Letters
TWEET OF THE WEEK
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The cost of targeting doctors
Letters
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EDITOR According to the statistics quoted , 96-99 % of Australia ’ s 111,000 registered medical practitioners are meeting or exceeding performance indicators (‘ Age discrimination ? Older GPs face mandatory competency checks ’, 8 December ).
Wouldn ’ t it make more sense to focus on identifying the poor performers , particularly the very few that generate most of the complaints ?
At present , we make nearly 110,000 registrants spend many hours on demonstrating compliance with CPD requirements , instead of delivering much-needed healthcare . A convincing case for such onerous CPD requirements has not been made .
Looking at AHPRA ’ s most recent annual report , the percentage of registered doctors who were not subjected to conditions , reprimands or suspensions was 99.21 %.
If you were an infectious diseases specialist , would you give antibiotics to 1000 people in order to treat eight sick ones ?
Dr Julian Parmegiani Psychiatrist , Sydney , NSW
EDITOR “ All doctors will have to undergo at least 50 hours of CPD per year ...” This represents some 200 standard consultations , 100 detailed palliative family discussions , six full days of clinical attachments , at least
FROM THE WEB
TWEET OF THE WEEK
“ While sales [ of codeinecontaining medicine ] represent a lucrative financial return of over $ 150 million a year for the pharmacy industry , patients are paying for this with their lives .”
— RACGP @ DrBastianSeidel bit . ly / 2iPJuWX
Follow us at @ australiandr two major conference / workshop events , or some $ 10,000- $ 15,000 of GP time .
I presume Medicare will be reimbursing this time via a new item number , as by my estimation , this represents another 2-4 % pay cut , depending on individual workloads . Dr Fergus Maclagan GP , Flagstaff Hill , SA
EDITOR The motivation for all this increased CPD and assessment is , allegedly , to protect the public and ensure high levels of clinical / performance among doctors and surgeons . In principle , this approach seems sensible and noble , and I feel most
Creepy people still need healthcare
( Police warn of sex offender targeting GPs , 4 December ) Decades ago , I encountered two such individuals , who would make an appointment , always have a groin problem and then become aroused . I ’ m sure that many young female colleagues experience the same situation . No alarms when I was young . Back then , our practice sent a letter to the individuals , saying that appointments with female doctors were not available to them , but the males were happy to see them . Never saw them again .
Dr Maureen Fitzsimon
Many creepy males book appointments with female GPs — being creepy is not a crime . The police can only do so much . On the flip-side — he has a right to medical care . The issue is flagging such patients discreetly ( this article is not discreet ), managing inappropriate behaviour within consults and empowering staff to report illegal behaviour ASAP .
Dr Natalie Barrington
Solo GPs are far from ‘ isolated ’
( Plan to support isolated doctors won ’ t be cheap , 4 December ) The assumption that GPs “ working in private solo practice , in part-time positions with limited patient contact hours or in after-hours work may be putting patients at risk ” is baseless , offensive and almost certainly wrong . As a full VR , QI & CPD up-todate GP in after-hours solo practice , I am in frequent
practitioners would agree maintaining safety and competence in practice is important .
However , what we don ’ t see is a proportionate increase in remuneration or rebates for clinical or practice services that all the compulsory CPD , training and revalidation is meant to underpin . Why are doctors ( or any other registered healthcare provider ) expected to pay escalating professional and registration fees and high costs for CPD and assessment when there does not seem to be a reasonable return on the investment ?
It is worth remembering that all regulatory ideology plays a major role in policy development .
contact with other GPs , ED consultants and on-call specialty registrars . In fact , I have more such contact now than I did when I was a member of a 10-12 GP metropolitan in-hours practice . The reason ? Back then 20-30 % of consultations were strictly medical , the remainder were administrative and / or preventative . Only the former group contained any quandaries . Moreover , after several intra-practice impromptu conferences , it
My academic experience has taught me that research evidence is all too often selected to match the ideology , rather than quality research being the scaffold for good policy .
Would it not be better if regulatory organisations pooled their funds and developed a valid process to identify poorly performing healthcare professional , rather than burden safe , competent practitioners with more and more expensive and laborious policy without any improvement in remuneration ?
Dr Gregory Parkin-Smith GP registrar , Dunsborough , WA
EDITOR Surely the AMA will initiate an age discrimination action to stop this madness in its tracks . They will protect our rights , won ’ t they ? Dr John Miller GP , Como , WA
EDITOR Careful what you wish for ! These changes , while laudable on their own , might have the consequence of making many simply retire , especially in rural areas .
Dr Andrew Nolan GP , Launceston , Tas
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became clear that most of my colleagues were either too busy , uninterested or knew no more than me . Now , more than 95 % of my consultations are medical and acute . Quandaries are frequent . Additionally , the board fails to understand or acknowledge the large amount of reading someone like me performs on a regular basis . AFP , MJA , Australian Doctor , NPS MedicineWise , Science and Therapeutic Guidelines are all read weekly . I feel anything but “ professionally isolated ”.
Dr Solly Zilman As a solo GP in an accredited practice , I take lots of medical students . They tend to keep me in touch with what management protocols the ivory tower specialists are advocating this season . I also learn a lot about how much I know by explaining things to them . Likewise , I learn a lot from the specialists to whom I refer my patients , as would any GP . This weird idea that solo GPs are somehow disadvantaged and isolated must come from people who have never been solo GPs . What will they come up with next — special hoops to go through for left-handed doctors ?
Dr Stephen Scholem
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