Assoc Professor Harald Puhalla, MD FRACS

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In Australia more than one million people are diagnosed with type 2 diabetes and at least two million have pre diabetes.

The rapid increase of type 2 diabetes goes in hand with the well-known obesity epidemic. A strong association in-between increased body fat and insulin resistance was initially described as part of the Syndrome X in the 1980’s. More recently in conjunction with hypertension and hyperlipidaemia, obesity and elevated glucose level were named metabolic syndrome. 80% of patients with type 2 diabetes are obese or overweight. When their diabetes becomes clinically apparent the risk for cardiovascular events rises sharply. In these patients obesity additionally increases their possibility of developing pulmonary embolism, cancer, osteoarthritis, depression or asthma.

Dr Michelle Crockett is the Clinical Lead and Senior HealthPathways GP Clinical Editor for the WentWest Primary Health Network's HealthPathways project. 

HealthPathways began in New Zealand and is an online tool designed to help GPs assess and manage conditions. In addition there is information about local referral options. It is now used in Australia with about 13 sites working on their own pathways. At Western Sydney we began our journey in 2012 starting with the diabetes pathways. Our first batch of pathways went live in November 2013 and we now have over 100 pathways on our live site and 100 more almost ready for publication.

Simplified diagram of the Hepatitis C virus replication cycle

The new treatments for hepatitis C, likely to be passed by the PBAC early next year, will not change the Northern Rivers Health Pathway, at least in the short term. 

The pathway is designed to give GPs a quick guide to the management of hepatitis C patients on the North Coast. A brief overview and flowchart are sufficient to determine if patients would qualify and benefit from referral. To save time the pathway has a list of recommended pre-assessment blood tests

The Line to Kyogle, Steve Garner 2012

A detailed study of 3,906 GPs – nearly one-in-five of the national GP workforce – has revealed that small-sized towns face the highest risk of GP turnover, with key influencing factors being GPs working in a location for less than three years, being contracted or salaried employees, or international medical graduates.

While remote and very remote GPs had the highest mobility rate, this group was not at significantly greater risk of leaving non-metropolitan practice completely. Rural GPs practising in towns of less than 5,000 residents, and in towns of up to 15,000 residents, were most likely to move to metropolitan areas.

Overall, annual location retention rates were 95 per cent in regional centres, 90 per cent in small rural towns, and 82 per cent in very remote areas.

Dr Geoffrey Boyce has retired and closed his neurology practice in Lismore. However he continues to offer a nerve conducton service from his rooms at 23 Dalley Street LIsmore, opposite St Vincent's Hospital. The service currently operates on alternate Fridays. 

Appointments can be made on the bookings number  9099 0538 and clinical information can be faxed to 02 6621 8237.0418 986 724