Australian Doctor Australian Doctor 3rd November 2017

3 NOVEMBER 2017
AUSTRALIA’S LEADING INDEPENDENT MEDICAL PUBLICATION I www.australiandoctor.com.au
NOT SO FAMILY
FRIENDLY? RAINBOW
BABIES
GP paternity pay
needs overhaul
Editorial, page 28 LGBTI parenting
Therapy Update,
page 25
Foot pain
Earn CPD points
online
GPs get new to-do list
21/7 pill
should go:
experts
College unveils latest accreditation standards
JOCELYN WRIGHT
WOMEN should use the
combined oral contraceptive
the “21st century way” and
take it every day without
breaks, according to leading
reproductive doctors.
The call for change was
made initially by Professor John
Guillebaud from University
College London in the UK.
He told the country’s
Royal College of General
Practitioners’ annual
conference in October that
the current 21/7 regimen was
“outdated” and should be
consigned to history.
Women should be offered
the pill on a 365/365 or 84/4
schedule, instead, he said.
“We argue for substituting
improved regimens that do not
intermittently cease to provide
full ovulation suppression.”
Breaks in administration
reduced the pill’s efficacy by
unsuppressing the ovary and
left women more vulnerable to
falling pregnant if they forgot to
restart the treatment, he said.
Sydney sexual health
physician Dr Terri Foran backed
the call, adding that Australian
women and doctors had been
running pill packets together for
decades.
“It’s well known out there
you can do this with every
combined oral contraceptive
except the ones that vary in the
amount hormone, such as the
triphasic birth control pills,” she
told Australian Doctor.
“We now know there are
HOW TO TREAT
PAUL SMITH
GPs will be required to warn patients
about potential out-of-pocket costs
associated with their referrals under
the RACGP’s new practice accredita-
tion standards released last week.
GPs will not be expected to give
detailed costs of specialists’ or other
providers’ services before making
referrals. However, the standards
say GPs must make sure patients are
informed of potential costs for a spe-
cialist consult or investigation.
GPs could do this by providing
patients with a contact list of special-
ists so they can compare costs and
select their own specialist, the stand-
ards suggest.
Dr Mike Civil, chair of the col-
lege’s expert committee on standards,
A U S 5 9 0 8 cont’d
_ A D page
- Sh
4 e s - Pr o
— Dr Mike Civil
RACGP spokesperson
own fees before providing treatment.
This could be carried out by includ-
ing billing information in waiting
areas, the standards say.
There is also an explicit requiremet
for practices to have systems in place
to manage seriously abnormal and
life-threatening test results after hours.
The college suggests giving diagnos-
tic service providers the contact details
of practice team members who can be
contacted outside of normal opening
hours. Practices must also ensure that
diagnostic services have the contact
details of the doctors who ordered the
test after a high-risk result.
However, Dr Civil says this does
not mean the ordering doctor has to
be available 24/7. 
cont’d page 4
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‘If there is potential
for a gap payment, it
is of value for patients
to know and to be
comfortable.’
says: “We don’t expect GPs to know
what the potential gap fees for services
supplied by other specialists or allied
health providers is.
“But if there is potential for a gap
payment, it is of value for patients to
know and to be comfortable.”
However, Dr Sean Stevens, deputy
chair of the practice owners’ lobby
group the Australian GP Alliance,
says: “We’ve been concerned about
doctors getting embroiled in long dis-
cussions about fees, but if the stand-
ards are about warning patients of
potential fees, that’s fine.”
The 5th edition of the standards,
released at the college’s annual confer-
ence in Sydney last week, also makes
it mandatory for practices to ensure
patients are fully informed about their
High-profile deaths,
such as that of
Prince, have cast
a spotlight on the
prescribing of
fentanyl patches.
News Review,
page 11
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13/01/2017 1:17 pm