Health Workforce Australia Report Gives The Nod To Physician Assistants

This report was completed in November 2011 and earlier this year was tabled to the Australian Health Ministers Advisory Council for consideration and it has now just been formally released. This comprehensive report conducted an extensive literature review of supporting documentation regarding Physician Assistants from overseas evidence and considered the impact of the two Australian Physician Assistant trials, which were conducted in Queensland and in South Australia. In addition the report also considered submissions from various key stakeholders such as personnel from the rule and remote health sector, Physician Assistant graduates and students from the Australian PA programs conducted by University of Queensland and other professional bodies representing nurses and doctors. The findings of this report are overwhelmingly supportive of the introduction of the Physician Assistant into the Australian health workforce. A number of concerns were raised by some respondents about introducing a new health professional, such as the competition of training placements for junior doctors and medical students, and potential competition with the existing nurse practitioner role. It is interesting to note that the report could not find any evidence that supported either of these two arguments. One thing the report alludes to is that the acceptance of the Physician Assistant role is based on the level of understanding. The greater the respondent understood the role of the Physician Assistant that more likely it was to be accepted. What does this report mean for Australian Physician Assistants? Firstly, it will stimulate a great deal of discussion, both positive and negative. The report clearly outlines positive impact that the physician assistant will have on the Australian health workforce and the overwhelming support of the rural and remote health sector. To date, most opposition to the Physician Assistant role has been based on a poor understanding of this model of healthcare, which this report confirms. The contents of the report provide a clear and detailed description of the role of Physician Assistant, which should lead to a greater understanding of the position. So, what is the next step? Well the next step is in fact already happening and as can be seen from the recent events in Tasmania, there is a desire in some states to commence the introduction of a Physician Assistant. Whilst the work being conducted in individual Australian states should continue, the Physician Assistant should also be considered at the national level.
Health Workforce Australia report gives the nod to physician assistants


Association Between Thiopurine Use And Nonmelanoma Skin Cancers In Patients With Inflammatory Bowel Disease: A Meta-analysis

E-mail: Received 13March2013; Accepted 5November2013 Advance online publication 14January2014 OBJECTIVES: Thiopurines are the mainstay of treatment for patients with inflammatory bowel disease (IBD). Thiopurine therapy increases the risk of nonmelanoma skin cancers (NMSCs) in organ transplant patients. The data on NMSC in patients with IBD on thiopurines is conflicting. METHODS: We searched electronic databases for full journal articles reporting on the risk of developing NMSC in patients with IBD on thiopurine and hand searched the reference lists of all retrieved articles. Pooled adjusted hazard ratios and 95% confidence intervals (CIs) were determined using a random-effects model. Publication bias was assessed using Funnel plots and Egger’s test. Heterogeneity was assessed using Cochran’s Q and the I2 statistic. RESULTS: Eight studies involving 60,351 patients provided data on the risk of developing NMSC in patients with IBD on thiopurines. The pooled adjusted hazards ratio of developing NMSC after exposure to thiopurines in patients with IBD was 2.28 (95% CI: 1.50 to 3.45). There was significant heterogeneity (I2=76%) between the studies but no evidence of publication bias. Meta regression analysis suggested that the population studied (hospital-based vs. population-based) and duration of follow-up contributed significantly to heterogeneity. Grouping studies based on population studied and duration showed higher hazard rations in hospital-based and shorter duration studies. CONCLUSIONS: The risk of developing NMSC in patients with IBD on thiopurines is only modestly elevated. The difference in pooled risk between population-based and hospital-based studies suggests the possibility that ascertainment bias could have contributed to this increased risk.

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Australian Gps Told To Shake Up Colorectal Cancer Referral System

David Goldsbury (Cancer Council New South Wales, Sydney, Australia) and colleagues found that patients who consulted their GP between colonoscopy and surgery waited a median of 12 additional days for surgery over those who did not. They suggest that improved guidance could promote important GP engagement in early diagnosis without leading to delays in treatment. “A more systematic approach might be needed for GP involvement in the treatment pathway, perhaps including official guidelines from primary care/GP organisations,” the authors write in BMJ Open. In a sample of 407 colorectal cancer patients in New South Wales who underwent colonoscopy and surgery between 2004 and 2007, 43% had at least one GP consultation between diagnosis and surgery. Having a GP consultation between diagnosis and treatment was more common in patients who had self-reported poor health such as those with diabetes, chronic obstructive pulmonary disease, and previous smokers, and these patients were also more likely to consult the GP after their surgery. This indicates that GP consultations were primarily for patients in high-risk groups, say the authors. However, the association between delay to surgery and GP consultation remained after adjustment for cancer site, comorbidities, disadvantage, and health status. The authors say that it is not possible to determine cause from effect in their study. It could be that an increased time between diagnosis and surgery allowed for more GP consultations, they suggest. Alternatively, GP consultations could reflect the GP’s engagement and time to consider the optimal referral pathway. However, the finding that rectal cancer patients (n=142) who consulted their GP before surgery were no more likely to undergo treatment at a center with radiotherapy access than those who did not (21 vs 25%), indicated that continuity of care may not be a consequence of greater GP involvement.

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Crohn’s Disease – Professor Thomas Borody Of Australia Comes To New York To Discuss Significant New Findings

Borody’s treatment. There are no references listed for this article. Article adapted by Medical News Today from original press release. Visit our Crohn’s / IBD category page for the latest news on this subject. Please use one of the following formats to cite this article in your essay, paper or report: MLA Moore, Eric. “Crohn’s Disease – Professor Thomas Borody Of Australia Comes To New York To Discuss Significant New Findings.” Medical News Today. MediLexicon, Intl., 2 Mar. 2006. Web. 11 Mar. 2014. APA Moore, E. (2006, March 2). “Crohn’s Disease – Professor Thomas Borody Of Australia Comes To New York To Discuss Significant New Findings.” Medical News Today. Retrieved from Please note: If no author information is provided, the source is cited instead. Rate this article (click to rate) Crohn’s Disease – Professor Thomas Borody Of Australia Comes To New York To Discuss Significant New Findings Public / Patient: add your opinion Reader OpinionsMost recent opinions are shown first John EllermanPosted by Merly on 26 Apr 2012 at 11:54 pmHi Guys If you haven’t been able to access John Ellerman’s product, I have access to this amazing product.

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Simpler Diagnosis Of Coeliac Disease: Australian Scientists Devise New Test

Optiscan Imaging’s endomicroscope being used in clinical gastroenterology study

Optiscan is focused on microscopic imaging technologies for medical markets.

Photograph: Walter and Eliza Hall Institute website Australian scientists have made progress towards a blood test that could dramatically simplify the diagnosis of coeliac disease. The test will do away with the need for people to eat gluten for weeks before a diagnosis can be made, says lead researcher Dr Jason Tye-Din, head of coeliac research at the Walter and Eliza Hall Institute in Melbourne. Results will take 24 hours and people will not need to have tissue samples taken from their intestines. A pilot study on 48 people shows the test is accurate after only three days of gluten consumption, says Tye-Din. Many people follow gluten-free diets without a formal diagnosis and the current testing method requires them to eat gluten again, which is often unpleasant and difficult, says Tye-Din, a gastroenterologist at Royal Melbourne hospital. It will, however, be several years before the new test is available for general use, he says. Coeliac disease is caused by an abnormal immune reaction to gluten in the diet, leading to damage to the small intestine. It can cause digestive symptoms such as nausea, vomiting, bloating, and diarrhoea, as well as lethargy, anaemia, headaches and weight loss. Long-term complications include malnutrition, osteoporosis, pregnancy issues and liver failure. Up to one in 60 women and one in 80 men in Australia have the condition, but most are undiagnosed. Tye-Din, whose study is published in the journal Clinical & Experimental Immunology, believes a simple test will greatly improve diagnosis and treatment. The study is supported by by Coeliac Australia, the Australian National Health and Medical Research Council and the Victorian government. Sign up for the Guardian Today Our editors’ picks for the day’s top news and commentary delivered to your inbox each morning.

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Optiscan Imaging (ASX: OIL) has noted commencement of a clinical study that is introducing Optiscan’s second generation endomicroscopy platform into the field of gastroenterology. The study is being undertaken by gastroenterologists and scientists from the Garvan Institute of Medical research and St Vincent’s Hospital in Sydney, in affiliation with the University of New South Wales. The gastroenterology market is now well established as a result of extensive use of Optiscan’s previous generation platform via a product marketed by Pentax Medical Corporation. The study has enabled the incorporation of the latest advances in Optiscan’s technology into a high definition Olympus endoscope. The resultant system combines advanced features of the Olympus endoscope with Optiscan’s latest developments in microscopic imaging during endoscopy. The result is an endoscope with a level of performance never before trialled in humans, incorporating desirable features discovered using the first generation product during thousands of endoscopy procedures, and other advances in endoscopic imaging. This study will apply these novel features in dynamic events relating to the permeability, or “leakiness” of the gut lining and how it is altered by inflammatory diseases. For Optiscan, the commencement of patient recruitment in this study is a key milestone in its strategy to advance the second generation platform into commercially viable markets. The same platform is currently the subject of product development for neurosurgery under a commercial partnership with Carl Zeiss of Germany, as well as a supply agreement recently secured with UK based MR Solutions for global supply into the pre-clinical imaging market. Optiscan is capitalised at around $10 million. Proactive Investors Australia is the market leader in producing news, articles and research reports on ASX Small and Mid-cap stocks with distribution in Australia, UK, North America and Hong Kong / China. Sign up to Proactive Investors Andrew McCrea’s Research Reports Sign up to Andrew McCrea’s Research Reports and Receive Latest Research & Flash Trades Submit Receive Proactive Investors Newsletter, Investor Forum Invites Receive Proactive Investors Newsletter, Event Invites, Special Stock Notifications Submit

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The Canadian Contribution To The Us Physician Workforce

Poll shows most Albertans favour renewable energy over coal

We limited the assessment of net annual migration patterns to physicians who graduated medical school before or during 2000 to avoid counting graduates who were still in residency training in 2006. We performed all other assessments using data on physicians who graduated before or during 2006. We performed simple frequency analysis by birth country, Canadian medical school of graduation, rural versus nonrural address and whole-or partial-county Health Professional Shortage Area status. We performed 2 analysis to test for significant differences between US-and Canadian-educated physician practice locations. The number of graduates of Canadian medical schools who practised in direct patient care in the United States by graduation year was obtained from both the 2004 and 2006 AMA Physician Masterfiles and was compared with Canadian physician migration data. To quantify longitudinal effects, patterns were averaged between 1960 and 2000 to account for possible attrition due to retirement (lower bound) and for graduates who might still be in residency training (upper bound). Despite delays in data reporting and other inaccuracies such as confusion about work versus practice address, the AMA Physician Masterfile is the most complete and authoritative source of information on physicians in the United States, particularly at a national level of analysis. 16 , 17 Previous studies that have compared AMA Physician Masterfile data with physician census surveys have found that AMA Physician Masterfile data were reliable and adequate for work-force projections and policy studies when aggregated to the state level. 17 We have previously shown that the AMA Physician Masterfile is valid for rural and whole-county Health Professional Shortage Areas where the accuracy of the data is nearly 90% for county-of-practice classification. 18 Canadian physician databases suffer from many of the same lags and accuracy problems as the AMA Physician Masterfile for similar reasons, particularly the administrative sources. US and Canadian databases were not directly linked but contemporary databases were used for temporal comparisons and to fill in gaps in each about the physicians who train in Canada and migrate to or from the United States. Download as PowerPoint Slide Fig.

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Photograph by: John Lucas John Lucas , John Lucas/Edmonton Journal EDMONTON – A new poll shows 80 per cent of Albertans surveyed would like renewable energy used to generate electricity instead of coal. Commissioned by the Canadian Association of Physicians for the Environment, the poll also found that two-thirds of Albertans are willing to pay higher prices for electricity generated by wind and solar power, and that a majority are convinced there are negative health effects related to burning coal. aWhen we saw the numbers, we were knocked out,a Gideon Forman, executive director of the Toronto-based physiciansa group, said Wednesday. aWe were just struck by how widespread the support was. aPeople are in agreement and in very large numbers.a Conducted in February by the market research firm Oraclepoll, the sampling of 750 people revealed 76 per cent of Albertans believe government should encourage businesses to use renewable energy, and that 74 per cent believe coal should be phased out if alternatives exist to meet the provinceas energy needs. Seventy-six per cent believe pollution produced by burning coal can harm the health of seniors, and 70 per cent believe those emissions also pose a risk to children. aAlbertans are suddenly becoming more aware of the effects of coal, and if we value their health then we need to start exploring reasonable alternatives,a said Dr. Joe Vipond, a member of the association who serves as an emergency room physician in Calgary. aItas not rocket science.a Donna Kennedy-Glans, Albertaas associate minister of electricity and renewable energy, agreed the government needs to reduce its reliance on coal, but said the transformation has to be carried out in a prudent manner. The physiciansa association wants coal-generated electricity phased out over 10 years, but the province deems it unrealistic. aI find the possibility for mixed generation very promising,a Kennedy-Glans said. aThe question is timing. If we were to just stop, we would be fiscally in a very difficult position.a Early last year, the physiciansa group published research that said pollution from the coal-fired plants contributes to more than 100 deaths and $300 million in medical costs in Alberta each year. Kennedy-Glans said a collaborative initiative whose members include representatives of industry, government and other interested parties has not established a connection between emissions from coal-fired electricity and such health effects. aI find that part of the (physiciansa) work very frustrating,a the associate minister said.

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Aging doctors to be put under the microscope in Nova Scotia

A Canadian Institute for Health study found that family doctors in particular are more likely to reduce their working hours than fully retire. (File)

(File) Ageism in health care needs to end, doctor says The Nova Scotia College of Physicians and Surgeons is moving ahead with plans to assess the competency of aging doctors. Recently, a 75-year-old doctor in northern Cape Breton voluntarily gave up her licence after she started to lose her hearing. In response, Dr. Gus Grant, registrar and CEO of the college, said there may be cases where a doctor can’t handle the full range of services due to an age-related limitation. Audio | Monitoring doctors in Nova Scotia If you look at the large group of physicians who are over the age of 70 if 70 is the number and I think 70 seems to be where there’s a line in the sand drawn by other provincesif you look at that larger group of physicians it would be worthwhile for the college to help those physicians identify their learning needs, help them tailor their practice to their skills, and to ensure confidence, to ensure public safety, he said. Grant said there are hundreds of doctors in Nova Scotia still working in their senior years andadvancing age should not, by itself, force a doctor to retire. He said theCollege of Physicians and Surgeons takes all complaints seriously, no matter what age the doctor is. Preventing problems When Nova Scotia adopts a monitoring program, it will join provinces such as Manitoba where doctors aged 75 years and older are tested every five years. Dr. Terry Babick, deputy registrar of the Manitoba College of Physicians and Surgeons, said most senior doctors offer adequate care, but occasionally problems arise. If in fact there is actually a threat to the public then the entire issue takes on a much more serious note, because these are generally educational in nature but if we perceive that there is a threat to public safety then we inform the registrar immediately, he said. In Manitoba, doctors are assessed through a random review of their charts. Babick said when minor problems are discovered the doctor isasked to take additional training.

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Inflammatory Bowel Disease Is As Canadian As The Mounties

Hospital sterilization: How problems slip through

Bernstein, M.D., of the University of Manitoba here, and colleagues. The researchers found that ulcerative colitis, the inflammatory bowel disease that affects only the large intestine, strikes an average of 194 of every 100,000 Canadians, with 11.8 new cases per 100,000 each year. Crohn’s disease, which affects the large and small intestines, is even more common in Canada and affects about 234 per 100,000 people, with an incidence of 13.4 per 100,000 each year. By comparison, ulcerative colitis prevalence is 58 to 157 per 100,000 in Northern Europe and about 167 per 100,000 for an area of Minnesota. Crohn’s disease prevalence ranges from 27 to 48 per 100,000 in Northern Europe to 144 per 100,000 in an area of Minnesota. Some Third World nations and areas in tropical latitudes have still lower rates. Although the reasons for these differences remain unclear, the hygiene hypothesis may help explain the distribution in Canada, said Richard Fedorak, M.D., of the University of Alberta in Edmonton, a co-author. “If you live in an environment that’s too clean or too sterile as a child your intestines are not exposed to bacteria of the same types and numbers you would be exposed to in a tropical area,” he said. which is especially true for Canada because much of the country has cold winters with little bacterial activity in the soil. Then if the genetic triggers are present, “your intestine is not able to tolerate bacteria as you get older and starts to destroy itself,” he added. Supporting this speculation, the researchers discovered differences among provinces: Nova Scotia in the Maritimes consistently had the highest rates of ulcerative colitis (19.2 incidence and 247.9 prevalence per 100,000) and Crohn’s disease (20.2 incidence and 318.5 per 100,000), Following closely is Alberta, with ulcerative colitis incidence of 11.0 and prevalence of 185.0 per 100,000 and Crohn’s disease incidence of 16.5 and prevalence of 283.0 per 100,000, and Manitoba had likewise high rates of ulcerative colitis (15.4 incidence and 248.6 prevalence per 100,000) and Crohn’s disease (15.4 incidence and 271.4 prevalence per 100,000); Whereas British Columbia, on the west coast, consistently had much lower rates of both ulcerative colitis (9.9 incidence and 162.1 prevalence per 100,000) and Crohn’s disease (8.8 incidence and 160.7 prevalence per 100,000). British Columbia proved to be an outlier, particularly for Crohn’s disease perhaps because of its milder winters, more precipitation, and “because its population ethnic make-up is somewhat different from the rest of Canada,” the researchers wrote. Much of British Columbia’s immigration in the past 20 years has been from Asia, they said. “Asians are known to have less [inflammatory bowel disease] than Caucasians,” perhaps because of genetics, less sterile conditions during childhood, or other environmental factors. Males and females generally had similar rates of ulcerative colitis though significantly more females had Crohn’s disease (1.31 ratio, 95% CI 1.23-1.40). Notably, though, the prevalence of Crohn’s disease was significantly greater in boys than girls (prevalence 49.6 versus 43.8 per 100,000, P=0.0001).

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Atlanta-Based EndoChoice Approved To Market Full-Spectrum Endoscopy System In Canada

The hospital says in this case, it wasn’t following the manufacturer’s specific guidelines for this specialized endoscope. “Endoscopes are particularly complex and difficult to clean because they’ve got very long, very narrow channels,” said infection prevention and control expert Dr. Mary Vearncombe. “It’s very difficult to make sure that those channels are flushed and disinfected properly in between uses, just because their diameter is so very narrow.” Dr. Armstong said the late discovery highlights a need to regularly review whether the team in charge of cleaning endoscopesis doing it properly. Common procedure He says the issue is analogous to the deadly E. coli contamination of the water supply in Walkerton, Ont. in 2000. In that case,procedures were in place to ensure safe drinking water, but checks weren’t done to ensure the processes were followed. “One knows what needs to be done to produce a safe water supply, but if the appropriate checks are put into place but they are not monitored and verified, then it’s possible to assume that everything’sOK and the processes are being followed without actually documenting that its actually done on a daily basis or a weekly basis,” said Armstrong,a McMaster University associate professor and consultant gastroenterologist at Hamilton Health Sciences. Every year, about 1.6 million endoscopic procedures are performed in Canada, a figure representing about five per cent of the population. Despite how common the procedure has become, hospitalstend totrack incidents of improper endoscope cleaning that result in patient harm on an ad-hoc basis, says Armstrong. Thatmeans the public only learns of problems when the media covers large-scale events disclosed by the hospital.

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The Fuse endoscopy system is comprised of colonoscopes and gastroscopes with multiple imagers enabling doctors to see more of the GI tract for diagnosis and treatment. Standard, forward-viewing endoscopy systems have a single imager so clinicians are switching to the Fuse system in an effort to improve the quality of their procedures. The Health Canada license means its Fuse system will be the first endoscopy equipment available with expanded viewing capabilities to reach Canadian patients, the company said. Endoscopes are thin flexible tubes with imaging capabilities that doctors use to view the upper and lower GI tracts of their patients. The news from Health Canada enables EndoChoice to begin delivering Fuse endoscopy systems to their gastroenterology specialist customers throughout Canada . “We intend to gain market clearance in several more countries in the near future,” said Mark Gilreath, Founder and CEO at EndoChoice. “While 2013 has been an exciting year for our company, the introduction of Fuse into Canada and other markets will enable us to make 2014 even more dynamic as we bring this game-changing technology to more clinicians.” EndoChoice is a medtech company focused on the manufacturing and commercialization of platform technologies including devices, diagnostics, infection control and endoscopic imaging for specialists treating a wide range of gastrointestinal diseases. EndoChoice leverages its direct sales organization to serve more than 2,000 customers in the United States and works with 34 distribution partners world-wide. The Company was founded in 2008 and has rapidly developed a proprietary product portfolio.

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How Can We Get Doctors To Work And Live In Remote Australia?

While numbers in the rural medical workforce are improving, many still claim those in regional Australia are missing out. It’s an issue the Rural Doctors Association will raise again when it asks for more money for country health from the Federal Budget. Dr Jean Covey, a General Practitioner in the north Queensland town of Charters Towers, says the shortage of doctors is very apparent there. “We are fully booked every week,” she says. “The (waiting) time to see any of our doctors is usually three weeks, and for myself personally it’s six weeks.” Dr Covey is desperate for a change of policy that would introduce better incentives for people to work in small towns like Charters Towers, rather than major regional centres. “We have, like many rural towns, have relied on overseas trained doctors” she says. “In 2009 the Federal Government changed the regional remoteness rating scheme, which has made it difficult in many of the small towns.” The current statistics point to an upswing in the numbers of doctors in regional Australia. In a report last month, the Australian Institute of Health and Welfare found that remote and very remote parts of Australia actually now have more GPs per capita than anywhere else in the country, thanks to a 16 percent rise in the number of medical practitioners working in the bush. But organisations like the Rural Health Workforce Australia say despite the increase people in regional Australia still face significant disadvantages when it comes to health care. With a quarter of the nation’s doctors due to retire in the next few years, the focus is now on the next batch of graduates. Townsville’s James Cook University runs a medical school, with a focus on rural Australia. The Dean of the JCU Medical School and the president of the Australian College of Rural and Remote Medicine, Professor Richard Murray, says getting doctors to work in the bush is a complex question. Particularly, he believes there needs to be a rethink on the types of students encouraged to study medicine. “We as educators sometimes overestimate our ability to change people.” “I think fundamentally the people who you recruit, are the people you graduate” he says. Of course, there’ll always be city kids becoming doctors, but there are people studying medicine that don’t fit the stereotype.

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