March 2014

Back to Third Med School?
Doctor numbers have hit the headlines again, but this time it may spark genuine debate on the Curtin proposal for a third medical school, which would be situated in the eastern suburbs and offer an undergraJefferies-Felicity-Dr May13.200x133duate degree. [Former WACHS chief now health consultant] Dr Felicity Jefferies’ report for Curtin University on the state of the WA medical workforce got a lot of press at home and nationally with the headline “1000 doctors short in Western Australia and its set to worsen”. Not that it’s news for those in rural areas but the loud opposition to another medical school has made decision-makers nervous. The Jefferies report may change that. There is cautious support from the State Government but silence from the Feds. The momentum will need to continue if Curtin is to get the politicians to toe the line.

Rethinking training strategies
Now a partner in Healthfix Consultancy, Dr Jefferies’ report also questions the ethics and economy our heavy reliance on Overseas Trained Doctors to fill the services gaps. With WA having the highest percentage of OTDs in Australia and doctor numbers still falling short in rural and outer metro areas, time is ripe for a strategy change. The report called for a comprehensive workforce review and a plan that involved medical students, interns and vocational training programs. The news was welcomed by WAGPET Chair Dr Damien Zilm who said that having enough doctors in the right locations was essential, adding the review would require “cross-sector collective action”.

Troubles in Paradise
When Medical Forum contacted Esperance GP, student and registrar mentor and Esperance Hospital stalwart Dr Donald Howarth about his involvement with Rural Health West over his 19 years in the Far South Coast town [see P25], he hinted at troubles in paradise with tensions mounting between some GPs and the hospital administration. Donald describes his frustrations at what he sees as attempts to “run a minimalist medical service at a minimalist cost”. He hopes this won’t be a repeat of the Kalgoorlie experience that saw GPs lose their hospital rights, leading to an exodus of 13 GPs. He said GP retention in remote and rural areas was simple – engagement with patients in hospitals. Last month he completed his last  anaesthesia list at the hospital and another doctor has also resigned after “feeling poorly appreciated for a long time.”

Cardiologist spending spree
Phylogica Ltd (ASX: PYC) recently responded to a share price query not long after Perth cardiologist Bernard Hockings underwrote a $6m rights issue and acquired a reported $1.78m in shares. This increased his company stake to 22.5% and secured him a position on the board. PYC is a biotech company that provides peptide drug discovery services to the pharmaceutical industry using their Phylomer peptide libraries and proprietary screening capabilities. Founder and current CEO Dr Richard Hopkins is from the Telethon Institute for Child Health Research. PYC lists Genentech (Roche Group), MedImmune (AstraZeneca), Pfizer and Janssen (Johnson & Johnson) as partners.

Fuel to the statin fire?
The ACCC is taking action against Pfizer Australia for alleged anti-competitive conduct – misuse of market power and exclusive dealing in relation to its supply of atorvastatin to pharmacies (Pfizer’s generic, post Lipitor). Before patent expiry in May 2012, Lipitor was a statin on the PBS, with annual sales exceeding $700m. The ACCC alleges that Pfizer offered significant discounts and the payment of rebates previously accrued on sales of Pfizer’s Lipitor, conditional on pharmacies acquiring a minimum volume of up to 12 months’ supply of Pfizer’s generic atorvastatin. Prior to Pfizer’s loss of patent protection, other generics suppliers were prevented from making competing offers.

GPs fight back
The RACGP has hit back at the report that pharmacists should conduct preventive health checks. Fragmentation of care was one argument, as was a poorly directed investment of $75m when the RACGP had evidence for effectiveness of health checks in general practice. They argued that in a 19-minute consultation (rebated $36.30 by Medicare) the GP can weigh, take blood pressure, measure blood glucose and cholesterol, take an appropriate history and produce a management plan. The college is talking patient safety and quality of care. Government is listening to anyone who will save them money.

e-Script via Queensland
The website blurb said “put a pharmacist in your phone with eRx Express[…]order your scripts anywhere anytime”. We downloaded the App and gave it a test drive. After entering our WA postcode we were offered a pharmacy in NSW. If this is all about convenience for the patient, why do they still have to take a paper script to their pick-up pharmacy? eRx developers have got Medical Director to print scripts that include a QR code for the eRx Express App. The patient forwards the script to their preferred pharmacy which pays $50 a month to join up and carry the receiving eRx Express Q software on a Windows Surface RT tablet. GPs must be registered to use ePrescribing through eRx Script Exchange. This IT experience appears to originate from the Malouf Pharmacy Group of 18 pharmacies in Queensland.

Midland looks for workers
SJGH Midland and Fiona Stanley Hospital recruiters will be going head to head over the next few months with the announcement that Midland will kick off its search for 1000 employees this month. It has 18 months [the hospital is due to open November 2015] to fill clinical and non-clinical positions and the first phase will target existing Swan District Hospital and St John of God Health Care staff.