WA News News & Reports Smooth as silk
Smooth as silk
Written by Jan Hallam
Monday, 28 August 2017


Just a few days ago, the Subiaco-based Ear Science Institute of Australia took receipt of the first tranche of its $4m grant from the Wellcome Trust in the UK to run human clinical trials for its ClearDrum device which is expected to help those suffering from chronic middle ear disease caused by ruptured ear drums.


ESIA’s Prof Marcus Atlas and Prof Xungai Wang, from Deakin University, have been working on the project for nearly a decade. ESIA CEO Sandra Bellekom told Medical Forum that human clinical trials would start mid-2018 in WA and several other states.


Middle ear disease affects millions all over the world and having a solution to multiple painful and often unsuccessful surgical interventions for so many people was an obvious attraction to the charitable Trust, which requires projects to focus on social need. Sandra said this clinical imperative has always been a driving motivation at ESIA.


“From a clinical point of view there is a deep level of frustration, not just among ear surgeons but audiologists everywhere, to see the same patient return over and over again for sometimes up to 5-6 grafts until they give up. Alleviating this patient suffering has been the real drive,” she said.


The device is similar in appearance and size to a contact lens and is created by a bio-compatible silk implant on which the patient’s own cells grow to repair the eardrum. Travelling alongside clinical trials is its commercialisation, which Sandra says is also a priority.


“We have to ensure these devices get out and into patients and for surgeons to use sooner than later and for it not just to be a journal article but be something meaningful,” Sandra said.


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While communication is one thing, investigation of notifications is another. We believe good doctors want the bad ones weeded out but they don’t want to be part of a witch hunt or get buried in lawyers, politics or paperwork.

The national Medical Board can respond to a complaint or act on the advice of the WA Medical Board to establish an assessment panel to either examine the health or performance and professional standards of a doctor. Health consumers are represented on panels along with medical practitioners.

The Medical Board and AHPRA have undisclosed lists of doctors who are approved by them as panellists and probably as expert witnesses. Many of these people, we believe, were ‘grandfathered’ across when National Law first came in (2010). Their impartiality is as unknown as they are. Then we have expected biases of the legal assessors, chosen by AHPRA, possibly thrown into the mix.

Is there a problem, Houston?

It is important this is sorted to everyone’s satisfaction as 42% of doctors in our survey thought panellists could lack impartiality to a serious extent.

In fact, only one quarter of doctors we surveyed (n=195) were happy with the impartiality shown by AHPRA or the Medical Board in processing a complaint (with 36% unhappy and 39% undecided). Nearly all of those who were unhappy said they were concerned that unfairness will be seriously damaging to someone. Investigation is a very confronting experience.

If someone is being investigated by a panel, either the panel or the person being investigated can opt for a more out-in-the-open State Administrative Tribunal (SAT) judicial hearing – the panel usually refers because it feels the evidence before it constitutes more serious professional misconduct.

What Fair Doctors Want

Talking to doctors, they appear to want an apolitical system of investigation that is fair and timely. They want to be treated reasonably. Unlike the legal profession, their work is mostly built around trust and honesty. They do not want a return to the ‘good old days’ where those with a political bent in the medical profession could influence what the Medical Board did.

While this is a very difficult area for us to investigate, with arguments and counter-arguments at every step, we cannot understand why the Medical Board would turn to arguably the most political organisation, the AMA, for its counsel (the national Board Chair met earlier this year with “senior leaders from AHPRA and representatives of the AMA” to workshop doctor complaints).

Why? Our e-Poll responses raise a question mark over the AMA’s involvement (and we don’t think AMA members have been polled on this issue.)

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