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Background: The medical profession has been slow in embracing email as a means of improving communication with patients. Aims: To explore the attitudes, practices and experiences of senior medical specialists towards email communication with their patients. Methods: A cross‐sectional qualitative interview of 30 medical staff specialists employed by Canberra Health Services, administered through one‐on‐one interviews conducted between June and August 2020 (several months into the COVID‐19 pandemic). Main outcome measures are the comments extracted from the interviews that were categorised into five domains: (i) integration of email use with patients; (ii) issues addressed through email; (iii) benefits of email communication; (iv) concerns and barriers to email communication; and (v) practice pointers for email use with patients. Results: Regular email correspondence with patients was not widespread. The main benefits identified were improved efficiency and flexibility, especially in the context of managing chronic disease and patient follow up. Participants also identified barriers, including time commitments, privacy and confidentiality, patient expectations and potential for misuse. Most participants were hesitant to endorse email with patients in their practices, citing concerns over the utility and safety of the medium and lack of established protocols and recommendations for email usage. Conclusions: There is a want and need for comprehensive and accessible professional guidance on email use with patients. Our results indicate opportunities to inform good clinical practice in respect of doctor–patient relationships, clinical workloads and risk management. There is also a need for formal guidelines on emailing with patients. The COVID‐19 pandemic has heightened the need for such guidelines. [ABSTRACT FROM AUTHOR]

Background: Prior research suggests that the quality of communication between doctors and patients influences the quality of medical care and adherence to treatment regimens, but little is known about factors that contribute to successful interactions between doctors and patients. Aim: To examine the quality of communication across the different medical specialties. Methods: A survey questionnaire was undertaken at a large metropolitan‐based hospital in Brisbane, Australia. In this initial study we surveyed 67 doctors across various specialties on a range of social cognition and personality measures. We then rated each of the specialties on the degree to which they rely on both procedures and diagnostics, as well as the extent to which they involve patient communication. Results: A regression analysis using spss 26.0 was undertaken to ascertain if doctor's satisfaction with their communication was related to these three aspects of the various specialties. Results revealed that communication satisfaction was negatively related to the degree to which the specialty relies on diagnostics. No relationship emerged between reliance on procedures and communication satisfaction. Last, communication frequency was positively related to communication satisfaction. Conclusions: We propose two possible accounts for this finding regarding diagnostics: (i) the cognitive demands of diagnosis disrupt communication; and/or (ii) diagnoses are interpreted by patients as opinions with which they are sometimes motivated to disagree. Further research is needed to replicate these findings and establish the underlying mechanism. [ABSTRACT FROM AUTHOR]

Background: It is widely accepted that early discussions about goals of care (GOC) should occur during a hospital admission. Whilst rapid response systems such as Medical Emergency Team (MET) calls were designed to identify patients at risk of deterioration early enough in their illness to intervene, it is becoming apparent that these teams frequently diagnose the dying patient. Aims: To determine how frequently Launceston General Hospital MET doctors are involved in discussions surrounding GOC. Methods: A retrospective audit of all MET calls and Code Blues at the Launceston General Hospital over an 18 month period was performed. Results: 50% of MET calls occurred in patients with no valid GOC form completed prior. At 3% of events, the GOC form was completed for the first time, and at 3% it was modified. At a further 3% the notes implied there had been a modification to the GOC but the form had not been completed. Conclusions: This audit confirms that documentation surrounding GOC is inadequate, and that at 9% of MET calls, MET doctors are involved in discussions surrounding treatment limitations. This suggests that further education and training is required for doctors working in inpatient care, including those who staff the MET. [ABSTRACT FROM AUTHOR]

Background: The recent implementation of a scheme to provide universal access to direct‐acting antiviral (DAA) medication to treat hepatitis C virus (HCV) places Australia in a unique position to reach global HCV elimination goals. To achieve this, increasing the uptake and success of DAA treatment in general practice settings is essential. Aims: To explore current enablers and residual barriers to HCV treatment in general practice settings in the post‐interferon era from both general practitioner (GP) and patient perspectives. Methods: Semi‐structured interviews with 11 GP and 27 patients were conducted to draw out both challenges and facilitators particularly relevant to DAA uptake and treatment journeys. Results: Key enablers for successful treatment identified by this study included peer‐led GP support and skill development, utilisation of electronic reminder systems, trusting relationships with patients and engaging with patients' social and family networks. Barriers related to accessible testing facilities and knowledge and confidence with DAA treatment continue to limit GP‐led treatment. Conclusions: Despite a universal access scheme, barriers to DAA prescription in general practice settings remain. These include access to fibrosis testing and GP confidence in DAA prescription. Strengthening peer‐led GP skill development and utilisation of electronic reminder systems may help GP prioritise HCV treatment. Access to fibrosis testing and pathology services with no out‐of‐pocket costs to patients, particularly in outer‐metropolitan areas, should be urgently addressed. [ABSTRACT FROM AUTHOR]

The article focuses on a survey conducted among doctors in Queensland, Australia, to determine their attitudes towards voluntary assisted dying (VAD) and willingness to participate. Topics include a majority of respondents agreed that patients have access to VAD as the minority were willing to participate as the coordinating practitioners; and Mental health diagnosis was identified as a significant barrier to doctors' participation, and respondents believed that a mental health assessment.

Background Healthcare professional ( HCP) time supporting insulin pump therapy ( IPT) has not been documented, yet it is important in planning and allocating resources for effective care. Aim This study aims to determine HCP time spent in IPT patient care to inform resource planning for optimal IPT delivery. Methods Twenty-four Australian adult IPT-experienced institutions (14 government funded, seven private, three both) collected data between April 2012 and January 2013 prospectively, including: patient demographics, HCP classification, purpose of HCP-patient interaction, interaction mode and HCP time with the patient. A subset of patients was tracked from pre-pump education until stable on IPT. Results Data on 2577 HCP-adult patient interactions (62% face-to-face, 29% remote, 9% administrative) were collected over 12.2 ± 6.4 weeks for 895 patients; age 35.4 ± 14.2 years; 67% female; 99% type 1 diabetes, representing 25% of all IPT patients of the institutions. Time (hours) spent on IPT interactions per centre per week were: nurses 5.4 ± 2.8, dietitians 0.4 ± 0.2 and doctors 1.0 ± 0.5. IPT starts accounted for 48% of IPT interaction time. The percentage of available diabetes clinic time spent on outpatient IPT interactions was 20.4%, 4.6% and 2.7% for nurses, dietitians and doctors respectively. Fifteen patients tracked from pre-pump to stabilisation over 11.8 ± 4.5 weeks, required a median (range) of 9.2 (3.0-20.9), 2.4 (0.5-6.0) and 1.8 (0.5-5.4) hours per patient from nurses, dietitians and doctors respectively. Conclusions IPT patient care represents a substantial investment in HCP time, particularly for nurses. Funding models for IPT care need urgent review to ensure this now mainstream therapy integrates well into healthcare resources. [ABSTRACT FROM AUTHOR]

Background: The information needs of patients with chronic obstructive pulmonary disease (COPD) towards the end of life are poorly understood. Aim: This study explored the views of patients with COPD and healthcare professionals, focusing upon information needs and treatment preferences. Method: In-depth, semi-structured interviews were held with patients with COPD following admission to hospital with respiratory failure, and focus groups held with healthcare professionals from hospital and community settings. Results: Ten patients were interviewed, who had a median 4 previous hospital admissions, and had smoked for median 47 years. Five focus groups were held with 31 healthcare professionals (18 nurses, 7 doctors, 6 allied health). The theme underpinning all discussions was of tension between maintaining hope and negotiating the reality of the illness and its consequences. Within this theme, patients tended to be optimistic, viewed acute exacerbations as separate from their underlying chronic illness, and were keen for intensive treatments, including intubation if acutely unwell. They had little understanding of the complexities of decision-making around treatment escalation. Both patients and health workers believed that information around end of life should be offered routinely, but delivered in a manner that recognises and maintains a form of hope. Conclusion: Patients and healthcare professionals believe information around illness course, future goals and treatment is important to care. An expanded view of hope may assist when providing such information, including when discussing goals of care in the setting of advanced illness. [ABSTRACT FROM AUTHOR]