Networked GPs

The Australian Divisions of General Practice (ADGP) is re-badging itself ­- to the Australian General Practice Network (AGPN). This is all about lifting the profile of GPs in the community and therefore amongst pollies who hold the purse strings. AGPN Chair Dr Tony Hobbs suggests “a united and cohesive network which is clear about its place in the health system, its priorities, and its point of difference….can be a recognisable force in driving primary health care reform and in the delivery of improved health outcomes”. In the rhetoric is a hint of centralisation of resources in contrast to the “local solutions by local doctors” which AGPN says is the cornerstone of its future success.

Pathology?

The Oz pathologists’ publication Pathway recently presented doom and gloom figures for the pathology workforce. 20% of the 1,459 total A&NZ workforce are over 60. In NSW, the figure is 44% for 50 general pathologists (those that serve mainly rural areas). They say pathology is fading into the background of medical curricula and graduates have little awareness of the work involved in diagnostics. Has anyone met a pathologist passionate about teaching and good at it? The college wants another 40 training positions, stat!

Ups and Downs

The October 2006 Birth Defects Registry Report points to a tripling of reported chromosomal defects in WA since 1980 to around 6 per 1000 births, with a corresponding increase in Down Syndrome prevalence. This is presumably due to an aging maternal population. Although live births for Down Syndrome have remained static in this time, termination of Down pregnancies has risen to around 2 per 1000 pregnancies and become the subject of religious debate, particularly with the suggestion that women of all ages should be offered Down screening. Live births with neural tube defects have declined slightly since the late 1990s, presumably the result of folate education/intervention.

Putting the heat on jellyfish

Busselton GP John Taylor appears to have nailed jellyfish sting treatment down to the simple application of hot water. This treatment method was head and shoulders over ice, vinegar, and aluminium sulphate application, in an experiment he did on medical students and had published in this January’s MJA. Hot water (45 degrees) gave pain relief that was strongest and longest by far.

STDs are, like, whatever!

At the same time the Pope is considering taking condoms off the “sin list” for the 8000 Africans dying from AIDS daily, we learn from a La Trobe University study that Oz teens “worry about pregnancy but not STDs”. Year 12 students, 35% of whom are sexually active, rely more on the pill while 17% use inadequate or no protection against pregnancy or STDs. The study, published in December’s A&NZJ of Public Health covers government, independent, and Catholic schools and gives national data on teenage pregnancy rates.

Cell Culture on Fire

Clinical Cell Culture (C3) has been burning funds while trying to commercialise its skin regeneration products. Despite no dividend issued and high market volatility, investors are still flocking to back the enigmatic Fiona Wood. Its recent $10m share purchase plan closed oversubscribed and C3 promptly went to institutional investors and raised $3.77m at the SPP price of 6.8c to fund further growth of the company. Company losses of $14.20m and $11.97m for consecutive years were almost all operating costs and with plenty of market approvals worldwide but no big orders, something has to happen in the next six months or so to prevent investors running a mile. Fiona Wood has 6.23m ordinary shares (and 150,000 options) in C3. With each share losing 5.46 cents in the 2005-06 financial year (and 8.38 cents the year before), and a current share price around 11c, things are less rosey on paper now. Nevertheless, following her reappointment to the board, Fiona pulls a non-executive director’s salary and benefits of $0.32m annually.

All smiles at MDA

It’s all smiles in the MDA National camp after a particularly good year – a “better than expected” net surplus of $18.1m thanks to strong investment earnings and a decline in expected net claims expense. Subscription premiums were up 4% to $52.6m. 2005/2006 showed a slight decrease in total number of claims with a steady number of total cases. There was a significant increase in the number of cases related to Medical Board coronial and other investigations, now >25% of all cases reported to MDA National. Smiles seem a little less forced than last year, with board elections a more sedate affair.

Two sides of the coin

Depending who you believe, the public health system is in crisis or coping admirably. The tarnish is coming off the official picture: public words have been traded between the Minister and senior specialists at RPH; prominent resignations from RPH and Charlies; staff and the public have petitioned to keep RPH open rather than move to Murdoch in 2011. In the hot seat is Dr Peter Flett, the new CEO of South Metro Health Service. He’s been quoted in The West as saying that there was no intention to wind down the services at RPH. Sounds like a case of selective reality.

Plugging the gaps

The shortage of hospital docs has spread to the private sector. The public hospital system relies heavily on international medical graduates these days to fill the gaps but now St John of God Subi has employed 13 international medical graduates (who work under supervision). The hospital sponsored the doctors on temporary work visas and had their initial 12 month contracts extended. Dr Michael Levitt, the Director of Medical Services at St John’s told the Subiaco Post that the process had worked very well.

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