Volume 198 Issue 3

New study findings provide us with a BOLD reminder of the burden of obstructive lung disease in Australia.

Christine F McDonald MB BS(Hons), PhD, FRACP · Nicholas Glasgow MB ChB, MD, FRACGP

How much longer do we have to wait for electronic health records that can generate reliable national data on Australian general practice?

Helena C Britt BA, PhD · Graeme C Miller MB BS, PhD, FRACGP

Introducing a series of articles emerging from a summit convened by the MJA in 2012, to pave the way for high-quality, relevant and implementable health and health care research.

R John Simes MD, SM, FRACP · Steven A R Webb MB BS, PhD, FCICM

The full content of this article is available by downloading the PDF.

The full content of this article is available by downloading the PDF.

Why is performance reporting necessary? Is there any evidence of benefit? And how can it help busy doctors, nurses and allied health clinicians?

Diane Watson PhD

Clinical registries are at a crossroads. Will we continue the current patchwork approach or will we make the changes that are needed to improve the efficiency and effectiveness of data collection and drive the quality of care?

Sue M Evans MClinEpi, PhD · Bebe Loff BA LLB, MA(MedLaw · Peter A Cameron MB BS, MD

Trials conducted in the general practice setting by general practitioner researchers to inform the practice of general practice.

Mark R Nelson MB BS(Hons), FRACGP, PhD

To the Editor: The impact of population ageing on health care expenditure was a hot topic in the late 1990s in Australia.1 Previous studies have adopted various modelling approaches to estimate age- and sex-specific health care costs to inform population health care expenditure projections.2-4 Medicare funds about 3800 medical services, including consultations provided by general practitioners and specialists, medical diagnostic services (such as medical imaging and ...

Catherine L Keating

To the Editor: The most common cause of difficult-to-treat depression may be a failure to diagnose bipolar II depression.

Andrew R Robertson · Greg M de Moore · Philip M Boyce

In Reply: Treatment recommendations for bipolar II depression differ minimally from those for bipolar I.

Michael Berk · Seetal Dodd · Lesley Berk

Information on refugee background and country of birth provides important pointers to possible health needs.

Melanie E Gibson-Helm · Andrew A Block · Helena J Teede

To the Editor: I read with great interest the recent article by Knox and Marshall.1 Chromoblastomycosis may result in a number of rare systemic complications that may be associated with significant morbidity. For instance, chromoblastomycosis may affect the cornea. This usually follows cataract surgery. Cladophialophora carrionii is the aetiological agent involved in corneal chromoblastomycosis.2 Keratitis occurs, resulting in ocular pain and decreased visual acuity. Topical and ...

Shailendra Kapoor

A position statement of the Australian and New Zealand Bone and Mineral Society and Osteoporosis Australia stresses the importance of vitamin D in bone health across the lifespan, and draws together the growing body of evidence that vitamin D is also important for non-bone health outcomes in infants, children and adolescents.

Georgia A Paxton MB BS, MPH, FRACP · Glyn R Teale MB BS, MD, FRANZCOG · Caryl A Nowson PhD, DipNutrDiet · Rebecca S Mason MB BS, PhD · John J McGrath MB BS, PhD, FRANZCP · Melanie J Thompson MB BS, FRACP · Aris Siafarikas MD, FRACP · Christine P Rodda MB BS, PhD, FRACP · Craig F Munns MB BS, PhD, FRACP

A cross-sectional study finds that symptoms and spirometric evidence of chronic obstructive pulmonary disease are common among people aged 40 years or older in Australia, and increase with age.

Brett G Toelle PhD · Wei Xuan PhD · Tessa E Bird RN · Michael J Abramson MB BS, PhD, FAFPHM · David N Atkinson MB BS, MPH · Deborah L Burton PhD · Alan L James MD, FRACP · Christine R Jenkins MB BS, MD, FRACP · David P Johns PhD · Graeme P Maguire MB BS, FRACP, PhD · A W (Bill) Musk MB BS, MD, FRACP · E Haydn Walters MA, DM, FRACP · Richard Wood-Baker DM, FRCP, FRACP · Michael L Hunter PhD · Bruce J Graham BSc, MEd, PhD · Phillipa J Southwell BMedSc(Hons) · William M Vollmer PhD · A Sonia Buist MD · Guy B Marks MB BS, PhD, FRACP

A qualitative study explores the experiences of patients treated for trauma in Victoria, revealing gaps in communication, information provision and post-discharge care.

Belinda J Gabbe MAppSc, MBiostat, PhD · Jude S Sleney BSc(Hons), MSc · Cameron M Gosling BAppSc(HM), GradDip(ExRehab), MAppSc · Krystle Wilson BN(Hons) · Melissa J Hart RN, Orth Cert, BEd, · Ann M Sutherland RN, AdvCertM’ment, GradDipOHE · Nicola Christie BA, PhD

A 3-year whole-of-hospital clinical service redesign program in a tertiary paediatric hospital in Western Australia finds that the introduction of a 4-hour-rule program for discharge or admission from the emergency department improves timeliness of care for patients throughout the hospital, with no adverse impact on the quality and safety of clinical care.

Liana Maumill RN, BN, PGDip(Paed Nsg) · Mia Zic BHlthSc, MIPH · Amanda A Esson BHlthSc · Gary C Geelhoed MB BS, FRACP, FACEM · Meredith M Borland MB BS, FACEM · Christopher Johnson MB BS, ANZCA · Philip Aylward BBA · Andrew C Martin MB BS, FRACP, MD

In an Australian first, a woman treated for breast cancer, who was menopausal after chemotherapy, has a viable ongoing pregnancy after ovarian cryopreservation and autotransplantation.

Lynn Burmeister MB BS, FRANZCOG, CREI · Gabor T Kovacs MD, FRANZCOG, CREI · Tiki Osianlis BSc(Hons), PhD

A reminder of the high incidence of both systemic and cutaneous lupus erythematosus in Indigenous Australians.

Johanna M Warren · Peter F Bourke PhD, FRACP · Lachlan J Warren MB BS, FRACGP, FACD

The recent apology from the German Medical Association is commendable, but it fails to mention many of the victims of Nazi medicine.

George M Weisz MD, FRACS, MA

“We cannot know the solutions until we first know the people … Most of us do not stay long enough or get close enough to the front line to ever be able to discover stories like this one.”

Krithika Murali MB BS, BMedSci

Clifford Bruce Osborne, known as Bruce, had an extensive and diverse medical career that included the rare achievement of Fellowships in three disciplines — general practice (1980), medical administration (1987) and psychiatry (2001). Throughout, Bruce remained committed to compassionate patient care and improved regional health services. Bruce was born on 23 February 1951 and grew up in Dandenong, Victoria. In 1975, he graduated in medicine from Monash University, ...

Hugh M Lowy

CorrectionSIncorrect text: In “Australia’s dietary guidelines and the environmental impact of food ‘from paddock to plate’” published in the 21 January 2013 issue of the Journal (Med J Aust 2013; 198: 18-19), there was an error in the third paragraph of the article. The statement “Around half of Australia’s fisheries are overfished” is incorrect. It should read “Forty per cent of Australia’s managed fish stocks have been ...

Linda A Selvey MB BS(Hons), PhD, FAFPHM · Marion G Carey MB BS(Hons), MPH, FAFPHM

CorrectionAuthorship statement omitted: In “Secondary prevention of coronary heart disease in Australia: a blueprint for reform” in the 4 February 2013 issue of the Journal (Med J Aust 2013; 198: 70-71), a full statement of authorship was omitted. Julie Redfern and Clara Chow coauthored the editorial on behalf of the Executive Committee and all participants in the National Secondary Prevention of Coronary Disease Summit held in December ...

Julie Redfern* BSc, BAppSc(Physio), PhD · Clara K Chow* MB BS, PhD, FRACP

A host of doctors have been recognised in this year’s Australia Day honours for their commitment to and care of the community

Karen Burge

Australia’s medical workforce is increasing in size, with new figures showing improved supply across all regions of the country. The Australian Institute of Health and Welfare (AIHW) Medical Workforce 2011 report found that between 2007 and 2011, the number of medical practitioners employed in medicine increased by just over 17% from 67 208 to 78 833. The overall supply of clinicians across all states and territories had increased 11.4% between 2007 and 2011, from 323 full-time equivalents (FTEs) per 100,000 people to 360. AIHW spokesperson Teresa Dickinson said the supply of medical practitioners rose in all areas, including major cities (up by 60 FTEs), inner regional areas (up by 60 FTEs), outer regional areas (up by 69 FTEs) and remote/very remote areas (up by 45 FTEs). The AIHW study provided information on the demographic and employment characteristics of medical practitioners registered in Australia in 2011. During that period, there were 87 790 medical practitioners registered in Australia and about 85% of them responded to the workforce survey. About 94% (73 980) of employed medical practitioners were working as clinicians, of whom 34% were general practitioners, 33% were specialists, 17% were specialists-in-training and 13% were hospital non-specialists. Of those employed as non-clinicians, which made up 6% of all employed medical practitioners, more than half reported being researchers or administrators. “Women are increasingly represented in the medical practitioner workforce, up from 34% in 2007 to 38% in 2011”, Ms Dickson said. The average weekly hours worked by employed medical practitioners remained steady during the survey period. The report showed that, in 2011, male medical practitioners worked an average of 45.9 hours per week, while female medical practitioners worked an average of 38.7 hours per week.

Cate Swannell

Professor Doris Young holds three positions at the University of Melbourne. She is Chair of General Practice, Associate Dean (Academic) and Assistant Dean (China) in the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne. Here, she shares the enthusiasm that has helped inspire the next generation of general practitioners

Interview by Karen

Dr Jo-Anne Manski-Nankervis is a part-time academic registrar, working under the mentorship of Professor Doris Young. What is your current role? I work at the General Practice and Primary Health Care Academic Centre at the University of Melbourne, where I am undertaking a PhD and working on Stepping Up, a National Health and Medical Research Council-funded clinical trial of a new model of care for insulin initiation for people with type 2 diabetes in general practice. I also work two sessions per week doing general practice at a clinic in Essendon. What inspired you to choose this career path? I had a fantastic general practice rotation in the final semester of my medical degree at the University of Melbourne, working with Dr Jock Sowerby in St Leonards. Jock and his patients opened my eyes to what general practice could achieve for patients and to the importance of the general practitioner–patient relationship. Professor Doris Young broadened my perspective as to the role that GPs could play in education and research that could benefit how GPs work. What do you find inspiring about Professor Young? Doris is incredibly approachable. She will always give an honest assessment about my work — good or bad — but is always motivating, supportive and cognisant of “the big picture”. She has the ability to identify and bring together teams that can work together and complement each other based on their strengths. Regardless of how I’m feeling when I walk into her office, I always come out with new ideas and am ready to take on new challenges. Where do you see your career heading in the future? I aim to continue my diabetes and health services research as well as my clinical work.

Cate Swannell

With a comfortable retirement on the horizon, paediatrics Professor David Brewster turned his back on a new house and the rich cultural life of Canberra to take up one more teaching position in a developing country

Linda Drake

The recent hacking of a Gold Coast practice’s medical records highlights the growing need for cyber security and insurance

Annabel McGilvray