Pathology rent targeted
Ho , ho , ho , how is Santa still healthy ? from page 1
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‘ The world is uglier than I thought ’
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GEIR O ’ ROURKE FEMALE doctors should be prepared to use their smartphones to record incidents of sexual harassment from male colleagues , says a leading campaigner against sexism in medicine .
Cameras should also be installed in operating theatres to tape bullying and resolve disputes , says Dr Gabrielle McMullin , the Sydney surgeon who made national headlines in 2015 after calling out the abuse of women in her field .
She argues nothing much has changed since she famously stated that a woman who complained about being sexually assaulted by a supervising surgeon would have enjoyed an easier career if she had just “ given him a blow job ” and stayed silent .
“ The last three years have taught me that the world is uglier than I had thought ,” she says on the MJA Insight website .
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PHOTO : Nic Bezzina
“ I continue to receive letters , emails and phone calls on a regular basis with complaints , not only from surgical trainees but trainees in all medical specialties , and also from nursing staff .” Because sexual harassment complaints
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often put the word of a senior doctor against a junior one , Dr McMullin argues it may be useful for victims to arm themselves with evidence — even though secretly taping conversations is against the law in some states . |
‘ My advice to young women is to always have their recording device [ phone ] at the ready ,’ Dr Gabrielle McMullin says .
“ My advice to young women is to always have their recording device [ phone ] at the ready .”
Dr McMullin also repeats her call for the introduction of “ black boxes ” in theatres , like those on aircraft , to keep an audio and video
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record of everything said and done during a procedure .
“ Realistically , the only effective means of resolving this ‘ he said , she said ’ situation would be for CCTV monitoring of behaviour in the operating theatre — the black box .”
Dr McMullin is hopeful that change could soon follow in the wake of the Harvey Weinstein and Don Burke scandals .
Last week Time magazine announced it had awarded its prestigious ‘ Person of the Year ’ title to “ the silence breakers of the # metoo movement ”, in which ordinary people shared their stories of sexual harassment , largely via social media platforms .
Women in Australian medicine were among those who took part , Dr McMullin said . “ Hopefully this is a tipping point and it will no longer be the way if you are a woman and complain , that you get ignored or paid off and dropped .”
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Pathology rent targeted
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that the government ’ s compliance regime could be used by the pathology corporates to gain an unfair advantage over GPs during negotiations .
“ The devil is going to be in the detail but when you think about it , the pathology companies are caught between wanting to capture market share and reduce the amount they are paying for rent — those two things work in different directions ,” he said .
Ho , ho , ho , how is Santa still healthy ? from page 1
insights into why — it comes down to the fact that he spreads joy and good cheer to millions of children .
Eminent psychiatrist Professor Gordon Parker said : “ The happiness / wellbeing literature indicates that those high on wellbeing live another decade and with mediating variables being lower weight , better cholesterol / triglyceride levels .
“ People high in wellbeing tend to favour giving rather than receiving ,” he said .
Professor Parker added : “ Like Winston Churchill , Santa has challenged everything we know about mental health , physical fitness and longevity . Churchill smoked excessively , was physically unfit after his 30s and averaged 10-20 standard drinks of alcohol a day for decades .
“ Yet he lived to his 90s , and his liver was fine on autopsy .
“ I think Santa must be an altruistic figure whose knowledge of wellbeing principles has prolonged his longevity — either that or he is the possessor of abnormal illness behaviour , simulating altruism and generosity of spirit while really evidencing a range of DSM-5 conditions , from eating disorders through to a fully blown Munchausen syndrome .”
Dr Stan Steindl ( PhD ), a Queensland clinical psychologist and expert on wellbeing , said we could all reap the health benefits of doing good this Christmas .
“ In fact , just a couple of weeks practising acts of kindness and compassion can have all sorts of positive effects , such as reduced blood pressure , better immune functioning and greater calmness … something we all need when dealing with the relations on Christmas Day .”
What ’ s hot and what ’ s not for osteoarthritis
MICHAEL WOODHEAD THERE is no cure for osteoarthritis , but there are many treatments backed by a good amount of evidence , according to draft guidelines from the RACGP .
The guidelines , released for public consultation , offer recommendations that cover lifestyle , non-drug treatments and medications for knee and hip osteoarthritis .
The guidelines are intended for use by GPs in the primary care setting , and are accompanied by a list of treatments that are not supported by evidence and are therefore not recommended .
Push to increase nicotine replacement therapy prescribing in pregnancy as a safe way to protect babies
JOCELYN WRIGHT NICOTINE replacement therapy ( NRT ) is safer than smoking in pregnancy and should be offered more often , according to researchers from the University of Newcastle .
One in four GPs and obstetricians never prescribe NRT during pregnancy , possibly due to mixed messages on its safety and efficacy in pregnancy , their review has found .
However , real-world studies show there are few or no harmful effects from NRT on fetal and pregnancy outcomes , they note .
The most important guidance for NRT in pregnancy is to use the lowest possible dose , while also using enough and as needed to deal with cravings , they say .
The modest efficacy rates seen for NRT in some studies could be explained by raised drug metabolism rates in pregnancy , which meant more of the drug was needed to achieve the same anticraving effects , they added .
“ As NRT is safer than smoking , clinicians need to offer this option
Recommended
• Paracetamol and NSAIDs
• Topical analgesics
• TENS ( transcutaneous electrical nerve stimulation )
• Yoga ( or other regular exercise )
• Weight loss
• Steroid injections
• Knee taping
• Heat packs
• CBT
• Walking cane
to all pregnant women who smoke ,” they concluded .
Co-author Dr Gillian Gould , a smoking cessation researcher and GP in NSW ’ s Hunter Valley , said the lack of oral NRT options on the PBS was a significant cost barrier , especially for Indigenous women .
“ It ’ s definitely an issue and one we ’ ve been trying to solve unsuccessfully so far . The oral forms of NRT — lozenges and
Not recommended
• Glucosamine / chondroitin
• Vitamin D
• Surgery ( arthroscopic debridement , meniscectomy and cartilage repair )
• Opioids
• Bisphosphonates / calcitonin
• Acupuncture
• Therapeutic ultrasound
• Capsaicin cream
• Ice packs
• Special footwear
The guidelines are open for consultation until 20 December . See https :// goo . gl / M3b6vo gum — are not on the PBS and they ’ re really quite expensive when you look at recommending them for a course of 12 weeks ,” she said .
“ You ’ re talking hundreds of dollars for a course , and it ’ s hard for GPs to prescribe something if they know [ the woman ] can ’ t afford it .”
The RACGP guidelines recommend offering NRT to pregnant women who have been unsuccessful in quitting without medication , before proceeding to patches , she noted .
According to Dr Gould , about 18,000 Indigenous babies are born every year , which meant that up to 9000 babies could be harmed because almost half their mothers smoked during pregnancy . MJA 2017 ; online .
Studies show there are few or no harmful effects from nicotine replacement therapy on fetal and pregnancy outcomes .
4 | Australian Doctor | 15 December 2017 www . australiandoctor . com . au