Australian Doctor Australian Doctor 15th December 2017 | Page 3

Surprise delivery at small-town practice
GEIR O’ROURKE
A GP has taken the ethos of
‘family practice’ to the next
level by delivering his own
receptionist’s baby after her
waters broke in the waiting
room.
Aimee Turnbull says she
had always joked about hav-
ing her first baby with the
help of Dr Grahame Deane at
Lake Cathie Medical Centre,
NSW, where she works.
But no one was laughing
when the 30-year-old went
into early labour in full view
of patients while standing at
the practice’s front desk.
“I was filling out a patient’s
appointment card when the
water started coming out of
me. It’s lucky I was standing
on a rubber mat!” Ms Turn-
bull recalled.
From there, things moved
quickly. An ambulance was
called, but the baby started
crowning before paramedics
arrived, and it was left to Dr
Deane to manage the birth
in the practice consultation
room.
“Dr Deane said he hadn’t
delivered a baby in four
years, but he’d been doing it
so long that I suppose it was
like riding a bike and he just
knew what to do,” Ms Turn-
bull said.
“He said he could feel the
head and grabbed my hand
to ask if I wanted to feel it
myself. But I remember say-
ing, ‘No, thank you, that’s
disgusting’.”
“Two minutes later, I was
looking at my son.”
Arriving at 32 weeks’ ges-
tation, baby Rory’s delivery
took 57 minutes from start
to finish.
Mother and baby were
taken by ambulance to Port
Receptionist Aimee Turnbull,
with the workmates who
helped deliver her baby.
Clockwise from left: Debbie
Ireland, Dr Nadia Acland, Dr
Sam Nelapati, Dr Lorraine
Evans, Danielle Eichorn, Dr
Grahame Deane, midwife
Leonie Morris and Brett
Lewis-Bain.
Macquarie Base Hospital and
later to John Hunter Hospital
in Newcastle so Rory could
get specialised care for his
immature lungs. He’s now
sleeping and eating well.
Although it was all over
Calls for Govt to cut IMG visas In Brief
GEIR O’ROURKE Staff writers
AUSTRALIA’S GP shortage
is over and the Federal
Government should severely
cut the number of IMG working
visas it’s handing out, the
RACGP warns.
The college says the recent
surge in locally trained medical
graduates means IMGs will
no longer be needed in the
medium or long term.
It also argues that the
recruitment of IMGs to work
in areas of need has failed —
largely because many move to
the cities as soon as they can.
“Due to the ability for …
IMGs to work anywhere in
Australia once they have
fulfilled their initial obligations
under the 10-year moratorium,
many have moved into major
cities to continue practising,”
the college says in a
submission to the Department
of Employment.
Since 2000 there has been
a 150% growth in overseas-
trained GPs practising in major
cities, compared with only
20% growth in Australian-
trained GPs, the college says.
“Overseas-trained GPs now
account for 49% of total FSE
GPs practising in major cities,
compared with just 24% in
2000-01,” it adds.
From March next year, IMGs
will no longer be able to work
under 457 temporary working
visas and will instead need to
apply for new “temporary skill
shortage” (TSS) work permits.
As part of the transition,
the RACGP wants general
practice to be dropped from
the Medium- and Long-term
Strategic Skills List of eligible
occupations.
Rural health advocates
have fiercely resisted any
change, fearing that reducing
IMG doctor numbers will
make it even harder to recruit
in the bush. But the RACGP
believes that issue can now be
solved with extra training and
government subsidies.
“Medical workforce issues
in Australia are no longer a
matter of supply, rather a
matter of maldistribution,” the
submission says.
before Ms Turnbull’s hus-
band, Arnold, had time to get
to the clinic, she said the GPs
and nurses at the practice had
become unofficial aunts and
uncles to the child.
“The girls told me later
that Dr Sam Nelapati, who
owns the practice, was even
pacing the hallways like an
expectant grandfather,” she
said. “In a perfect world, I
might have preferred it to
have been at the hospital, but
being at work makes it a little
bit special.”
Dr Deane, who has deliv-
ered 2800 babies during his
career, said he hoped it didn’t
become a regular occurrence,
however.
“I’m not going to recom-
mend it to everyone else, but
it was nice because the whole
practice came together as an
amazing team; everyone just
stepped up and helped out,”
he said. “It’s a really fantas-
tic group of people we have
working here, and we really
are a family practice in the
fullest sense of the word.”
Stop paternalism over breast density, say experts
ALL women who have breast
screening should be notified of
their mammographic density,
according to Professor Gelareh
Farshid, clinical director of
BreastScreen SA. Failure to
disclose breast density to
protect women from anxiety
over higher risk is patronising
and misguided, he writes in the
MJA. Disclosure is needed for
informed decision-making on
other tests, he says.
MJA 2017; online
Haemochromatosis screens are a
‘win-win’ for patients and community
MICHAEL WOODHEAD
SCREENING for
haemochromatosis is justified
because patients with only
moderately elevated levels of
serum ferritin benefit from iron
reduction treatment, genetic
specialists say.
About one in 200 Australians
have the hereditary condition
and would benefit from
normalisation of ferritin levels,
according to researchers at the
Murdoch Children’s Research
Institute in Melbourne.
In their study of 94 patients
with haemochromatosis, those
randomised to iron reduction
treatment every three
weeks showed significant
improvement in fatigue-related
wellbeing, especially cognitive
function, compared with
those randomised to sham
(plasmapheresis) treatment.
Patients were identified as

having haemochromatosis via
family history or community
screening and had serum
ferritin levels of 300-1000ug/L.
The iron reduction treatment
also improved hepatic fibrosis
The condition affects around one in 200 Australians.
markers and serum markers
for oxidative stress.
“We would like to see
doctors test more readily for
this condition so that anyone
with haemochromatosis and
raised body iron levels can
have treatment to normalise
those levels,” said co-author
Professor Martin Delatycki,
director of Clinical Genetics at
Austin Health in Melbourne.
“We are also calling for
the Federal Government
to fund screening of all
members of the community
for haemochromatosis since
treatment can benefit the more
than 100,000 Australians with
this condition, even if they
have a moderate increase in
iron levels. In addition, giving
blood benefits the whole
community, so it’s a win-win.”
Lancet Haematology 2017;
online.
www.australiandoctor.com.au
New guidelines address thunderstorm asthma
UPDATED guidelines
developed by the National
Asthma Council include
new recommendations on
thunderstorm asthma, allergic
rhinitis and managing patients
with asthma-COPD overlap.
The latest version of the
Australian Asthma Handbook
includes new information
and advice on thunderstorm-
triggered asthma, such as
the use of inhaled and intranasal corticosteroids during the
pollen season. The guidelines also recommend identifying and
treating patients with asthma-COPD overlap differently from
patients with COPD or asthma alone because they have more
symptoms, more flare-ups, use health services more often and
have higher mortality than patients with either condition alone.
Drug name changes become official from January
THE PBS is to adopt changes to the names of more than 90
listed drugs from 1 January as part of an ongoing program
to align with international conventions. Changes to active
ingredient names range from minor spelling differences such
as ‘oestradiol’ to ‘estradiol’, to substantial name changes
such as ‘thyroxine’ to ‘levothyroxine’ and ‘hexamine’ to
‘methenamine’. Practice software programs have already
adopted some of the name changes. The transition period for
packaging and product information extends until 2020.
15 December 2017
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Australian Doctor
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