Monday 20 July 2009
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Skin screening shown to save lives ■ Michael Woodhead
T
he evidence is in to support whole body screening to reduce mortality from melanoma, say Queensland researchers. A study (link) by the Viertel Centre for Research in Cancer Control, Cancer Council Queensland, shows that whole body screening is associated with a 14% lower risk of being diagnosed with a thick melanoma – the type most likely to cause death. Published in the International Journal of Cancer (online 16 July), the case control study of
14% reduction in thick melanoma 3,762 patients with melanoma found that whole-body clinical skin examination in the three years before diagnosis was associated with a reduced risk of a diagnosis of a melanoma of >0.75mm thickness. There was a 38% higher risk of being diagnosed with a thin
melanoma in screened patients, which was attributed to earlier diagnosis due to the recent surge in popularity of skin screening. The results support a population-based skin screening program, subject to evaluation of cost effectiveness, the study authors say. “The current study provides the best evidence to date and, in the absence of a randomised trial, the best evidence we are likely to achieve for some time that skin screening by a doctor will reduce mortality from melanoma,” they say. What do you think? comment@6minutes.com.au
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Unhappy GPs eyeing early retirement ■ Jared Reed One in three older GPs intend to retire early, blaming poor job satisfaction, increasing red tape and the threat of burnout. An MJA (191:2:75-77) survey (link) of 178 GPs in WA found widespread disillusionment with the country’s medical system, brought about by increased bureaucracy and diminishing lifestyle through overwork. Female GPs wanted to continue working to a later age than their male counterparts,
possibly because they were more satisfied with their work as a result of part time working arrangements, the authors say. Diminishing job satisfaction and discontent are amenable to intervention, say the report’s authors, and would be a more immediate and cost-effective option over training new doctors. Fixing these external factors could help stem an outflux of retiree GPs - a vital measure given around onequarter of the Australian medical workforce are aged
over 55, they argue. "Older GPs find change difficult, and declining morale occurs partly because current medical practice is considerably different to that for which they were trained,” they write. “Measures such as encouraging men GPs to gradually reduce workloads, eliminating unnecessary bureaucratic demands, and improving financial rewards might increase job satisfaction.” What do you think? comment@6minutes.com.au
Call to scrap 'failed' Team Care Arrangements ■ Michael Woodhead Team Care Arrangements should be scrapped because they are not doing what they were set up to do and also make more work for GPs, according to an article (link) in the MJA today. There is no evidence that Team Care Arrangements are encouraging GPs to shift from episodic care of chronic disease to a more global approach, say GP researchers from Canberra. Instead, they say the onerous requirements of Team Care
Arrangements make co-ordination unwieldy and effectively freeze the patient’s management for months until the GP can obtain agreement from all providers. The care co-ordination requirements of the care plans are being widely ignored, they say. There is also evidence that Team Care Arrangements are being used to give patients access to cut price allied health services such as dentistry, psychologists and podiatry, the authors say. If the aim is to help patients with chronic health problems
move away from episodic care, a better solution would be a program to give all such patients a comprehensive patient summary, as recommended by the RACGP, they write. "[This] would enable the GP to draw up well considered treatment objectives and priorities, provide clinical information of real value to other health professionals, identify and resolve problems of co-ordination, and eliminate oversights,” they suggest. What do you think? comment@6minutes.com.au
Before prescribing, please review Approved Product and PBS Information by clicking here. Pfizer Australia Pty Ltd (ABN 50 008 422 348). 38–42 Wharf Road, WEST RYDE NSW 2114 References: 1. Sever PS, et al. Lancet 2003; 361: 1149–58. 2. LaRosa JC, et al. N Engl J Med 2005; 352: 1425–35. 3. LIPITOR Approved Product Information. 4. PBS listed February 1998 (www.medicareaustralia.gov.au). BATMAN and all related characters and elements are trademarks of and © DC Comics. (s08). LIPITOR*® Reg Trademark Pfizer Inc. Pfizer Medical Affairs 1800 675 229. www.pfizer.com.au 01/09 H&T PZR0394/6MIN