Alcohol floor price

WA Health hosted a day-long seminar in March with a gallery of local and national experts from ED physicians to academics tackling the hot health topics around obesity and alcohol abuse. Everyone was singing from the same song sheet and with the Minister Roger Cook in the audience he was very much the focus of their attention. In February we reported ACEM’s snap survey of ED patients affected in some way by alcohol, revealing WA was the worst in the country. Former Perth physician now head of emergency medicine research at Monash Medical Centre Dr Diana Egerton-Warburton used the survey to call for political action. Many of the speakers mentioned introducing a minimum floor price for alcohol as the NT government has done. So what is the minister waiting for? When Medical Forum caught up with him afterwards, he said it was not as simple as that. “What the seminar showed was that the health community was unified in its opinions, and that accounts for a lot, but it’s also their job to bring the community along with them. We didn’t have tobacco legislation because the health community said smoking kills you, it happened because the health community was able to convince the community how harmful it was. Risky alcohol consumption is the same. We have to get the community behind the restrictions and the laws will follow.”

Flu blues

Is there a more political season than the flu season! We have been inundated with updates regarding when to vaccinate for the best protection (not too soon and not too late, which is somewhat empty advice); which serum is the best – Superman v Batman – and of course the hoary old chestnut, who should give the patient the jab. Is little wonder the punters pick up their bat and head to the vitamin C shelf. Keeping the focus on getting people vaccinated in a timely fashion is probably all we need to worry about.

Skyping high

Continuing on message is a theme the folks at Qoctor take seriously. Qoctor is the web-based GP clinic based in Melbourne, though when you think about that, does it matter where it’s based? We heard from their bugles that Qoctor delivered its 10,000th sick note recently. Patients access a doctor by filling an online form and booking in a Skype session with a registered GP. We spoke recently to one of the directors of Qoctor, Dr Aifric Boylen, who took umbrage at the suggestion the service was opening itself up to unscrupulous doctor shoppers. As far as she was concerned, Qoctor provided the same level of service as a bricks and mortar surgery. Kalamunda GP Dr Sean Stevens, when asked his opinion, voiced probably a majority GP view that it sounded terrible for continuity of care and chronic disease patients. Dr Boylen said the world was changing and it was not only doctors’ time that was precious. It launched Dr Sicknote in 2015 and has issued 10,678 certificates online. They claim to have saved patients 16,017 hours and saved Medicare $491,188. The Qoctor team is now made up of eight qualified GPs and one pharmacist.

AHPRA triage complaints

We read with interest a media report of the 2018 Medico Legal Congress in Sydney which quoted Kym Ayscough, executive director of regulatory operations at AHPRA, announcing a recent trial which triaged complaints against doctors to reduce time lags. WA was a participant and apparently it was a huge success. So successful in fact the system will be rolled out nationally. She told the meeting that triaging increased the proportion of assessments within 20 days from 8% to 37%. The system involves a committee with a smaller quorum than usual, but at least one health practitioner and one community member, who will decide whether a complaint can be closed early. We shot off a query to AHPRA to discover who was on the WA committee. A spokesperson said that the medical board members from WA, SA and NT were eligible to participate in the triage assessment fir those three jurisdictions. SO a WA case may have board members from SA and NT on the triage committee.

After-hours shrinkage?

National Home Doctor Service announced that it would be curtailing some of its after-hours services in Bunbury, Mandurah and Rockingham when the Federal Government imposed a 30% cut in the Medicare rebate for after-hours visits by non- VR GPs and an advertising ban. The changes took effect on March 1. The GP rebate will stay at $129.80, while non-VR GPs’ rate has been cut to $100. The Medical Republic reported that non-VR GPs accounted for 60% of the after-hours workforce. Whether it is a reduced volume of calls due to the advertising ban or workforce issues, it is a development that will have the watchers watching.

Anxiety and heart attack

Anxiety around heart attack is a good thing according to German researchers. Those patients with anxiety disorder and symptoms of a heart attack sought medical treatment sooner, thus improving their chance of survival. Women took action two hours sooner and men 48 minutes, which is not statistically significant in terms of cardiac improved outcome for men. What’s the solution, we wonder – a lot of anxious people bedded down in EDs across Germany?

Who’s phased?

GlobalData sent Medical Forum two media releases around oncology trials. The first around immune-oncology Phase II trials showed they increased 57% during 2008-17. Phase III or IV trials increased little or remained the same. They concluded: “This shows the fast pace immune-oncology features with regard to the development of new drugs. It also highlights the relatively early stage the field is in, considering that 88% of the trials are in Phase II or below.” The second said that most oncology clinical trials in China (2012-17) failed to meet the planned enrolment targets, particularly Phase II clinical trials. In fact, the greatest discrepancy between planned targets and actual numbers of enrolled subjects (enrolment efficiencies of 87.8%) was in Phase II trials. Not surprisingly, there wasn’t enough data to include Phase IV clinical trials. They listed the top drugs investigated. Phase II trials often recruit up to 100 or so people taking part. In these trials a new treatment is compared with another treatment already in use, or with a dummy drug (placebo). If results show a new treatment is as good as existing treatment, or better, it then moves into phase III.

Health Care Homes sites

Health Care Home trial sites are up and running until November 19. Doing a quick calculation about 40% of the trial sites in WA are corporate centres, which we understand have a different funding arrangement. The clinics are AHG Super Clinic Midland, Ballajura Medical Centre, Bayswater Medical Centre, Beechboro Family Practice, Belridge Medical Group, Brookside Medical Centre, Claremont Medical Centre, Cottesloe Medical Centre. Craigie Medical & Dental Centre, DR7 Medical Centre, GP Superclinic @ Midland Railway Workshops, Hay Street Medical Centre, Highland Medical Madeley, Joondanna Medical Centre, Lindisfarne Medical Group, Homeless Healthcare, Walter Road East General Practitioners and Yanchep Medical Centre.

Aged care efficiencies

The media release from August 2016 spoke of Bethanie Dementia Consultant Michelle Harris running podcast courses in dementia. She was a UK-trained nurse. The press release talked of the growing number of people with dementia. Where is she now? Google says she studied at ECU, where Facebook says she completed her Aged Care studies. Bethanie switch says she left them in January after some 10 years with them, wasn’t replaced and the courses are now run externally. With at most Aged Care Facilities having at least 80% of the elderly with dementia, this sector is looking for efficiencies.

WA Farewells the Stanfords

After 16 years at the helm of St John of God Health Care, it was time for Dr Michael Stanford and wife Sally to say their goodbyes to the Perth medical community who turned out in force at a function at the Art Gallery of WA. Michael will be taking up a non-executive board position at Healthscope next month.

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