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Medicare is covering less of specialist visits. But why are doctors’ fees so high in the first place?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/susan-j-mendez-2219444">Susan J. Méndez</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Fees for medical specialists are going up faster than <a href="https://www.abc.net.au/news/2024-09-25/medicare-rebates-only-covering-half-of-specialist-costs/104389360">Medicare rebates</a>, leading to a bigger gap for patients to pay.</p> <p>Recent data from the <a href="https://www.aihw.gov.au/reports/medicare/mbs-funded-services-data/contents/summary">Australian Institute of Health and Welfare</a> shows that in the first quarter of this year, Medicare rebates covered just over half (52%) of the total fees. This is <a href="https://www.abc.net.au/news/2024-09-25/medicare-rebates-only-covering-half-of-specialist-costs/104389360">down from 72%</a> two decades ago, and the lowest proportion on record.</p> <p>Doctors can charge what they like, while the government determines the Medicare rebate. The difference between the two, or the gap, is what impacts patients. For GPs, the government provides an incentive for doctors to <a href="https://www.health.gov.au/our-work/increases-to-bulk-billing-incentive-payments#1-november-2023-changes">bulk bill</a>, but there’s no such incentive for other specialists.</p> <p>Doctors blame large gap payments on rebates being too low, and they’re partly right. After adjusting for inflation and increasing demand, the average dollar amount one person receives in Medicare rebates annually dropped from <a href="https://www.aihw.gov.au/reports/medical-specialists/referred-medical-specialist-attendances">A$349 to $341</a> over the past decade.</p> <p>But this is only a part of the problem. When many people can’t afford hundreds (if not thousands) of dollars for essential specialist care, we need to look at why fees are so high.</p> <h2>How do specialists set their fees?</h2> <p>Although general practice is technically a speciality, when we talk about medical specialists in this article, we’re talking about non-GP specialists. These might include paediatricians, oncologists, psychiatrists and dermatologists, among many others.</p> <p>In determining fees, specialists consider a combination of patient-level, doctor-level and system-level factors.</p> <p>Patient characteristics, such as the complexity of the patient’s medical condition, may increase the price. This is because more complex patients may require more time and resources.</p> <p>Specialists, based on their experience, perceived skill level, or ethical considerations, may charge more or less. For example, <a href="https://www.sciencedirect.com/science/article/pii/S0277953623007104?via%3Dihub">some specialists report</a> they offer discounts to certain groups, such as children or pensioners.</p> <p>System-level factors including the cost of running a practice (such as employing staff) and practice location also play a role.</p> <p>Problems arise when prices vary considerably, as this often signals limited competition or excessive market power. This holds true for medical services, where patients have little control over prices and rely heavily on their doctors’ recommendations.</p> <p>In <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4909881">recent research</a>, my colleagues and I found fees varied significantly between specialists in the same field. In some cases the most expensive specialist charged more than double what the cheapest one did.</p> <h2>Doctor characteristics influence fee-setting</h2> <p>My colleagues and I <a href="https://doi.org/10.1016/j.healthpol.2024.105119">recently analysed</a> millions of private hospital claims from 2012 to 2019 in Australia. We found the wide variation in fees was largely due to differences between individual doctors, rather than factors such as patient complexity or the differences we’d expect to see between specialties.</p> <p>Up to 65% of the variance in total fees and 72% in out-of-pocket payments could be attributed to differences between doctors in the same field.</p> <p>To understand what doctor-level factors drive high fees, <a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4909881">we looked at</a> data from a representative survey of specialists. We found older specialists have lower fees and higher rates of bulk billing. Practice owners tended to charge higher fees.</p> <p>We also found doctors’ personalities affect how much they charge and how often they bulk bill patients. Doctors who scored more highly on the personality trait of agreeableness were more likely to bulk bill patients, while those who scored more highly on neuroticism tended to charge higher fees.</p> <p>What we couldn’t show is any evidence fees were associated with competition.</p> <h2>Effects on patients</h2> <p>This is not a competitive market. On the contrary, it has high entry restrictions (long training requirements) and a limited supply of specialists, particularly in <a href="https://www.aihw.gov.au/reports/workforce/health-workforce">rural and remote areas</a>. Meanwhile, patients’ access is controlled by the need for referrals which expire, generally after a year.</p> <p>Patients are often unable to shop around or make informed decisions about their care due to a lack of information about the true cost and quality of services.</p> <p>For private hospital services, the fee structure is complicated by the fact that several providers (for example, surgeon, anaesthetist, assistant surgeon) bill separately, making it difficult for patients to know the total cost upfront.</p> <p>Despite efforts to introduce price transparency in recent years, such as through the government’s <a href="https://medicalcostsfinder.health.gov.au/">Medical Costs Finder</a> website, the system remains far from clear. Reporting is voluntary and the <a href="https://doi.org/10.1016/j.healthpol.2020.06.001">evidence is mixed</a> on whether these tools effectively reduce prices or increase competition.</p> <p>All of this contributes to high and unpredictable out-of-pocket costs, which can lead to financial strain for patients. About <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release#barriers-to-health-service-use">10.5% of Australians</a> reported cost was a reason for delaying or avoiding a specialist visit in 2022–23.</p> <p>This raises important questions about equity and the sustainability of Australia’s universal health-care system, which is built on the principle of equitable access to care for all citizens.</p> <h2>What can be done?</h2> <p>Patients can take steps to minimise their costs by proactively seeking information. This includes asking your GP for a range of options when you’re referred to a specialist. Note the referral from your GP can be used for any other doctor in the same specialty.</p> <p>Similarly, ask the specialist’s receptionist what the fee and rebate will be before making an appointment, or for a <a href="https://www.ama.com.au/articles/informed-financial-consent#Two">detailed quote</a> before going to hospital. Shop around if it’s too high.</p> <p>But responsibility doesn’t only lie with patients. For example, the government could seek to address this issue by increasing investment in public hospital outpatient care, which could boost competition for specialists. It could also publish the range of fees compared to the rebate for all Medicare-billed consultations, rather than relying on voluntary reporting by doctors.</p> <p>Price transparency alone is not enough. Patients also need quality information and better guidance to navigate the health-care system. So continued investment in improving health literacy and care coordination is important.</p> <p>If things don’t change, the financial burden on patients is likely to continue growing, undermining both individual health outcomes and the broader goals of equitable health-care access.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239827/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/susan-j-mendez-2219444">Susan J. Méndez</a>, Senior Research Fellow, Melbourne Institute of Applied Economic and Social Research, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/medicare-is-covering-less-of-specialist-visits-but-why-are-doctors-fees-so-high-in-the-first-place-239827">original article</a>.</em></p> </div>

Money & Banking

How cutting edge AI technology is helping doctors reduce waitlists

<div> <p>Artificial intelligence is now being used by Australian specialist doctors to reduce patient wait times and experts say it could be a game changer for the health sector, where some patients are waiting months or even years for an appointment.</p> </div> <div> <p>Leading Australian tech company <a title="https://www.medowhealth.ai/" href="https://www.medowhealth.ai/" data-outlook-id="ad0ccae0-1f97-484e-ba83-d8d566a7608a">Medow Health</a> has developed an AI “co-pilot” technology which automates medical reports for specialist doctors while operating in the background during patient consultations, saving clinicians hours which allows them to see more patients each day. </p> </div> <div> <p>“This technology transforms the way medical reports are formulated and processed, helping specialists reduce their paperwork and freeing up valuable time and resources which can be better spent on patient care,” said Joel Freiberg who co-founded Medow Health with his brother after his own experience with a chronic illness coupled with watching their father who is a respiratory specialist dictate reports until 10pm from the dinner table, prompting them to come up with a more efficient way for clinicians to work.</p> </div> <div> <p>“The idea was to improve what really is an archaic reporting system, which saw specialists taking notes with their back to the patient during consultations or having to speak into a dictaphone to be transcribed later, instead of solely focusing on the patient in front of them,” Mr Freiberg said.</p> </div> <div> <p>The uptake from specialists utilising the new technology has been swift, with doctors reporting the technology is giving them back two to three hours a day, reducing burnout and allowing them to see multiple more patients in that time if they choose.</p> </div> <div> <p>“Instead of your doctor staring into the computer typing notes, they can really concentrate on your needs and wellbeing while the technology does the note taking in the background and creates an almost instant report that the doctor just has to review rather than formulate from scratch,” Mr Freiberg said.</p> </div> <div> <p>Data from the Australian Medical Association on “hidden waitlists” for a specialist outpatient appointment shows some people are languishing for years for an initial consultation - up to 800 days for an initial appointment for an Ear, Nose and Throat Surgeon, up to 898 days for an urgent appointment with a neurosurgeon, while waitlists for a gastroenterologist or ophthalmologist can be as long as five years and up to 36 months to see a paediatrician.</p> </div> <div> <p>Mr Freiberg said the new cutting edge technology could supercharge a reduction in waitlists and speed up the appointment process.</p> </div> <div> <p>“We’re not trying to replace doctors, we’re trying to help them. Manually producing medical reports is a time-consuming and complex process that requires extensive paperwork and hours of labour-intensive work,” he said.</p> </div> <div> <p>“By using cutting edge AI specific to each medical specialty to examine patient interactions, formulate reports, and provide valuable insights we can enable doctors to do what they do best - focus on patient care,” Mr Freiberg said.</p> </div> <div> <p>Chris O’Brien Life House Chief Executive and medical oncologist Professor Michael Boyer who is on the Medow Health Clinical Advisory Council agreed the technology will improve patient care and help reduce waiting lists.</p> </div> <div> <p>"Any piece of technology that allows doctors to focus on the patient, helps deliver better care,” Prof Boyer said.</p> </div> <div> <p>"This technology helps the health professional to really turn their attention to the patient and what matters, instead of worrying about what notes they need and what letters they need to write. It allows them to focus on what is important.</p> </div> <div> <p>"There's no doubt this technology saves time and while it might only allow a single doctor to see an extra one of two patients a day, if you multiply that across the health system then it makes a big difference,” Prof Boyer said.</p> </div> <div> <p>Engagement with Medow Health is taking off in Australia, with the company reporting growth of more than 50 percent month on month across 15 different specialties including Cardiology, Gastroenterology, ENT, Geriatric, Orthopaedic Surgery, Paediatric, Neurology, General Surgery and Breast Surgeons, with some of Australia’s leading specialist doctors among the investors and Medtech Entrepreneurs to invest in its recent Seed round.</p> </div> <div> <p><strong>About Medow Health AI</strong></p> </div> <div> <p><em>Medow Health AI is a pioneering Australian based healthcare technology company dedicated to revolutionising the medical industry through the power of artificial intelligence to streamline processes, improve patient care, and enhance overall efficiency in healthcare settings.</em></p> </div> <div> <p><em> The company was founded by Joel Freiberg and soon after his brother Josh and former CTO and colleague Andrew joined as co-founders using their combined 30 years experience in technology and software to help build the business into the leading Specialist AI platform it is today.</em></p> </div> <div> <p><em>Joel lives with Crohn’s disease and has experienced long waits to see a specialist. The pair recognised there was a need for change growing up as they watched their father, a respiratory physician spend endless hours doing admin after work. </em></p> </div> <div> <p><em>The company has just completed a $1M funding round in the first half of 2024, grown the team to 10 full time employees and signed a partnership with Magentus the owner of leading specialist electronic medical record systems Genie & Gentu (who Medow Health integrates with).</em></p> <p><em>Image credits: Shutterstock</em></p> </div>

Caring

How old’s too old to be a doctor? Why GPs and surgeons over 70 may need a health check to practise

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>A growing number of complaints against older doctors has prompted the Medical Board of Australia to <a href="https://www.medicalboard.gov.au/News/2024-08-07-Medical-Board-consults-on-new-approach-to-keep-late-career-doctors-in-safe-practice.aspx">announce</a> today that it’s reviewing how doctors aged 70 or older are regulated. Two new options are on the table.</p> <p>The first would require doctors over 70 to undergo a detailed health assessment to determine their current and future “fitness to practise” in their particular area of medicine.</p> <p>The second would require only general health checks for doctors over 70.</p> <p>A third option acknowledges existing rules requiring doctors to maintain their health and competence. As part of their <a href="https://www.medicalboard.gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx">professional code of conduct</a>, doctors must seek independent medical and psychological care to prevent harming themselves and their patients. So, this third option would maintain the status quo.</p> <h2>Haven’t we moved on from set retirement ages?</h2> <p>It might be surprising that stricter oversight of older doctors’ performance is proposed now. Critics of mandatory retirement ages in other fields – for judges, for instance – have long questioned whether these rules are “<a href="https://law.unimelb.edu.au/__data/assets/pdf_file/0019/2061019/02-Blackham.pdf">still valid in a modern society</a>”.</p> <p>However, unlike judges, doctors are already <a href="https://www.medicalboard.gov.au/Registration/Registration-Renewal.aspx">required to renew their registration</a> annually to practise. This allows the Medical Board of Australia not only to access sound data about the prevalence and activity of older practitioners, but to assess their eligibility regularly and to conduct <a href="https://www.ahpra.gov.au/Notifications/Further-information/Guides-and-fact-sheets/Performance-assessments.aspx">performance assessments</a> if and when they are needed.</p> <h2>What has prompted these proposals?</h2> <p>This latest <a href="https://www.ahpra.gov.au/documents/default.aspx?record=WD24%2f33840&dbid=AP&chksum=vCEdxXaBs0%2bMeMZFxSb7SQ%3d%3d&_gl=1*3ol06k*_ga*MzU1NjAzMTc1LjE3MjMwMDA1Nzc.*_ga_F1G6LRCHZB*MTcyMzAwMDU3Ny4xLjEuMTcyMzAwMDU4My4wLjAuMA..">proposal</a> identifies several emerging concerns about older doctors. These are grounded in external research about the effect of age on doctors’ competence as well as the regulator’s internal data showing surges of complaints about older doctors in recent years.</p> <p>Studies of medical competence in ageing doctors show <a href="https://qualitysafety.bmj.com/content/29/2/113">variable results</a>. However, the Medical Board of Australia’s consultation document emphasises studies of neurocognitive loss. It explains how physical and cognitive impairment can lead to poor record-keeping, improper prescribing, as well as disruptive behaviour.</p> <p>The other issue is the number of patient complaints against older doctors. These “notifications” have surged in recent years, as have the number of disciplinary actions against older doctors.</p> <p>In 2022–2023, the Medical Board of Australia took disciplinary action against older doctors about 1.7 times more often than for doctors under 70.</p> <p>In 2023, notifications against doctors over 70 were 81% higher than for the under 70s. In that year, patients sent 485 notifications to the Medical Board of Australia about older doctors – up from 189 in 2015.</p> <p>While older doctors make up only about 5.3% of the doctor workforce in Australia (less than 1% over 80), this only makes the high numbers of complaints more starkly disproportionate.</p> <p>It’s for these reasons that the Medical Board of Australia has determined it should take further regulatory action to safeguard the health of patients.</p> <h2>So what distinguishes the two new proposed options?</h2> <p>The “fitness to practise” assessment option would entail a rigorous assessment of doctors over 70 based on their specialisation. It would be required every three years after the age of 70 and every year after 80.</p> <p>Surgeons, for example, would be assessed by an independent occupational physician for dexterity, sight and the ability to give clinical instructions.</p> <p>Importantly, the results of these assessments would usually be confidential between the assessor and the doctor. Only doctors who were found to pose a substantial risk to the public, which was not being managed, would be obliged to report their health condition to the Medical Board of Australia.</p> <p>The second option would be a more general health check not linked to the doctor’s specific role. It would occur at the same intervals as the “fitness to practise” assessment. However, its purpose would be merely to promote good health-care decision-making among health practitioners. There would be no general obligation on a doctor to report the results to the Medical Board of Australia.</p> <p>In practice, both of these proposals appear to allow doctors to manage their own general health confidentially.</p> <h2>The law tends to prioritise patient safety</h2> <p>All state versions of the legal regime regulating doctors, known as the National Accreditation and Registration Scheme, include a “paramountcy” provision. <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/act/consol_act/hprnl428/s3a.html">That provision</a> basically says patient safety is paramount and trumps all other considerations.</p> <figure class="align-center zoomable"><figcaption></figcaption></figure> <p>As with legal <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2010-104a#sec.3">regimes regulating childcare</a>, health practitioner regulation prioritises the health and safety of the person receiving the care over the rights of the licensed professional.</p> <p>Complicating this further, is the fact that a longstanding principle of health practitioner regulation has been that doctors should not be “<a href="https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3383892">punished</a>” for errors in practice.</p> <p>All of this means that reforms of this nature can be difficult to introduce and that the balance between patient safety and professional entitlements must be handled with care.</p> <h2>Could these proposals amount to age discrimination?</h2> <p>It is premature to analyse the legal implications of these proposals. So it’s difficult to say how these proposals interact with Commonwealth age- and other anti-discrimination laws.</p> <p>For instance, one complication is that the federal age discrimination statute includes an exemption to allow “qualifying bodies” such as the Medical Board of Australia to discriminate against older professionals <a href="https://www8.austlii.edu.au/cgi-bin/viewdoc/au/legis/cth/consol_act/ada2004174/s22.html?context=1;query=inherent;mask_path=au/legis/cth/consol_act/ada2004174">who are</a> “unable to carry out the inherent requirements of the profession, trade or occupation because of his or her age”.</p> <p>In broader terms, a licence to practise medicine is often compared to a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6797044/">licence to drive</a> or <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236877/">pilot an aircraft</a>. Despite <a href="https://www.smh.com.au/national/nsw/mandatory-test-older-drivers-facing-discrimination-says-pensioner-group-20170607-gwm45u.html">claims of discrimination</a>, New South Wales law requires older drivers to undergo a medical assessment <a href="https://www.nsw.gov.au/driving-boating-and-transport/driver-and-rider-licences/older-drivers-and-riders/assessments">every year</a>; and similar requirements affect older <a href="https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://www.casa.gov.au/guidelines-medical-assessment-aviation&ved=2ahUKEwil-9GXlOKHAxUdslYBHdN_EboQFnoECBkQAQ&usg=AOvVaw0SgpoCCKjNriMN20fs16rq">pilots and air traffic controllers</a>.</p> <h2>Where to from here?</h2> <p>When changes are proposed to health practitioner regulation, there is typically much media attention followed by a consultation and behind-the-scenes negotiation process. This issue is no different.</p> <p>How will doctors respond to the proposed changes? It’s too soon to say. If the proposals are implemented, it’s possible some older doctors might retire rather than undergo these mandatory health assessments. Some may argue that encouraging more older doctors to retire is precisely the point of these proposals. However, <a href="https://www1.racgp.org.au/newsgp/professional/ahpra-eyes-mandatory-health-checks-for-older-gps">others have suggested</a> this would only exacerbate shortages in the health-care workforce.</p> <p>The proposals are open for <a href="https://www.medicalboard.gov.au/News/Current-Consultations.aspx">public comment</a> until October 4.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236305/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/christopher-rudge-108366">Christopher Rudge</a>, Law lecturer, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-olds-too-old-to-be-a-doctor-why-gps-and-surgeons-over-70-may-need-a-health-check-to-practise-236305">original article</a>.</em></p> </div>

Body

Dr Chris Brown to reunite with Amanda Keller on new show

<p>Dr Chris Brown and Amanda Keller will be reunited on screen for the first time in two years. </p> <p>Keller confirmed on her WSFM breakfast show that she will reunite with Brown for his new series <em>Once in a Lifetime, </em>and will be travelling across the globe to film the show. </p> <p>“It’s a show called Once in a Lifetime, and Chris Brown is hosting this," she told listeners on Tuesday morning. </p> <p>“And this is a show I know that he’s wanted to do for years … I do know which country I’m going to, but I’m not allowed to say. It’s in Africa.</p> <p>“It’s Chris’s show. He and I are hanging out, and I’m going to be having experiences.</p> <p>“My nature is to over-research things and there’s nothing I can do. I can’t do that. So it’s a TV show where I can go into it floating, I can get on a plane and not have to be anxious about having to prepare something.</p> <p>“It’s a real gift for me, so I’m excited. But I have arranged for people to come in and play with you while I’m away.”</p> <p><em>Once in a Lifetime</em> will air on Channel 7, and was announced last year. </p> <p>It is an animal adventure series starring Brown, where he will be "pushed to his limits in the pursuit of the ultimate animal encounter," according to a Channel 7 spokesperson. </p> <p>“But he will not be travelling to the furthest corners of the globe alone. In the most delicious twist, Chris will be taking the country’s most intriguing and entertaining personalities along … as his veterinary assistant," they added. </p> <p>This is the first time the duo are reuniting on screen after working on <em>The Living Room</em> together for a decade before it was axed in 2022. </p> <p><em>Images: Ten</em></p>

You don’t need a doctor to get more physically active – here are 10 simple steps you can take by yourself

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/nerys-m-astbury-410114">Nerys M Astbury</a>, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a></em></p> <p>We all know physical activity has many <a href="https://www.nhs.uk/live-well/exercise/exercise-health-benefits/">health benefits</a>, including for mental health. It helps <a href="https://theconversation.com/exercise-can-reduce-stress-and-improve-sleep-particularly-for-women-with-breast-cancer-186144">manage stress</a>, ease joint or back pain, and boost energy levels.</p> <p>Exercise can also improve <a href="https://theconversation.com/exercise-and-the-brain-three-ways-physical-activity-changes-its-very-structure-150203">brain function</a> and <a href="https://theconversation.com/exercise-really-can-help-you-sleep-better-at-night-heres-why-that-may-be-192427">sleep</a>, and lift mood. In contrast, inactivity or spending too much time <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6308180/">sedentary</a> is a leading factor in developing a range of diseases.</p> <p>The <a href="https://www.who.int/publications/i/item/9789240015128">World Health Organization</a> recommends we should do a weekly minimum of 150-300 minutes of moderate intensity physical activity, such as walking, or 75 minutes of vigorous physical activity, such as swimming, jogging or an exercise class – as well as <a href="https://theconversation.com/strength-training-could-be-the-answer-to-one-of-the-worlds-worst-killers-228665">regular strength training</a>.</p> <p>However, many people <a href="https://www.who.int/teams/health-promotion/physical-activity/global-status-report-on-physical-activity-2022">fail to meet these guidelines</a>. So what to do about this <a href="https://www.weforum.org/agenda/2022/12/lack-exercise-inactivity-preventable-diseases/">health crisis</a>?</p> <p>There is already <a href="https://www.bmj.com/content/376/bmj-2021-068465">evidence</a> that when GPs give patients guidance and continued support to increase physical activity, this encourages them to be more physically active – at least in the short term. However, we don’t yet know the best way for doctors to communicate with patients to help them sustain these increased activity levels so the current guidance and support on offer to patients isn’t as effective as it could be.</p> <figure><iframe src="https://www.youtube.com/embed/vCCD1xHKpZc?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>For example, my <a href="https://www.bmj.com/content/386/bmj-2023-078713">latest research</a> examines the <a href="https://www.bmj.com/content/340/bmj.c1900">“motivational interviewing” (MI)</a> method GPs currently use to encourage patients to change their lifestyle. MI is a patient-centred, non-confrontational communication style that helps patients address any problem behaviour by exploring their ambivalence towards changing it. MI has been shown to help patients with a host of health problems, including <a href="https://pubmed.ncbi.nlm.nih.gov/25577724/">addiction issues</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/23001832/">eating disorders</a>, <a href="https://pubmed.ncbi.nlm.nih.gov/25726920/">smokers</a> and those with <a href="https://pubmed.ncbi.nlm.nih.gov/33637368/">diabetes</a> to change their behaviour.</p> <p>However, I found that while MI programmes can help patients increase their total amount of physical activity – the benefits are only short term.</p> <h2>Ten simple ways to be more physically active</h2> <p>If you want more physical activity in your life, then, there are many self-directed things you can do to help yourself, without joining a programme or seeing your GP.</p> <p>Here are ten simple and effective ways to help you become – and stay – more physically active:</p> <p><strong>1) Don’t sit, stand</strong></p> <p>We <a href="https://theconversation.com/sitting-is-bad-for-your-health-and-exercise-doesnt-seem-to-offset-the-harmful-effects-225056">sit a lot</a>. In fact, it’s likely you’re sitting right now – and you needn’t be. Sitting for long periods has been <a href="https://doi.org/10.1016/j.amepre.2010.05.024">linked</a> with many adverse health outcomes, so try to stand more.</p> <figure><iframe src="https://www.youtube.com/embed/wUEl8KrMz14?wmode=transparent&start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p><strong>2) Take the stairs</strong></p> <p>Being physically active needn’t mean expensive gym memberships. Try building physical activity into your daily routine. One easy way to do this is by swapping the lift or escalator for the stairs.</p> <p><strong>3) Make it fun</strong></p> <p>If you like doing something, you’re <a href="https://theconversation.com/why-you-shouldnt-let-guilt-motivate-you-to-exercise-220342">more likely</a> to continue doing it. Why not try an activity you liked doing as a child, or even something new? Who knows, you might enjoy it.</p> <p><strong>4) Phone a friend</strong></p> <p>Exercising <a href="https://theconversation.com/exercise-can-be-punishing-but-heres-how-to-stop-thinking-of-it-as-a-punishment-76167">with a friend</a> or loved one is a great way to stay motivated, and it can make physical activity more fun too.</p> <p><strong>5) Do less, more often</strong></p> <p><a href="https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-023-01272-8">“Snacktivity”</a> – a term for breaking up your activity into shorter <a href="https://theconversation.com/forget-the-gym-in-january-exercise-snacking-is-the-way-forward-69702">activity “snacks”</a> – can help you increase activity in convenient, manageable bursts while reaping the health benefits.</p> <p><strong>6) Track your progress</strong></p> <p>Activity trackers aren’t a fad. There is <a href="https://doi.org/10.1016/S2589-7500(22)00111-X">evidence</a> that just using an activity tracker such as a pedometer to count steps or a smart watch that logs activity can help increase your activity levels, reduce body fat and increase muscle mass – and increase your overall physical fitness.</p> <p><strong>7) Get into a habit</strong></p> <p>We know it takes about ten weeks to <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505409/">form a habit</a>. Repetition is key – so stick with it and keep going. Once you’ve formed a physical activity habit, it will be <a href="https://www.psychologytoday.com/gb/basics/habit-formation#:%7E:text=Building%20healthy%20habits%20can%20involve,listening%20to%20music%20while%20exercising">hard to shake it off</a>.).</p> <p><strong>8) Hold still</strong></p> <p>Try to incorporate <a href="https://en.wikipedia.org/wiki/Isometric_exercise">isometric exercises</a> like the plank or wall squats into your routine. These exercises, which need no equipment, require you to tighten muscles and hold still – and have been shown to <a href="https://bjsm.bmj.com/content/57/20/1317">lower your blood pressure</a>.</p> <p><strong>9) Set a goal</strong></p> <p>Give yourself an achievable target to work towards – it will <a href="https://theconversation.com/three-tips-to-help-you-stay-motivated-to-keep-exercising-all-year-long-175868">motivate you</a> to reach your goal.</p> <p><strong>10) Reward yourself</strong></p> <p>And don’t forget to reward yourself when you meet that goal. You can also build in rewards to mark your progress along the way. After all, who doesn’t like to treat themselves when they’ve done well?<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/231991/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/nerys-m-astbury-410114">Nerys M Astbury</a>, Associate professor, <a href="https://theconversation.com/institutions/university-of-oxford-1260">University of Oxford</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/you-dont-need-a-doctor-to-get-more-physically-active-here-are-10-simple-steps-you-can-take-by-yourself-231991">original article</a>.</em></p> </div>

Body

Doctor shares her holy grail tips for overcoming eye sensitivity

<p>As the chill of winter sets in, many people find that their eyes become more sensitive and prone to dryness. This can be particularly challenging for those who already suffer from dry eye syndrome. </p> <p>Dr. Jacqueline Beltz is a leading Australian Ophthalmologist and the founder of <a href="https://www.okkiyo.com" target="_blank" rel="noopener">OKKIYO</a>, a beauty brand that makes PRIORITEYES mascara for people with sensitive eyes.</p> <p>Dr Beltz has shared her insights into dry eye syndrome and how winter can exacerbate symptoms, also sharing her top tips for managing eye sensitivity during the colder months.</p> <p><strong>Understanding Dry Eye Syndrome</strong></p> <p>The surface of the eye is covered by a delicate layer of tears, essential for comfort, vision, protection, and nutrition. The tear film comprises two main layers: an outer lipid (oily) layer and an inner aqueous (watery) layer. The lipid layer, produced by oil glands in the eyelids, prevents tears from evaporating too quickly, while the aqueous layer, consisting of water, electrolytes, and proteins, spreads tears evenly across the eye and helps them adhere to the surface.</p> <p>When the balance of tear production, evaporation, absorption, and drainage is disrupted, it can lead to dry eye syndrome. Symptoms may include redness, irritation, a gritty sensation, tired eyes, itching, excessive watering, and fluctuating vision. In severe cases, dry eye can be painful and significantly impact daily life.</p> <p><strong>How common is dry eye syndrome?</strong></p> <p>Dry eye syndrome is a widespread issue, particularly among older adults. According to the Blue Mountains Eye Study, 57% of adults over the age of 50 experience some degree of dry eye. This condition is notably more prevalent in women, with higher rates observed compared to their male counterparts. The increased prevalence in women is often attributed to hormonal changes, particularly during and after menopause. </p> <p>A more recent study, Optometry Australia’s 2022 Vision index found that over 85% of Australians are estimated to have experienced dry eyes at some point in their lives. Of those affected, 55% say they only developed the condition following the beginning of the pandemic in 2020. They reported that almost 1 in 5 (18%) of people experience dry eye symptoms frequently. </p> <p>These statistics highlight the importance of understanding and managing dry eye, especially as we age.</p> <p><strong>DEWS II Study and Treatment Approaches</strong></p> <p>The DEWS II (Dry Eye Workshop II) study provides a comprehensive framework for understanding and treating dry eye syndrome. According to the study, dry eye is a multifactorial disease characterised by a loss of homeostasis (or balance) in the tear film, accompanied by eye symptoms. Factors such as tear film instability, hyperosmolarity (increased saltiness), inflammation, and neurosensory (altered feelings or sensations) abnormalities play significant roles.</p> <p>There are two primary types of dry eye: aqueous deficient and evaporative. Most individuals have a combination of both. Aqueous deficient dry eye occurs when there is insufficient production of the watery layer of tears, often due to aging, hormonal changes, or certain medications. Evaporative dry eye is typically caused by environmental factors or conditions affecting the lipid layer, such as meibomian gland dysfunction (MGD).</p> <p><strong>Winter's Impact on Dry Eyes</strong></p> <p>Winter poses unique challenges for dry eye sufferers. Cold, dry air, indoor heating, and wind can all exacerbate symptoms. Here's how to combat these winter-specific issues:</p> <p><em><strong>1. Humidify Your Environment</strong></em></p> <p>Indoor heating reduces humidity levels, leading to increased tear evaporation. Consider using a humidifier to maintain moisture in the air, especially in bedrooms and living spaces. This helps keep your eyes hydrated.</p> <p><em><strong>2. Protect Your Eyes Outdoors</strong></em></p> <p>Cold winds can strip away the tear film. When outside, wear wraparound sunglasses to shield your eyes from the elements. This not only protects your eyes from the wind but also from UV rays, which can be strong even in winter.</p> <p><em><strong>3. Stay Hydrated</strong></em></p> <p>Dehydration can worsen dry eye symptoms. Drink plenty of water throughout the day to maintain overall hydration, which supports healthy tear production.</p> <p><em><strong>4. Optimise Your Diet</strong></em></p> <p>Certain foods can promote eye health. Omega-3 fatty acids, found in fish like salmon and flaxseeds, have anti-inflammatory properties that can help manage dry eye symptoms. Incorporate these into your diet for added benefits.</p> <p><em><strong>5. Use a Warm Compress</strong></em></p> <p>A warm compress can help improve the function of the meibomian glands, which produce the oily layer of the tear film. This is particularly helpful for those with meibomian gland dysfunction, or MGD. Gently apply a warm, damp cloth to your closed eyelids for 10-15 minutes, followed by a gentle massage of the eyelids to encourage oil secretion. It is important to avoid rubbing or compressing the eyeballs.</p> <p><em><strong>6. Use Over-the-Counter Lubricant Eye Drops</strong></em></p> <p>Artificial tears can provide temporary relief by supplementing the natural tear film. Choose preservative-free options to avoid further irritation, and use them frequently.</p> <p><em><strong>7. Remember to have regular eye checks</strong></em></p> <p>In Australia, Optometrists provide our primary eye health check ups. Dr Beltz recommends adults over the age of 40 see their optometrist once a year, but if you’re struggling with symptoms of dry eye in winter, an extra check up might help and your optometrist will be able to help you to come up with an individualised treatment plan.</p> <p><em><strong>8. Invest in Quality Eye Products</strong></em></p> <p>For those who wear makeup, using products designed for sensitive eyes is crucial. <a href="https://www.okkiyo.com/products/protect-and-preserve-mascara" target="_blank" rel="noopener">PRIORITEYES</a> mascara by OKKIYO has been specifically formulated to be gentle on sensitive eyes, avoiding common irritants while providing excellent performance.</p> <p><strong>Managing Dry Eye in Winter: A Recap</strong></p> <p>Winter can be tough on our eyes, but with the right strategies, you can manage dry eye symptoms effectively. Maintain a humid environment, protect your eyes from cold winds, stay hydrated, and incorporate eye-healthy foods into your diet. Regularly use warm compresses and opt for gentle, high-quality eye products like PRIORITEYES mascara. </p> <p>Dry eye syndrome may be a common condition, but it doesn't have to dominate your life, especially during the harsh winter months. With these tips, you can keep your eyes comfortable and healthy all season long. For personalised advice and treatment, always consult with your eye care professional.</p> <p>Stay warm, stay hydrated and take care of your eyes this winter!</p> <p><em>Image credits: Shutterstock </em></p>

Body

Doctor shares his top tips for tackling jet lag

<p dir="ltr">Dr Nick Coatsworth has shared his fool-proof hacks to tackle jet lag on your next international flight. </p> <p dir="ltr">The TV host and doctor often travels around the world for work, and as a result, knows a thing or two about feeling jet lagged. </p> <p dir="ltr">"I hate jet lag. I suffer from it a lot," he told <em><a href="https://travel.nine.com.au/latest/flight-tips-how-to-avoid-jet-lag-dr-nick-coatsworth/37872af3-ff61-48c1-810d-4b20f4d2bde2">9Travel</a></em>.</p> <p dir="ltr">Despite being prone to jet lag, Coatsworth has honed his own tips for tackling the dreaded side effect of travelling across time zones.</p> <p dir="ltr">"Stay awake for as long as you possibly can to try and reset your body clock," he advises.</p> <p dir="ltr">Another go-to hack to overcome jet lag is a simple change you can make as soon as you board the plane. </p> <p dir="ltr">"As soon as I get on the plane I change my watch to the destination time," he said.</p> <p dir="ltr">While there are many tips and tricks floating around that people use to beat the dreaded jet lag, Dr Nick said all you can do is try to adjust to a new time zone as soon as possible. </p> <p dir="ltr">"Ultimately you've just got to push through the fatigue and try and resync yourself as quickly as possible," he says.</p> <p dir="ltr"><em>Image credits: Nine / Shutterstock</em></p>

Travel Tips

Dr Chris Brown's hilarious dig at Channel 10

<p>The new season of<em> Dancing With The Stars</em> premiered on Sunday night with <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Chris Brown</span><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;"> </span><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">presenting alongside longtime host </span><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Sonia Kruger</span><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;"> for the very first time.</span></p> <p>The former <em>Bondi Vet</em> star left Channel 10 to join Seven a year ago, and while things reportedly ended amicably between them, he couldn't help but take a dig at his former employer on<em> Dancing With The Stars.</em></p> <p>At the beginning of the episode, Sonia explained that all contestants were safe and “no one’s going home tonight”. </p> <p>Chris feigned relief that he was also "safe" and couldn't be fired on the first night of his new gig, to which Sonia quipped that only the dancers could be voted off and that she and Chris were "as safe as anyone can be in entertainment”.</p> <p>“Shout out to Channel 10,” he quickly remarked, eliciting laughter from the audience. </p> <p>The comment could be in reference to Channel 10 axing a handful of shows over the past few months, leaving several high-profile TV personalities out of work. </p> <p>Yahoo Lifestyle reported that the reboot of <em>Gladiators</em> had been cancelled after one season, and the network confirmed in May that both <em>The Bachelor </em>and <em>The Masked Singer </em>won't be returning this year. </p> <p>In another part of DWTS, Chris also joked abut how his previous role on Channel 10’s <em>The Living Room</em> made him “rivals” with<em> Better Homes and Gardens</em> presenter Adam Dovile.</p> <p>“Now Adam, we do need to address the elephant in the room,” he said.</p> <p>“We were TV rivals for many, many years in the cutthroat vicious world of Friday night lifestyle television.</p> <p>“It’s hard to even look you in the eye, the fury is so deep. But I can’t stay angry at you, look at that smile!”</p> <p><em>Images: Channel 10</em></p>

Result of Chris Dawson's appeal announced

<p>In a significant decision, the state's highest criminal appeal court has denied Chris Dawson's attempt to overturn his conviction for the calculated murder of his wife, Lynette, whose mysterious disappearance in 1982 remains one of Sydney's most perplexing cases.</p> <p>Dawson was found guilty in 2022 of murdering Lynette Joy Simms, who was 33 years old when she disappeared from their Bayview home in January 1982. Despite extensive investigations, her body has never been recovered.</p> <p>Justice Ian Harrison, who presided over the trial, determined that Dawson, a former teacher and rugby league player, murdered Lynette to remove what he saw as an obstacle to a new life with "JC", his former student and the babysitter of the couple's two children. JC moved into Dawson's home within days of Lynette's disappearance. Harrison sentenced Dawson to a maximum of 24 years in prison, with a non-parole period of 18 years.</p> <p>Now 75, Dawson appealed the conviction in the NSW Court of Criminal Appeal. On Thursday at 2pm, the court dismissed his appeal, solidifying the initial verdict.</p> <p>Compounding his legal woes, Dawson's non-parole period was extended by a year after his conviction for unlawful sexual activity with a student in 1980. Consequently, Dawson will not be eligible for release until 2041, when he will be 93 years of age.</p> <p>After Lynette was officially declared missing, Dawson remarried twice. He wed JC on January 15, 1984, at the Bayview home he had shared with Lynette. Later that year, the couple relocated to Queensland. JC left Dawson in early 1990 and made her first police statement regarding Lynette's disappearance in May that year, prompting renewed investigations.</p> <p>Dawson's legal team presented five grounds for appeal. They argued that the delay in criminal proceedings disadvantaged Dawson and that Harrison's verdict was unsupported by evidence. They claimed the Crown failed to disprove that Lynette was alive on January 9, 1982, and that the evidence as a whole did not substantiate Dawson's guilt.</p> <p>Harrison maintained in his August 2022 judgment that proving Lynette's death around January 8, 1982, was crucial to the Crown's case. Dawson's barrister, Belinda Rigg, SC, argued that it was plausible Lynette was alive on January 9 and had contacted Dawson at his part-time job, suggesting she needed time away to resolve personal issues. However, Harrison found Dawson's claim – solely supported by his own testimony, which he did not present at trial – was a lie.</p> <p>Justice Christine Adamson, one of the appellate judges, highlighted the absence of phone records, noting the uncertainty they posed: "We don’t have the phone records, and there’s no way of knowing whether the phone records are going to be completely neutral, or exculpatory, or inculpatory."</p> <p>Rigg contended during the appeal that Dawson's ability to verify his account independently had been compromised by the delay.</p> <p>The court's decision to dismiss Dawson's appeal reinforces the gravity of his crimes and underscores the enduring quest for justice in one of Australia's most enduring mysteries.</p> <p><em>Images: Twitter (X) | Nine</em></p>

Legal

Doctor Who actor dies at the age of 99

<p>Legendary <em>Doctor Who</em> actor William Russell has died at the age of 99. </p> <p>Russell made his debut on the long-running hit sci-fi show back during its first episode in 1963 as the character Ian Chesterson, where he became the first companion alongside the then doctor William Hartnell. </p> <p><em>Doctor Who</em> show runner Russell T Davies led the tributes online, writing, "What a sad loss."</p> <p>"William played the Doctor's very first companion, Ian Chesterton, back in 1963," Davies explained in the Instagram tribute alongside an image of the two together.</p> <p>"A schoolteacher, trapped on the Tardis by a wily old Doctor, unable to get home, whisked off to the Stone Age, Skaro, the Crusades, planet of the Zarbi..! Wonderful! A fine, nimble, witty, heartfelt actor who absolutely sold the truth of those early years."</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/C7zaEDQNPv5/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C7zaEDQNPv5/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Russell T Davies (@russelltdavies63)</a></p> </div> </blockquote> <p>Davies said that Russell had been a "star booking" for the show, praising both the actor and man he knew off set.</p> <p>"He later went on to marry Rita Fairclough as Ted Sullivan on <em>Coronation Street</em>. In the photo, I bumped into him on a train in 2018! I was star-struck," he continued.</p> <p>"He spoke with so much pride and joy about his son, Alfred Enoch, who I'd seen in King Lear at the Royal Exchange. Absolutely lovely man. A fine, long life. Well done, sir, well played."</p> <p>William Russell made his television debut in 1956, starring in the TV series <em>The Adventures of Sir Lancelot</em>, which led to an illustrious career both on the screen and the stage. </p> <p>Russell appeared once more in <em>Doctor Who</em> after his initial episode, reprising his role in 2022 during the final episode of Jodie Whitaker's run as the Doctor, 57 years after his own last appearance. </p> <p>Not only did fans of the show adore his appearance, but it also scored him a Guinness World Record for having the biggest gap between TV appearances.</p> <p>He is survived by his four children, Robert, Laetitia, Vanessa and Alfred, as well as four grandchildren, James, Elise, Amy and Ayo.</p> <p><em>Image credits: BBC / Dan Wooller / Shutterstock Editorial </em></p> <p style="box-sizing: border-box; margin: 16px 0px 20px; padding: 0px; border: 0px; font-stretch: inherit; font-size: 18px; line-height: 28px; font-family: 'Proxima Nova', system-ui, -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Fira Sans', 'Droid Sans', 'Helvetica Neue'; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; vertical-align: baseline; caret-color: #333333; color: #333333;"> </p>

Caring

Doctors at war

<p><em>In the annals of military history, the valour and sacrifices of doctors who served alongside soldiers in combat zones often go unrecognised. Yet their stories, as retired colonel Robert Likeman poignantly illustrates in his Australian Doctors at War series, reveal a legacy of courage and commitment that is integral to understanding the full scope of wartime heroism.</em></p> <p>---</p> <p>Winston Churchill, in his <em>Sketches on Service During the Indian Frontier Campaign of 1897</em>, wrote, “The spectacle of a doctor in action among soldiers, in equal danger and with equal courage, saving life where others are taking it, allaying pain where all others are causing it, is one which must always seem glorious, whether to God or man”.</p> <p>It is certainly true that doctors in a combat zone share the risks of shot and shell equally with the fighting soldier, but they also experience the added stress of taking responsibility for those wounded and dying on the battlefield, and in situations where the best of treatment cannot be readily given.</p> <p>Glorious or otherwise, the stories of our Australian Army doctors at war remain relatively unrecognised. Doctors have always been among the first to volunteer – in all 1,242 doctors served with the first Australian Imperial Force, careless for their own safety, and 55 of them failed to return. These men represented a significant proportion of the medical workforce in Australia, which by 1937 only reached 5,000. In World War 2, with the introduction of compulsory military service, the number of serving doctors exceeded 2,500. Hardly any of them are still with us today, but their children and grandchildren are our fellow citizens, and in many cases our local doctor may be one of these. It is a legacy not to be dismissed lightly. </p> <p>Those who have served in the Army know that treating the ailments of soldiers and preserving their health occupies much more time than dressing their wounds. In World War 1, fought over the agricultural lands of Europe, infectious diseases such as gas gangrene, tetanus and trench fever were common. In the deserts of World War 2, these were replaced by hepatitis, sandfly fever and eye infections. New Guinea presented a wholly different spectrum of disease, dominated by malaria, scrub typhus and amoebic dysentery. The maintenance of “fighting fitness” was a daily struggle for the doctors. </p> <p>The 2021 Interim Report of the Royal Commission into Defence and Veteran Suicide did not identify medical officers as being particularly at risk of psychological injury as a result of their service in a war zone. But in view of their exposure to mass trauma and death, they might be assumed to have a significant risk of Post Traumatic Stress Disorder, both from the chances of being wounded or killed, and from the guilt associated with the failure to preserve life. Two of the medical officers who served at Gallipoli shot themselves on their return to Egypt, perhaps because they had seen men die who might have been saved with better medical attention. Fourteen other doctors from the 1st Australian Imperial Force are known to have committed suicide after their return to Australia. </p> <p>Close to 3,000 Australian nurses served overseas with the Australian Army Nursing Service in World War 1, but female doctors were not permitted to enlist. A significant number of them however, at least 19, served in the British Army or in voluntary hospitals in Europe. One of them, Phoebe Chapple, was awarded the Military Medal for Bravery. In World War 2, 22 women doctors were commissioned in total – moreso due to the shortage of manpower than from egalitarian principles – though none of them were posted overseas. In recent overseas deployments, women doctors in the Army have quite properly taken their rightful place.</p> <p>The military service and civilian practice of all the Australian doctors who served in both World Wars has been meticulously documented in my six-volume series, <em>Australian Doctors at War</em>, published by Halstead Press. Your relatives may be among them.</p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2024/06/Robert_Likeman_01.jpg" alt="" width="1280" height="720" /></p> <p><em>The Inevitable Hour</em> is the sixth and final volume of my <em>Australian Doctors at War</em> series, covering the period from January 1943 to the disbanding of the Second Australian Imperial Force in April 1947. Even after the Japanese had been driven from Papua and New Guinea, they still retained most of the archipelago. The threat to Australia was great, and despite being a then small nation, the country mobilised quickly to disrupt Japanese holdings in Madang, Wewak and Wau. Overcoming the constant influx of wounded men needing treatment, suffering themselves from afflictions such as hepatitis, dysentery and depression, aggravated by extreme and tropical climates, Australia’s medical officers were under considerable pressure, during the war and in the monumental demobilisation of the 2nd AIF that followed Japanese defeat.</p> <p><em><strong>ABOUT THE AUTHOR</strong></em><br />Robert Likeman is a graduate of Oxford University, where he studied Classics, Oriental Languages and Medicine. He is a specialist in obstetrics and gynaecology, in tropical medicine, and in rural and remote medicine. After service in the British Army he migrated to Australia in 1972. He is the author of seven books of military history and two biographies, and co-author of a textbook of obstetrics and gynaecology for doctors practising in developing countries.</p> <p><em>Images courtesy of Robert Likeman.</em></p>

Books

Australia can afford to bulk bill all GP visits. So why don’t we?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/yuting-zhang-1144393">Yuting Zhang</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/karinna-saxby-1045932">Karinna Saxby</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Being able to afford health care is a <a href="https://www.abs.gov.au/media-centre/media-releases/more-people-putting-seeing-health-professionals-due-cost">pressing issue</a> for many Australians. And encouraging GPs to bulk bill is <a href="https://theconversation.com/cheaper-medicines-and-a-new-approach-for-mental-health-care-will-the-budget-make-us-healthier-229612">one measure</a> the government is taking to ease the strain.</p> <p>So what would it take for GPs to bulk bill everyone? In our <a href="https://onlinelibrary.wiley.com/doi/10.1111/1467-8462.12553">recent paper</a>, we calculated this is possible and affordable, given the current health budget.</p> <p>But we show recent incentives for GPs to bulk bill aren’t enough to get us there.</p> <p>Instead, we need to adjust health policies to increase bulk-billing rates and to make our health system more sustainable.</p> <h2>How do the incentives work?</h2> <p>In recent years, the government has introduced various incentives to try and encourage GPs to bulk bill (so patients pay nothing out-of-pocket).</p> <p>The most recent has been the “<a href="https://www.health.gov.au/our-work/increases-to-bulk-billing-incentive-payments#1-november-2023-changes">triple bulk-billing incentives</a>” or “triple bonus” for short. These have been in place since November 2023.</p> <p>Under these incentives, GPs in metropolitan areas are paid a A$20.65 bonus if they bulk bill concession card holders or children under 16 years. GPs in rural and remote areas are paid $31.35-$39.65 extra. These bonus payments are in addition to regular Medicare rebates GPs receive.</p> <p>But when we looked at whether these latest incentives are likely to work to boost bulk billing, we found a city-country divide.</p> <h2>City GPs may not be convinced</h2> <p>We worked out the triple bonus will not help most people in metropolitan areas.</p> <p>That’s because in these areas the bonus is much lower than what patients currently pay out-of-pocket. In other words, if GPs did bulk bill these groups, their income would be lower than what they could have charged. So the bonus wouldn’t be enough incentive for them to bulk bill.</p> <p>For example, we found in greater Melbourne, the average out-of-pocket costs for a non-bulk billed GP visit <a href="https://melbourneinstitute.unimelb.edu.au/research/HALE-Hub/data">is about</a> $30-$56 depending on the suburb. This is much higher than the $20.65 triple bonus amount in metropolitan regions. We see similar patterns across all metropolitan areas.</p> <h2>But country GPs may be swayed</h2> <p>The picture is different in rural and remote areas. Here, the average out-of-pocket cost for a non-bulk billed GP visit <a href="https://melbourneinstitute.unimelb.edu.au/research/HALE-Hub/data">varies substantially</a> – around $28-52 in rural regions and $32-123 in remote areas. The highest cost on the mainland was $79 but GP visits on Lord Howe Island were the most expensive overall, at $123.</p> <p>For patients living in areas where their actual payment is less than the bonus amount, the incentive does help. In other words, it would be financially advantageous for GPs to bulk bill these patients, but not where the out-of-pocket costs are higher than the bonus.</p> <p>Our <a href="https://melbourneinstitute.unimelb.edu.au/research/HALE-Hub/data">online map</a> shows where GPs are most likely to bulk bill. The map below shows how out-of-pocket costs vary around Australia.</p> <p><iframe id="SPzgj" class="tc-infographic-datawrapper" style="border: none;" src="https://datawrapper.dwcdn.net/SPzgj/" width="100%" height="400px" frameborder="0"></iframe></p> <h2>How about bulk billing for all?</h2> <p>The picture is a little more complex when we start talking about bulk billing all GP visits – regardless of location or patients’ concession card status.</p> <p>We worked out this would cost about $950 million a year for all GP services, or $700 million a year for face-to-face GP consultations.</p> <p>This is within reach under the current budget, especially for face-to-face GP consultations.</p> <p>The government has earmarked <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/budget-2023-24-building-a-stronger-medicare#:%7E:text=%243.5%20billion%20in%20bulk%20billing,40%2Dyear%20history%20of%20Medicare">$3.5 billion</a> over <a href="https://archive.budget.gov.au/2023-24/bp2/download/bp2_2023-24.pdf">five years</a> for the “triple bonus” incentives. That’s $700 million a year.</p> <h2>We can afford to, but should we?</h2> <p>Introducing free GP visits for all would require careful consideration, as it would encourage more GP visits.</p> <p>This might be a good thing, particularly if people had previously skipped beneficial care <a href="https://www.abs.gov.au/media-centre/media-releases/more-people-putting-seeing-health-professionals-due-cost">due to high costs</a>. However, it may encourage more people to see their <a href="https://www.sciencedirect.com/science/article/abs/pii/S1574006400801675">GP unnecessarily</a>, taking away limited resources from those who really need them. This could ultimately increase wait times for everyone.</p> <p>So providing free GP visits for all may not be efficient or sustainable, even if it’s within the budget.</p> <p>But paying more than $50 for a GP visit, as many do, seems too expensive and also makes the health-care system less efficient.</p> <p>That’s because primary care is <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/primary-health-care">often considered</a> high-value and preventive care. So if people can’t afford to go to the GP, it can lead to more expensive hospital and emergency room costs down the track.</p> <p>So we need to strike a balance to make primary care more affordable <em>and</em> sustainable.</p> <h2>How do we strike a balance?</h2> <p>One, concession card holders and children should get free primary care regardless of where they live. This would allow more equitable care to populations who need health care the most. Bulk bulling children is a <a href="https://www.sciencedirect.com/science/article/abs/pii/S016726812200292X#:%7E:text=Beside%20the%20benefits%20for%20the,and%20Kuh%2C%202002%3B%20Centers%20for">long-term investment</a>, which may delay onset of diseases, and prevent intergenerational poverty and poor health.</p> <p>Two, the government could also provide free primary care to all people in rural and remote areas. It can do this by lowering the triple bonus to match what GPs currently charge. Over time, GPs and the government can evaluate and <a href="https://www.auspublaw.org/blog/2023/4/the-civil-conscription-sub-clause-in-section-51xxiiia-of-the-australian-constitution-no-impediment-to-reform-of-medicare">negotiate</a> fair prices for GPs to charge. This can be adjusted in line with inflation and other measures.</p> <p>Three, the government can increase Medicare rebates (the amount Medicare pays a doctor for a GP visit) so patients not covered above only pay about $20-30 a visit. We consider this an affordable amount that will not result in more use of primary care than necessary.</p> <p>Four, the government can design a policy to reduce unnecessary GP visits that take away limited GP time from high-need patients. For example, patients currently need to see GPs to get <a href="https://theconversation.com/specialist-referral-rules-havent-changed-much-since-the-70s-but-australias-health-needs-sure-have-144506">referral letters</a> although they already have an established specialist for their ongoing chronic conditions.</p> <p>Five, the government can provide GPs funding needed to improve patient outcomes and reward GPs who provide <a href="https://bmjopenquality.bmj.com/content/10/1/e001127.abstract">high-quality preventive care</a>. The current fee-for-service funding model hurts good doctors who keep their patients healthy because doctors are not paid if their patients do not come back.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/230204/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/yuting-zhang-1144393"><em>Yuting Zhang</em></a><em>, Professor of Health Economics, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/karinna-saxby-1045932">Karinna Saxby</a>, Research Fellow, Melbourne Institute of Applied Economic and Social Research, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australia-can-afford-to-bulk-bill-all-gp-visits-so-why-dont-we-230204">original article</a>.</em></p> </div>

Money & Banking

Today show star and veteran doctor dies at age 69

<p>A veteran doctor and regular guest on the <em>Today</em> show Dr Ric Gordon has passed away at the age of 69 from pancreatic cancer. </p> <p>Known for sharing his expertise as an obstetrician and fertility specialist, Dr Gordon became a household name after he delivered the first baby on Australian television. </p> <p>Upon hearing of his death, veteran radio host and beloved Australian author Wendy Harmer revealed Dr Gordon delivered both her babies even after she and her partner dropped out of IVF.</p> <p>In a post on X, she wrote, “He was a pioneer in IVF in Australia and gave hope to so many... and was kind and caring professional. Vale.”</p> <p>Nine News confirmed the “sad news” of Dr Gordon’s passing from pancreatic cancer on Saturday, as presenter Georgie Gardner said “he will be deeply missed”.</p> <p>Professionally known as Dr Ric Porter, he had previously hosted Nine’s long-running lifestyle hit <em>Good Medicine</em>, which ran for nine years in the 1990s. </p> <p>Dr Gordon was a part of the team of doctors who delivered the first IVF birth in NSW in 1983, and during his career, he delivered more than 5000 babies, including in 2003 when he safely delivered a baby live on the <em>Today</em> show.</p> <p>Reflecting on the moment in 2022, Dr Gordon told <em>Today</em> viewers it was an extraordinary moment in television.</p> <p>“It went so well, it was a great morning and a good outcome,” he said. “The baby cried when it was meant to cry, mum and dad were happy."</p> <p>The well-known doctor also drew some controversy over his career, including an offensive analogy where he used the Holocaust to explain weight loss on the same breakfast TV program in 2015. </p> <p>Despite apologising for saying “there were no overweight people in the concentration camps”, his apology was dismissed by many for being “insufficient” and “unsatisfactory”.</p> <p>Dr Gordon said at the time, “I’m very sorry it upset those people. It was never my intention.”</p> <p>He added that he had “done a lot of study” on the Holocaust and his comments were merely “used as a medical example”.</p> <p><em>Image credits: Today </em></p>

Caring

Dr Chris Brown recalls "dramatic" personal renovation disaster

<p><em>Dream Home</em> host Dr Chris Brown has revealed his own renovation fail on the latest episode of the show. </p> <p>The vet turned TV star has taken on a new role where he guides six teams of aspiring renovators through the joys — and pitfalls — of house remodelling in the new Channel 7 reality show. </p> <p>Speaking to 7NEWS, the star recalled the terrifying moment his home nearly fell in on itself when he was trying to build a garage. </p> <p>“On my first renovation, I decided I needed a garage underneath my house,” he said, adding that he had council approval for the renovation. </p> <p>“With a couple of tradies, we went about digging out the garage underneath the house, in the sand.</p> <p>“We just kept on digging, digging, digging, until a rather large sound indicated the house was about to fall into the hole!</p> <p>“So that’s about as dramatic as it as it gets.</p> <p>“To have your house sort of falling in on itself, that was a pretty big learning curve.”</p> <p>He said that the problem was solved "very quickly" with a lot of underpinning and structural support. </p> <p>“A lot of those steel support posts that you can sort of wind up and down, they went in, and thankfully the house didn’t fold in half,” he said, laughing at the situation. </p> <p>He added that unexpected situations like this are what make renovation shows so appealing as "there’s so much natural drama, you don’t have to fake anything." </p> <p>“Choices have to be made, and it’s either the right way or the wrong way, and you only really discover that as you go along," he added. </p> <p>“Sometimes it’s too late to turn back once you realise you’ve made a terrible mistake.”</p> <p>Chris added that his role on the show is almost as a"coach" to the pairs, supporting them through the renovation challenges, and helping them get to the finish line. </p> <p>“What these couples are going through, and just how much they put on the line to get these renovations done, is quite inspiring and quite uplifting and but also thoroughly entertaining,” he said. </p> <p><em>Image: Seven</em></p>

Real Estate

University gives resident cat an honorary doctorate

<p>A university in the US has handed out an honorary doctorate to a surprising recipient: the resident campus cat. </p> <p>For four years, Max the cat has been a respected member of the Vermont State University, putting a smile on students' faces through his friendly demeanour. </p> <p>When Max's owner Ashley was contacted by the school and told their plans to give Max the special honour, she "thought they were crazy", but it brought a big smile to her face.</p> <p>"We live on the main entrance to campus and when my daughter started attending as a junior, she started seeing everyone and how they kind of doted on Max," Ashley told <a href="https://9now.nine.com.au/today/vermont-state-university-resident-cat-max-dow-given-honorary-doctorate-in-literature/57d96d7c-ecc5-460f-85ac-ceee24e119b5" target="_blank" rel="noopener"><em>Today Extra</em></a>.</p> <p>"So we started an Instagram page that we keep updated with some of the photos and then I started getting tracked down by people on campus saying, 'Oh Max has been on the Dean's desk and he's been on the desk of the head of graduate studies, and he just kind of makes himself at home.'"</p> <p>Ashely said that Max's calming presence has helped many students who are stressed about their studies, or those who are feeling homesick. </p> <p>"They were just talking about how he was so helpful during finals week because everybody was picking him up and doing selfies with him and he was making everyone calmer," she said.</p> <p>"There's a real sense of community because I heard he was getting attacked by feral cats if he was on campus after 5pm, so I put up some posters and asked the students to give me a call or shoot me a text if they see him out after dark and they started arriving on our doorstep with him saying 'Hey, we brought Max home.'"</p> <p>Max was bestowed the honorary degree of "doctor of litter-ature", although will not be attending the next graduation ceremony. </p> <p style="box-sizing: border-box; margin: 24px 0px 0px; padding: 0px; border: 0px; font-stretch: inherit; line-height: 1.333; font-size-adjust: inherit; font-kerning: inherit; font-variant-alternates: inherit; font-variant-ligatures: inherit; font-variant-numeric: inherit; font-variant-east-asian: inherit; font-variant-position: inherit; font-feature-settings: inherit; font-optical-sizing: inherit; font-variation-settings: inherit; vertical-align: baseline;"><em>Image credits: Today Extra / Vermont State University </em></p>

Family & Pets

"Devastated": Chris Pratt mourns sudden death of longtime friend and stunt double

<p>Superstar of big and small screen Chris Pratt is grieving the death of his longtime friend and former stunt double, Tony McFarr, who was found dead at his home near Orlando, Florida, on Monday. McFarr was 47, and the cause of his death remains undetermined.</p> <p>Pratt and McFarr began their professional relationship on the set of <em>Jurassic World</em> in 2015. Their collaboration continued on <em>Passengers</em>, <em>Guardians of the Galaxy Vol. 2</em>, and <em>Jurassic World: Fallen Kingdom</em>. Over the years, they developed a strong bond that clearly extended beyond their work on screen.</p> <p>In an emotional Instagram tribute on Friday, Pratt expressed his heartbreak over the loss of McFarr. "We did several movies together," Pratt wrote. "We golfed, drank whiskey, smoked cigars, and spent endless hours on set. I'll never forget his toughness."</p> <p>Pratt then recalled a particularly intense moment during the filming of <em>Guardians of the Galaxy Vol. 2</em> when McFarr suffered a severe head injury but quickly returned to work. "He was an absolute stud. He was always a gentleman and professional. He'll be missed."</p> <p>Pratt concluded his tribute by offering prayers to McFarr's friends and family, especially his daughter. He shared a series of photos showcasing their time together on set, displaying their striking resemblance, particularly when dressed in matching costumes.</p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2024/05/ChrisPratt_Insta02.jpg" alt="" width="1280" height="970" /></p> <p>In addition to doubling for Pratt in several films, McFarr's impressive career included work on other major Marvel productions like <em>Captain America: Civil War</em> and <em>Ant-Man and the Wasp</em>. He also served as Jon Hamm's stunt double in the 2018 action comedy <em>Tag</em>.</p> <p><a href="https://www.tmz.com/2024/05/16/chris-pratt-stunt-double-tony-mcfarr-dead-dies-guardians-of-the-galaxy/" target="_blank" rel="noopener">According to TMZ</a>, McFarr's mother, Donna, reported that "he passed away Monday at his home just outside Orlando -- and while we're told the family doesn't know the exact circumstances of his death just yet ... Donna does say his passing is unexpected and shocking."</p> <p>"She says Tony was active and healthy ... and we're told the medical examiner's office is running toxicology tests now. The Orange County Medical Examiner confirms to us they have the case ... and that an official cause is still pending."</p> <p><em>Images: Instagram</em></p>

Caring

Doctor beats cancer using his own treatment

<p>Australian doctor Richard Scolyer has been declared cancer free, thanks to a first-of-its-kind treatment he helped to develop.</p> <p>The 56-year-old professor, who has been recognised around for the world for his pioneering melanoma research, was diagnosed with aglioblastoma, a terminal kind of brain tumour, after suffering a seizure last June.</p> <p>After receiving his devastating diagnosis, the doctor agreed to be a "guinea pig" to undergo a world-first cancer treatment that he had a hand in developing. </p> <p>Now the world-leading pathologist and Australian of the Year has given a remarkable update, stating he is cancer free.</p> <p>“I had brain #MRI scan last Thursday looking for recurrent #glioblastoma (&/or treatment complications). I found out yesterday that there is still no sign of recurrence. I couldn’t be happier!!!!!” the professor shared on X, formerly known as Twitter.</p> <p>Before Dr Scolyer was diagnosed with cancer, he was fit and active, and had been hiking mountains in Poland with his wife.</p> <p>“I felt normal. I didn’t have any symptoms at all,” he told <em>A Current Affair</em> earlier this year.</p> <p>Just days after, he suffered a devastating seizure, and when he returned to Australia, underwent a series of tests which resulted in a diagnosis with glioblastoma – an aggressive and terminal form of brain cancer that would give him a average of 14 months to live. </p> <p>Teaming up with his friend and medical oncologist Georgina Long, Scolyer decided to undergo the new treatment, which came with a long list of risks. </p> <p>“No one knew what it was going to do, people were nervous because it could actually cause my life to end more quickly. But when you’re faced with certain death, it’s a no-brainer for me,” said Professor Scolyer, who also hoped the treatment would make a difference for other cancer patients.</p> <p>Dr Scolyer also underwent surgery to remove as much of his tumour as possible, and in April, he updated his social media followers to share that10 months after his diagnosis, his tumour had not returned. </p> <p>Speaking to ABC’s <em>Australian Story</em> at the time, Professor Scolyer said he was “blown away” by the results.</p> <p>“This is not what I expected. The average time to recurrence for the nasty type of brain cancer I’ve got is six months. So, to be out this far is amazing,” he said. </p> <p><em>Image credits: Instagram</em></p>

Caring

It’s so hard to see a doctor right now. What are my options?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/anthony-scott-10738">Anthony Scott</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Deciding whether to wait and see if your health condition improves or go to a GP can be a difficult task. You might be unsure about where to go, whom to see, how much it will cost and whether you’ll need to take time off work.</p> <p>These choices can create significant barriers to accessing health care in Australia. There is often limited information available about the pros and cons of the different options. Often, we stick to what we know, unaware of better alternatives.</p> <p>But making the wrong decision about how to access care can impact both your health and finances. So what are your options? And what policy reforms are needed to improve affordable access to care for all Australians?</p> <h2>How quickly can I be seen?</h2> <p>Access depends on how long it takes you to speak to a GP, or be seen in an emergency department, or by a community pharmacist, or a nurse practitioner whom you can see directly. Access depends on where you live and the time of day.</p> <p>The rise of telehealth means GPs now get paid to talk to you on the phone, which is great for many minor ailments, medical certificates, repeat scripts or getting test results. Call centres such as <a href="https://www.healthdirect.gov.au/">Healthdirect</a> have been available for some time and now <a href="https://www.vved.org.au/patients/">virtual emergency departments</a> can also see you online.</p> <p>There are even GPs who only provide their services <a href="https://www.instantscripts.com.au/gp-online/">online</a> if you can pay. A phone call can save you valuable time. Before COVID, you needed to take half a day off work to see a GP, now it takes five to ten minutes and the GP even calls you.</p> <p>Things get more tricky outside of normal working hours and at weekends – appointments are harder to come by, it is unlikely you will be able to see a GP whom you know, and out-of-pocket costs might be higher.</p> <p>If you can’t wait, your local emergency department is likely to be more accessible, or you might be lucky enough to live near a bulk-billed Medicare <a href="https://www.health.gov.au/find-a-medicare-ucc">urgent care clinic</a>, where you don’t need an appointment. Tomorrow’s federal budget <a href="https://www.smh.com.au/politics/federal/more-free-urgent-care-clinics-part-of-8-5-billion-health-commitment-20240511-p5jcse.html">will include</a> funding for another 29 urgent care clinics, on top of the 58 already operating.</p> <p>But things are much worse if you live if a rural or remote area, where choice is limited and you need to wait much longer for GP appointments or travel long distances. Telehealth helps but can be expensive if it is not with your usual doctor.</p> <h2>Who will I see?</h2> <p>Access depends on who you will see. At the moment, this will usually be your GP (or, depending on the severity of your health concern, your community pharmacist or local emergency department staff). But to see your preferred GP you might need to wait as they are usually very busy.</p> <p>But a <a href="https://www.health.gov.au/resources/collections/issues-papers?language=en">review</a> of “scope of practice” in primary care aims to free up GPs’ time and use their skills more effectively.</p> <p>So in future, you could receive more of your health care from qualified nurses, nurse practitioners, pharmacists and other health professionals.</p> <p>But which tasks can be delegated to other health professionals is a significant bone of contention for GPs. For GP practices facing significant cost pressures, safely delegating tasks to other less costly health professionals also makes good business sense.</p> <h2>How much will it cost?</h2> <p>Access depends on out-of-pocket costs. Bulk billing of GP services reached a peak of <a href="https://www.health.gov.au/resources/publications/medicare-quarterly-statistics-state-and-territory-december-quarter-2023-24?language=en">89.6%</a> in the September quarter of 2022 but plummeted to 76.5% by the September quarter of 2023.</p> <p>Last November, bulk billing incentives for children under 16 and those on concession cards were tripled, and between November and December 2023 bulk billing had <a href="https://www.health.gov.au/ministers/the-hon-mark-butler-mp/media/bulk-billing-slide-stopped-thanks-to-albanese-government?language=en">increased</a> from 76.5% to 77.7%.</p> <p>They key issue for patients is that it remains uncertain whether a GP will bulk bill you. You often don’t know this until you get into the consultation, at which point you can’t back out. Unless the whole practice bulk bills and so it is guaranteed, it’s entirely up to the GP whether you are bulk billed. It’s difficult to think of any other service where you don’t know how much you will pay until after you have used it.</p> <h2>How can policymakers improve access to care?</h2> <p>Government policies to strengthen primary care have focused on giving patients improved access through telehealth, urgent care clinics and <a href="https://www.health.gov.au/resources/publications/strengthening-medicare-taskforce-report?language=en">Strengthening Medicare</a> initiatives, which are currently being developed.</p> <p>But uncertainty surrounding out-of-pocket costs can deter people from seeking medical attention, or delay care or go instead to the emergency department or urgent care clinic where there is no out-of-pocket cost.</p> <p><a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/latest-release">Cost is a factor</a> that leads to 20% of those with a mental health problem and 30% of those with chronic disease to delay or avoid visiting a health professional. Those most in need are more likely to miss out on necessary visits and prescriptions, sometimes with disastrous consequences. A recent <a href="https://academic.oup.com/qje/advance-article-abstract/doi/10.1093/qje/qjae015/7664375?login=false">study</a> shows people can die if they stop heart medications due to increased out-of-pocket costs.</p> <p>The next task for policymakers should be developing policies to guarantee there are no out-of-pocket costs for those on low incomes. This could be a worthwhile investment in our health and should be included in tomorrow’s budget.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/229191/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/anthony-scott-10738">Anthony Scott</a>, Professor of Health Economics, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/its-so-hard-to-see-a-doctor-right-now-what-are-my-options-229191">original article</a>.</em></p> </div>

Caring

Quiet beach town offering $450k job with free house and car

<p>A picturesque beach town in Western Australia has found a creative way to bring jobs to the area: by offering a range of enticing bonuses. </p> <p>The town of Bremer Bay, south-east of Perth, is desperate for healthcare providers to join the small town and have offered a range of persuasive perks to a doctor who would be willing to leave a big city for the job in the regional location. </p> <p>Bremer Bay is next to the Fitzgerald River National Park and nearly 40 minutes away from the closest town. Currently, they only have one temporary doctor; the next permanent GP is in Albany, almost 200 kilometres away, and the town is looking for the "Swiss army knife of doctors" to step up.</p> <p>According to the job listing on Seek, the successful applicant will be granted a rent-free five-bedroom house and a four-wheel drive, on top of a salary of up to $450,000 a year.</p> <p>"Live rent-free in a scenic location, experiencing the true essence of rural Australia," the advertisement reads.</p> <p>"We offer a competitive 70 per cent of Billings or a generous Salary, based on your preference. In addition, you'll enjoy the convenience of a beautiful new 5-bedroom home and 4X4."</p> <p>Applicants must be registered with the Australian Health Practitioner Regulation Agency and be willing to train as a rural generalist.</p> <p>According to the <a title="Australian Institute of Health and Welfare" href="https://www.aihw.gov.au/reports/rural-remote-australians/rural-and-remote-health" target="_blank" rel="noopener">Australian Institute of Health and Welfare</a>, people living in rural and remote areas have higher rates of hospitalisations, deaths and injury compared to city-dwellers, while also having poorer access to primary health care services.</p> <p><em>Image credits: Shutterstock</em></p>

Money & Banking

Yes, Kate Middleton’s photo was doctored. But so are a lot of images we see today

<p><a href="https://theconversation.com/profiles/t-j-thomson-503845">T.J. Thomson</a>, <em><a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em></p> <p>Rumours and conspiracies have been <a href="https://www.nytimes.com/2024/02/28/style/princess-kate-middleton-health.html">swirling</a> following the abdominal surgery and long recovery period of Catherine, Princess of Wales, earlier this year. They intensified on Monday when Kensington Palace released a photo of the princess with her three children.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/C4U_IqTNaqU/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/C4U_IqTNaqU/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by The Prince and Princess of Wales (@princeandprincessofwales)</a></p> </div> </blockquote> <p>The photo had clear signs of tampering, and international wire services <a href="https://apnews.com/article/kate-princess-photo-surgery-ca91acf667c87c6c70a7838347d6d4fb">withdrew the image</a> amid concerns around manipulation. The princess later <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616">apologised for any confusion</a> and said she had “experimented with editing” as many amateur photographers do.</p> <p>Image editing is extremely common these days, and not all of it is for nefarious purposes. However, in an age of rampant misinformation, how can we stay vigilant around suspicious images?</p> <h2>What happened with the royal photo?</h2> <p>A close look reveals at least eight inconsistencies with the image.</p> <p>Two of these relate to unnatural blur. Catherine’s right hand is unnaturally blurred, even though her left hand is sharp and at the same distance from the camera. The left side of Catherine’s hair is also unnaturally blurred, while the right side of her hair is sharp.</p> <p>These types of edits are usually made with a blur tool that softens pixels. It is often used to make the background of an image less distracting or to smooth rough patches of texture.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=358&fit=crop&dpr=1 600w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=358&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=358&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=450&fit=crop&dpr=1 754w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=450&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/581145/original/file-20240312-26-rhmkk1.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=450&fit=crop&dpr=3 2262w" alt="" /></a><figcaption><span class="caption">At least eight logical inconsistencies exist in the doctored image the Prince and Princess of Wales posted on social media.</span> <span class="attribution"><a class="source" href="https://www.instagram.com/p/C4U_IqTNaqU/">Photo by the Prince of Wales/Chart by T.J. Thomson</a></span></figcaption></figure> <p>Five of the edits appear to use the “clone stamp” tool. This is a Photoshop tool that takes part of the same or a different image and “stamps” it onto another part.</p> <p>You can see this with the repeated pattern on Louis’s (on the left) sweater and the tile on the ground. You can also see it with the step behind Louis’s legs and on Charlotte’s hair and sleeve. The zipper on Catherine’s jacket also doesn’t line up.</p> <p>The most charitable interpretation is that the princess was trying to remove distracting or unflattering elements. But the artefacts could also point to multiple images being blended together. This could either be to try to show the best version of each person (for example, with a smiling face and open eyes), or for another purpose.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Like many amateur photographers, I do occasionally experiment with editing. I wanted to express my apologies for any confusion the family photograph we shared yesterday caused. I hope everyone celebrating had a very happy Mother’s Day. C</p> <p>— The Prince and Princess of Wales (@KensingtonRoyal) <a href="https://twitter.com/KensingtonRoyal/status/1767135566645092616?ref_src=twsrc%5Etfw">March 11, 2024</a></p></blockquote> <h2>How common are image edits?</h2> <p>Image editing is increasingly common as both photography and editing are increasingly becoming more automated.</p> <p>This sometimes happens without you even knowing.</p> <p>Take HDR (high dynamic range) images, for example. Point your iPhone or equivalent at a beautiful sunset and watch it capture the scene from the brightest highlights to the darkest shadows. What happens here is your camera makes multiple images and automatically stitches them together to make an image <a href="https://www.adobe.com/creativecloud/photography/hub/guides/what-is-hdr-photography.html">with a wider range of contrast</a>.</p> <p>While face-smoothing or teeth-whitening filters are nothing new, some smartphone camera apps apply them without being prompted. Newer technology like Google’s “Best Take” <a href="https://blog.google/products/photos/how-google-photos-best-take-works/">feature</a> can even combine the best attributes of multiple images to ensure everyone’s eyes are open and faces are smiling in group shots.</p> <p>On social media, it seems everyone tries to show themselves in their best light, which is partially why so few of the photos on our <a href="https://www.tandfonline.com/doi/abs/10.1080/15551393.2020.1862663">camera rolls</a> make it onto our social media feeds. It is also why we often edit our photos to show our best sides.</p> <p>But in other contexts, such as press photography, the <a href="https://www.ap.org/about/news-values-and-principles/telling-the-story/visuals">rules are much stricter</a>. The Associated Press, for example, bans all edits beyond simple crops, colour adjustments, and “minor adjustments” that “restore the authentic nature of the photograph”.</p> <p>Professional photojournalists haven’t always gotten it right, though. While the majority of lens-based news workers adhere to ethical guidelines like those published by the <a href="https://nppa.org/resources/code-ethics">National Press Photographers Association</a>, others have let deadline pressures, competition and the desire for exceptional imagery cloud their judgement.</p> <p>One such example was in 2017, when British photojournalist Souvid Datta admitted to <a href="https://time.com/4766312/souvid-datta/">visually plagiarising</a> another photographer’s work within his own composition.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Photographer Souvid Datta appears to have plagiarized Mary Ellen Mark: <a href="https://t.co/iO1Lm8CowU">https://t.co/iO1Lm8CowU</a> <a href="https://t.co/jswHyApGNj">pic.twitter.com/jswHyApGNj</a></p> <p>— PetaPixel (@petapixel) <a href="https://twitter.com/petapixel/status/859824132258537472?ref_src=twsrc%5Etfw">May 3, 2017</a></p></blockquote> <p>Concerns around false or misleading visual information are at an all-time high, given advances in <a href="https://theconversation.com/nine-was-slammed-for-ai-editing-a-victorian-mps-dress-how-can-news-media-use-ai-responsibly-222382">generative artificial intelligence (AI)</a>. In fact, this year the World Economic Forum named the risk of misinformation and disinformation as the world’s greatest <a href="https://www.weforum.org/agenda/2024/01/ai-disinformation-global-risks/">short-term threat</a>. It placed this above armed conflict and natural disasters.</p> <h2>What to do if you’re unsure about an image you’ve found online</h2> <p>It can be hard to keep up with the more than <a href="https://theconversation.com/3-2-billion-images-and-720-000-hours-of-video-are-shared-online-daily-can-you-sort-real-from-fake-148630">3 billion photos</a> that are shared each day.</p> <p>But, for the ones that matter, we owe it to ourselves to slow down, zoom in and ask ourselves a few simple <a href="https://www.aap.com.au/factcheck-resources/how-we-check-the-facts/">questions</a>:</p> <p>1. Who made or shared the image? This can give clues about reliability and the purpose of making or sharing the image.</p> <p>2. What’s the evidence? Can you find another version of the image, for example, using a <a href="https://tineye.com/">reverse-image search engine</a>?</p> <p>3. What do trusted sources say? Consult resources like <a href="https://www.aap.com.au/factcheck/">AAP FactCheck</a> or <a href="https://factcheck.afp.com/">AFP Fact Check</a> to see if authoritative sources have already weighed in.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225553/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/t-j-thomson-503845">T.J. Thomson</a>, Senior Lecturer in Visual Communication & Digital Media, <em><a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/yes-kate-middletons-photo-was-doctored-but-so-are-a-lot-of-images-we-see-today-225553">original article</a>.</p> <p><em>Hero image: The Conversation / X / Instagram</em></p>

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