Where to now, Superclinics?
We were told that putting GP clinics alongside EDs was going to save millions (by cost shifting to the Commonwealth?) and relieve overburdened EDs. Not really, according to a study published in the MJA last month that looked at 2009-11 ED attendances at Freo Hospital, Charlies and RPH. Researchers say the AIHW figures were flawed as they considered urgency status (ED triage scale) instead of complexity as judged by them. As a consequence, estimated GP-type attendances dropped from 25% to 11%. They concluded that After-hours GP clinics, super clinics and polyclinics fill service gaps but have minimal effects on ED attendances. The AIHW has since announced that it is reviewing its research methodologies, including consultation with some of the researchers who contributed to the MJA article.
All in together
Web marketing of practices is hotting up with a report that IPN is unhappy with Primary Health Care’s marketing of its 1800 Bulk Bill website, which lists this group’s bulk billing practices, based on a location search. And if you type “Primary Care Practices in Perth CBD” into Health Engine you now get a collection of physiotherapists, GPs afterhours, chiropractors, Chinese medicine practitioners, optometrists, podiatrists and nurse practitioner clinics. With Dr Marcus Tan as CEO, and the injection of funds from Seven West Media and Telstra, it appears Health Engine has moved from primarily listing medical practitioners.
Big Guns gun for polio
The Australian Government responded to lobbying from Global Poverty Project’s Australian Director, Samah Hadid and pitched in $80m for worldwide polio eradication. Microsoft billionaire and philanthropist Bill Gates was close by. The Polio Eradication and Endgame Strategic Plan 2013-2018 also had Canadian and UK Governments contributing, and The Bill Gates Foundation was chipping in a US$1.8 billion, with US$5.5 billion calculated to end this disease worldwide by vaccinating in hard-to-reach areas. Akram Azimi, the 2013 Young Australian of the Year [who appeared in Medical Forum in June], is an ambassador for the campaign run by 25-year-old West Australian Michael Sheldrick, who holds a UWA arts and law degree and has food, education and other vaccines as part of the package.
Snapshot of rural GPs
November 2012 census figures have yielded some interesting trend data from the Rural Health West report Minimum Data Set Report and Workforce Analysis Update 2012. It looks at the GP workforce in RA 2 to RA 5 in WA. An additional 39 FIFO doctors (equal GP/registrar split) made up the largest workforce increase. Average age of the overall GPs was 48.4 years, with doctors aged 55-64 making up 23% of the workforce (64% male). Only 8.5% of the doctors lived in RA 5 (Very Remote) locations. There was a 14% turnover of the workforce in a year, with most moving to Perth (39.5%), interstate (14%) and overseas (9.3%). There were nine additional doctors in the 65+ age group in 2012. Amongst 202 proceduralists, a third was overseas trained. The number of IMGs working in the bush is the lowest since 2007 but they still accounted for 51.8% of the rural and remote medical workforce in WA. There was a record 86 GP registrars in the rural workforce – 19 more than 2011 and they are getting older. Their average age was up to 36.5 years from 32 years in 2002.
Gestational diabetes risk
UWA researchers say that while obesity in the obstetric population is increasing, the risk of gestational diabetes is increasing. This risk is better predicted using a series of cardiometabolic risk factors in pregnancy, including body mass index (BMI), blood pressure, lipids, glucose, insulin and high-density lipoprotein (HDL) – better than blood sugars or BMI. They’ve derived a formula to help clinicians identify women who should be targeted for post-pregnancy intervention.
Driving kids to drink
A line of kids clothing for four-year-olds sporting the logos for the Jim Beam Racing Kids Team, liquor ads outside schools and sporting commentators slipping in booze promos are among the “Top 10 alcohol advertising shockers of 2012-13” according to the first annual report of the Alcohol Advertising Review Board led by Prof Fiona Stanley and Prof Mike Daube. Both said that the findings showed that self-regulation of alcohol advertising was failing, irresponsible alcohol promotions were common, young people were heavily exposed to alcohol advertising, and there is an urgent need for regulation on alcohol promotion.