Medical Musings - (Canberra Doctor - Family Doctor Week 2017)

The vast majority of health problems are managed solely by GPs. The trusted relationship between GPs and their patients is fundamental to patient care in Australia, enabling safe disclosure of health care concerns and the provision of evidenced and patient-centred medical advice. Decisions about patients’ health care are part of an informed and collaborative approach between patients and their GPs.

 

Family Doctor Week

Because of the amazing work done by Australia’s GPs, the AMA celebrates their work with our annual Family Doctor Week.  The purpose of this year’s theme “Your family doctor: all about you” is to remind the Canberra community about the central role that GPs play in their health care. Having a regular GP is good for your health and helps ensure continuity of care – something fundamental to good preventive care.

The AMA wants Australians to understand that a GP's primary focus is firmly on what is best for the patient when it comes to preventive health, diagnostics and treatment, chronic disease management, and end of life care.  When people have a trusted family doctor it is good for their health: those with an ongoing relationship with a family doctor have been shown to experience better health outcomes.

In this issue of Canberra Doctor, we feature articles highlighting different aspects of general practice for Canberra’s busy doctors.  Front and centre is a profile of the recently retired Dean of the ANU Medical School, Professor Nick Glasgow, whose background was general practice. Local GP and AMA President-elect, Dr Antonio Di Dio tells us what inspires him, Gaylene Coulton, the CEO of Capital Health Network, lets us know the latest from our local PHN and Dr Louise Stone pens an open letter to the next generation of aspiring GPs and other specialists. And much more.

 

When the chemistry is wrong…

Many of you will have read, with alarm, of plans for pharmacies to begin ordering pathology tests.  This was an ill-conceived move, and I was very relieved to hear that Sonic Healthcare had decided to withdraw from pharmacy-based screening programs.  The primary health care system we rely on is built around a medical model that can provide life-long continuity of care. 

For better or worse, the Government is promoting this principle through its Health Care Homes trials.  Suddenly allowing non-medical health professionals to try to take over the work of experienced and highly-trained doctors would have been irresponsible at best, and frankly dangerous at worst.  Pharmacists ordering pathology tests puts patients’ health at risk, and increases medical costs for families.

 As Canberra’s doctors know well, specialized clinical judgement and many years of training are required to make decisions about whether patients need pathology tests.  The interpretation of tests results and outcomes should be the province of GPs.  Diagnostic tests, as well as other screening activities and health checks must only be conducted if they are clinically indicated, have an evidence base, and are cost-effective.  It should be about benefit to patients.  Pharmacists play a key role in the health system, and have a well-established collaborative role with GPs – ordering pathology tests is completely out of their scope of practice.

As Canberra’s doctors know well, specialized clinical judgement and many years of training are required to make decisions about whether patients need pathology tests.  The interpretation of tests results and outcomes should be the province of GPs.  Diagnostic tests, as well as other screening activities and health checks must only be conducted if they are clinically indicated, have an evidence base, and are cost-effective.  It should be about benefit to patients.  Pharmacists play a key role in the health system, and have a well-established collaborative role with GPs – ordering pathology tests is completely out of their scope of practice.

 

Mental health    

Over recent weeks the AMA (ACT) has been in contact with Mental Health Minister, Shane Rattenbury, about a number of serious issues that have arisen with mental health services in Canberra. While workforce has been the major focus, including the implications following the recent resignations of two psychiatrists from the adult mental health unit, there’s no doubt that other staffing issues - access to child and adolescent services, and cover in the Emergency Department at Canberra Hospital - are also having an impact.

 

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Mental Health Minister, Shane Rattenbury

 

The ACT Government budget saw the announcement of a new ‘Office for Mental Health,’ there are some emerging concerns.  Earlier this year, Minister Rattenbury made his initial appointments to the keenly-awaited Mental Health Advisory Council. The Council was set up to advise the Minister on matters including emerging or urgent mental health issues, and mental health policy.  In appointing members to the Council, the Minister is required to ensure the Council included consumers, carers, and other members who have expertise in primary mental illness prevention and treatment, care or support.

With a total of seven appointments made by the Minister, it’s extremely disappointing that he could not find room on the Council for either a psychiatrist or general practitioner. AMA (ACT) is determined to follow this matter up and I have written to the Minister asking for further information.  Watch this space.