We d n e s d a y 7 O c t o b e r 2 0 0 9
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GPs lose joint injection rebate ■ Michael Woodhead
T
he Medicare rebate for synovial joint injections will be removed from 1 November, in a move the AMA says will cause financial and physical suffering for thousands of elderly patients. AMA president Dr Andrew Pesce says the government expects the medical profession to absorb this service as part of a standard patient consultation. However, he warns the costcutting move will mean that many older patients will now have
to pay a minimum of $23 per injection for up to 25 injections per patient per year. “This is another example of a random Budget cut made for base economic reasons without any consultation with the medical profession about the cost of providing the service or the health impact on patients,” Dr Pesce says. “To suggest that joint injections can be incorporated into a standard consultation is proof that the government has been poorly advised on this decision." Dr Pesce says the injections are
one of the few effective treatments for older patients with intractable knee or shoulder pain who often spend months on waiting lists for joint replacement surgery. “This latest Medicare rebate cut means that, for many of them, their wait will now be long and painful.” “Our GP members tell us that synovial joint injections are among the most gratifying treatments for patients – they walk in with pain and walk out with a smile,” he says. What do you think? comment@6minutes.com.au
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Back pain patients recover in a year ■ Michael Woodhead Reassuring news for patients with chronic low back pain, with a new Australian study showing that four out of ten patients will recover within a year. The better than expected prognosis was seen in a one year follow up study of more than 900 patients presenting in primary care with a new episode of low back pain. Complete recovery was seen in 35% of patients by nine months and in 41% of patients by one year, says study
author, Dr Luciola da Menezes Costa, from The George Institute at the University of Sydney. His findings, published in the BMJ online today, also show that factors associated with delayed recovery from back pain included taking previous sick leave for low back pain, high disability levels, low levels of education and being born overseas. “Our findings suggest that the prognosis is moderately optimistic for patients with chronic low back pain. Patients with recent onset, non-radicular chronic low back
pain can be reassured that they have a good chance of recovery,” he concludes. Dr Costa says his study may have found a higher than expected rate of recovery because almost all patients were followed up, whereas in other studies many had been lost to follow up. However, other researchers said low back pain was often an episodic and life-long problem and research on what happens to patients over much longer time scales was needed. comment@6minutes.com.au
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Pet threats may be key to domestic violence ■ Michael Woodhead Women experiencing domestic violence may be reluctant to speak out or take action because their pets are effectively being held hostage, researchers say. A study by a domestic violence service in NSW has found that abusive partners often threaten to harm or kill a pet, making women reluctant to leave or seek help. Writing in the MJA (191: 409), researchers urge doctors to ask women who are at risk of domestic violence if they have pets, and whether their pets
Women are reluctant to leave pets are at risk of violence. They say women in such situations often become very attached to pets and their partners use this to control and intimidate them. In a survey of women being helped by a domestic violence service, they found that among the pet
owners, one in four partners had threatened to harm or kill their pet. Out of concern for their pets, women delayed leaving home or calling police and pressing charges against a perpetrator of violence. The researchers say the RSPCA provides emergency accommodation for pets of women and children seeking refuge from domestic violence. But women often feel reluctant to speak up and the authors encourage doctors to raise the question of pets and their health. comment@6minutes.com.au
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