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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]

The article presents the position of the Society of Hospital Pharmacists of Australia (SHPA) regarding direct to consumer advertising of prescription medicines in Australia. SHPA claims that this advertising practice puts pressure on doctor-patient relationship. As responsible health professionals SHPA believes that pharmacists must proactively participate with doctors and consumers on decisions regarding medications based on the best and most complete information.

New mothers and their infants are high frequency users of primary health care services in Australia providing opportunities for GPs to engage with women about common postnatal morbidities. This study aimed to explore women's views of GP care in the first year following birth. We used semistructured interviews with a subsample of women who had participated in a population-based survey of women who gave birth in two Australian states (Victoria and South Australia) in 2007. Twenty-nine women were interviewed. Prominent themes that emerged were around issues of disclosure, including women's views on ways practitioner interactions and systems of care facilitate or hinder disclosure and subsequent discussion of health problems. Women reflected on the role GPs played in their health and wellbeing after childbirth, the importance of enquiry, communication style and the way access to, and time in, consultations impact on disclosure, perceived support and discussions. To improve care for women after childbirth we need to know the contexts that facilitate disclosure. Findings from this qualitative study deliver an important message to clinicians: women value primary care, identify issues that facilitate and hinder disclosure and describe 'good' encounters as ones where they feel understood, supported and reassured. [ABSTRACT FROM AUTHOR]

Context: Primary care physicians are well placed to identify patients in need of advance care planning (ACP) and initiate ACP in advance of an acute situation.Objectives: This study aimed to understand Australian general practitioner (GP) clinical decision making relating to a patient's "need for ACP" and the likelihood of initiating ACP.Methods: An experimental vignette study pseudorandomly manipulated factors thought to influence decision making regarding ACP. Patient-level factors included gender, age, type of disease, medical severity, openness to ACP, doctor-patient relationship, and family support. An accompanying demographic survey assessed health professional-level factors, including gender, years of experience, place of training, place of practice, caseload of patients with ACP, direct personal experience in ACP, and self-reported attitudes toward ACP. Seventy GPs were recruited, and each completed six unique vignettes, providing ratings of patient need for ACP, importance of initiating ACP in the coming months, and likelihood of initiating ACP at the next consultation.Results: Older patients, with malignant or cardiovascular disease, severe clinical presentations, good doctor-patient relationship, female gender, and poor family support were more likely to receive prompt ACP. Positive GP attitudes toward ACP were associated with greater likelihood of initiating ACP promptly.Conclusion: Patients with presentations suggesting higher mortality risk were identified as being in need of ACP; however, the likelihood of initiating ACP was sensitive to GP attitudes and psychosocial aspects of the doctor-patient interaction. Training materials aimed at encouraging GP involvement in ACP should target attitudes toward ACP and communication skills, rather than focusing solely on prognostic risk. [ABSTRACT FROM AUTHOR]

The article discusses medical research being done as of September 2014. It references several studies, including one about treatment decision making among rheumatoid arthritis patients published in the 2014 issue of "Rheumatology," one about foreskin tightening among boys published in the 2014 issue of "Cochrane Database of Systematic Reviews" and another on prescribing anticipatory medications to people nearing the end of life published in the 2014 issue of "Palliative Medicine."

Discusses a conference on evidence-based medicine held at the Monash University Medical School in Melbourne, Australia. Details on the Cochrane Collaboration, an international network of clinicians and clinical epidemiologists devoted to bringing together the best available evidence on medical care and its delivery; The need to improve the effectiveness of the patient-physician interaction; Various speakers at the meeting.

Reports that Australian doctors view adolescents as problematic and time-consuming. Description of teenage patients by negative characteristics.

The author offers advise for fellow female general practitioners (GP) on how to deal with patients behaving inappropriately. She highlights some of the findings of a representative survey of 600 female GP which identified those who had experienced sexual harassment during their careers. She also shares her own experience of sexual harassment by patients. She expresses concerns about the absence of specific services for any harassment of physicians in Australia.

Objective. This study aimed to describe the prevalence of perceived workplace bullying in the Australian medical workforce, and investigate the relationship between workplace bullying and job satisfaction, health status, and current and planned medical workforce participation. Methods. An electronic cross-sectional survey of doctors currently in the paid workforce, conducted between April 2008 and October 2009, was nested within a longitudinal cohort study investigating factors affecting the recruitment and retention of the Australian medical workforce. To address the specific aims of this study, a subset of questions in the survey investigated the prevalence of self-reported bullying; physical and mental health; workforce participation patterns; job satisfaction; and job stressors. Results. Seven hundred and forty-seven participants responded to the bullying question and were included in this analysis. Twenty-five percent of participants reported being bullied in the last 12 months. There were no differences in the reported rates of bullying across age groups, sex and country of medical qualification. Bullied doctors were least satisfied with their jobs (P <; 0.001), had taken more sick leave in the last 12 months (P <; 0.001), and were more likely to be planning to decrease the number of hours worked in medicine in the next 12 months (P = 0.01) or ceasing direct patient care in the next 5 years (independent of their age or the number of hours currently worked in patient care) (P = 0.006). Conclusions. Our findings suggest that Australian doctors, independent of age or sex, have experienced workplace bullying, and although no conclusions can be made about causal pathways, there were strong associations between this exposure and poorer health and wellbeing, and on remaining in the medical workforce. What is known about the topic? Bullying and harassment have a significant impact on mental health, job satisfaction, and intention to leave the workforce. Workplace bullying in healthcare organisations affects the individuals involved, the organisations and the patients. The prevalence of workplace bullying throughout the medical workforce in Australia or elsewhere has not been investigated, with previous studies focussing on subsets of doctors, particularly junior doctors. What does this paper add? This paper found that 25% of doctors participating in this study reported experiencing persistent behaviours in the last 12 months that had undermined their professional confidence or self-esteem. There were no differences in the prevalence of bullying observed between sexes, age groups, country of medical qualifications, or employment sector. Victims of bullying had poorer mental health, had taken more sick leave in the last 12 months, were less satisfied with their current jobs and with being doctors, were more affected by job stressors and were more likely to be considering ceasing direct patient care than non-bullied doctors. What are the implications for practitioners? Practitioners need to be alert for potential bullying and harassment within healthcare organisations and be prepared to act decisively to minimise its impact on staff health, satisfaction and retention, and patient quality of care. [ABSTRACT FROM AUTHOR]

Speculates on the health of physicians in light of a study that two thirds of junior doctors show signs of obsessive-compulsive behavior. Study conducted by Australian medical graduates; How the push by medical schools to produce doctors who are emotionally sensitive to their patients' needs may be detrimental to the doctors' well-being; How caring physicians were more likely to become burnt out and exhausted.

Mentions a change in the national guidelines in Australia for managing acute back and musculoskeletal pain. Advice to general practitioners to use neutral and non-threatening terms to avoid frightening patients or delaying their recovery; Comments of Professor Peter Brooks, executive dean of the Faculty of Health Sciences at the University of Queensland, about putting a positive spin on language; Idea that positive pain management will promote partnership between doctor and patient and reduce disability; Details of the review; Criticism of the report in the media.

Presents several brief articles related to medicine for March 27, 1999. Spain's approval of genetically modified food; Proposal in Australia that doctors be prohibited from seeing more than 80 patients per day; View of UNAIDS' Peter Piot that an AIDS vaccine is still ten years off.