Australian Doctor Australian Doctor 28th July 2017 | Page 29

Letters
TWEET OF THE WEEK

Practice nurses deserve more

Letters

Your Views
EDITOR I work in both hospitals and general practice arenas , and I can tell you that the responsibility , autonomy and pressure many practice nurses work under is a very long way from the protocol and guideline-driven practice of many hospital nurses ’ jobs .
GP practice nurses carry a lot of responsibility for their patient load , and very often are overworked and definitely underpaid .
Yes , more often than not GP practice nurses do not do shift work , but hospital nurses get paid loading and all sorts of extras for working late , evening and night shifts .
So why shouldn ’ t the GP practice nurses ’ day shifts be just as wellremunerated as their hospital colleagues ?
Dr Thomas Shashian GP registrar , Melbourne , Vic
EDITOR I don ’ t think I ’ ve worked in a no-nurse practice since 2006 (‘ GP practices warned : Pay nurses more or they ’ ll walk ’, 12 July ).
Whether or not you can afford to pay a reasonable wage to a nurse , or , for that matter , to yourself , depends on circumstances .
Hospital nursing pays better , but it is a very unattractive alternative , and positions for nurses in general
FROM THE WEB

TWEET OF THE WEEK

“ Most infections requiring antibiotics by GPs are treated with simple [ antibiotics ] - unlike hospitals using second / third and forth gen drugs liberally .”
— Dr John Crimmins @ JohnACrimmins
Follow us at @ australiandr practice in New Zealand ( where everyone has them ) are prized jobs . On the ward , their workload is much heavier physically and varies from frantic to unbearable .
In a GP clinic , nurses are allocated reasonable time slots to do their work , plus there are no afternoon or night shifts . So in a less formalised environment , it ’ s up to the nurses to prove their worth outside their traditional salt mines .
Dr Iliya Englin GP , Canterbury , New Zealand
$ 250K ? Fat chance
( Budget deficits , 14 July ) Never once in my 36-year career have I ever come within a bull ’ s roar of an annual income of $ 250k annual income . Mr McMaster needs a reality check .
Dr Wayne Wardman One of my patients who has worked in a Commonwealth Government office for the last 30 years retired with $ 1.2m in Super . How many of us will retire with that kind of money ?
Dr Sundar Subbaram The table of average costs for an average GP also leaves out the $ 4-5000 of indemnity cover ; FRACGP fees ; AMA membership and the associated costs of achieving one ’ s precious CME points , which usually means several conferences over the threeyear triennium at about $ 700 each .
Dr Peter Bradley I ’ d make a few other suggestions . 1 . Move away from Sydney or Melbourne . There are schools , activities , friends and satisfying work elsewhere . 2 . Private school is not mandatory , or even selective schooling . Lots of bright children do well in their local school . 3 . We always had family holidays — we camped
and hiked or stayed at a bush resort or beach house . And it only ever cost a few thousand dollars .
Dr Katriona Herborn
Real-time right now
( Elderly people pressured to sell prescription painkillers to cover funeral costs , 13 July ) We need real-time prescription monitoring — not just for S8s , but for all potentially addictive medications ( diazepam is S4 ). It is important to acknowledge that the Federal Government purchased the rights for the system used in Tasmania to good effect and made it available to all the states and territories years ago . The delay has been at state / territory level .
TracyS
EDITOR I love my nurses . They deserve to be paid well . But as we are in a poorer area with 90 % bulk-billing , and my costs have skyrocketed , with Medicare rebates frozen , I , myself , have taken a pay cut , year after year .
How little do the nurses ’ unions want GPs to earn ? Why not advocate for general practice , not just nurses , because they are always saying we are a team , aren ’ t they ?
Dr Maureen Fitzsimon GP , Cornubia , Qld
Selective science
( Are magic and quackery trumping evidence and reason ? 14 July ) Fewer people learn any science at school nowadays . As a result , they will fall for any glib explanation or pseudo science that suits their fancy . It ’ s no longer to do with the veracity of an argument , but the salesmanship of the person making it that holds sway .
Dr John Miller
Put to the test
( Audit of GP registrar test ordering raises eyebrows , 17 July ) As a GP supervisor , I ’ m going to stick up for the registrars . Ordering tests can
Watch and wait
EDITOR Good to know we needn ’ t worry too much about low-grade malignancies (‘ 20 years on , what happens to men who forgo prostate surgery ?’ 14 July ). But there should have been comments on treatments such as brachytherapy , hormonal and direct radiotherapy , and their effect on prognosis . We should still screen older guys and those younger with a family history of prostate cancer with PSAs and DRE to catch those with high-grade malignancies , and not just leave patients wondering if it is ‘ brewing ’. That ’ s why we do screening colonoscopies and breast cancer screening .
Dr Peter Strickland
Retired GP , Vasse , WA EDITOR Preposterous . “ Less than 1 %” absolute is not the same as 0 % absolute . If airline regulations were changed so that there was a less than 1 % absolute increased risk of dying from flying over 20 years of flying , there would be an outcry .
Dr Andrew Nielsen psychiatrist , Brisbane , Qld
Have your say
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be an important learning tool , to correlate the results to what you see clinically . This increases the registrar ’ s clinical confidence over time , which leads to less test ordering as their clinical skills mature . This is all part of the learning process , so I ’ m not at all surprised by the results .
Realistic
Pharmacy ’ s limits
( Pharmacists miss red flags in secret-shopper sting , 11 July ) This is the very reason that pharmacists should never be ordering pathology and treating diseases , as they are not trained to make clinical decisions on asthma and diarrhoea , etc , and cannot therefore recognise ‘ red flags ’, nor be expected to do so . The Pharmacy Guild of Australia should advise its members about not making clinical decisions , and to refer patients to their GP for illnesses and injuries outside their expertise .
Hypocrites GP
Straight talking
( Overcoming obesity , 14 July ) Okay . I noticed I was developing a spare tyre and did something about it . Early . Better diet , more exercise .
Rural GP
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