WA News Doctor Polls
Poll Results
Investment, Philanthropy, Diabetes, Guidelines – June 2013

dollar-sign-eye142 GPs took the 10 minutes to participate in this poll – 40% were female -- within the seven-day window.

Do you support philanthropy by Western Australians as a desirable way of funding community health care?                              

35% Yes

25% No

27% Perhaps

13% Uncertain                          

Doctors Comment

Respondents swung between those who thought the wealth of the state’s resources boom should help those less fortunate to health care being the responsibility of government. “We pay so much tax surely community health care should not need donations.”

Many felt that philanthropy offered “unequal care” and the government should provide even and sustainable funding. Funding from philanthropy should be viewed as a “top-up” source for the health budget. “[Philanthropy] makes a valuable contribution but cannot be relied upon as primary funding. Funding universal health care is a government function. If left to private or philanthropic sources, the most vulnerable will fall through the cracks.”

However, a number acknowledged that there was a limit to health care funding. “It is best that all of us who are capable i.e. healthy, working, reliable, regard it essential, like defence spending.” “Those who can afford to give should be encouraged to do so.”

Several respondents said philanthropy could be best used to top up research which was chronically underfunded.

For one doctor, the issue was close to home. While time constraints made personal philanthropy tricky, this person thought it existed in the profession – among GPs “more likely than those in other specialities.” “There is, however, still a perception amongst the public that all doctors are greedy and earn much too much money. This can be very irritating, particularly if comments extend to one’s children which happened to mine community.”

Last word: “We should all be doing SOME pro bono work.”

 

Do you agree with the RACGP idea that patients with specified health problems in need of chronic care are registered with a particular general practice to receive that care?

45%  Yes

32%  No

18%  Perhaps

5%  Uncertain

Doctors Comment

Among those who chose to comment, there was a general consensus that chronic disease management was hamstrung by patients not being registered with a practice and noting a waste of resources chasing up patients who flit between practices.

Medicare came in for criticism. “If patients are to register with a practice for complex care there needs to be more flexible remuneration so we can get nurses to actually spend time coordinating that care.”

For one respondent, registration needs to be even more personal. “Rather than registering with a practice, a patient should register with a doctor. I have worked in multi-doctor practices and find patients who will only see me and not happy seeing other doctors in the practice.”

However, there was also suspicion that once patients were enrolled. The “feds will take over the purse strings completely and we will do nothing but tick boxes to achieve an ever changing set of goals that we will have little control over.”

Choose UP TO THREE of the following, if you consider they are most needed for GPs to deal with the impending rise in diabetes incidence?

31%  Diabetes nurse educators

12%  Special interest GPs                             

8%  Podiatrists                                        

21%  Dietitians                                               

23%  Improved patient education                    

4%  Other                                                      

0.2%  Uncertain                                               

0.8%  None of the above                                   

Do you think encouraging more patient self-management of Type 2 diabetes will produce better outcomes, dollar for dollar, than most other measures?         

49%  Yes                                                           

10%  No                                                            

36%  Maybe, with conditions                            

5%  Uncertain

As a general rule, do you believe internship placements for junior doctors should give priority to graduates who are ... [up to THREE choices possible]                                                                  

32%  Trained in the same State                        

12%  Rural background                                  

28%  Australian-trained                                     

16%  Australian citizens                                    

10%  No priority – should be a level playing field in all these areas                  

2%  Other                                                       

1%  Uncertain                                                  

Doctors Comment

Those who commented on this question were largely in favour of priority to WA trained doctors for local internships, regardless of being an Australian or overseas doctor. “If they've trained in WA, they have a better understanding of the health issues specific to this state.”

However, overseas students did come in for some treatment … “it should be made clear that they will not be considered in the first draft for intern positions”.

How often do you think busy doctors are likely to treat or manage a health problem in a way that is outside recommended guidelines?

11%  Very often                                                

36%  Often                                                        

42%  Occasionally                                             

6%  Rarely                                                      

2%  Not at all                                                 

3%  Uncertain                                                  

Doctors Comment

Guidelines, for those who commented, needed to be flexible – with no one patient (or doctor for that matter) being alike. As one doctor said, “a doctor has to devise a treatment suitable to those individual patients Unlike researchers we can't just say they didn't make it to the end of the study.”

Last word: “My opinion is that clinical guidelines are drawn up by groups of people who have no experience of what it means to practically carry out those guidelines.” 

Looking back over the last 10 years, do you wish you had spent more time planning your financial future?                                                             

49%  Yes                                                 

34%  No                                     

11%  Uncertain                                      

6%  Doesn’t apply                                         

Does your experience with financial planners indicate they understand adequately your chosen career?                                                         

14%  Yes                                                           

51%  No                                                       

20%  Uncertain                                                

15%  Doesn’t apply                                         

 

 
Doctors: The Care Factor – May 2013

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Our May survey went to GPs and 142 responded. On June 28, the Doctors Drum breakfast will look at this very issue. We asked doctors in our May E-poll where they thought the state of caring within the profession was at.

From your experience, is the level of personal caring shown by general practitioners towards patients over the last 10 years ...     

Increasing   11%                    

Decreasing    33%                     

About the same  38%                      

Uncertain/Can’t say 18%       

Doctor Comments

Time pressure was the clear defining factor for respondents. The increasing complexity [“more time is needed to organise diagnoses and treatment”], corporatisation [“increasingly difficult for GPs to develop personal care/relationships in large practices” and “the aggressive approach to five-minute medicine is resulting in decreased personal caring”] and bureaucratisation [“Too little time because of red tape and concerns over litigation”] are taking their toll and inhibiting doctors’ ability to give as much of themselves to their patients.

Some are struggling to maintain their historical levels of caring [“I know a lot of my colleagues would like to continue caring but have had to toughen up to protect their own mental health”] but some think the next generation are less keen on self-sacrifice.

The problem could be more widespread: “As a society we have become more individualised and less caring about others. GPs are in many ways right to not be working such long hours but the pendulum seems to have swung too much in the other direction. Many will only work hours to suit themselves with little thought for patient convenience or for those that cannot afford to pay.”

The light at the end of the tunnel? “Doctors will always care.”

To book a seat at the Doctors Drum breakfast at Observation Rendezvous on June 28, go to www.doctorsdrum.com.au.

 

 
Euthanasia, Sex Workers, Women’s Health – April 13

Woman-no-to-violence328 GPs and Specialists responded to our questions on euthanasia (we compared with 2008 results) and eating disorders. In a followup poll, 197 GP respondents (male 55%, female 45%) spoke up on women’s health issues, ranging from post-natal depression, sexual assault, decriminalisation of the sex industry and the new fashion-statement, tattoos

Has a patient or relative ever raised voluntary euthanasia as an acceptable option, in the course of your professional work?

Yes                            51%

No                              47%

Undecided                  2%

If legislation on voluntary euthanasia in WA could be drafted with suitable safeguards, do you think it would be supported by the medical profession?

                                                  2008           2013

Yes                                            35%            41%

No                                             37%            38%

Unsure                                       28%            21%

ED. It seems that while the number of doctors who don’t support euthanasia has remained almost the same, some of the undecided have migrated to the affirmative

 

Which of these factors would you think play a major role in the development of postnatal depression in women [Choose 4 maximum]?

24%  Emotional or physical isolation.   
23%  Pre-existing problems in relationship(s) with people who are close.   
15%  Uncertainty about parenthood due to inadequate modelling from extended family.   
14%  Past traumatic events that re-surface during or after pregnancy.   
10%  Traumatising intervention in childbirth, past or current pregnancy.   
6%   Realistic fears around the impending child’s living environment.   
5%   Other.   
1%   Uncertain   
1%   None of the above.

If a patient confides in you that they have been sexually assaulted, do you feel confident in assisting that person gather evidence and make a complaint?

Yes              51%     
No                35%     
Uncertain    14%

ED. No significant difference in male vs. female responses

Did you know that the Sexual Assault Resource Centre (SARC) can offer any doctor phone advice 24 hours a day?

Yes            77%     
No              21%     
Uncertain    2%
ED. No significant difference in male vs. female responses.

Permanent tattoos have become more fashionable in Australia and some people consider them a mark of individuality. Some wear them openly and others privately. For whatever reason, have YOU been tattooed?

Yes                         5.5%     
No                           94%     
Prefer not to say    0.5% 

What are the biggest barrier(s) to doctors diagnosing an eating disorder [multiple choice]?

62%  Patient is skilled in hiding the fact.        
47%  Doctor lacks skills in asking the right questions.        
44%  The mental health nature of the problem.     
30%  Doctor knows there is a lack of treatment resources, once uncovered.       
30%  The long term nature of the problem.        
20%  Resistance from the patients' families.        
6%   Other.        
3%   Nil – no barriers to diagnosis. 

Ed. Around half the 328 GPs and Specialists polled said they felt poorly skilled to make a diagnosis of a problem that patients mostly hide anyway. Most families are on the doctor’s side but about a third of doctors feel community resources are lacking for a long term problem with a strong mental health component. Only 3% said there were no barriers to diagnosis.

Do you believe decriminalisation of the sex industry would improve health outcomes for sex workers?

Yes              59%     
No                23%     
Uncertain    18%     
ED. No significant difference between male and female reponses.

What about those in the community who use sex worker services?

Yes             53%     
No               25%     
Uncertain    22%     
ED. There was no significant difference between male and female reponses on the ‘Yes’ although more women favoured the ‘Uncertain’ response (30%) over the ‘No’ response (17%), compared to men.

 
Euthanasia, Sex Workers, Women’s Health – April 13

Woman-no-to-violenceLast month 328 GPs and Specialists responded to our questions on euthanasia (with 2008 comparative results) and eating disorders. This month there were 197 GP respondents (male 55%, female 45%). Doctors spoke up on women’s health issues, ranging from post-natal depression, sexual assault, decriminalisation of the sex industry and the new fashion-statement, tattoos.!

Q. Has a patient or relative ever raised voluntary euthanasia as an acceptable option, in the course of your professional work?

Yes                 51%
No                   47%
Undecided        2%

If legislation on voluntary euthanasia in WA could be drafted with suitable safeguards, do you think it would be supported by the medical profession?

                   2008                2013
Yes             35%                41%
No               37%                38%
Unsure       28%                21%

ED. It seems that while the number of doctors who don’t support euthanasia has remained almost the same, some of the undecided have migrated to the affirmative.

 

Which of these factors would you think play a major role in the development of postnatal depression in women [Choose 4 maximum]?

24%  Emotional or physical isolation.   
23%  Pre-existing problems in relationship(s) with people who are close.   
15%  Uncertainty about parenthood due to inadequate modelling from extended family.   
14%  Past traumatic events that re-surface during or after pregnancy.   
10%  Traumatising intervention in childbirth, past or current pregnancy.   
6%   Realistic fears around the impending child’s living environment.   
5%   Other.   
1%   Uncertain   
1%   None of the above.

If a patient confides in you that they have been sexually assaulted, do you feel confident in assisting that person gather evidence and make a complaint?

Yes              51%     
No                35%     
Uncertain    14%

ED. No significant difference in male vs. female responses

Did you know that the Sexual Assault Resource Centre (SARC) can offer any doctor phone advice 24 hours a day?

Yes            77%     
No              21%     
Uncertain    2%
ED. No significant difference in male vs. female responses.

Permanent tattoos have become more fashionable in Australia and some people consider them a mark of individuality. Some wear them openly and others privately. For whatever reason, have YOU been tattooed?

Yes                         5.5%     
No                           94%     
Prefer not to say    0.5% 

Around half the 328 GPs and Specialists polled said they felt poorly skilled to make a diagnosis of a problem that patients mostly hide anyway. Most families are on the doctor’s side but about a third of doctors feel community resources are lacking for a long term problem with a strong mental health component. Only 3% said there were no barriers to diagnosis.

What are the biggest barrier(s) to doctors diagnosing an eating disorder [multiple choice]?

62%  Patient is skilled in hiding the fact.        
47%  Doctor lacks skills in asking the right questions.        
44%  The mental health nature of the problem.     
30%  Doctor knows there is a lack of treatment resources, once uncovered.       
30%  The long term nature of the problem.        
20%  Resistance from the patients' families.        
6%   Other.        
3%   Nil – no barriers to diagnosis. 

Do you believe decriminalisation of the sex industry would improve health outcomes for sex workers?

Yes              59%     
No                23%     
Uncertain    18%     
ED. No significant difference between male and female reponses.

What about those in the community who use sex worker services?

Yes             53%     
No               25%     
Uncertain    22%     
ED. There was no significant difference between male and female reponses on the ‘Yes’ although more women favoured the ‘Uncertain’ response (30%) over the ‘No’ response (17%), compared to men.

 
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