- Written by David Guest
“It’s all in your head”, noted rogue London neurosurgeon, Henry Marsh, on a recent visit to Australia.
As someone whose tamperings have altered more people’s memories and capabilities than nearly any other, he speaks with some authority. Marsh asserts that the brain is the ultimate integrator of the psyche and the soma, and that its role in formulating our perceptions is paramount.
Nevertheless, convincing patients that the brain is where they feel their calf pain is a common and often difficult task for GPs.
“The problem’s in your back where your sciatic nerve is getting squished. However, you feel the pain is coming from where the nerve goes, and that’s down your leg. You're actually aware of the pain because of the nerves going the other way, up to your brain.”
“That’s not much comfort, doc. How about some pills to get rid of the pain?”
- Written by David Guest
Statistics from NSW Health have confirmed the clinical impression of many North Coast GPs that the flu season has hit early this year. They report the predominant strain is influenza A (H3N2) but levels of influenza B have also increased in recent weeks.
While the symptoms of influenza are similar to many viral infections with sore throat, cough, nasal discharge and blockage, the high temperatures, lethargy and myalgia of influenza that last for four or five days have been common presentations in recent weeks.
The availability of PCR testing for viral antigens on nasal and throat swabs has been a significant advance in the rapid diagnosis of respiratory tract infections. However the clinical utility of this testing is lessened as the prevalence of influenza rises in the general community.
- Written by Dr Kim Kerr
Fourteen members of the Lismore Runners group travelled to China recently to participate in their chosen version of the Great Wall of China run, a full marathon, half-marathon, 10 km or 5 km. We ranged in age between 55 and 70 years.
The first ‘wall’ was obtaining our Chinese visas – two of us had applications rejected and needed to fly to Sydney for new passports, receiving the visas with only two days spare.
When we flew into Beijing we had a few days to sightsee before the actual run. Of course Tienanmen Square was one of the first places we visited. Our guide warned us not to mention the words Taiwan, Tibet, or tanks/riots while in the square, as there were lots of people listening - the walls have ears! - and she could get into trouble.
Indeed, each light post had about six CCTV cameras watching us, and we were given to believe that there were lots of plain clothes police officers around.
- Written by Dr Ian McPhee
The medical profession is best placed to help colleagues encountering mental health issues, writes Dr Ian McPhee*, a self-confessed ‘black dog’ sufferer.
In recent times there has been a broad, very public focus brought to the matter of doctors' mental health. Not at all unreasonably, it is the plight of hospital-based, junior doctors that has captured the bulk of attention. Something has happened to make JMO life even more stressful. It isn't just the long hours - we all endured those - nor is it exam pressures, likewise experienced by everyone.
Medicine, as much as it might be the same in so many respects, has begun eating its young.
At the behest of a local practice, the Federal MP for Page, Kevin Hogan, has resolved contradictory government advice about whether medical practitioners can bill Medicare for providing medical reports for NDIS clients.
Mr Hogan (and Health Minister, Greg Hunt) was contacted in early June by the Practice Manager of the Lismore GP Super Clinic, Terese Forzan, seeking clarification on whether GPs could “bill Medicare for a consult item for the time taken to complete a National Disability Insurance Agency (NDIS) form.”
Ms Forzan added, “Medicare has advised its Directions made under subsection 19(5) of the Health Insurance Act do not cover a consult item for the completion of a NDIS form.”
Calling this a matter of “national importance’, she said the situation was confusing to local doctors, and clear advice from the ministerial level was required.
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