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Mind the pay gaps There was one big money story this year and it wasn ’ t the MBS freeze .
More depressing details emerged over the pay gaps between GPs and other specialists .
In August , Australian Doctor revealed that the average GP earned $ 102 an hour in 2015 , after practice costs but before tax .
Among the main specialists , this represented the lowest earnings , lower than psychiatrists ($ 139 ) and paediatricians ($ 132 ).
The figures , drawn from the MABEL longitudinal survey , also revealed that 25 % of GPs ( or 7000 doctors ) were earning less than $ 79 an hour .
Based on the same data , the average female GP under 60 earned $ 41,500 less during the year than the average male GP working the same hours .
Dr Isis Maitland-Scott , a Sydney GP and Australian Doctor columnist , put it simply : “ I cannot imagine how it is reasonable that one gender of doctor doing exactly the same job as the other gender can receive significantly less money for it , yet , here it is — here it still is .”
Drug shortages The year was a frustrating one for clinicians and patients faced with ongoing shortages of widely used drugs , such as metformin , and vaccines , such as Bexsero for meningococcal B disease .
Drugs such as glyceryl trinitrate tablets for angina and many formulations of HRT also remained out of stock for much of the year , with suppliers blaming manufacturing problems . Suppliers and pharmacists also scrambled to find workarounds when lifesaving medications such as EpiPens were in short supply .
Fever pitch It was one of the worst flu seasons in recent memory despite high rates of vaccination with government-funded quadrivalent vaccine . The high numbers of deaths and hospitalisations from flu were blamed on the emergence of a virulent mutated A ( H3N2 ) virus strain which was not covered by the mismatched strains included in the vaccine .
The 2017 winner of the year : Greg Hunt ? He ’ s made no big policy announcements , splashed very little cash and reformed almost nothing , but there can be little doubt that Greg Hunt has had a successful year .
Nearly 12 months into his term as health minister , no one will say a bad word about him — in public at least .
In April , he signed pre-budget ‘ compacts ’ with the AMA and the RACGP . In return for an end to the Medicare freeze , the groups pledged support for the My Health Record and the MBS Taskforce Review , much to the consternation of their members .
Former health advisor Dr Bill Coote described the budget compacts as the “ most extraordinary documents ” he ’ d seen in 30 years
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DR ISIS MAITLAND-SCOTT , A SYDNEY GP , SAID : “ I CANNOT IMAGINE HOW IT IS REASONABLE THAT ONE GENDER OF DOCTOR DOING EXACTLY THE SAME JOB AS THE OTHER GENDER CAN RECEIVED SIGNIFICANTLY LESS MONEY FOR IT . AND YET , HERE IT IS . HERE IT STILL IS .” |
DOCTORS ’ INCOME
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Minister for Health Greg Hunt .
in medico-politics .
Mr Hunt also said good things about sorting out mandatory reporting and he ’ s been attempting to stop health insurers flogging junk policies in return for their giant taxpayer subsidises .
Other alleged reforms — such as the Medicare Guarantee Fund , which seem to have been created purely to allow the minister to say the words ‘ Medicare ’ and ‘ Guarantee ’ in the same sentence — have been less useful .
But he ’ s done nothing to actively enrage doctors and , for a health minister , that ’ s really saying something .
We are still waiting for a general practice policy that will deliver something good for patients , but there is a long list of minsters before him who have failed to do that .
Cochrane collisions Evidence-based medicine clashed head-on with clinical reality this year with a furious row triggered by the high priests of randomised double blind controlled trials — the Cochrane Collaboration .
It released its review of the new breed of hepatitis C antivirals , seen by many as the one bright hope against a disease ravaging the
lives of millions worldwide .
However , Cochrane concluded that there was “ little evidence they clear the virus from the body , only that they may clear the hepatitis C virus from the blood . Our results presumably overestimate the benefit and underestimate harm . The quality of the evidence was very low ”.
Professor Greg Dore , head of the viral hepatitis clinical research program at Sydney ’ s Kirby Institute for Infection and Immunity in Society , said the conclusions were bizarre .
Cure rates were above 90 %, he said . The short-term nature of the clinical trials also meant they were never set up to detect whether the virus was being cleared from the body , rather than just the blood .
Australian Doctor interviewed the lead author of the Cochrane review , Dr Janus Jakobsen , who was unapologetic .
“ The drug companies are touting a wonder cure and clinicians ’ experience is limited to dealing with small numbers of patients . Cochrane has different , higher standards of evidence when making its proclamations and the evidence is absent ,” he said at the time .
Professor Dore responded by pulling up the reviewers for their ignorance of clinical reality , which meant they took a perspective on evidence so pure that it risked “ snow-blindness ”.
Green light for voluntary assisted dying After marathon sessions of emotionally wrought debate , MPs in Victoria finally passed voluntary assisted dying reforms in November . Doctors were as divided on the issue as politicians .
The reforms will mean that ,
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from 2019 , terminally ill adults in the state can request an assisted death following clinical assessment by doctors .
Premier Daniel Andrews , who came to support euthanasia after the death of his father last year , said after the historic vote : “ This is a day of reform , a day of compassion , a day of giving control to those who are terminally ill .”
Bastian ’ s stand For RACGP president Dr Bastian Seidel , this year can be read in numerous ways . In terms of raising the college ’ s media profile , he ’ s been a big winner .
He ’ s appeared live on TV for numerous high-profile issues , ranging from free flu vaccination for all to the welfare of Manus Island detainees and out-of-pocket costs for patients .
But he has also embroiled the college in numerous sagas that have angered , even enraged , its membership .
It all started in May with the proposed changes to the college constitution , effectively demoting the college council and replacing it with a new corporate board .
Backed by the college executive , it provoked a heated debate on whether the influence of GPs in the RACGP was being watered down .
The plan — three years in the making — was booted when put to the membership at an extraordinary general meeting in Melbourne .
Only 46 % voted in favour of the shift — short of the 75 % required .
Then came news of the college ’ s pre-budget pact with the Minister for Health .
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Dr Bastian Seidel . |
The college offered support for a variety of reforms in return for what looked like a very slow thaw to the hated Medicare freeze .
Australian Doctor reported that the pact wasn ’ t formally endorsed by council , with two councillors saying they were unaware of what was going on until the deal was publicly announced . Dr Seidel refused to answer any questions .
Despite his silence , when the story was published , he went on the GPDU Facebook page and accused Australian Doctor of deliberately making the story up .
Then , in October , came the turmoil on marriage equality . The council had voted to stay neutral on the issue at its August meeting — an apparent attempt not to inflame the debate . Dr Seidel defended the decision .
It turned out the stance contradicted the college ’ s own curriculum , which says GPs have “ an important role to play in advocating to reduce discrimination ” faced by the LGBTIQ community . The row became heated . Members threatened to quit . An emergency council meeting was held , and Dr Seidel offered an apology admitting he had made a mistake . It was warmly accepted .
But in November , voluntary assisted dying passed the Lower House of the Victorian Parliament .
A college media release was issued : “ RACGP welcomes moves to allow terminally ill Victorian patients to die with dignity and respect ”. It called for the legislation to be used as a blueprint for other states .
Debate raged again . Should the college declare support for euthanasia in the absence of a consultation with its members on an issue of conscience for so many GPs ?
The row is still running . Professor John Murtagh , who has threatened to quit over the affair , says he is still trying to find out if college council endorsed the statement or whether it was what he described as a “ captain ’ s call ” by Dr Seidel himself .
So far Dr Seidel has refused to say .
Both his supporters and critics would agree on one thing : over the past 12 months he has certainly stirred things up . ●
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