Owners push the envelope
Medical Forum caught up with Hills GP Dr Sean Stevens to talk about the momentum of the newly formed national Australian GP Alliance, which met for the first time in March. AGPA was forged from the fires of the ongoing pathology rental issue (which this month’s budget will hopefully clarify). However, it has taken on greater complexity which may startle some of the representative organisations around town. The aim of the group, says Sean, is to find solutions for issues such as pathology rental, Health Care Homes, dealing with the PHNs and risk and governance management that reflect concerns of independent practice owners. There has been growing disquiet that when it comes to owners’ specific needs, the AMA and the College are hamstrung to help because of conflicts of craft interests and charters. They needed some muscular lobbying of their own and like all good grassroots movements, local politicians will be targeted. Sean said there is a strong appetite among the 75 owners who attended the Sydney meeting and subcommittees have been formed and action plans drawn up. The strategic planning committee will meet in Melbourne on May 13 to discuss the fallout from the Federal budget.
Screening better, not more
On P16, we speak to Prof Christobel Saunders about breast cancer research and she also had some interesting things to say about the hot topic of screening and the need to tailor it to avoid unnecessary treatment. “At the moment the only discriminating feature is age. We offer everyone a mammogram over the age of 50. If we could work out who is at very high risk and screen them more often and differently, and determine who was at very low risk and wouldn’t benefit from screening, that would be useful,” she said. “Screening has great value for a limited number of women and of less value for another group of women. Surely we should work out who would benefit. We also need better technology.” She said while technology had improved, it was still essentially the same test as 30 years ago. Breast screening services around the country were united in the need to find better ways to screen. “Overdiagnosis is a real issue but we don’t know who we are overdiagnosing and overtreating,” she said. Research into tailored screening was in the wind and Christobel hoped WA and Victoria would be trial sites.
The whole nine months
PHD candidate and KEMH’s chief sonographer Michelle Pedretti’s research into preterm birth is indicates that a shortened cervix between 16 and 26 weeks of pregnancy is strongly associated with preterm birth. She told Medical Forum that the length of the cervix should be routinely measured at the standard mid-trimester foetal anatomy scan and hopes that GPs will record this in a patient’s record. While the majority of scans are transabdominal, there was a case for some women to have their cervixes measured transvaginally for greater accuracy. “Women who have had a previous preterm birth, surgery on their cervix or a pre-mid-trimester pregnancy loss are considered higher risk of preterm birth and should have their cervix measured transvaginally at 16, 19 and 21 weeks,” she said.
It was a big month for WA-based online appointments company HealthEngine with its founders Dr Marcus Tan and Adam Yap sealing a capital raising deal with Sequoia India (through Alium Capital) for $26.7m. The Australian Financial Review reported that the deal was a $7m bonus as it was believed the company was looking to raise $20m. Sequoia will have a seat on the board alongside what Marcus described as “cornerstone investors” Seven West Media and Telstra Ventures. He also signalled the intention of HealthEngine to enter overseas markets. The AFR quoted him as having “grand aspirations and we want to improve healthcare globally” which he added would likely to be done through acquisitions. HealthEngine was named among Westpac’s 200 Businesses of Tomorrow alongside fellow Perth company, Chemo at Home.
Terminations via telehealth
We haven’t heard much from Dr Marie’s clinic in Midland, which has contract for delivering non-Catholic services for the new Midland Hospital, such as contraceptive advice. Dr Marie’s website shows they offer bulk billed “tele-abortion” for women over 16 years who request medical abortions before eight weeks gestation with certain safeguards in place. At the World Congress on Public Health in Melbourne, Darwin University’s A/Prof Suzanne Belton said telehealth abortions using tablets were a safe and effective way for Australian women to seek a termination. “It is a low-risk procedure. Very few women needed extra support at a hospital for assistance with bleeding or additional pain relief. Since September 2015, more than 1000 women have used the service which is very affordable”.