Australia

In which John discusses the complicated reasons why the United States spends so much more on health care than any other country in the world, and along the way reveals some surprising information, including that Americans spend more of their tax dollars on public health care than people in Canada, the UK, or Australia. Who's at fault? Insurance companies? Drug companies? Malpractice lawyers? Hospitals? Or is it more complicated than a simple blame game? (Hint: It's that one.) For a much more thorough examination of health care expenses in America, I recommend this series at The Incidental Economist: http://theincidentaleconomist.com/wordpress/what-makes-the-us-health-care-system-so-expensive-introduction/ The Commonwealth Fund's Study of Health Care Prices in the US: http://www.commonwealthfund.org/~/media/Files/Publications/Issue%20Brief/2012/May/1595_Squires_explaining_high_hlt_care_spending_intl_brief.pdf Some of the stats in this video also come from this New York Times story: http://www.nytimes.com/2013/06/02/health/colonoscopies-explain-why-us-leads-the-world-in-health-expenditures.html?pagewanted=all This is the first part in what will be a periodic series on health care costs and reforms leading up to the introduction of the Affordable Care Act, aka Obamacare, in 2014.  

I’m sure there are times when all us GPs feel under-appreciated — by our patients, staff, specialist colleagues or society in general. You can’t blame them for sometimes taking us for granted — it’s part of the human condition. People don’t value what they have until they lose it, whether “it” is the ability to walk or a domestic fairy who makes sure there’s always spare toilet paper. It’s a common lament that we can’t be at our own funerals to hear how much we’re loved. Mind you, eulogies are rarely objective and balanced. Nonetheless, it’s a pity we’re not around to hear the praise — deserved or otherwise — that is expressed once we’re gone. The long-serving, somewhat-taken-for-granted GP has a non-fatal way of bringing out the appreciation in his or her patients and staff: moving on. After 10 years of GP-ing in the Noosa hinterland and a lifetime of living in south-east Queensland, I headed south of the border: to northern NSW. The hardest part of the move for me — harder than selling my house in a depressed market, harder than dealing with banks, builders, real estate agents, solicitors and Australia Post, harder even than trying to get rational answers out of my telecommunications company after they cut off my internet and phone prematurely — was telling my patients that I was leaving. I knew many of my patients were very attached. I knew they’d come to me expecting to receive a loyal, life-long partner kind of doctoring, rather than the one-night-stand variety. But I had no idea how difficult it would be to break the “I’m leaving you” news again and again and again. Hard as breaking up a relationship may be, at least you only have to do it once when you leave a romantic partnership. For me, telling patients I was leaving felt a bit like breaking up with hundreds of boyfriends, one after the other after the other. You may interpret this as my being too close to my patients or not close enough to my boyfriends, but the fact is I found the protracted process exhausting, emotionally draining and just plain horrible. The “it’s not you, it’s me” part goes without saying and I know I am far from irreplaceable, but seeing the tears well up in countless eyes because of the words I’ve uttered was enough to break my tender heart. Looking on the bright side, as I am wont to do, if I’d ever felt under-appreciated, I sure don’t now. I received more expressions of gratitude in those last three months than I did in the previous decade. To hear how influential I was in some of my patients’ lives put a warm glow in my battered heart. And as much as it hurt me to see my patients upset, it probably would’ve hurt me more if they’d been completely indifferent to my leaving. However, I did please someone. Mrs L had been trying for years to get her husband to agree to move interstate to be near family. His last remaining excuse was that his multiple complex medical problems meant that he couldn’t possibly leave me, his long-term GP. A grateful Mrs L rang me within hours of my informing them of my impending departure to say: “He’s finally come around. Thank you so much for deciding to leave us.” It’s nice to be appreciated! (This blog post has been adapted from a column first published in Australian Doctor www.australiandoctor.com.au/opinions/the-last-word/the-last-word-on-moving-on- ) Dr Genevieve Yates is an Australian GP, medical educator, medico-legal presenter and writer. You can read more of her work at http://genevieveyates.com/  

Despite record numbers of patients, accident and emergency departments are struggling to recruit and retain staff. Why?  

A snapshot of how I ended up starting my "FY3" in Australia teaching anatomy to medical students and the lessons I have learnt along the way. I hope this will help current foundation year trainees consider something a little different...  

Stream STI podcast: Australia’s HPV vaccination programme and disappearing genital warts by BMJ talk medicine from desktop or your mobile device  

How well do you know how to manage vancomycin dosing? Here’s a fun video, only 10 minutes long, to play with. It’s been produced by two Illawarra-Shoalhaven clinical pharmacists and self rates as “Australia’s 4th funniest vancomycin education website”. Can’t go past that tag line!  

The disparity in health status between Indigenous and non-Indigenous people in Australia and New Zea  

Hi guys, my name is Angela! I am currently an F2 doing a year in Australia! My key interest is neurosurgery and as a neurosurgery SHO now in Adelaide, I thought I'd start a blog on a few neurosurgery/neurology issues I encounter regularly on the wards. This is aimed to help all medical students studying neurology/F1/SHO in neurosurgery. Few topics could include: Basic management of neurosurgery/neurology patients - the neurology exam Ophthalmology exam and lesion representation Understanding GCS Raised intracranial pressure Acute head injury Seizure management Cauda equina Headaches Decreased conscious level Cord compression Electrolytes imbalance in the neurosurgical patient Fluid management in the neurosurgical patient Acute meningitis Any thoughts/comments?  

Naked Scientists - 14th Aug 2013 - Naked in Australia  

Stream Prof Stuart Biddle – Mythbusting Sports Medicine Australia Keynote Presenter: Physical Activity by BMJ talk medicine from desktop or your mobile device  

WHO welcomes the Government of Australia’s commitment to providing health professionals and more funding to boost the fight against Ebola virus disease.  

Aaron is a Junior Doctor working away in sunny Australia. Aaron has been a longstanding FOAMed Advocate, and enjoys the interplay of medicine and technology. When not traveling along the path of medicine, he enjoys rock climbing, sailing and giving his drumkit a decent hit.  

Most pregnant woman want to know the best foods to eat and what to avoid. The possible dangers of eating liver, the need to avoid unprocessed cheeses and too much tuna, and, above all, the importance of folate supplements are widely appreciated. Two linked papers from Australia (Dodd and colleagues; doi:10.1136/bmj.g1285) and Norway (Englund-Ogge and colleagues; doi:10.1136/bmj.g1446) have explored whether eating “healthily” can improve clinically important pregnancy outcomes.1 2  

Naked Scientists - 28th Aug 2013 - Shark Camouflage in Australia  

Quetiapine was approved in 2009 and 2010 for the adjunctive treatment of major depressive disorder (MDD) in several countries worldwide, including the European Union, Canada, the United States, and Australia. These approvals followed three industry sponsored trials of quetiapine versus placebo added to an antidepressant for depression in adults who had an inadequate response to at least six weeks of antidepressant treatment. All three trials showed statistically significant improvements in symptoms of depression compared with placebo.1  

Ireland introduces standardised packaging of cigarettes: Ireland has passed legislation banning all forms of marketing branding (including logos and colours) from cigarette packaging. It is the first country in Europe to introduce standardised packaging and the second in the world. Australia introduced it in 2012.  

Stream Prof Stuart Biddle – Mythbusting Sports Medicine Australia Keynote Presenter: Physical Activity by BMJ talk medicine from desktop or your mobile device  

Naked Scientists - 21st Aug 2013 - Australia's First BBQ  

Launch48 run Launchpad events for entrepreneurs in the UK and Australia. It's a 4 month incubation program for startups giving them advice from experts in al...  

No doubt there will be plenty of debate generated by a series of lectures in Australia next month by Danish physician Professor Peter Gøtzsche, managing director of the Nordic Cochrane Centre based at Rigshospitalet in Copenhagen (details here).