Botox-many-needles200

Sticking in the needle

Last edition and in this month’s letters pages, cosmetic docs have raised some serious issues about the questionable standards and safety of some ‘practitioners’ in the injectables area. AHPRA’s public consultation, which is trying to establish who is doing what to whom and where, appears to be shooting over the top of the problem. It assumes that this area is the province of medical practitioners when doctors and news reports over the past five years tell us it’s not. A couple of facts might offer some insight into this turbulent landscape. Firstly, it’s big business. Australians spend about $1b on cosmetic surgical and medical and related procedures and treatments. Australians throw more than $350m worth of Botox at their wrinkles. There are about 30,000 liposuction procedures and about 8000 breast augmentation surgeries. It would seem that AHPRA should perhaps set its sights lower.

Code 18 passes…just
The ACCC has authorised the Medicines Australia Code of Conduct (edition 18) for five years but with significant changes, whereby pharmaceutical companies must report ‘transfers of value’ (such as speaking fees, advisory board fees, or sponsorships to attend a conference). This includes to individual professionals without their consent first being required. Medicines Australia no longer has to report food and beverages, capped at $120 per head (plus GST and gratuities). MA has been given until October 1, 2016, to implement these changes after which six monthly reports are to be issued and data made more accessible to patients and third parties (such as healthcare professionals, consumers, researchers and the media). The RACGP has welcomed the changes, but says they don’t go far enough.

Lifeline for women’s service
Last month we reported that RFDS was being forced to relinquish its Rural Women GP Program because funding was being diverted to the Rural Health Outreach Fund administered by Rural Health West. News from Belinda Bailey, CEO of Rural Health West, has reassured GPs and communities that those who currently receive a service will be offered a service in this new funding arrangement. She added that priority would be given to new patients and areas with RA 5 classification.

Trust-road-sign200In CPD we trust
A senior doctor contacted us via our medicalhub website complaining that an AHPRA audit had rejected his certificate of completion for CPD issued by the Royal Australian College of Physicians. Apparently the certificate wasn’t enough, he should have produced the source documents. When we rang Dr Stephen Milgate, from the Senior Active Doctors Association, he told us the National Law required a doctor to produce original documents for ID and criminal checks, but nowhere was it stated that they had to do the same for CPD. Digging into the fine print of the Medical Board’s CPD registration standard we found this: “Medical practitioners are required to ensure their CPD activities are recorded, either by keeping records themselves or by using college processes, and to produce these records when the Board requires them to do so as part of an audit or investigation. Records must be kept for three years.” This raises two questions: Does AHPRA trust the college on its word? Are the colleges willing to share AHPRA’s administrative burden? A response from RACP was pending at the time of going to press.

Doctors in distress
Over the past 18 months, stories of mental and physical distress of doctors and medical students has pushed out beyond the collegial code of silence and have fuelled the now famous Beyond Blue survey and most lately a move by the Medical Board of Australia to fund a national health program. It has contracted the AMA to ensure consistent services across the nation and it is expected that the existing Doctors Health Advisory Services operating nationally will get the gig. In WA that service has been coordinated for a long time by Dr David Oldham and a small team of committed doctor colleagues who have worked hard to keep the service going. At the time of going to press David was hopeful that the DHAS WA would get the nod from the AMA DHS. The group was to submit an expression of interest. On the matter of mandatory reporting, David said there would be no change to WA’s stand against the practice.

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