Shiloh
Editor, Senior Moderator
Source: http://www.theaustralian.news.com.au/story/0,25197,25690820-23289,00.html
GPs cut out of the swine flu loop
Opinion: Thomas Lyons | June 27, 2009
Article from: The Australian
GENERAL practice has a confusing relationship with the government. It, the government, knows we are out there in the community and knows that people come to see us. It also knows the taxpayer picks up the bill.
We, the GPs in GP-land, know we work hard to ensure the ongoing health and wellbeing of all Australians, taxpayers and otherwise. There is an ambivalent tension between us. We know the limitations of our resources but we feel the government distrusts what we say, regarding us an expensive pain that requires treatment.
For example, next month the government will increase the number of GP audits by a whopping 500 per cent. Medicare apparently thinks we spend too much time with patients and are over-charging. Meanwhile, federal Health Minister Nicola Roxon is asking GPs to focus on preventative health.
That is good but time consuming.
Given this mixed message, it's little wonder GPs believe the government does not hear us when we say that we do not have the resources to see acute patients, manage chronic patients and implement preventative health strategies for those who are well but leading unhealthy lifestyles.
We can see only one patient at a time.
I work 50 to 60 hours a week. Yet the message is that GPs may be penalised for the time we spend with patients. This is absurd.
Another illustration of this confusion and mistrust occurred when I presented, uninvited, to one of the first pandemic planning meetings in Queensland when avian influenza (bird flu) was in the news a while back. Everyone else at the table was welcomed by name. I was merely acknowledged by name.
I attempted to explain that in the event of a pandemic, GPs would be at the coalface in the community and would require infrastructure support, such as a guaranteed supply of protective masks and reliable supplies of Tamiflu. Obviously, I don't want my receptionists or myself to be put at risk.
Yet I was advised bluntly that they were not there to plan for general practice or engage the wider community. The meeting was about the needs of government employees and hospital staff.
They then proceeded to ignore me.
It's happening again with H1N1, swine flu. GPs are up in arms over the failure of government support. Classic example: The Australian on June 13 ran a front-page story about a GP in South Australia who was unable to source Tamiflu for a 17-year-old for eight days, whereas professional football players can have it within 30 minutes.
Roxon responded by promising another $4million to support general practice, although no one knows how she will spend it. Although the dulcet ker-ching of the cash register is soothing, it's not enough. We need consideration, competent leadership and consultation. Australia is lucky that H1N1 is a benign illness -- at least so far -- as it's running its own course, spreading 10 times faster here than in New Zealand and Japan.
The government has quietly capitulated after failing to make the case for home quarantine. Delaying the likelihood of a more lethal mutation and development of Tamiflu resistance gives vaccine manufacturers more time to develop an effective vaccine.
There was a point early on that things could have been handled differently at the local level. Flu clinics should, and could, have been run at local levels. Even a caravan parked in a car park near a shopping centre can be a makeshift flu clinic. Better-resourced labs could have been set up to run the tests quickly, so GPs could property treat football and non-football players alike.
The sense we get here in GP-land is that when a government is in election mode it's happy to spend money to run focus groups and hire expensive advertising gurus to make sure that the political message hits home.
In contrast, when it comes to managing a biological emergency that affects us all, but not the results of an election, politicians rely on middle-level health bureaucrats who fail miserably to explain anything to the public.
The result is all too often a confused mish-mash about not panicking. Panic about what? No one knows what is going on. If the government were capable of listening and willing to trust GPs, this swine flu pandemic would have been managed more effectively and more easily. Unfortunately, pigs haven't learned to fly ... yet.
Thomas Lyons is a general practitioner on the Queensland Gold Coast.
GPs cut out of the swine flu loop
Opinion: Thomas Lyons | June 27, 2009
Article from: The Australian
GENERAL practice has a confusing relationship with the government. It, the government, knows we are out there in the community and knows that people come to see us. It also knows the taxpayer picks up the bill.
We, the GPs in GP-land, know we work hard to ensure the ongoing health and wellbeing of all Australians, taxpayers and otherwise. There is an ambivalent tension between us. We know the limitations of our resources but we feel the government distrusts what we say, regarding us an expensive pain that requires treatment.
For example, next month the government will increase the number of GP audits by a whopping 500 per cent. Medicare apparently thinks we spend too much time with patients and are over-charging. Meanwhile, federal Health Minister Nicola Roxon is asking GPs to focus on preventative health.
That is good but time consuming.
Given this mixed message, it's little wonder GPs believe the government does not hear us when we say that we do not have the resources to see acute patients, manage chronic patients and implement preventative health strategies for those who are well but leading unhealthy lifestyles.
We can see only one patient at a time.
I work 50 to 60 hours a week. Yet the message is that GPs may be penalised for the time we spend with patients. This is absurd.
Another illustration of this confusion and mistrust occurred when I presented, uninvited, to one of the first pandemic planning meetings in Queensland when avian influenza (bird flu) was in the news a while back. Everyone else at the table was welcomed by name. I was merely acknowledged by name.
I attempted to explain that in the event of a pandemic, GPs would be at the coalface in the community and would require infrastructure support, such as a guaranteed supply of protective masks and reliable supplies of Tamiflu. Obviously, I don't want my receptionists or myself to be put at risk.
Yet I was advised bluntly that they were not there to plan for general practice or engage the wider community. The meeting was about the needs of government employees and hospital staff.
They then proceeded to ignore me.
It's happening again with H1N1, swine flu. GPs are up in arms over the failure of government support. Classic example: The Australian on June 13 ran a front-page story about a GP in South Australia who was unable to source Tamiflu for a 17-year-old for eight days, whereas professional football players can have it within 30 minutes.
Roxon responded by promising another $4million to support general practice, although no one knows how she will spend it. Although the dulcet ker-ching of the cash register is soothing, it's not enough. We need consideration, competent leadership and consultation. Australia is lucky that H1N1 is a benign illness -- at least so far -- as it's running its own course, spreading 10 times faster here than in New Zealand and Japan.
The government has quietly capitulated after failing to make the case for home quarantine. Delaying the likelihood of a more lethal mutation and development of Tamiflu resistance gives vaccine manufacturers more time to develop an effective vaccine.
There was a point early on that things could have been handled differently at the local level. Flu clinics should, and could, have been run at local levels. Even a caravan parked in a car park near a shopping centre can be a makeshift flu clinic. Better-resourced labs could have been set up to run the tests quickly, so GPs could property treat football and non-football players alike.
The sense we get here in GP-land is that when a government is in election mode it's happy to spend money to run focus groups and hire expensive advertising gurus to make sure that the political message hits home.
In contrast, when it comes to managing a biological emergency that affects us all, but not the results of an election, politicians rely on middle-level health bureaucrats who fail miserably to explain anything to the public.
The result is all too often a confused mish-mash about not panicking. Panic about what? No one knows what is going on. If the government were capable of listening and willing to trust GPs, this swine flu pandemic would have been managed more effectively and more easily. Unfortunately, pigs haven't learned to fly ... yet.
Thomas Lyons is a general practitioner on the Queensland Gold Coast.
