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"Your GPS is wrong": Hilarious outback sign causes double takes

In the ongoing battle between technology and good old-fashioned road signs, it seems the good people of Quairading, a tiny town in Western Australia, have taken matters into their own hands. The battleground? Old Beverley Road, a path that might be best described as the Bermuda Triangle of rural routes. A local Facebook post revealed the existence of at least two signs urging drivers to defy their GPS and embark on a detour through the town. The signs don't beat around the bush either, bluntly stating, "Your GPS is wrong, this is not the best route to Perth". It's a brave move, considering most people tend to trust their navigation apps more than their own instincts (or road signs). The post quickly became a social media sensation, garnering over 15,000 likes and hundreds of comments. One person couldn't contain their excitement, proclaiming, "Finally vindicated, I've been telling my GPS they're wrong for years!" Some conspiracy theorists speculated that this was all part of an elaborate marketing scheme by Quairading to boost tourism. "I think it's a clever ploy by Quairading to make tourists drive through their town," one person suggested. "Maybe stop for coffee, etc. Marketing 101." If it is intentional, hats off to Quairading for the creativity; they've managed to turn road safety into a guerrilla marketing campaign. Quairading Shire president Jo Haythornthwaite responded to the comments by setting the record straight, explaining that Google and GPS suggest Old Beverley Road as a shortcut to Perth, but in reality, it's a slippery, gravel-covered disaster waiting to happen. According to her, "What Google does not recognise is that their suggestion of taking the Old Beverley Road leads travellers and tourists onto a low-lying road that has 15kms of gravel, is very slippery when wet, and is prone to flooding." To combat the persistent GPS misguidance, the Shire tried the diplomatic route, requesting that Google update its algorithm to favour the safer alternative. Unfortunately, it seems Google was either too busy directing people to non-existent streets or enjoying a virtual road trip to pay attention. Frustrated but undeterred, the signs were erected as a last-ditch effort to send a clear message: "Turn around! Or prepare for an off-road adventure you didn't sign up for!" The signs, much like a seasoned comedian, delivered the punchline: a noticeable decrease in traffic along Old Beverley Road. While Quairading might not have exact numbers, they've declared victory in their quest to keep road users safe. As Ms Haythornthwaite put it, "So, without knowing specific numbers, we believe that, although some continue to use the less safe route of the Old Beverley Road, many travellers are taking notice and following the signage." And so, the small town of Quairading triumphs in the great GPS versus road sign showdown. Perhaps, in the grand scheme of things, we all need a little more trust in the wisdom of quirky road signs. After all, who knows the terrain better than the locals who've been there, done that, and put up the signs to prove it?

Travel Trouble

No, antibiotics aren’t always needed. Here’s how GPs can avoid overprescribing

<a href="https://theconversation.com/profiles/mina-bakhit-826292">Mina Bakhit</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> The growth in antibiotic resistance threatens to return the world to the pre-antibiotic era – with deaths from now-treatable infections, and some elective surgery being restricted because of the risks of infection. Antibiotic resistance is a major problem worldwide and should be the concern of everyone, including you. We need to develop new antibiotics that can fight the resistant bacteria or antibiotics that bacteria would not be quickly resistant to. This is like finding new weapons to help the immune system fight the bacteria. More importantly, we need to use our current antibiotics – our existing weapons against the bacteria – more wisely. <h2>Giving GPs the tools to say no</h2> In 2022, more than <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/aura-2023-fifth-australian-report-antimicrobial-use-and-resistance-human-health">one-third of Australians</a> had least one antibiotic prescription, with <a href="https://www.safetyandquality.gov.au/publications-and-resources/resource-library/analysis-2015-2022-pbs-and-rpbs-antimicrobial-dispensing-data">88%</a> of antibiotics prescribed by GPs. Many people <a href="https://pubmed.ncbi.nlm.nih.gov/28289114/">mistakenly think</a> antibiotics are necessary for treating any infection and that infections won’t improve unless treated with antibiotics. This misconception is found in studies involving patients with various conditions, including respiratory infections and conjunctivitis. In reality, not all infections require antibiotics, and this belief drives patients requesting antibiotics from GPs. Other times, GPs give antibiotics because they think patients want them, even when they might not be necessary. Although, in reality they are <a href="https://pubmed.ncbi.nlm.nih.gov/17148626/">after symptom relief</a>. For GPs, there are ways to target antibiotics for only when they are clearly needed, even with short appointments with patients perceived to want antibiotics. This includes: <ul> <li> using <a href="https://pubmed.ncbi.nlm.nih.gov/32357226/">decision guides</a> or tests to decide if antibiotics are really necessary </li> <li> giving <a href="https://www.safetyandquality.gov.au/our-work/partnering-consumers/shared-decision-making/decision-support-tools-specific-conditions">patients information sheets</a> when antibiotics aren’t needed </li> <li> giving a “<a href="https://pubmed.ncbi.nlm.nih.gov/33910882/">delayed prescription</a>” – only to be used after the patient waits to see if they get better on their own. </li> </ul> All these strategies need some <a href="https://www.nps.org.au/assets/NPS/pdf/NPS-MedicineWise-Economic-evaluation-report-Reducing-Antibiotic-Resistance-2012-17.pdf">training</a> and practice, but they can help GPs prescribe antibiotics more responsibly. GPs can also learn from each other and use tools like <a href="https://pubmed.ncbi.nlm.nih.gov/24474434/">posters</a> as reminders. To help with patients’ expectations, public campaigns have been run periodically to educate people about antibiotics. These campaigns <a href="https://pubmed.ncbi.nlm.nih.gov/35098267/">explain why</a> using antibiotics too much can be harmful and when it’s essential to take them. <h2>Giving doctors feedback on their prescribing</h2> National programs and interventions can help GPs use antibiotics more wisely One successful way they do this is by <a href="https://pubmed.ncbi.nlm.nih.gov/34356788/">giving GPs feedback</a> about how they prescribe antibiotics. This works better when it’s provided by organisations that GPs trust, it happens more than once and clear goals are set for improvement. The NPS (formerly National Prescribing Service) MedicineWise program, for example, had been giving feedback to GPs on how their antibiotic prescriptions compared to others. This reduced the number of antibiotics prescribed. However, <a href="https://australianprescriber.tg.org.au/articles/the-end-of-nps-medicinewise.html">NPS no longer exists</a>. In 2017, the Australian health department did something similar by sending <a href="https://behaviouraleconomics.pmc.gov.au/projects/nudge-vs-superbugs-behavioural-economics-trial-reduce-overprescribing-antibiotics">feedback letters</a>, randomly using different formats, to the GPs who prescribed the most antibiotics, showing them how they were prescribing compared to others. The most effective letter, which used pictures to show this comparison, reduced the number of antibiotics GPs prescribed by <a href="https://behaviouraleconomics.pmc.gov.au/sites/default/files/projects/nudge-vs-superbugs-12-months-on-report.pdf">9% in a year</a>. <h2>Clearer rules and regulations</h2> Rules and regulations are crucial in the fight against antibiotic resistance. Before April 2020, many GPs’ computer systems made it easy to get multiple repeat prescriptions for the same condition, which could encourage their overuse. However, in April 2020, the Pharmaceutical Benefits Scheme (PBS) <a href="https://www.pbs.gov.au/pbs/industry/listing/elements/pbac-meetings/psd/2019-08/antibiotic-repeats-on-the-pharmaceutical-benefits-scheme">changed the rules</a> to ensure GPs had to think more carefully about whether patients actually needed repeat antibiotics. This meant the amount of medicine prescribed better matched the days it was needed for. Other regulations or policy targets could include: <ul> <li> ensuring all GPs have access to antibiotic prescribing guidelines, such as <a href="https://www.tg.org.au/">Therapeutic Guidelines</a>, which is well accepted and widely available in Australia </li> <li> ensuring GPs are only prescribing antibiotics when needed. Many of the conditions antibiotics are currently prescribed for (such as sore throat, cough and middle ear infections) are self-limiting, meaning they will get better without antibiotics </li> <li> encouraging GP working with antibiotics manufacturers to align pack sizes to the recommended treatment duration. The recommended first-line treatments for uncomplicated urinary tract infections in non-pregnant women, for example, are either three days of trimethoprim 300 mg per night or five days of nitrofurantoin 100 mg every six hours. However, the packs contain enough for seven days. This can mean patients take it for longer or use leftovers later. </li> </ul> <h2>Australia lags behind Sweden</h2> Australia has some good strategies for antibiotic prescribing, but we have not had a sustained long-term plan to ensure wise use. Although Australian GPs have been doing well in <a href="https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-surveillance-system/aura-2021">reducing antibiotic prescribing</a> since 2015, <a href="https://pubmed.ncbi.nlm.nih.gov/35098269/">more</a> could be done. In the 1990s, Sweden’s antibiotic use was similar to Australia’s, but is now less than half. For more than two decades, Sweden has had a national strategy that reduces antibiotic use by about <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677604/">7% annually</a>. It is vital Australia invests in a similar long-term national strategy – to have a centrally funded program, but with regional groups working on the implementation. This could be funded directly by the Commonwealth Department of Health and Ageing, or with earmarked funds via another body such as the Australian Centre for Disease Control. In the meantime, individual GPs can do their part to prescribe antibiotics better, and patients can join the national effort to combat antibiotic resistance by asking their GP: “what would happen if I don’t take an antibiotic?”. <a href="https://theconversation.com/profiles/mina-bakhit-826292">Mina Bakhit</a>, Assistant Professor of Public Health, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/no-antibiotics-arent-always-needed-heres-how-gps-can-avoid-overprescribing-213981">original article</a>.

Caring

I think I have the flu. Should I ask my GP for antivirals?

<a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>, and <a href="https://theconversation.com/profiles/yong-qian-koo-1457640">Yong Qian Koo</a>, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> If you test positive for COVID and you’re eligible for antivirals, you’ll likely ask your GP for a script to protect you from severe disease. <a href="https://healthdispatch.com.au/news/immunisation-coalition-urging-people-with-flu-like-symptoms-to-g">Antivirals</a> are also available to fight influenza viruses, via a doctor’s prescription. But they have a mixed history, with their benefits at times <a href="https://theconversation.com/controversies-in-medicine-the-rise-and-fall-of-the-challenge-to-tamiflu-38287">overstated</a>. It can be difficult to get an appointment to see your GP. So when should you make the effort to see a GP for a prescription for influenza antivirals? And how effective are they? <h2>What exactly is influenza?</h2> The flu is primarily a viral infection of the respiratory system that can spread through sneezing, coughing, or touching contaminated objects then touching your nose or mouth. Common symptoms include headache, sore throat, fever, runny or blocked nose and body aches that last a week or more. Influenza is actually a group of viruses, divided into several <a href="https://www.cdc.gov/flu/about/viruses/types.htm#:%7E:text=There%20are%20four%20types%20of,global%20epidemics%20of%20flu%20disease,%20https://www.cdc.gov/flu/professionals/acip/background-epidemiology.htm">sub-groups</a>. Flu A and B are the <a href="https://www.health.gov.au/resources/collections/aisr?language=en,%20https://www.health.gov.au/resources/collections/australian-influenza-surveillance-reports-2023?language=en">most common groups</a> that circulate in humans. <h2>What are flu antivirals?</h2> Influenza antivirals, target specific parts of the viral life cycle, which prevents the virus replicating and spreading. Most flu antivirals <a href="https://www.nejm.org/doi/full/10.1056/NEJMra050740">target</a> neuraminidase, an important enzyme the virus uses to release itself from cells. On the other hand, COVID antivirals work by inhibiting other parts of the viral life cycle involved in the <a href="https://www.tga.gov.au/news/media-releases/tga-provisionally-approves-two-oral-covid-19-treatments-molnupiravir-lagevrio-and-nirmatrelvir-ritonavir-paxlovid">virus replicating itself</a>. Three influenza antivirals are <a href="https://australianprescriber.tg.org.au/articles/influenza-overview-on-prevention-and-therapy.html#r20">used in Australia</a>. Relenza (zanamivir) is an inhaled powder and Tamiflu (oseltamivir) is a capsule; both are five-day treatments. Rapivab (peramivir) is a single injection. These antivirals may also come with <a href="https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm">side effects</a>, such as a headache, vomiting, cough, or <a href="https://www.immunisationcoalition.org.au/resources/antiviral-treatments-for-influenza/">fever</a>. Tamiflu and Relenza generally cost A$40-50 in Australia, plus the cost of the consultation fee with your doctor, if applicable. <h2>How effective are antivirals for the flu?</h2> Antivirals have the greatest effect if started 24-72 hours after symptoms. This is to prevent the virus from reaching <a href="https://www.mdpi.com/1660-4601/19/5/3018">high levels in the body</a>. Among healthy adults, if Relenza or Tamiflu are started within 48 hours from your first symptoms, they can <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008965.pub4/full">reduce the duration</a> of symptoms such as cough, blocked nose, sore throat, fatigue, headache, muscle pain and fever by just under a day. For people who have developed severe flu symptoms or who have existing health conditions such as heart disease or chronic obstructive pulmonary disease (COPD), antivirals that start later (but still before day five of symptoms) can still reduce the <a href="https://academic.oup.com/cid/article/52/4/457/378776?login=true">severity of infection</a> and reduce the <a href="https://thorax.bmj.com/content/thoraxjnl/65/6/510.full.pdf?frbrVersion=3">chance of</a> <a href="https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/215903">hospitalisation</a> and <a href="https://academic.oup.com/jac/article/72/11/2990/4091484?login=false">death</a>. In a study from the 2009 swine flu (H1N1) pandemic in the United States, treatment with antivirals (Tamiflu and Relenza) <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3358088/">reduced</a> the chance of needing to be hospitalised. Around 60% of hospitalisations prevented were among 18-64 years olds, around 20% in children 0-17 years, and 20% in adults aged over 65. The research is less clear about whether antivirals prevent the development of flu complications such as secondary bacterial pneumonia. They might, but so far the data aren’t clear. <h2>Are flu antivirals becoming less effective?</h2> Antiviral resistance to Tamiflu has been <a href="https://link.springer.com/article/10.1007/s10096-020-03840-9">reported</a> around the world, mostly in <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223162/">immunocompromised people</a>, as they <a href="https://link.springer.com/article/10.1007/s10096-020-03840-9">have</a> a weakened immune system that allows higher viral loads and prolonged viral shedding. The impact of the antiviral resistance is unclear but there is evidence indicating resistant strains can uphold their ability to replicate effectively and spread. So far it’s not clear if these stains cause more severe disease. However, government agencies and surveillance programs are constantly monitoring the spread of antiviral resistance. Currently there is <a href="https://www.cdc.gov/flu/treatment/antiviralresistance.htm">minimal concern</a> for strains that are resistant to Tamiflu or Relenza. <h2>Antivirals can also prevent the flu if you’ve been exposed</h2> Tamiflu and Relenza can also be used to <a href="https://onlinelibrary.wiley.com/doi/10.1111/irv.12046">prevent flu infections</a>, if we’re exposed to the virus or come into contact with infected people. Some studies suggest Tamiflu and Relenza can <a href="https://www.bmj.com/content/326/7401/1235.long">reduce the chance of developing symptomatic influenza</a> by 70-90%. Many health agencies around the world <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8165743/">recommend</a> “prophylactic” treatment for high-risk patients in hospitals or age care setting when people have been in contact with others infected with influenza. <h2>So who should talk to their GP about a prescription?</h2> <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/racf-antiviral-treatments-and-prophylaxis.aspx#:%7E:text=The%20Australian%20Therapeutic%20Guidelines*%20recommends,of%20severe%20disease%20from%20influenza.&text=people%20with%20chronic%20conditions%20including,heart%20disease">Australian guidelines recommend</a> doctors offer antivirals to people with influenza who have severe disease or complications. Doctors can also consider treatment for people at higher risk of developing severe disease from influenza. This includes: <ul> <li>adults aged 65 years or older</li> <li>pregnant women</li> <li>people with certain chronic conditions (heart disease, Down syndrome, obesity, chronic respiratory conditions, severe neurological conditions)</li> <li>people with compromised immunity</li> <li>Aboriginal and Torres Strait Islander people</li> <li>children aged five years or younger</li> <li>residents of long-term residential facilities</li> <li>homeless people.</li> </ul> Doctors can prescribe antivirals for the prevention of influenza <a href="https://australianprescriber.tg.org.au/articles/influenza-overview-on-prevention-and-therapy.html#r20">in</a> vulnerable people who have been exposed to the virus. Antiviral treatment also can be <a href="https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm#:%7E:text=Antiviral%20treatment%20also%20can%20be,48%20hours%20of%20illness%20onset">considered</a> for otherwise healthy symptomatic patients who have confirmed or suspected influenza, if they can start treatment within 48 hours of developing symptoms. In some instances a doctors can make a clinical diagnosis of influenza based on the symptoms and known close flu positive contacts of the patient. However, it is preferred to have flu diagnosed by one of the approved diagnostic tests, such as a <a href="https://24-7medcare.com.au/influenza/australian-gp-influenza-2023-guide/">rapid antigen test</a> (RAT) or the more accurate <a href="https://www.health.nsw.gov.au/Infectious/factsheets/Pages/influenza_factsheet.aspx">PCR test</a>, similar to what is perfomed for COVID. There are also now combo tests that can <a href="https://www.tga.gov.au/news/media-releases/first-combination-covid-19-and-influenza-self-tests-approved-australia">distinguish between SARS-CoV-2 and influenza virus</a>. Remember, the flu can cause <a href="https://www.abc.net.au/news/2023-07-23/flu-season-hitting-children-hard-antivirals-may-help/102633722">severe illness or death</a>, particularly among people from the high-risk groups. So if you think you might have the flu, wear a mask and stay away to avoid spreading the virus to others. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/210457/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/lara-herrero-1166059">Lara Herrero</a>, Research Leader in Virology and Infectious Disease, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>; <a href="https://theconversation.com/profiles/wesley-freppel-1408971">Wesley Freppel</a>, Research Fellow, Institute for Glycomics, <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a>, and <a href="https://theconversation.com/profiles/yong-qian-koo-1457640">Yong Qian Koo</a>, , <a href="https://theconversation.com/institutions/griffith-university-828">Griffith University</a> Image credits: Shutterstock This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/i-think-i-have-the-flu-should-i-ask-my-gp-for-antivirals-210457">original article</a>.

Body

Should you register with a GP? What is MyMedicare and how might it change the care you get?

<a href="https://theconversation.com/profiles/anthony-scott-10738">Anthony Scott</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> <a href="https://www.health.gov.au/our-work/mymedicare">MyMedicare</a> is a new voluntary scheme that allows patients to register with their usual GP, in an attempt to improve continuity of care and health outcomes. From October 1, the scheme will give registered patients access to longer telehealth consultations. Then, from next year, GP clinics with patients who are frequently admitted to hospital or are aged care residents will be able to access additional “blended” funding, which sits outside Medicare’s usual fee-for-service. MyMedicare was announced in the May budget, with A$19.7 million of funding over four years, alongside a range of <a href="https://www.health.gov.au/sites/default/files/2023-05/building-a-stronger-medicare-budget-2023-24_0.pdf">other health reforms</a>, including funding for practice nurses to improve team-based care, as well as new incentives to increase bulk billing rates. We’re still waiting on a lot of detail about how the scheme will function. But here’s what we know so far – and what it might mean for patients and GPs. <h2>What do we know about MyMedicare?</h2> The scheme is voluntary for GPs and patients. In addition to patients opting in, GPs will also need to sign up, and have been able to do so since the start of July. There will be a gradual roll out and it will take three years to cover all of Australia. Though details are yet to be confirmed, from mid-2024 individual GPs will receive “<a href="https://www.acponline.org/about-acp/about-internal-medicine/career-paths/residency-career-counseling/resident-career-counseling-guidance-and-tips/understanding-capitation">capitation</a>” payments for patients who have more than ten hospital admissions per year. These patients are likely to have complex needs and multiple conditions and, for various reasons, may not be able to access a GP as much as they should. Though not yet confirmed, GPs are likely to <a href="https://www.ausdoc.com.au/news/the-mymedicare-enrolment-scheme-is-open-for-gp-practices-should-you-sign-up-now/">receive</a> $2,000 per patient per year, plus a $500 bonus for keeping patients out of hospital. The funding provides incentives for the GP to coordinate their care and provide the patient with access to nursing and allied health if required. It’s hoped this will stop patients going to hospital as often. There will also be similar payments for providing regular visits to patients in residential aged care facilities. <h2>Will MyMedicare make a difference to patients?</h2> Let’s consider four key areas patients are concerned about: 1) Continuity of care Research shows greater <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2753.2009.01235.x">continuity of care</a> – developing a relationship with and seeing the same provider or team for your care – improves patient outcomes and reduces costs to the health system. People who use MyMedicare to get a regular GP may see some of these benefits. But many patients already see the same GP or visit the same practice, especially those with chronic conditions. So registration with a practice may not make much difference for this group of patients. What are the other benefits of registration? 2) Reducing hospital admissions Avoiding hospitals can be beneficial – in hospitals, there are no home comforts, they are inconvenient for you and relatives, there is little privacy, and they can be costly. Patients with ten or more hospital admissions in a year have been targeted as they have more complex chronic conditions and may be from vulnerable populations. Better access to a GP could prevent patients visiting the emergency department or prevent overnight hospital admissions. Research shows financial incentives for GPs to better manage chronic disease <a href="https://journals.sagepub.com/doi/full/10.1177/01410768211005109">can reduce hospital admissions</a>. However, <a href="https://bmjopen.bmj.com/content/5/4/e007342?cpetoc=&int_source=trendmd&int_medium=trendmd&int_campaign=trendmd">hospital admissions could also increase</a> if the scheme identifies significant levels of previous unmet need. 3) Reducing barriers to care MyMedicare does not directly address many of the <a href="https://link.springer.com/article/10.1186/1475-9276-12-18">barriers to accessing GP services</a>. If GPs are getting paid more and still getting fee for service payments, will MyMedicare patients be guaranteed to be bulk billed? This has not yet been mentioned, but could be an important part of the scheme to attract patients. People with chronic disease have <a href="https://grattan.edu.au/report/not-so-universal-how-to-reduce-out-of-pocket-healthcare-payments/">two to three times higher</a> out-of-pocket costs than those who do not, and <a href="https://healthsystemsustainability.com.au/the-voice-of-australian-health-consumers/">30%</a> of patients with chronic disease would find it difficult to pay for care if they became seriously ill. Unfortunately MyMedicare will not directly reduce out-of-pocket costs, which may be the real reason why people use “free” emergency department care. 4) Making it clear and easy to sign up It is also unclear how the process of registration will work for patients. Will patients be offered a choice of alternative GPs? If chosen, will GPs be obliged to take them? At the moment, there are no public data about out-of-pocket costs and quality of care provided by different GPs, and so it will be impossible for patients to make an informed choice. Information to inform choice on a website would be useful, as is the case for <a href="https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder">specialists</a>. It’s also unclear if patients who chose to register will find it harder to move GPs or continue to see other GPs if they wish to. The advantages to patients of MyMedicare need to be made clear to encourage them to register and be supported to exercise informed choice if they wish. <h2>Will it make a difference for GPs?</h2> Patient registration can mean a more secure and predictable stream of future income for some patients and also less competition (in terms of “losing” patients to other GPs) and more continuity of care. Moving away from fee for service towards a blended payment model is <a href="https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD011865.pub2/full">widely recognised</a> to support higher value health care. Yet GPs are wary of moving from fee for service to capitation payment. Capitation payments are fixed, so GPs take on more financial risk if they have more complex patients who are more costly to treat and manage in terms of time and effort. Whether the $2,000, plus $500 bonus, plus normal fee for service payments are sufficient to cover the costs of treating very complex patients is unclear. Overall, GPs will get more money, and along with the other announcements in the budget, will receive a significant investment of resources invested in primary care. Our previous <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/hec.3572">research</a> has shown a 5% increase in earnings for GPs is predicted to reduce the total number of GPs by up to 1% (equivalent to around 310 GPs in 2021) at a time of significant GP shortages. If they get paid more, they would prefer to work less. But this could also be offset because the increase in funding will hopefully make general practice more attractive as a career and so there will be more postgraduate doctors <a href="https://www.sciencedirect.com/science/article/pii/S0167629612000902">choosing to be a GP</a>. Voluntary patient registration under MyMedicare has potential to strengthen the relationship between patients and their GP, and focuses on keeping patients out of hospital and properly cared for in residential aged care. But the devil is in the detail and we will need a proper evaluation to determine the impacts on health outcomes, costs and access to health care. <img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/206183/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /> <a href="https://theconversation.com/profiles/anthony-scott-10738">Anthony Scott</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-you-register-with-a-gp-what-is-mymedicare-and-how-might-it-change-the-care-you-get-206183">original article</a>.

Caring

Should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts

<a href="https://theconversation.com/au/team#fron-jackson-webb">Fron Jackson-Webb</a>, <a href="http://www.theconversation.com/">The Conversation</a> Australian of the Year and body positivity advocate Taryn Brumfitt has <a href="https://www.smh.com.au/healthcare/doctors-should-avoid-discussing-patient-s-weight-australian-of-the-year-says-20230707-p5dmhv.html">called for</a> doctors to avoid discussing a patient’s weight when they seek care for unrelated matters. A 15-minute consultation isn’t long enough to provide support to change behaviours, Brumfitt says, and GPs don’t have enough training and expertise to have these complex discussions. “Many people in larger bodies tell us they have gone to the doctor with something like a sore knee, and come out with a ‘prescription’ for a very restrictive diet, and no ongoing support,” Brumfitt <a href="https://www.smh.com.au/healthcare/doctors-should-avoid-discussing-patient-s-weight-australian-of-the-year-says-20230707-p5dmhv.html">told the Nine newspapers</a>. By raising the issue of weight, Brumfitt says, GPs also risk turning patients off seeking care for other health concerns. So should GPs bring up a patient’s weight in consultations about other matters? We asked 5 experts. Brett Montgomery - GP academic Yes, sometimes – but with great care. I agree that weight stigma is damaging, and insensitively raising weight in consultations can <a href="https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0251566" target="_blank" rel="noopener">hurt people's feelings and create barriers</a>to other aspects of health care. I also agree people can sometimes be “overweight” yet <a href="https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0287218" target="_blank" rel="noopener">quite healthy</a>, and that common measures and categories of weight are <a href="https://theconversation.com/bmi-alone-will-no-longer-be-treated-as-the-go-to-measure-for-weight-management-an-obesity-medicine-physician-explains-the-seismic-shift-taking-place-208174">questionable</a>. On the other hand, I know obesity <a href="https://www.racgp.org.au/FSDEDEV/media/documents/RACGP/Position%20statements/Obesity-prevention-and-management.pdf" target="_blank" rel="noopener">is associated with</a> heart disease, joint problems, diabetes and cancers. GPs should be ready to help people with their weight when they want help. <a href="https://www.bmj.com/content/377/bmj-2021-069719.full?ijkey=FnARkmvxLOMFvlb&keytype=ref">Our assistance somewhat effective</a>, though sadly dietary efforts often have minimal effect on weight in the long term. Meanwhile, treatments causing larger weight changes (<a href="https://insightplus.mja.com.au/2021/10/bariatric-surgery-public-system-access-still-terrible/">surgery</a> and <a href="https://www.nature.com/articles/s41366-022-01176-2">some medicines</a> are often financially inaccessible. I feel safe discussing weight when my patient raises the issue. Fearing hurting people, I often avoid raising it myself. I focus instead on health rather than weight, discussing physical activity and healthy diet – these are good things for people of any size. Emma Beckett - Nutrition scientist No. It’s not likely to succeed. Large systematic reviews bringing together multiple studies of multiple weight-loss diets show weight loss is not generally maintained long term (<a href="https://pubmed.ncbi.nlm.nih.gov/32238384/">12 months</a> to <a href="https://www.nature.com/articles/0802982">four years</a>). The idea that weight is about willpower is outdated. The current body of evidence <a href="https://theconversation.com/whats-the-weight-set-point-and-why-does-it-make-it-so-hard-to-keep-weight-off-195724">suggests</a> we each have a weight set point that our body defends. This is determined by genetics and environment more so than education. There may be associations between weight and health outcomes, but losing weight <a href="https://theconversation.com/just-because-youre-thin-doesnt-mean-youre-healthy-101185">does not necessarily equate</a> with improving health. Fat stigma and fatphobia are <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866597/">harmful too</a> and can <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4381543/">compromise access to health care</a>. Instead, consider asking a better question. Healthy eating reduces disease risk <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3935663/">regardless of weight</a>. So maybe ask how many vegetables are your patients eating. Would they like to see a dietitian to discuss strategies for a better-quality diet? Liz Sturgiss - GP/researcher No. A <a href="https://pubmed.ncbi.nlm.nih.gov/33211585/">US study</a> estimates it would take a family doctor 131% of their work hours to implement all preventive health-care recommendations. It's impossible to address every recommendation for preventative care at every consultation. One of the key skills of a GP is balancing the patient and doctor agenda. <a href="https://www.obesityevidencehub.org.au/collections/treatment/weight-bias-and-stigma-in-health-care">Weight stigma</a> can deter people from seeking health care, so raising weight when a patient doesn't have it on their agenda can be harmful. A strong <a href="https://academic.oup.com/fampra/article/38/5/644/6244494?login=false">therapeutic relationship</a> is critical for safe and effective health care to address weight. Weight is always on my agenda when there is unexpected weight loss. If a patient has rapid weight loss, I am concerned about an undetected <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7283307/">cancer</a> or infection. Additionally, I am increasingly seeing patients who are unable to afford food, who often have <a href="https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/introduction">poor oral health</a>, who lose weight due to <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/1747-0080.12580">poverty</a>. Weight loss for the wrong reasons is also a very concerning part of general practice. Nick Fuller - Obesity researcher Yes. GPs should play a role in the early detection of weight issues and direct patients to evidence-based care to slow this progression. <a href="https://pubmed.ncbi.nlm.nih.gov/31032548/">Research</a> shows many people with obesity are motivated to lose weight (48%). <a href="https://pubmed.ncbi.nlm.nih.gov/31032548/">Most</a> want their clinician to initiate a conversation about weight management and treatment options. However, this conversation <a href="https://pubmed.ncbi.nlm.nih.gov/32385580/">rarely occurs</a>, resulting in <a href="https://pubmed.ncbi.nlm.nih.gov/33621413/">significant delays to treatment</a>. Starting the conversation presents challenges. Although obesity is a complex disease related to multiple factors, it's still <a href="https://pubmed.ncbi.nlm.nih.gov/25752756/">highly stigmatised</a>in our society and even in the <a href="https://pubmed.ncbi.nlm.nih.gov/23144885/">clinical setting</a>. Sensitivity is required and the wording the clinician uses is important to make the patient feel safe and avoid placing blame on them. Patients often <a href="https://pubmed.ncbi.nlm.nih.gov/20823355/">prefer terms</a> such as “weight” and “BMI” (body mass index) over “fatness,” “size” or “obesity”, <a href="https://pubmed.ncbi.nlm.nih.gov/27354290/">particularly women</a>. Measuring weight, height and waist circumference should be <a href="https://pubmed.ncbi.nlm.nih.gov/33621413/">considered routine in primary care</a>. But this needs to be done without judgement, and in collaboration with the patient. Helen Truby - Nutrition scientist Yes. A high body weight contributes to many chronic conditions that negatively impact the <a href="https://www.aihw.gov.au/australias-health/summaries">quality of life and mental health</a> of millions of Australians. Not all GPs feel confident having weight conversations, given the sensitive nature of weight and its stigma. GPs' words matter – they are a <a href="https://doi.org/10.1111/nbu.12320">trusted source</a> of health information. It’s critical GPs gain the skills to know when and how to have <a href="https://doi.org/10.1186/s12875-019-1026-4">positive weight conversations</a>. GPs need to offer supportive and affordable solutions. But effective specialist weight management programs are few and far between. More equitable access to programs is essential so GPs have referral pathways after conversations about weight. GPs' time is valuable. Activating this critical workforce is essential to meet the <a href="https://www.health.gov.au/resources/publications/national-obesity-strategy-2022-2032?language=en">National Obesity Strategy.</a> <a href="https://theconversation.com/au/team#fron-jackson-webb">Fron Jackson-Webb</a>, Deputy Editor and Senior Health Editor, <a href="http://www.theconversation.com/">The Conversation</a> Image credits: Getty Images This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/should-gps-bring-up-a-patients-weight-in-consultations-about-other-matters-we-asked-5-experts-209681">original article</a>.

Body

Gastro or endometriosis? How your GP discusses uncertainty can harm your health

You wake with stomach pain that worsens during the day and decide to see your doctor. You describe your symptoms and your doctor examines you. Then the doctor says, “From what I hear, I think you could just have a stomach bug. Rest and come back in three days.” This might be a less definitive answer than you’re after. But doctors can’t always be sure of a diagnosis straight away. As <a href="https://link.springer.com/article/10.1007/s11606-022-07768-y">my review</a> shows, doctors use various ways of communicating such uncertainty. Sometimes there is a mismatch between what doctors say when they’re uncertain and how patients interpret what they say, which can have harmful consequences. <h2>Why does uncertainty matter?</h2> Doctors <a href="https://link.springer.com/article/10.1007/s11606-017-4164-1">cannot always explain</a> what your health problem is or what caused it. Such diagnostic uncertainty is a normal and <a href="https://doi.org/10.1001/jama.2022.2141">ever-present part</a> of the processes leading to a diagnosis. For instance, doctors often have to rule out other possible diagnoses before settling on one that’s most likely. While doctors ultimately get the diagnosis right <a href="http://dx.doi.org/10.1136/bmjqs-2012-001615">in 85-90%</a> of cases, diagnostic uncertainty can lead to diagnostic delays and is a huge contributor to harmful or even deadly misdiagnoses. Every year, <a href="https://www.mja.com.au/system/files/issues/213_07/mja250771.pdf">an estimated</a> 21,000 people are seriously harmed and 2,000-4,000 people die in Australia because their diagnosis was delayed, missed or wrong. That could be because the wrong treatment was provided and caused harm, or the right treatment was not started or given after the condition had already considerably progressed. More than <a href="https://www.mja.com.au/system/files/issues/213_07/mja250771.pdf">80% of diagnostic errors</a> could have been prevented. Three medical conditions – infections, cancer and major vascular events (such as strokes or heart attacks) – are the so-called “<a href="https://doi.org/10.1515/dx-2019-0019">Big Three</a>” and cause devastating harm if misdiagnosed. In my review, the top three symptoms – fever, chest pain and abdominal pain – were most often linked to diagnostic uncertainty. In other words, most of us will have had at least one of these very common symptoms and thus been at risk of uncertainty and misdiagnosis. Some groups are less likely to be diagnosed correctly or without inappropriate delay than others, leading to <a href="https://doi.org/10.1001/jama.2022.7252">diagnostic inequities</a>. This may be the case for <a href="https://www.liebertpub.com/doi/10.1089/whr.2022.0052">women</a>, and other groups marginalised because of their <a href="https://onlinelibrary.wiley.com/doi/10.1111/acem.14142">race or ethnicity</a>, <a href="https://doi.org/10.1016/j.socscimed.2020.113609">sexual orientation or gender identity</a>, or <a href="https://doi.org/10.1001/jama.2022.7252">language proficiency</a>. <h2>How often do you hear ‘I don’t know’?</h2> My research showed doctors often make diagnostic uncertainty clear to patients by using explicit phrases such as: “I don’t know.” But doctors can also keep quiet about any uncertainty or signal they’re uncertain in more subtle ways. When doctors believe patients prefer clear answers, they may only share the most likely diagnosis. They say: “It’s a stomach bug” but leave out, “it could also be constipation, appendicitis or endometriosis”. Patients leave thinking the doctor is confident about the (potentially correct or incorrect) diagnosis, and remain uninformed about possible other causes. This can be especially frustrating for patients with chronic symptoms, where such knowledge gaps can lead to lengthy diagnostic delays, as reported for <a href="https://doi.org/10.1016/j.ajog.2018.12.039">endometriosis</a>. Subtle ways of communicating uncertainty include hedging with certain words (could, maybe) or using introductory phrases (my guess, I think). Other implicit ways are consulting a colleague or the Internet, or making follow-up appointments. If patients hear “I think this could be a stomach bug” they may think there’s some uncertainty. But when they hear “come back in three days” the uncertainty may not be so obvious. Sharing uncertainty implicitly (rather than more directly), can leave patients unaware of new symptoms signalling a dangerous change in their condition. <h2>What can you do about it?</h2> 1. Ask about uncertainty Ask your doctor to share any <a href="http://dx.doi.org/10.1515/dx-2021-0086">uncertainty and other diagnostic reasoning</a>. Ask about alternative diagnoses they’re considering. If you’re armed with such knowledge, you can better engage in your care, for example asking for a review when your symptoms worsen. 2. Manage expectations together Making a diagnosis can be an evolving process rather than a single event. So ask your doctor to outline the diagnostic process to help manage any <a href="http://dx.doi.org/10.1136/ebm.14.3.66">mismatched expectations</a> about how long it might take, or what might be involved, to reach a diagnosis. Some conditions need time for symptoms to evolve, or further tests to exclude or confirm. 3. Book a long appointment When we feel sick, we might get anxious or find we experience heightened levels of fear and other emotions. When we hear our doctor isn’t certain about what’s causing our symptoms, we may get even more anxious or fearful. In these cases, it can take time to discuss uncertainty and to learn about our options. So book a long appointment to give your doctor enough time to explain and for you to ask questions. If you feel you’d like some support, you can ask a close friend or family member to attend the appointment with you and to take notes for you. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/gastro-or-endometriosis-how-your-gp-discusses-uncertainty-can-harm-your-health-196943" target="_blank" rel="noopener">The Conversation</a>.

Caring

With so many GPs leaving the profession, how can I find a new one?

Perhaps you have been happily attending the same GP for many years. They know your medical history better than anyone. Then all of a sudden they retire, or the practice closes, or it gets taken over by a bigger company and everything at the practice changes. Or maybe you’ve just had an unexpected visit to hospital and they ask who your GP is on discharge, then you realise you’re in need of one. More than 80% of Australians <a href="https://pubmed.ncbi.nlm.nih.gov/29779298/">visit a GP</a> each year and those with chronic medical conditions will attend multiple times within the same period. It’s important to have a good GP who can coordinate your care. So how do you find a new one to develop a trusted relationship with? As practising GPs ourselves, we are often asked: “Do you know a good GP?” This can be a somewhat difficult question to answer, as each person’s perception of “good” is highly subjective, dependent on many factors. Studies of peoples’ preferences have varied results. One study found the <a href="https://pubmed.ncbi.nlm.nih.gov/21334160/">listening ability</a> of the GP to be important. Other studies found patients put more value in <a href="https://pubmed.ncbi.nlm.nih.gov/18332402/">clinical competency</a>, a <a href="https://bjgp.org/content/70/698/e676">trusting relationship or continuity of care</a>. So a better question is: what GP will be a good fit for me? <h2>What factors are important to you? 6 aspects to consider</h2> Here are some tips to help speed up your search for your new GP. Remember though, it may take a few visits to develop a trusting relationship and know if the fit is right for you. <h2>1. Your health needs</h2> If you are young and healthy, a GP offering a convenient service and who is easy to book in quickly with may suffice. For those living with chronic complex conditions or disabilities who need to visit often, a consistent and thorough doctor is recommended. <h2>2. Cost</h2> Bulk-billing doctors are becoming rarer given the rising cost of services, salaries, equipment and utilities. To stay afloat, these doctors are having to see more patients in less time. This could result in a poorer understanding of you as an individual and your health values and goals. Again, this might not be a problem for simple consults. But if you get a serious disease down the track, you might wish you’d had a regular GP all along, because they would know you and your history. If you’re able to wear some extra cost but wondering how much to pay, consider the Australian Medical Association recommendation as your guide – a standard 15-minute <a href="https://www.ausdoc.com.au/news/rebate-gap-blows-out-47-standard-gp-consult/#:%7E:text=In%20its%20latest%20list%20of,currently%20sits%20at%20just%20%2439.10.">consult cost</a> is $86 with a $39 rebate from Medicare. <h2>3. Accessibility and practice size</h2> Consider the distance you need to travel and the opening hours you may need, including weekend availability. Bigger practices are more likely to be able to get you in to see a doctor, if not your doctor, and often have longer opening hours. Having more than one preferred GP within the same practice can provide more flexibility and they will each be able to access your medical records and results. You may want to enquire also about disability access and telehealth options. <h2>4. Reviews</h2> Online recommendations can be tricky to interpret. Only <a href="https://www.center4research.org/believe-online-reviews-doctors/">6–8% of people</a> post online reviews for doctors. And there are plenty of people out there who have inappropriate requests or expectations of GPs, which may be their basis for a negative review. Also, someone who has been happily seeing their GP for decades is less likely to post a rating than a one-off visitor. Be sure to consider what reasons were given for a negative review – was it because of actions taken, an attitude, or a personality clash? – and how those reasons align with your preferences. In saying that, community Facebook groups are often a hotspot for discussions about local GPs and recurrent positive recommendations can and should be held in higher regard. <h2>5. New doctors</h2> There are many young GPs starting off in the profession or new to the area. Many will be fantastically caring and competent. But these doctors are not going to come with recommendations yet. These GPs often have plenty of appointment slots, and the most recent up-to-date training. Being an early adopter of their services could be to your benefit. <h2>6. Sub-specialists</h2> Many GPs have special interests and advanced skills, such as skin cancer care, musculoskeletal medicine, women’s health or mental health. They may have done postgraduate training, usually listed on the practice website along with their special interests. They are likely to have a shorter waiting time and lower costs than specialists – so consider these doctors if your needs match their expertise. <blockquote class="twitter-tweet"> The answer to solving the GP workforce crisis? Fix inequities in conditions and pay to attract junior doctors back to general practice. <a href="https://t.co/VnzF63mD4O">https://t.co/VnzF63mD4O</a> — GPRA (@GPRALtd) <a href="https://twitter.com/GPRALtd/status/1541592411776090113?ref_src=twsrc%5Etfw">June 28, 2022</a></blockquote> <h2>Other things to check</h2> About 80% of practices go through a <a href="https://www.semphn.org.au/general-practice-accreditation">practice accreditation process</a>, which proves attainment of standards set by the Royal Australian College of General Practitioners. Such practices will advertise this status on their website and at the entrance to the clinic. You can also ask about a doctor’s qualifications and about the standard consultation length. This may range from 10 to 20 minutes. Don’t be afraid to ask these questions when calling a practice about your first visit. The final and arguably most important test is how you connect when you meet them in person. Finding a GP can be like finding your favourite cardigan. You don’t know it’s your favourite until it has been worn in. Similarly you don’t know that your GP is great until you’ve journeyed with them through some potentially challenging times of your life. We encourage you to use the above tips to find a suitable GP, then give them some time to get to know you and grow a therapeutic relationship. With continuity of care, trust will grow, as will knowledge about you and your values. This will ultimately improve your overall health care experience. Image credits: Getty Images This article originally appeared on <a href="https://theconversation.com/with-so-many-gps-leaving-the-profession-how-can-i-find-a-new-one-190666" target="_blank" rel="noopener">The Conversation</a>.

Caring

“A serious chip on her shoulder”: Pauline Hanson refuses to see ‘foreign’ doctors

Pauline Hanson has revealed that she refuses to be treated by doctors trained outside of Australia, claiming that she doesn’t trust them and that they are not up to Australian standards. The controversial leader of the right-wing One Nation party made the revelation while slamming a proposal from Health Minister Brad Hazzard to remove barriers preventing overseas doctors from working in Australia. Mr Hazzard told the <a href="https://www.dailytelegraph.com.au/news/nsw/brad-hazzard-slams-barbed-wire-fence-blocking-foreign-doctors-from-easing-gp-crisis/news-story/c8c2564f2705459be3c745f9fca74c22" target="_blank" rel="noopener">Daily Telegraph</a> that the “barbed wire fence” of red tape medical graduates trained overseas face to practice in New South Wales has forced hundreds of doctors to quit the industry, even as the country faces a GP shortage that risks creating a healthcare “apocalypse”. “This should be ringing alarm bells in the offices of the Federal Health Department and the Royal Australian College of General Practitioners (RACGP),” he said. Speaking to Sky News, Hanson questioned the red tape Mr Hazzard was referring to and went on to claim that his plan would lower the standards in healthcare. “Lowering the standard again which I believe that if you do that and allow these foreign doctors here that are not up to our standards,” she said. “Well then you're going to play Russian roulette with people's lives.” “I personally will not go to a foreign doctor because I don't trust ... the system when I know they've allowed them into this country and most of them don't pass the first test.” To practise medicine in Australia, doctors who have earned medical degrees from overseas institutions need to be registered with the <a href="https://www.medicalboard.gov.au/Registration/International-Medical-Graduates.aspx">Australian Medical Council</a>, which can involve passing a written exam and clinical exam, including demonstrating a minimum standard of English speaking skills through proof of education in English or passing one of several exams. Hanson claimed that a lot of overseas doctors had to take the test “a couple of times” and that many couldn’t pass because “they can’t speak English” - though it is unclear which test she was referring to. “You can't be a doctor in this country if you can't communicate with the patient. It's not good at all,” she said. “If we allow these foreign doctors in that can't pass the test, they've already lowered the standard twice.” To combat this lowering of standards, Hanson said the solution should be paying GPs more to prevent them from moving into specialist areas to get a higher wage. “We've got to stop draining doctors from other countries and bringing them out here to Australia because, you know, we have a world standard in (medicine),” she continued. “The people (Australia is) bringing over from overseas, we're lowering our standards.” Her comments have come under fire across social media, with many rallying to support internationally-trained doctors and praising them for the care they have provided. “Pauline Hanson yet again demonstrated prejudice against foreign trained doctors. Maybe we should fast track our current medical students? Oh that would be lowering standards then as well! And who still has mandates? Misleading bigoted crap once again from this troublemaker!” one person noted. “To all my wonderful colleagues, Australian or from other countries, who Pauline Hanson might consider foreign. I am so sorry. You are wonderful,” one emergency physician <a href="https://twitter.com/KristinJBoyle/status/1579640575925837824" target="_blank" rel="noopener">tweeted</a>. “Our health system depends on you. Thank you for working alongside me and for treating me and my family. 🙏” <blockquote class="twitter-tweet"> My GP came to Australia from overseas, he is an excellent communicator and caring doctor, I thank him for picking up my cancer. What Pauline Hanson is doing is spewing racist bile based on her own prejudices. She is a truly awful human being with a serious chip on her shoulder — Dr Anthony (Tony) Moore 💉💉💉💉 (@PerpetualWinger) <a href="https://twitter.com/PerpetualWinger/status/1579652006733828102?ref_src=twsrc%5Etfw">October 11, 2022</a></blockquote> Another doctor wrote: “My GP came to Australia from overseas, he is an excellent communicator and caring doctor, I thank him for picking up my cancer. “What Pauline Hanson is doing is spewing racist bile based on her own prejudices. She is a truly awful human being with a serious chip on her shoulder.” Image: Sky News

News

Couple ‘draw’ 7,237 kilometre bicycle in name of climate change

A couple has taken a stand against climate change that can be seen from the skies, having cycled more than 7,000 kilometres to create the image of a bike to encourage others to ditch their cars. UK-based couple Arianna Casiraghi and Daniel Rayneau-Kirkhope first took it upon themselves to “draw” a 956-kilometre-wide bicycle across Europe in 2019, telling the Guardian they did it to “draw attention to the scale of climate breakdown” and get others to think about choosing bikes over cars for shorter trips. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/ChRmUTSM9j8/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/ChRmUTSM9j8/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Arianna🇮🇹 - Daniel🇬🇧 - Zola🐶🇫🇮 (@bicycleswillsavetheworld_)</a> </div> </blockquote> Though a pandemic, injuries, and poor weather made their short trip anything but, the Italian-British duo eventually finished the task. After quitting their jobs in 2019 to start the ride, Casiraghi suffered a knee injury that put a hold on their journey until November, when the cold and rain made it so miserable they had to stop again. Plans to restart the ride in March 2020 were derailed, but Casiraghi said finishing what they had started was both for a sense of accomplishment and so they didn’t let down the people who had been following their progress. Their trip, which totalled 131 days of cycling, finally came to an end on August 15 and the couple took to Instagram to share the news. “We have completed our gps-trace drawing! And what a drawing it is!” they wrote. “We cycled 7237 km through 7 countries to draw our massive bicycle and hopefully encourage one or two people to use their bike instead of the car.” The pair revealed they had also beaten several records, including the Guinness World Record for the largest GPS drawing, the unofficial record for the largest one completed by a bicycle, and “we have definitely drawn the biggest bicycle ever!” As if their feat wasn’t impressive enough, the duo also took their Italian water dog, Zola, along for the ride, using custom-built bikes that had a compartment for the pooch to sit in whenever she wasn’t running alongside. <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/CeWkHS1s06U/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CeWkHS1s06U/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Arianna🇮🇹 - Daniel🇬🇧 - Zola🐶🇫🇮 (@bicycleswillsavetheworld_)</a> </div> </blockquote> "We tried to go on small roads where possible, or off-road, so Zola could walk a bit," Rayneau-Kirkhope said. The planning of their drawing was also a complex task, with their first draft route taking them directly through Charles de Gaulle Airport. Reflecting on their trip, the couple said Casiraghi’s injury proved to be “really quite demoralising”. "We had to stop travelling in order to rest and undertake dedicated physiotherapy sessions, which unfortunately meant that our project got delayed," they said. But, people’s reactions to their journey far outshone the harder moments. "The highlight of the trip has been the incredible support that we have received from people along the road," they said. "Without them, cycling through the cold and rainy winter months would simply not have been possible with our tight budget. "We still are amazed about how open-minded and selfless people can be." As for what’s next, the pair said they would be heading home for a rest before hitting the pedals again - though their next trip won’t be so artistic. "Now, we will go home and rest before going for another cycling trip," they said. "No drawing, just pedalling in whichever direction we bloody well please!" Image: @bicycleswilsavetheworld_ (Instagram)

International Travel

Why bulk billing may be on the verge of collapse

If you’ve noticed that trips to the doctor are getting more expensive, you’re not the only one. With a continuing decline in the number of local GPs, a shortfall of doctors trained overseas arriving in Australia, rising operating costs and plummeting revenue from Medicare rebates, many clinics have been left with no other choice than to start charging fees, including those who need their services most. Over the past decade, the average out-of-pocket expenses for GP services have risen by 60 percent, as reported by <a href="https://www.dailymail.co.uk/news/article-11081047/Australian-GPs-say-bulk-billing-brink-collapse.html" target="_blank" rel="noopener">The Daily Mail</a>. As a result, a growing number of GPs are starting to advise their patients that they can no longer bulk-bill, a practice the Royal Australian College of General Practitioners vice-president Bruce Willett says is no longer sustainable. “It’s now got to the point where practices can no longer sustain bulk billing,” he told The Australian. Director Peter Stratmann said bulk billing no longer being a viable option has resulted in the sector heading to the brink of collapse, with clinics closing and a need to charge fees to make ends meet. “We've seen practices having to close and increasingly in the last number of weeks we've seen practices impose private billing fees, because otherwise they won't make it,” Dr Stratmann said. “They just can't make ends meet without imposing some private fees.” Dr Stratmann admitted that this will put pensioners in a difficult position and that he fears they will overwhelm the hospital system for non-urgent care. In 2021, almost nine out of ten GP visits in Australia were bulk billed with no out-of-pocket expenses for the patient, with GP bulk billing rates growing to a record high of 88.4 percent in the December quarter according to Medicare data. The news comes just days after health minister Mark Butler addressed the issues facing primary care at the annual Australasian Medical Association conference, saying it is in “worse shape than it’s been in the entire Medicare era”. “It's hard enough to get a GP right now and we know that the current generation of older GPs are pretty exhausted, particularly over the last two and a half years, and we just do not have the pipeline coming through,” Mr Butler said. 'It is probably the most terrifying trend that I see in primary care.' As part of its commitment to general practice, the federal government has established the Strengthening Medicare Taskforce, boosted by a $750 million Strengthening Medicare fund. “The government is committed to ensuring Australians get the care they need, when they need it and without worrying about the cost,” Mr Butler said. Image: Getty Images

Caring

GPs could soon prescribe creativity to improve wellbeing

<a rel="noopener" href="https://journals.sagepub.com/doi/10.1177/1757913920911961" target="_blank">A new paper</a> exploring the effects of crochet on wellbeing has sparked a wider discussion of the benefits of getting creative can be good for our mental health. After surveying more than 8000 crocheters, Dr Pippa Burns, a medical researcher at The University of Wollongong, found that 89.5 percent of respondents felt calmer from engaging in the craft, while 82 percent felt happier. These findings didn’t really surprise Burns, who also crochets. “It’s very mindful because you’re counting stitches,” she said. “You’re not thinking about who said what at work or what you need to do tomorrow. You’re just focused on what you’re creating.” A potential treatment Though the prescription of crocheting and sewing has been slow in Australia, other countries have supported the move. In the UK and Germany, more than half of GPs refer their patients to community services - including crocheting and sewing - for a range of social, emotional, or financial issues, in a practice called social prescribing. This practice has been endorsed by both the Royal Australian College of General Practitioners (RACGP) and the Consumers Health Forum of Australia. According to Burns, a more targeted education campaign is needed to help GPs and the broader public understand the benefits of social prescribing and increase its uptake. “It’s about society viewing health more holistically,” Burns said. “You don’t just have to have clinical or pharmacological interventions. You can also have creative interventions that could be just as important to someone’s recovery.” The Black Dog Institute is also conducting its own study on the benefits of social prescribing. Clients of their depression clinic have been taking part in arts on prescription workshops with the Art Gallery of NSW, with preliminary results finding participants experienced significant increases in mental health, wellbeing, and feelings of social inclusion. Professor Katherine Boydell, the institute’s lead researcher, believes social prescribing could contribute to improving health outcomes of patients, and even reduce care costs. Doing something badly An eight-week program called ‘Creativity on Prescription’, devised by social enterprise Makeshift and designed in consultation with Burns, a GP, and a psychologist, allows participants to trial a new creative activity each week. From dancing and painting to gardening, these activities aim to help participants manage anxiety, depression, and other mental health issues. “People experience a different version of themselves,” said Caitlin Marshall, Makeshift’s co-founder and a social worker. “And that’s really important for personal change to happen.” However, the biggest obstacle for many is the perception they’re not artistic or creative enough. “You can go for a run and be really crappy at running and you’re still going to get the benefit of that,” Marshall countered. “Creative practices give us the same thing.”

Mind

22-year-old dies of cervical cancer after GPs turned her away 15 times

A 22-year-old woman died of cervical cancer after GPs turned her away 15 times and told her not to worry about the “Jade Goody effect”. Emma Swain pleaded with her GP for a smear test as she was experiencing symptoms, but was told she was too young by medical professionals. Instead, doctors had placed the blame on her contraceptive pill for her symptoms and told her what happened to Jade Goody was unlikely to happen to her. In 2009, TV personality Jade Goody died from cervical cancer at the age of 27. Emma first approached her doctor about a smear test in May 2013 after experiencing back pain and bleeding after sex. But her request was refused because the cervical screening is only offered to women over the age of 25. Her GP has since admitted that if the 22-year-old had been given the smear test, she may still be alive. Devastated at the loss of his daughter, Darren Swain <a rel="noopener" href="https://www.mirror.co.uk/news/uk-news/woman-22-cervical-cancer-told-23084319" target="_blank">told the Mirror</a>: “To have watched one of your children go through that and to know it could have been prevented is incredibly hard to accept. “We trusted these people – the professionals – to know what they were doing. I’ll never forgive them.” Darren, 51, said: “Basically, he told her she was worrying over nothing. He couldn’t have been more wrong. It cost Emma her life.” Over the course of four months, Emma contacted her doctor 14 times but was advised to swap her brand of contraceptive pill. She changed her pill five times during those four months. Unfortunately, Emma was diagnosed with cervical cancer in December of that year and died the following year in 2014. Emma’s family has since been fighting a six-year legal battle, one that they have recently won. Her family has been awarded compensation for her death. In a letter to the dad-of-three, Dr Stephen Golding, Dr Hendrik Parmentier and practice nurse Maureen Dillon from The Haling Park Partnership in Croydon, South London, apologised for what happened to Emma. They wrote: “We admit that if the care and treatment provided to your daughter had been of a reasonable standard, on the balance of probabilities, she would have survived.” A spokesperson for the surgery told the Mirror: “Since Emma’s death, the practice has reviewed its processes to ensure lessons have been learned.”

Caring

The new device that charges your phone while you’re on the go

Researchers from Queen’s University in Canada have developed an energy-harvesting device that exploits the side to side movement of a backpack that will generate electricity while you walk. The trial version would be suitable for people who work or trek to remote areas and the device has enough power to deploy an emergency beacon or a GPS. The researchers experimented with seven different conditions for energy harvesting and found that a load of nine kilograms generated the optimum amount of power without any extra effort to the wearer. The nine kilograms would be made up of clothes, food, a stove, fuel, a sleeping bag and a tent which was packed for a long trek. The weight of the device and the backpack adds another five kilos. The setup in total produces about .22 watts of electricity which is enough to power GPS and emergency beacons. <a href="https://royalsocietypublishing.org/doi/10.1098/rsos.182021">In the paper</a>, the researchers Jean-Paul Martin and Qingguo Li calculate that adding more weight to the backpack will help it generate more power. “Modelling predicts that an increase in electrical power production could be achieved by increasing the weight carried,” they write. “If generating over (one Watt) of electrical power was desired for powering higher demand devices, such as talking or browsing the internet with a cell phone, our model indicates that over 20 kilograms of weight would need to be carried.” In total, you would be carrying 14 kilograms on your back to generate enough power for your GPS or emergency beacon. Although this might seem like too much weight for most people, it’s next to nothing for soldiers who are used to carrying at least 27 kilograms and as much as 45 kilograms on their back for long-haul missions in Iraq and Afghanistan.

Technology

Medical centre to be investigated after patient spots controversial sign on door

A Victorian medical clinic is set to be investigated after implementing a policy to charge patients more to see a female GP. Myhealth at North Eltham in Melbourne created a sign that told patients that it would cost $7 more for a standard consultation with a female GP than what it costs to see a male. The medical clinic has been accused of discrimination as a large percentage of women prefer to see female doctors, so they will be the ones receiving the extra fee. According to <a href="https://www.theage.com.au/national/victoria/melbourne-gp-clinic-charging-more-to-see-female-doctors-20180523-p4zh2z.html" target="_blank">The Age</a>, the clinic pushed up the price for female GPs as “women’s issues take longer”. Twitter user Maeve Marsden shared the sign on Twitter and wrote: “My friend goes to Eltham North Clinic in #Victoria and they’ve just instituted extra fees for female doctors because ‘women’s issues take longer’. Surely this is illegal ... if it’s not illegal, it’s still outrageously sexist”. <blockquote class="twitter-tweet"> This is so fucked. My friend <a href="https://twitter.com/TheMilkeWay?ref_src=twsrc%5Etfw">@TheMilkeWay</a> goes to Eltham North Clinic in <a href="https://twitter.com/hashtag/Victoria?src=hash&ref_src=twsrc%5Etfw">#Victoria</a> and they’ve just instituted extra fees for female doctors because “women’s issues take longer.” Surely this is illegal? <a href="https://t.co/Vwm0aafM1z">pic.twitter.com/Vwm0aafM1z</a> — Maeve Marsden (@maevemarsden) <a href="https://twitter.com/maevemarsden/status/999139271645675521?ref_src=twsrc%5Etfw">May 23, 2018</a></blockquote> Twitter users were quick to share their frustration and disbelief of the pricing policy. “It’s basically a gender tax and it’s discrimination,” one user wrote. “They’re reducing access to healthcare by increasing the price based on the gender of the physician. I’d contact the medical licensing board about this and/or make a human rights complaint.” Federal Health Minister Greg Hunt has been informed of the situation and is reportedly calling for an investigation. “The Minister is deeply concerned. Not only is this practice offensive, it is potentially discriminatory,” a spokeswoman for Mr Hunt said. Victoria’s Equal Opportunity and Human Rights Commissioner, Kristen Hilton, described the behaviour of the clinic as unlawful. “Under the Equal Opportunity Act 2010 it is against the law for doctors to treat someone unfavourably because of their gender,” she told <a href="https://www.theguardian.com/australia-news/2018/may/23/melbourne-clinic-told-it-may-be-breaking-law-by-charging-more-to-see-a-female-doctor" target="_blank">The Guardian Australia.</a> “This could include charging someone more to see a doctor because they are female." The clinic has not yet commented.

Money & Banking

GP dies months after noticing pain in shoulder

The sensation of pulling a muscle is one that’s not uncommon for many Australians. But for 63-year-old GP Pauline Vizzard, it was a sign of something worse to come. <a href="http://www.news.com.au/" target="_blank">News.com.au</a> reports family, friends and patients of the normally energetic doctor were shocked when it was revealed the shoulder pain she experienced was not caused by a torn muscle, but an aggressive cancer manifesting in her ribcage. Following her diagnosis Vizzard, who up until that point has been considered fit and healthy, was found to be riddled with disease in her organs and passed within a month. And what makes matters worse, the cause of the cancer was found to be asbestos exposure from Vizzard’s time working at a hospital in the NSW Hunter Region. “It was a surprise on everyone’s behalf,” her son Ben Harrison, 34, told <a href="http://www.news.com.au/" target="_blank">News.com.au</a>. “You sort of associate asbestos cancers with people who may work in industry for all their life, and to have someone who is so removed from what you’d normally expect to be a high-risk industry... there’s no cure for mesothelioma at all, it’s fatal 100 per cent of the time.” After fighting the disease Vizzard passed in April 2015. One patient wrote on a tribute page: “I’m finding it extremely hard to believe this every morning when I wake. Pauline was my doctor close to 30 years. I will miss her dreadfully.” Another said: “Not only a great doctor and an integral part of the Singleton community but an aunty who I have always loved and admired. Sadly missed but so fortunate to have known her.” Around 600 people still die of asbestos-related incidents around Australia each year, with a rise in DIY home renovations believed to be one of the driving forces. The Asbestos Safety and Eradication Agency’s 2016-17 report recorded an increase in occupational exposure to 70 per cent from 64 per cent the previous year." David Jones, Hunter Region executive partner from Carroll & O’Dea Lawyers, which managed Dr Vizzard’s case, said: “As the case demonstrates, mesothelioma has a long latency period after exposure, meaning that workers exposed to asbestos a generation ago might still contract the disease. “Asbestos in situ can still be found in many older public buildings and homes, and as the fabric of these infrastructures containing asbestos products deteriorates, the dangers of exposure to asbestos fibres is on the increase. Many are part of the ageing public infrastructure.” To find your nearest testing lab, call 1800 621 666. If you think you may have been exposed, register details on the <a href="https://www.asbestossafety.gov.au/national-asbestos-exposure-register">National Asbestos Exposure Register</a>.

News

5 tips for finding the right GP

Choosing a general practitioner (GP) for you or your loved ones is an important step on your health journey, but it can be a difficult and stressful decision to make. A good GP will become almost a partner in your wellbeing, as their knowledge of you and your concerns will help them notice problems you may have thought nothing of, and can make carefully informed decisions about referrals, tests, and medication with you. Unfortunately, nothing lasts forever, and there will likely come a time when you must find a new GP. Whether you’ve moved to a new area, your current GP retires, or you’re just not comfortable with them moving forward, here are our top tips for selecting the right GP for you. 1. Ask around Just as you might ask friends for advice on local tradies or coffee spots, the people you know are going to be an invaluable resource for finding your GP. This step can be a good one to take before any others, because you are more likely to hear firsthand why a friend or acquaintance likes or dislikes a certain GP. 2. Narrow your search Did you know that the Australian Government offers a handy online service to help you find medical professionals in your area? <a href="https://www.healthdirect.gov.au/australian-health-services" target="_blank">Visit this link</a> to search for a GP (or dentist, physiotherapist, psychologist, podiatrist, optometrist, etc.) near you. You can narrow down the field by selecting options that are important to you, like whether they bulk bill, accessible parking and building, and what after-hours options are available. 3. Bills, bills, bills Thinking about how a prospective GP bills can be a helpful tool to inform you about their practice. A practice that bulk bills all patients may be more concerned with seeing a greater volume of people each day to maximise their billing. While this is very convenient for some, a practitioner who charges you a gap for their service on top of the Medicare fee is perhaps more likely to spend longer with a patient for in-depth consultations. Considering which of these options is more important to you is helpful information to have going before making up your mind. 4. Bonus level If you have a number of GPs who potentially meet your needs, then it can be helpful to take a look at what extra things each have to offer you as a patient. Things to consider include: <ul> <li>Home visits</li> <li>After hours services</li> <li>Areas of specialisation (many GPs will have extra qualifications that could be helpful to you)</li> <li>Location</li> <li>Ease of booking</li> </ul> 5. Take the plunge Once you believe you’ve found a god candidate, it’s time to meet with them in person. At this first visit, be sure to speak with them about any of your specific health concerns you have – they are going to perform their best when they are armed with all the information. Remember that your initial consultation isn’t an unbreakable vow – if it doesn’t turn out to be a good fit for you, you are under no obligation to go back. What’s your best tip for someone searching for a new GP?

Caring

Essential GP service on the chopping block

Concern is growing among medical professionals that Medicare Benefit Scheme (MBS) payments for after-hours visits are set to face the chopping block in the upcoming Federal Budget, in a move that could affect thousands of sick Aussies. The National Association for Medical Deputising Services (NAMDS) has commissioned research to assess the popularity of GP home visits, after Federal Health Minister Greg Hunt claimed that the service was being “rorted” by some households. Mr Hunt said while the government was committed after-hours medical care, they must be funded correctly, “We also have a commitment to ensuring that every service provided is genuine and that every doctor is up to scratch. I am concerned about reports that some doctors are claiming to be providing urgent services when they're not urgent at all.” NAMDS President Dr Spiro Doukakis was quick to jump in however, saying the service actually saved money and helped ease pressure on overcrowded hospitals. Dr Doukakis explained his position in an interview with <a href="http://www.smh.com.au/" target="_blank">Fairfax Media</a>, "Doctor home visits are an essential Medicare service and are relied on by 2 million Australian families – especially carers of people with disability, the elderly and young children.” Are you concerned about these budget cuts?

Body

Over-65s use twice as many GP resources

A new report from the University of Sydney finds that over-65s use twice as many GP resources as the average population.Older Australians spend more time with their GP, see them more frequently and for more health problems, according to the report that looked at the challenge for Medicare in the future.But considering the government has been encouraging over-65s to visit their GPs more often through such policies as “well checks” the findings aren’t that surprising, according to lead investigator Helena Britt.She said that there needed to more investment in primary care to prevent patients from needing more expensive care."If you have people living longer, you have more and more problems to be managed and therefore you must use up more resources," Associate Professor Britt told The Age."General practice is one of the cheapest parts of Medicare. Perhaps if we gave general practice more power as a gatekeeper, we may prevent some of the far more expensive services from building up."According to The Age, the over-65 population grew by 18 per cent as a proportion of the population between 2000-2001 and 2014-2015. Their use of GP services grew by 22 per cent in terms of GP-patient encounters, 30 per cent in terms of problems managed in general practice and 20 per cent of GP clinical time. Most over-65 patients have one or more chronic disease and 60 per cent have at least three."There's nothing to suggest that another age group is suffering as a result of increased utilisation by over-65s," Professor Britt said.Steve Hambleton, the federal government's chief advisor on primary health care, said it wasn’t primary care but acute care episodes that could threaten the sustainability of Medicare. However, general practice played a role in ensuring patients with chronic conditions did not deteriorate."General practice costs are not the problem," Dr Hambleton said."It's when people go to hospital and consume all the acute resources. How do we stop people going from two diseases to five diseases?"Related links: <a href="/health/caring/2015/08/strength-and-flexibility-exercises/">3 great moves for strength and flexibility that all over-60s should do</a><a href="/health/wellbeing/2015/09/friends-are-key-to-keeping-fit/">Why a friend is the key to keeping fit</a><a href="/health/wellbeing/2015/09/what-body-does-while-you-sleep/">8 interesting things that happen to your body while you sleep</a>

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Cheat sheet: A guide to GPS

If your headed on a road trip these holidays, then you will need this summary of the Technology How-To video from Facebook earlier this week, here is a little cheat sheet of the facts to give you more information about using a GPS. If you’d like to re-watch the video, scroll down.What you should look for when buying a GPS:<ul><li>Depending on how much you want to spend, will dictate what features you can look for.</li><li>All GPS come with basic functions, so if that’s all you want then you can look for the lower price points.</li><li>If you want things like Bluetooth, free map updates, traffic information and other extras, then you will be looking a spending more.</li><li>In any case, look for a GPS where you can easily update maps without it costing you a fortune.</li></ul><iframe width="560" height="315" src="http://www.youtube.com/embed/fkMHRX9djKo?list=UUINQbVop3O-f3ZPkwssVp_A" frameborder="0" allowfullscreen=""></iframe>

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