Gladstone - June 2009

Well, its back in Gladstone ED for four weeks. It actually feels good being back for a number of reasons. Familiar place and faces help but I think the more focused and purposeful work is what I was missing.

Day 2 and 3 were days off, but starting yesterday was the beginning of a nine day stint. No problem with this though as each day is a set shift, and apart from the two nights I am second "on call" the time off between shifts is my own.

Have done some walking around the Botanical Gardens. It was very wet in February and I found it not possible to explore the gardens much when I was here then, but in June its much dryer and more amenable to being explored. The design of the gardens is interesting ... small sections representing examples of different forest areas around Queensland and northern New South Wales, some endangered.

Yesterday I received a phone call from the nurse at Hawthorn. She was experiencing the frustration of one of my patients who had been refused to be seen by more than one of the doctors at Hawthorn. This is one of the reasons I left Hawthorn, no medical services teamwork, no commitment of the majority of the doctors to quality patient care and the singular lack of respect for the humanity of the patients of the practice. As a community health centre where the socially disadvantaged, those with the ills of the human condition should be able to attend for their medical needs, such cherry-picking behaviour from doctors should not be permitted. It shames me to admit it openly but it feels good to be out of that place. I also feel greatly saddened for the patients who became dependent on me as their GP and who will have difficulty finding someone else who will treat them with respect. I also feel distress for the nurse who does care, and will be feeling the same frustrations that I did. Saying more in this public forum is not appropriate.

I also had an other interesting phone call the day before yesterday from a GP down in Melbourne who informed me that I still had a DD permit for one of my methadone program patients. Interesting that notifying the Drugs and Poisons Unit that I was leaving pharmacotherapy and all existing permits needed to be canceled by 15th May did not seem to produce the desired outcome. I know they received it but it appears no one acted on the body of the notification, that I could no longer hold any DD permits and needed current permits canceled. Quite a few years ago for process expediency permits that automatically lapsed after 12 months and had to be renewed, became permits that never lapsed unless actively canceled. Since that time those who "fall off" the program have a permit still in their name and unless a doctor recognises this fact will hold a permit in perpetuity for no functional reason other than permits no longer lapse. I guess I may need to call DPU reminding them of my written notification and request when I get back to Melbourne.

As a final note I wanted to say that one of the doctors who works here at Gladstone sat his second part Australian Medical Council exams and received his results yesterday. He did not pass. This guy has many years experience, highly competent and from a culture very similar to Australia. I am baffled why he did not pass, although his results were such that he almost passed and so is going to be given a "re-sit" of the examination. I wish him all the best in this reassessment, and express my concern that perhaps the AMC examination is in fact a little too rigid. I know no details of the examination pass criteria, but having worked shoulder to shoulder with him in February and now having the pleasure of working with him again now, I find it perturbing that he did not pass. Yes I know a standard of care and competence is required, but he is certainly one I would trust with my life and the lives of my family.

There is some incongruity here.

Thanks for sharing my thoughts with me. I will post again in a few days time.