AHPRA state of play
AHPRA has recently released its annual report, and as its principal ‘shareholders’, you will probably like to know that it’s stayed nicely in the black the past financial year with a net surplus of $1.8m. Income (88.23%) was derived from registration fees ($150.4m) and 5% from application fees ($8.5m). In WA there were 10,246 registered medical practitioners with 419 notifications (4.1%); WA recorded an increase in notifications (781, across all registrants) from the previous year (750). There were 37 mandatory notifications issued to WA doctors across three main categories – standards/impairment; alcohol or drugs; and sexual misconduct; while 554 were being actively monitored (343 for eligibility/suitability; 55 for conduct; 74 for health; and 82 for performance). Some good news is that resolution wait-times are lower than the previous year.

He Can Still be a Herodavid bowie 160David Bowie
A lot of words have been written since pop legend David Bowie died on January 10 but we found this blog – written as a thank you letter to the singer by Cardiff palliative care consultant Dr Mark Taubert – particularly moving. Mark had never met Bowie but was an out-and-out fan. More powerfully, from a medical point of view, Mark thanked Bowie and his courage to document his dying in his last album, Blackstar, especially the single and its video, Lazarus. It enabled Mark to open conversations about death and dying with his patients like nothing had done before. Discussions about dying a “good death” at home, symptom control, advance care planning, no-resus orders – all became easier through the filter of “what did Bowie do?”. For one patient they wondered together “who may have been around you when you took your last breath and whether anyone was holding your hand. I believe this was an aspect of the vision she had of her own dying moments that was of utmost importance to her, and you gave her a way of expressing this most personal longing to me, a relative stranger. Thank you.”
http://blogs.bmj.com/spcare/2016/01/15/a-thank-you-letter-to-david-bowie-from-a-palliative-care-doctor/

Inquiry heat on AHPRA
The AHPRA annual report shows the local office has been hot on practitioners’ heels, second only to NSW for the number of notifications. The agency’s national activity has come to the attention of the Senate Community Affairs References Committee, urged along by South Australian Senator Nick Xenophon, and it will be inquiring and reporting on the medical complaints process. It will look into the prevalence of bullying and harassment in the profession and the roles of the Medical Board, AHPRA and others in managing investigations into professional conduct. It also turns the spotlight on the National Law as it relates to the complaints handling process and there’s sure to be plenty of doctor input into that one. The committee is expected to report on June 23.

Stats all in together
Our ears pricked up when we read in the national media that Bupa was going to name and shame individual high-rolling specialists. We thought it sounded too crystal clear to be that transparent. A Bupa spokesperson told us that it will use “aggregated claims data from its 4m members to help consumers understand the average for typical surgical procedures”. Not quite as ‘courageous’ as first thought, however, the idea behind it is interesting. Bupa will begin publishing the average costs for common procedures, state-by-state, but not what individual surgeons charge, by the first quarter of 2016 and it hopes this will create competition and drive down prices. Without consumer action that might be a long time coming but then again if private health insurance premiums rise as the companies hope, pressure might be applied from all sides.

My DNA, Your Info
Wow, is there anything pharmacies can’t do? Apart from dispensing statins, flu jabs and anti-depressants, some pharmacies are now offering to test customers’ DNA. The myDNA pharmacogenomic test (which identifies gene variations in enzymes) apparently can predict the correct medication and dose for an individual based on their DNA. The media release said 10,000 GPs and specialists have been asking patients to have the test done – if you’re out there, we’d love to talk to you. About 200 Chemmart Pharmacies across Australia are conducting the tests – 27 in WA are ready to go with another 47 interested. Analysis is being conducted by Clinical Laboratories and clinical interpretation by My DNA Life. We’re told 265 West Australians have already had the test.

Safe access zones in WA
Abortion is an emotive and volatile issue. This month’s letters page is testament. It has come into sharp focus locally with the opening of the new SJG Midland Public Hospital and its refusal to perform such procedures for public patients on religious grounds. With the Midland Marie Stopes clinic now performing those abortions and contraceptive procedures with State Government funding, it has attracted the attention of the religious organisation 40 Days for Life, which was to start a Lenten prayer vigil outside the Dr Marie premises from February 10. The organiser Joanne Cicchini didn’t return our calls but the Australian CEO of MSI Alexis Apostolellis told Medical Forum that his organisation had petitioned for the introduction of safe access zones at all its sites and “zoning is critically needed for WA”. “Every woman has the right to access medical treatment without prejudice or harassment. Every staff member has the right to go to work without being shamed for doing so, particularly when their role is to support the health and wellbeing of others.”

phone-wait-asleepWhistle while you wait … and wait
What is going on at the PBS Authority line? We have had a second complaint from a local doctor about the length of time it’s taking to get scripts authorised. To paraphrase Oscar Wilde’s Lady Bracknell once is a misfortune, twice looks like carelessness. In November we reported a doctor’s complaint (described to us as “ridiculous delays” of at least five minutes) to the Department of Human Services. We reported faithfully its statement that, oops, “one-off technical issue”, “normally very low wait times” and how about an average speed of answer of 42 seconds. This latest complaint reports unreasonably long delays “every day”, which have forced doctors in this particular practice to write scripts at home at night because the waiting time is less. They claim that in the past couple of months they have lost more than half an hour each day waiting for a phone authorisation. A department response to one of the docs at least acknowledged a problem “they are working on”. The official media response was a carbon copy of the first, except the average speed of answer has blown out to 47 seconds. Alarmingly the statement says the line has been operating normally even bettering its average speed of answer in January to 23 seconds. You can accept a one-off spot fire but when lightning strikes at the same place twice, the smoke alarm is well and truly ringing. At the time of going to press, Alan Tudge had just been sworn in as Human Services Minister. We will give him time to find his coffee cup then we will ask the politician to respond. If you have experienced problems, send us an email at editor@mforum.com.au.

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