IMGs and bush medicine
Last edition we had one doctor’s anonymous letter in support of the uprooting of IMGs and a Guest Column from Dr Penny Wilson, uncertain about her earlier decision to become one of 4500 students on a 10-year bonded recruitment to rural practice. The federal parliamentary report Lost in the Labyrinth (2012) looked at issues around our current national reliance on the 8460 IMG doctors working under the 10-year moratorium, many in rural areas but most in cities and large towns. The RDAA and AMA have not favoured the moratorium as a way of getting doctors into the bush. Also arising from the report was the lack of opportunity for IMGs seeking registration in Australia to undergo clinical examinations. The Australian Medical Council (AMC) has opened a test centre in Melbourne with facilities that match those of major teaching hospitals. It’s expected that the test centre will eventually take over all testing from the hospitals.

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DSM-5 controversies
The recent update of DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) after a 20-year gap, has sparked some controversy that we are medicalising normal behaviours so the medical industry (psychiatrists in particular) can treat accordingly. Things such as binge-eating disorder, hoarding disorder, and disruptive mood dysregulation disorder in kids reportedly have too-low thresholds. Medical Forum received The Book of Woe by psychotherapist Gary Greenberg for review, billed as an expose of the psychiatric profession’s bible, and how human suffering has been turned into a commodity. For example, the author suggests the politics behind mental health classification of autism, ADHD and bipolar disorder has been linked to an unhealthy relationship with pharma companies and other parts of the medical industry. Given that escaping slavery and homosexuality were once classified as mental illnesses, it makes an interesting read.

No room for bullying
Research conducted by Avant reveals that 44% of Australian doctors admit to outbursts of disruptive behaviour. That’s interesting when you compare it with the 78% who say they’ve been on the receiving end of verbal abuse and physical intimidation. Dr Gerald Hickson, a US expert in disruptive behaviour amongst doctors, has just completed a series of seminars around Australia, including Perth, discussing the issue. It’s a ‘no-brainer’ that the treatment and welfare of patients is directly affected by how medical practitioners interact with each other. A strained conversation (or worse) with a colleague followed by a difficult consultation with a demanding patient and ‘tell someone who cares’ comes to mind. The Patient Advocacy Reporting System (PARS) in the USA suggests that there’s a direct link between positive interaction between doctors and better patient outcomes. And there’s a financial bonus – you won’t be paying for your lawyer’s next Porsche!

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Growing up male
It’s a health hazard, or that’s the news from the team at the Australian Institute of Health and Welfare. In its report into the health of Australian males 0-24, it comes as no surprise that the major cause of death was vehicle accidents with three times more males likely to die like this than females. Also concerning was that 43% between the ages of 14 and 19 were at risk of injury from drinking too much alcohol over the past year; 6% in this age group smoked daily which was less than the 8% of girls who smoked; and of all chlamydia notifications among males, 53% of them came from males aged 15-24. The news is not so rosy for guys over 25 with obesity figures tipping 31% and 66% with a waist circumference that put them at risk of chronic disease. It just leaves us holding our breath for the next 50 years.


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