Australian Doctor Australian Doctor 30th June 2017 | Page 31

This Week
PIC
OF THE
WEEK
QUOTES OF
THE WEEK
IRAN Two-year-old Emad is
pictured being rescued from
Tehran’s parliament building
during a terrorist attack in
which 13 people were killed
on 7 June (main image).
Emad and his mother were at
the parliament to appeal for
assistance to treat Emad’s
mucopolysaccharidoses, a rare
disease caused by the body’s
inability to produce specific
enzymes, when they found
themselves in the perilous
situation. After the photo went
viral, a large number of Iranians
successfully campaigned for
help for the family. Ministers
have since arranged for free
medical care for Emad, who is
pictured inset having a check-
up with a doctor.
“I have to
become a doctor
again because
in my previous
life, I was only a
doctor.”
Iraqi refugee Hekmat Alqus
Hanna prepares to sit the
HSC despite having been a
GP for 17 years in his native
country.
Photos: Reuters
Are health helplines really that helpful?
Journal
Talk
Michael Woodhead
HAVING raised two kids with their fair share
of middle-of-the-night wheezes and high
fevers, thankfully we only once had cause
to call an after-hours phone helpline
The responses were so vague and risk
averse that we subsequently chose to take
our sick kids to see a real-life doctor for
out-of-hours health scares. So it doesn’t
surprise me that despite fielding almost one
million patients encounters a year, there
has been surprisingly little research into the
nature of after-hours helplines and exactly
what they do.
But finally, a little light has been shed on
these encounters by officially sanctioned
phone hackers at the University of
Adelaide. In a novel study, they were able
to analyse 200 de-identified health advice
‘phone consults’ as offered by government-
funded Healthdirect triage nurses.
Writing in the International Journal
of Medical Informatics, the researchers
suggest that health advice line
consultations differ in three major ways
from the traditional, face-to-face primary
care consultation.
The first big difference is that the advice
line call-taker also has to act as receptionist
and “get some basic details” to set up
a patient record. They also have to be a
market researcher and conduct a mini-
survey, with questions such as, “what
would you have done if you didn’t call us
tonight?” at the end of the consult.
Another difference is the need for a
call-taker to get the patient to perform their
own physical examination or describe their
physical condition.
In the case of a caller with chest pain,
one exchange went something like this:
“Okay Tom, can you lift your arms up and
out above your chest — does the pain get
worse when you do that?”
Perhaps the biggest difference though,
is that health advice lines aren’t allowed
to provide a diagnosis. They can only
suggest actions, such as self-care for minor
illnesses or going to see a GP or to the ED
within a specified time period. However,
in practice, the advice line nurses would
sometimes give an indirect diagnosis by
using the words: “It sounds like …”
The researchers note the whole health
advice line process is highly structured with
a number of software prompts.
They say their findings might be used to
help improve service delivery and patient
satisfaction.
But given the limited options offered
by these multimillion dollar advice lines,
I’m inclined to agree with the AMA’s
emergency medicine spokesperson
Associate Professor David Mountain, who
said phone protocols can never replace a
face-to-face doctor consultation.
“You could provide much more after-
hours services, we could provide more
resources for EDs, we could certainly
provide much more access to GPs,” he told
the ABC in 2013.
International Journal of Medical
Informatics 2017; online.
SNAPSHOT
DISABILITY DOLDRUMS
New data show that very slow progress has been made in the
past 12 years on improving the lives of those with disability.
Percentage of people with
a disability living in the
community that are:
100%
2015
2003
83 % 84 %
2015
2003
48 % 49 %
2015
32 %
Employed
2015
31 % 30 %
2003
24 %
Aged 20 or older
and have completed
Year 12
2003
Have a driving
license
Want to get out
more often
“Let’s be very
clear that this
is a bill about
nothing. It is a
Seinfeld bill.”
Greens leader Senator
Richard Di Natale blasts
the lack of substance in the
government’s Medicare
Guarantee Bill.
‘I’ve had threats
on my life,
threats of rape
from numerous
people, threats
with my family.”
Hannah, a psychiatric
nurse, tells the SBS Insight
program on the neglect
of mental health among
healthcare professionals
that she is regularly
threatened by patients.
“There’s [medical
cannabis] sitting
in warehouses,
and the
Commonwealth
is taking two
days in its
[prescribing]
approvals.”
The Department of Health’s
Deputy Secretary in charge
of drug regulation, Adjunct
Professor John Skerritt,
says people should ask
their GPs to access
the drug via the Special
Access Scheme.
Source: AIHW, Disability in Australia
www.australiandoctor.com.au
30 June 2017 | Australian Doctor |
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