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Organ donation after voluntary assisted dying (VAD) in Australia may potentially increase organ transplant rates. Despite significant international experience with donation after VAD, there has been little discussion of this in Australia. We review potential ethical and practical concerns relating to donation after VAD and advocate action to establish programmes in Australia that ensure safe, ethical and effective donation after VAD. [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: 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]

Abstract: Doctor–patient language discordance has been shown to lead to worse clinical outcomes. In this study of patients undergoing primary percutaneous coronary intervention for ST‐elevation myocardial infarction at an Australian health service, we demonstrated that limited English proficiency (LEP) is an independent predictor of prolonged symptom‐to‐door time, but does not lead to worse 30‐day mortality compared with English‐proficient patients. More effort needs to be placed in providing public health education in varied languages to encourage early presentation to hospital for patients with LEP. [ABSTRACT FROM AUTHOR]

The article presents author's views on generosity of patients in volunteering their time to help physicians in training develop their skills. Patients attend hospitals at early hours on weekends to be practice subjects. Highlights the patient-physician relationship that develops due to the longitudinal and considered management of complex chronic conditions is formidable; and patients want to assist junior doctors to become well rounded.

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: Australia's Indigenous people suffer from higher cancer mortality than non-Indigenous Australians, a discrepancy partly caused by differences in beliefs about treatment efficacy between Indigenous patients and their non-Indigenous healthcare providers. This paper critically reviews the literature associated with Indigenous beliefs about cancer treatment, both 'bush medicine' and biomedical, in order to provide recommendations to healthcare providers about accommodating Indigenous beliefs when treating cancer. Methods: A search was undertaken of peer-reviewed journal papers using electronic databases and citation snowballing. Papers were selected for inclusion based upon relevance to themes that addressed the research questions. Results: Literature suggests that Indigenous beliefs about treatment efficacy for cancer involve five themes: (i) concerns about the toxicity of treatment; (ii) disconnect with the physician; (iii) fears about absence from home during treatment; (iv) different beliefs about disease aetiology; (v) biomedical cancer treatments failing to address holistic health. Conclusions: Although some information is known about Indigenous Australian healing beliefs and practices associated with cancer treatment, few studies have addressed ways in which Indigenous and biomedical approaches to cancer treatment might be integrated. Some recent work has examined the role of belief in cancer treatment, specifically bush medicine, but more research is required. [ABSTRACT FROM AUTHOR]

Background: The growing demand for complementary and alternative medicine (CAM) is undeniable. We report a first study about the attitudes and behaviour of Australian rehabilitation physicians to CAM. Methods: A prospective cross-sectional survey was undertaken to document the prevalence of, knowledge about and referrals to CAM therapies and their perceived effectiveness, by a sample of Australian rehabilitation physicians. Results: Thirty-six out of 94 actively practising rehabilitation physicians from the Australasian Faculty of Rehabilitation Medicine, the Royal Australasian College of Physicians, replied to the survey, a response rate of 38%, and 85% reported familiarity with CAM, the most familiar therapies being acupuncture (80%), yoga (74%) and Tai-Chi (72%). CAM referral was reported in 84%, 38% personally used CAM, 94% of patients enquired about CAM therapies, 32% of respondents routinely enquired about CAM use. Age, sex and year of Fellowship were not associated with familiarity, personal use or frequency of patient enquiry about CAM. Those who reported to be very familiar with CAM were more likely to routinely enquire about CAM use ( P = 0.028) and be more confident in prescribing certain CAM therapies ( P < 0.05). Conclusion: Australian rehabilitation physicians report similar CAM referral rates to Canadian physiatrists and Australian general practitioners. The most commonly prescribed therapies were acupuncture, yoga and Tai-Chi. Almost all patients use CAM therapies, but only a minority of rehabilitation physicians enquires about CAM use on a regular basis. The latter may avoid potentially harmful drug interactions, as well as improve the quality of the physician–patient relationship. [ABSTRACT FROM AUTHOR]

The article focuses on patient–doctor dissatisfaction in the management of medically unexplained physical symptoms Topics discussed include role medical education and training in management of patients; offering quality of life to patients; and developing medical career of physicians, and medical practioners.

Type 2 diabetes mellitus and other chronic cardio-metabolic conditions are significant contributors to the large disparities in life expectancy between Indigenous and non-Indigenous Australians. Type 2 diabetes is more prevalent from a young age among Indigenous Australians and is often preceded by a cluster of risk factors, including central obesity, dyslipidaemia, albuminuria and socio-economic disadvantage. Management of type 2 diabetes in Australian Indigenous peoples can be challenging in the setting of limited resources and socio-economic disadvantage. Key strategies to address these challenges include working in partnership with patients, communities and primary healthcare services ( PHC, Aboriginal community controlled and government services) and working in a multidisciplinary team. Population prevention measures are required within and beyond the health system, commencing as early as possible in the life course. [ABSTRACT FROM AUTHOR]