company documents during his stint at construction giant Leighton Holdings. Primary has attempted to rebrand itself following the death of founder Dr Ed Bateman in 2015 but has had a hard time attracting sufficient numbers of GPs. Dr Parmenter joined IPN in 2000 Traditional urine cultures would still have a role, if treatment failed or if there was evidence of a more complicated UTI. UTI, physicians can rely on the typical symptoms and focus on acknowledging and managing the patient’s complaints,” the Univer- sity of Ghent researchers advised. However, traditional urine cul- tures would still have a role to play, if treatment failed or if there was evidence of a more compli- cated UTI, they conceded. Melbourne GP Dr Sara Whit- burn said the findings confirmed what often happened in practice and would give GPs greater confi- dence to treat empirically. “It does mean we have to be quite clear about what symptoms the women are feeling because we have to be confident we’re getting a good history of an uncompli- cated UTI,” she told Australian Doctor. “A good symptom history is as useful as doing dipstick and investigations, and I think [these findings] will be really useful in practice,” she added. As a GP specialising in women’s health, Dr Whitburn said she saw many women experiencing other vaginal symptoms and advised “anything that doesn’t fit an uncomplicated UTI” still merits an MSU. Clinical Microbiology and Infection 2017; online. while working as a GP at the Mosman Practice on Sydney’s North Shore, now one of IPN’s largest privately billing practices. He rose rapidly and was appointed CEO in 2006. He went on to achieve annual revenues of nearly $400 million. As CEO, Dr Parmenter acheived revenues of nearly $400 million for IPN. He will take up his position as Primary’s managing director and CEO in September. Mr Gregg will continue to run the $1.75 billion healthcare group in the meantime. Primary’s chairman, Rob Ferguson, says Dr Parmenter is “ideally placed to lead the company through the next stage of its evolution”. Primary’s profits have declined sharply in recent years, partly because of pressure on its bulk-billing medical centres amid the Medicare freeze. The company expects a full-year after-tax underlying profit of around $92 million for 2017, down from $104 million in 2016 and $111.5 million in 2015. As a sign of the times, it has recently shifted away from a reliance on universal bulk-billing, partnering with former AMA president Dr Kerryn Phelps to launch a private billing venture, Health & Co. Opioid scripts land doctor couple with $30k fine ANTONY SCHOLEFIELD A HUSBAND and wife, both doctors, have both been found guilty of professional misconduct after one inappropriately prescribed oxycodone to the other. Adelaide anaesthetist Dr Christie Lang was accused of unlawfully prescribing oxycodone to her husband for more than two months without authority. In the same proceedings, brought by the Medical Board of Australia, Staff wri ters Restraints still used on mental health patients IPN boss jumps ship to biggest rival BRETT EVANS In Brief plastic surgeon Dr Clayton Lang was accused of inappropriately procuring the drug from his wife. The board claimed that both doctors had also prescribed oxycodone to a family friend for more than two months, without authority and without taking adequate notes. The couple admitted all the accusations. The SA Health Practitioners Tribunal said both doctors were extremely competent in their own fields. “Both are contrite and have learnt their lesson. The lapses giving rise to these proceedings will not be repeated,” the tribunal said. “[Dr Christie Lang’s] CV and references leave no doubt that she is a hard-working and extremely competent anaesthetist who holds high moral and ethical values for which she is highly respected by her peers. www.australiandoctor.com.au “[Dr Clayton Lang’s] CV and references indicate that he is extremely competent in his specialty and is highly regarded by his peers, all of whom are aware of his difficulties with the board in this matter.” The tribunal fined them $15,000 each but decided not to suspend either of them. They were also ordered to pay $12,500 to cover the medical board’s legal costs. MENTAL health patients are still being physically and mechanically restrained despite a push to eliminate the practice in Australia. National data on restraints in specialised public mental health hospitals, released last week, show the rate of people physically restrained in 2015-16 was about nine times for every 1000 bed-days. Mechanical restraint involving the use of either straps and belts was less common, at under two events per 1000 bed days. Children were physically restrained at a rate of 11 times per 1000 days in a mental health bed. Rates of physical restraint were highest for forensic services, at about 110 events per 1000 beds-days — 20 times the rate for general mental health services. AIHW report: Mental Health Services in Australia: bit.ly/1MC78OI Hold the phone, waiting room music fees set to rise THE sounds of Barry White wafting through the waiting room will become a little more expensive from July. Fees for playing licensed music in waiting rooms or during phone calls are set to rise by 1.5%. Payable to the Phonographic Performance Company of Australia, the tariffs apply to practices playing music from any source other than TV and radio, which are exempt from licensing requirements. Surgeries with between three and five external phone lines must pay $156 for hold music, while the fee for waiting room music is just under $78. To receive a hard copy of the new tariffs, email PPCA at [email protected] or call [phone]. Australia’s first medical cannabis shipment arrives THE first two commercial shipments of medicinal cannabis products have arrived in Australia under the Federal Government’s new policy to allow controlled importation of the drug. The shipments to Melbourne and Perth, both from Canada, are expected to be followed by others throughout the month. Federal Minister for Health Greg Hunt said children suffering from epilepsy and patients dealing with side effects caused by cancer treatment were most likely to benefit from the products. 12 May 2017 | Australian Doctor | 3