“ Wear odd socks June 1 make point Drs in crisis .”

— Dr Geoff Toogood , cardiologist and mental health advocate @ gdtoogood

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College conned

( RACGP chief defends budget pact with govt , 16 May ) The AMA ’ s graph plotting CPI against Medicare from 1985- 2015 sort of tells the story , doesn ’ t it ? Most of us thought the rebates had sunk to about half of what they should be , but it ’ s actually worse . So even if they lift the freeze in a year , it matters not . GPs will still be receiving only about a half of what they should . By the govt ’ s own admission , 85 % of GP services are bulk-billed , so half is all they will get — forever — unless something drastic is done . There is nothing in the RACGP ’ s agreement that comes close to doing this . The college was conned , and still thinks it achieved something worthwhile . How sad .

Subtractor

Rural folk miss out

( Call to cut hospital transfer time of stroke patients , 17 May ) I guess those living in rural or remote locations and have a thrombotic stroke just miss out .

Rick Hambour That is great , but what about outside of the cities ? It would be nice if the country areas got upgrades before the cities start

worrying about shaving off response times for their cases . These goals eat up the funding that has to be shared among the entirety of each state and territory . Clearly , there needs to be a bigger push for country funding . Not only do you have to contend with one helicopter over a larger geographical area in the country but you also have to allow for the helicopter not being operational due to servicing and / or change of shift .

Karina

It takes two to tango

( 8 reasons for GPs to grill patients about alternative therapies , 9 May ) Well , it actually goes both ways . When I see a patient , I write back to all their involved

health ‘ professionals ’ I know of . While that ’ s usually doctors , it includes physios , hand therapists , etc . Apart from the two above , I have never received a letter from a chiropractor , podiatrist , osteopath , etc . You will counter that I should make the time , but let ’ s be honest — who has the time to chase down whichever quack the patient is currently seeing ? And if the patient with dedifferentiated chondrosarcoma wants to go to Mexico for a vegetable cleanse , good luck to them . But it will be without my involvement . awfulpod I used to scoff at acupuncture , but then realised a less arrogant approach is more productive . And yes ,

acupuncture does work , but it ’ s operator-dependent . Examples of ‘ alternative ’ remedies now firmly in the therapeutic armamentarium also abound ( eg , magnesium ). So if a patient is taking something alternative , I inquire what it is supposed to do and whether it does it . If so , I exert myself to look it up . Who knows , I might even learn something .

Iliya Englin

Dose a confounder

( 4 new findings about heart attack risk with NSAIDs , 10 May ) We need to look at the specifics of the study — eg , what doses were used . A recently published study ( see : bit . ly / 2pNi5XN ) showed the non-inferiority of celecoxib compared with a common NSAID with respect to cardiovascular safety , but they used 200mg daily of celecoxib and more than 2000mg of ibuprofen , whereas in Australia the maximum dose commonly used is 1200mg .

Fouad Dawood What about dosing of the anti-inflammatories ? If we start at half-dose for the first few weeks , and then increase to full dose , is the risk reduced relatively ?

Lawrencetlc

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