Rent is about supply and dema~nd Value our nurses EDITOR I am cynical ('NSW abandons rules on round-the-clock registered nurses in aged care', 10 May). I find the registered nurses who are in long-term positions in nursing homes provide excellent, well-informed information about my patients and I value their judgement I wonder if there will instead be a nurse practitioner available who can bulk-bill to Medicare and transfer the cost from nursing home owner to the Federal Government. Dr Lucy Alexander GP, Hobart, Tas
Letters Your Views EDITOR This is back to the future and was Labor government policy in 2009 ('Turnbull's pathology "peace deal" another attack on general practice', 16 May). Pathology companies are not forced to pay high rents. They volunteer to do so, due to competition. Contrary to the PM's position, they do not need big corporate legislative protection from a little general practice. I am concerned waiting rooms are being used as vo ting booths by som e corporates . This w ill legislate against small practices. It is anti-competitive. It reduces a p atient 1s free dom of choice. I was invited in 2009 to argue this point, and I won. In the 1973 national referendum, the people decided the government could not fix the price of goods and servtces. This is unconstitutional, which is why the laws were changed. David Dahm Health practice, accounting and tax adviser Adelaide, SA
Join the dots
EDITOR It's not an attack on general practice - it is an attack on unscrupulous and unethical practice owners. I welcome it, since such deals distort real competition and potentially rort the taxpayer through artificially inflated demand. Dr Horst Herb GP, Darrigo, NSW
Have your say All letters should contain the sender's title, address and daytime phone number. Letters should be exclusive, no more than 250 words and may be edited. Letters should be sent to: Fax: (02) 8484 0800 or email: mail@australiandoctor.com.au
EDITOR The RACGP hasn't connected the dots yet ('Bulkbilling rates will stay, says health department', 11 May). Labor started the freeze and the Liberals continued it. The common link is the health department, with all their statistics. Like it or not, the health department is correct, because bulk-billing rates are determined by doctor-to-patient ratios, not by the actual rebate. The way to decrease bulk-billing is to decrease the number of GPs, which the RACGP has the power to do, but at present they seem to want to graduate more and more. Dr James Moxham GP, Blackwood, SA
Australian Doctor team Editor-in-chief.· Clifford Fram (02) 8484 0765 Editor: Jo Hartley (02) 8484 07 41 Deputy editor: Paul Smith (02) 8484 0795 Medical editor: Dr linda Calabresi MBBS FRACGP (02) 8484 0903 Therapy Update/Grand Rounds editor: A/Prof Amanda McBride MBBS MHPol (02) 8484 0879 How to Treat editor: Dr Claire Berman MBBCh (02) 8484 0749 Clinical news editor: Michael Woodhead (02) 8484 0674 Reporter: Tessa Hoffman (02) 8484 0789 Chief content producer/ Smart Practice editor: Cheree Corbin (02) 8484 0860 Deputy chief content producer: Gita Sankaran (02) 8484 0806 Content producers: Gill Canning (02) 8484 0786 Sophie Attwood (02) 8484 0606 Photo editor: Stacey Shipton (02) 8484 0799 Graphic designers: Edison Bartolome (02) 8484 0872 Antony Mazzaferro (02) 8484 0894 CEO: John King Sales and marketing inquiries: (02) 8484 0603 Classified pages bookings: Classifieds Manager gpclassifieds@cirrusmedia.com.au Production co-ordinator: Eve Allen (02) 8484 0764 OEMAILUS:
To email s1aff, use the following format: first name.sumame@cirrusmedia.com.au
OOtle 1- -- ~
• ' ·_,
f5j:) f _,.
FROM THE WEB
-.;;---;
~·-
-,
australiandoctor.com.au patients sent to residential rehab by court order. The success rate at six months is close to zero. Mandatory rehab can be beneficial for some, but for most people it only provides a short-term reduction in the misuse of the drug of choice. In the end, the person concerned has to want to change, and then they don 't need medical incarceration. Frank
Lure of after-hours (Inner-city GPs cite fears over after-hours 'gouging', 20 May) I believe the higher paying items are excessively used , and that includes [after-hours consults for] URTis or minor presentations. Most of the deputising services' letters reflect non-urgent conditions and minimal intervention. The pay is lucrative enough for after-hours doctors to depart practices and work for deputising services. Maher Luka No audit needed . Simply close the service. Every tax dollar is important, and such services are not needed. There are better ways to deal with afterhours, like the telephone triage system.
v
Trimming the fat (Path labs move to nonfasting lipid testing, 11 May) About time too, as I am tired of deleting the fasting advice from the eReferral forms . If I tell people to return when fasting, around 10% never get the test done. If told to have the test d?ne immediately by the onsite pathology service, almost all patients comply. The difference in results is,
Missed cancers?
for all practical purposes, negligible. gobbogibbs Wonderful news. Send patients straight to the lab, or get the nurse to bleed them then and there. Make the review appointment at the same time. Should make patient life easier, doctor life easier and raise compliance. drnutsandbolts
Delist Osteomol too (Panadol Osteo delisting may impact adherence, 13 May) I feel it was a great move to delist Panadol Osteo as
there were lots of people on it. Most of my patients are happy when I tell them they need to buy it OTC . But now we have the PBS-listed paracetamol modifiedrelease, Osteomol. They should take this off the PBS as well to make the necessary savings. Jonathan
Mandating change (Should we force severely addicted patients to undergo treatment?, 13 May) I have worked in the drug and alcohol service since the mid1980s and have seen many
www.australiandoctor.com.au
(College backs new PSA testing guidelines, 10 May) Many cases of aggressive prostate cancer will be missed. If the same recommendation was made for breast cancer, there would be an outcry. The death rates for both cancers are about the same in Australia. I have had patients and friends who have had very painful deaths from prostate cancer because they were not screened early enough for successful treatment. There will be medicolegal problems in following the RACGP recommendations, and I am going to back GPs who use PSA testing and digital rectal examination over those who don't. Hypocrites GP
The views expressed in this publication are not necessari~ those of Cirrus Media.
Australian ~«tor is an indepet1denl publicatioo senring the needs of Australia's general prnctitioners. nhas no affiliatioo with any medical 01!J3nisatioo or associalioo, and lXI' editorial content is free of influence from advertisers. Australian Doctor is sent free to full -time GPs in private practice and certain prescnbing and staff spedalists. It is available to other readers oo subscnptioo for $390.00 pa including GST. Overseas rates a~y.l'tlooe (02) 8484 0666. Average Net Distribution Period ending September 20t 5 t 9,474
CmCULATIONS
AUDn'BOARD
•
Australian Doctor is published 48 times a year by Cirrus Media, Tower 2, 475 VIctoria Avenue, Locked Bag 2999, Chatswood DC, NSW 2067 l'tl: (02) 8484 0888 Fax: (02) 8484 0800 Emai: m a i -.oom.au
www.australiandoctor.com. au (Inc in NSW) ACN t32 71 9 881 ABN 80132 719 861 ISSN 1039-7116 c Copynght 2014 www.clrrusmedia.com.au Printed by Offset Alpine, under IS014001 Enviroo mental certification.
e1
?EFC.
Thlsprodudill l!om..-1~ ~lomtt..-w:l
--~
~lnNMJr.
,_..,_
~,.~
-
3 June 2016
I
;ptok.org....
Australian Doctor
I
33