Choosing Wisely
The Royal Australian College of General Practitioners (RACGP) is a proud first-wave member of Choosing Wisely Australia.
The RACGP recommendations are:
- Don’t order colonoscopy as a screening test for bowel cancer in people at average or slightly above average risk. Use faecal occult blood screening (FOBT) instead
- Don’t order chest x-rays in patients with uncomplicated acute bronchitis
- Don’t routinely do a pelvic examination with a Pap smear
- Don’t treat otitis media with antibiotics, in non-Indigenous children aged 2 -12 years, where reassessment is a reasonable option
- Don’t test thyroid function as population screening for asymptomatic patients.
Visit the Choosing Wisely website for the full list of 61 recommendations.
Dr Frank R Jones
RACGP President
Close the Gap 10th anniversary
The RACGP marked the 10th anniversary of Close the Gap Day on Thursday 17 March with events and celebrations around the country acknowledging the successes of the campaign so far and the hard work still ahead to achieve health equality by 2030.
RACGP Council members and staff were joined at the RACGP national office in Melbourne by Wurundjeri Elder Uncle Colin Hunter, Aboriginal GP and RACGP Fellow Dr Tammy Kimpton, along with representatives from the Victorian Aboriginal Community Controlled Health Organisation (VACCHO), Victorian Aboriginal Health Service (VHAS), Australian Indigenous Doctors’ Association (AIDA) and National Aboriginal Community Controlled Health Organisation (NACCHO).
A photo album of the day’s events is on the RACGP Facebook page.
RACGP Queensland staff attended an educational morning tea hosted by Mary Martin of the Queensland Aboriginal and Islander Health Council (QAIHC) and RACGP WA held a sundowner with guests including Richard Walley, Kicks4Kidzfounders Des Headland and Rod Willet and a number of RACGP members.
Join the RACGP in demanding health equality for Aboriginal and Torres Strait Islander people within a generation. Visit the Oxfam website and sign the pledge to close the gap.
Managing family violence
The RACGP continues to advocate for resources to support the management of family violence. Stakeholders from several Aboriginal and Torres Strait Islander health organisations recently attended a workshop hosted by the RACGP to provide expert guidance and discuss the most appropriate channels for GPs and Aboriginal Health Workers/Practitioners (AHWPs) to access family violence information and services.
Abused women use medical services more frequently because of increased rates of emotional health issues, with estimates that up to five abused women per doctor, per week attend unsuspecting GPs.
It’s vital that GPs are adequately skilled to identify victims of family violence. The RACGP’s Abuse and violence: working with our patients in general practice (White book) is an extensive resource providing evidence-based guidance on appropriate identification and response in clinical practice to patients experiencing abuse and violence.
New General Practice Experience pathway coming
The RACGP has recently reviewed the General Practice Experience (GPE) pathway and a new GPE pathway has been developed, including an individualised education program and structured learning support for medical educators.
Places are limited for 2016. Applications will be open Monday 18 April to Friday 13 May and successful candidates will begin the pathway on Monday 30 May 2016. More details will be available via In Practice and the RACGP website in the coming weeks.
RACGP Clinical Pearl
Assessment of cirrhosis: Accessing new treatments for Hepatitis C
All people with Hepatitis C are eligible to access the new Hepatitis C treatments listed on the PBS. However, the presence of cirrhosis influences treatment duration and regimen and a person’s cirrhosis status must be provided when seeking PBS authority.
Assessment can include transient elastography (FibroScan) to measure liver stiffness. Alternatively, a serum biomarker such as the aspartate aminotransferase (AST) to platelet ratio index (APRI) score can be calculated from routine blood test results. The presence of cirrhosis is also important to identify people who require long-term care, including liver cancer surveillance once cured of their Hepatitis C.
Some useful information can be found in section 4. Pre-treatment assessment in the Australian recommendations for the management of hepatitis C virus infection: Consensus statement 2016. A range of RACGP-accredited training can be found at ASHM.
In Practice poll
Local GP advocacy networks
Australia’s healthcare sector has seen significant transformation over recent years, including changes to locally-based general practice and the establishment of Primary Health Networks (PHNs). Government funding was originally provided to the Divisions of General Practice, which then shifted to Medicare Locals and now PHNs. This period has seen a significant change in the focus of these organisations as directed by successive governments.
RACGP member feedback suggests that these reforms have led to a decrease in opportunities for GPs to engage with other local GPs and discuss areas of mutual interest or concerns. As the peak body for general practice, the RACGP is seeking to support members and ensure that the local GP voice is not lost within the forever changing health landscape.
In response to member feedback, the RACGP Expert Committee – General Practice Advocacy and Funding (REC-GPAF) will be conducting a pilot project that aims to understand GPs’ interest and potential participation in improving advocacy and engagement at a local level.
The proposed model will provide GPs with a unique platform to discuss a range of local and national issues. For example, partnerships with local services or the impacts of commonwealth and state/territory political measures on general practice.
The RACGP is canvassing the views of the broader membership in order to inform the development of the pilot project and implementation of the local GP advocacy networks.