Letters
TWEET OF THE WEEK
Clinical connection is the key
Letters
Your Views
EDITOR I have worked remotely in the NT for the last 11 years and the discharge summary system is excellent, compared with when I was working in Queensland(‘ Tip of the iceberg’, 20 October). Discharge notifications and discharge summaries all arrive electronically the same day the patient is discharged. If the patient is seen in ED, notes are sent to the clinic immediately. It is nearly perfect.
I worked as a hospital specialist in Queensland and despite my ruling that no patient was to go home without a discharge summary, it did not always happen and information was not always accurate.
My worst story was a patient who handed me her hospital summary meant for the GP when I saw her a week after discharge. It had one word on it,“ constipation.”
The patient had had neutropenic sepsis, pericardial effusion requiring a window, cardiac arrest, seizures, extrapyramidal symptoms and acute renal failure.
I rapidly did a new one myself and rang the GP. Dr Jan Bowman GP, Yeronga, Qld EDITOR To say that“ hospitals have robust systems for ensuring adequate clinical handover from ED
FROM THE WEB
TWEET OF THE WEEK
“ There is absolutely no reason why insurance companies should have your medical records. Period.” # auspol # http:// bit. ly / 2glg2Xz
— Dr Bastian Seidel @ drbastianseidel
Follow us at @ australiandr to the ward, from one medical team to another, and even one shift to the next” is simply a nonsense.
Having worked and done assessment visits to a number of hospitals around Australia, this just doesn’ t seem to be the case.
I work in mental health and pride myself on my communication. Patients have constant electronic access to their notes and letters, and I write a summary sent by secure messaging every time I review a patient. A patient recently said to me,“ My
Seniors will suffer
( Thousands of GP practices in for a funding cut: AMA, 12 October) The removal next April of the aged care incentive payment($ 5000) introduced to offset the costs of the non-attendance work at residential aged care facilities( RACFs) is poor policy and the think tank that came up with this bizarre decision better duck for cover. Already GPs in our region are advising RACFs they will not be taking on the care of any new residents and they intend to try and ease out of attending RACFs entirely. Consequently, practices that withdraw from RACFs will not be able to provide training opportunities for their registrars or younger doctors and medical care to RACFs will steadily disappear.
Dr Donald Rose Once the aged care incentive is dropped, my local aged care facility will be required to bring the patient, all relevant documentation and enough staff to deal with special needs to our surgery. We have already provided a ramp and entrance suitable for disability transport to deliver patients to the ground level of our clinical area. I recommend others insist on the same. It will also mean one patient and one Medicare
item each person and service, instead of the multiple patient discount already operating for aged care visits.
Dr Phillip Chalmers
A premium problem
( Quackery targeted in private health insurance overhaul, 13 October) As long as no Medicare benefits are payable, I don’ t have an issue with alternative therapies being covered by private health insurance. Bupa has been very open in saying that those extras attracted the“ young well”, whose premiums subsidised the“ old sick”. The massive elephant in the room is the fact that private insurance
GP says you send too much information, could you send him less?”
Clearly handover and communication is critically important for patient safety. We need to agree how we achieve it, consistently, in every state, every practice, every hospital, 24 / 7 / 365.
If My Health Record were the repository for everything and we all had access when needed, we would not need anything more.
Dr Richard Harvey psychiatrist, Batesford, Vic
is currently reporting massive profits. According to AHPRA, their profit increased by $ 1.5 billion dollars, or 17 %, over the last financial year. The reason premiums are unaffordable is because they are too high.
Dr David Shooter
Defending TSH tests
( Crackdown to target GP ordering of thyroid tests, October 12) I’ m probably one of the 20 % of doctors who order two-thirds of the TSH tests. Symptoms of both hypothyroidism and hyperthyroidism can be quite non-specific. I have picked up both in people who had tiredness, and not
A sporting chance
EDITOR Exams are like sport— except the results can be the difference between continuing in one’ s chosen profession or trying to survive as a taxi driver(‘ Let IMGs appeal‘ unfair’ exams, says review’, 16 October). Like sport, exams have rules both formal and informal.
As an examiner and helper of IMGs, I compare this situation to an IMG national football team coming to the MCG to play the Melbourne Demons. They are surprised the MCG has posts instead of a rectangular goal with netting. The ball is egg-shaped. There are 18 Demons to their 11. The Demons use their hands. Naturally, the IMGs get done. Some cry‘ foul’.
It is wrong to keep taking their money. IMGs need to understand they are playing Australian rules football. They need to learn the rules, practise them and we established Aussie docs need to help them more.
Emeritus Professor Max Kamien, GP, City Beach, WA
Have your say
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much else, including severe Graves’ disease, on a couple of occasions. I presume the amount spent on thyroid function blood tests includes the blood tests for monitoring of thyroid disease. And really, if thyroid disease is common, is it that inappropriate to check for it?
Dr Inessa Stinerman I am probably on that list of doctors too. We have 173 patients with Hashimoto’ s disease, with 74 of them on thyroxine, a very cheap drug that makes patients feel so much better. Once on it, it takes a long time for them to get their metabolism up, so it is very important to catch it early. Therefore, an annual screening TSH seems very reasonable. With active Hashimoto’ s disease, their requirement for T4 fluctuates so I check them quarterly as the activity of their disease varies widely.
Dr Peter Stephenson
Exercise ennui
( An hour of exercise per week may help beat depression, 12 October) Correct. But having said that, it is extremely difficult to exercise when one can barely eat, sleep or move from depression.
Dr Peta Fairweather
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