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