Some Health Apps Seem To Be Getting Very, Very Expensive!

They would sure want to make a real positive difference – and fast!

Here is an article discussing some of the newer ones!

Would you pay $1500 a month for a health app?

By David Swan

September 29, 2024 — 5.00am

A cohort of buzzy digital health start-ups is jostling for a piece of the nation’s lucrative healthcare market but are facing questions over their strategies, pricing and efficacy, with some charging nearly $1500 a month before they’ve publicly launched.

The preventative health sector has taken flight over the past 12 months, spurred by high-profile American figures like Andrew Huberman, Joe Rogan and Dr Peter Attia, who espouse the benefits of “biohacking” and the use of technology to help become “superhuman”.

The excitement surrounding so-called health super apps has now spread to Australia. A crop of start-ups is winning millions of dollars in venture capital funding as they race to onboard local users, promising comprehensive diagnostic testing, coaching, and performance optimisation.

Some consumers have reported early positive results from the highly personalised, data-focused apps. But medical groups, including the Royal Australian College of General Practitioners, are concerned that several of the platforms offer few health benefits and may, in fact, be causing harm.

In some cases, customers are paying a hefty premium for a product not yet ready for public launch. One health app, Compound, was charging users $995 a month (or $1495 with medication) – more than 10 times the cost of a typical gym membership – before it hit pause on its operations last week.

Related Article

Compound is the men’s longevity arm of telehealth provider Eucalyptus. Last year, it was valued at $520 million and has received financial backing from venture capital firms Blackbird and AirTree, which declined to comment for this piece. More than 4000 Australian men had registered their expression of interest in its all-in-one men’s health app, which encompasses diagnostics, nutrition, and training.

This month, Compound suspended operations, however, informing its customers via email that the platform required an overhaul. Its executives and engineers are now rebuilding it from scratch.

Eucalyptus chief Tim Doyle said that the issues stemmed from scaling up what was a very labour-intensive, manual offering.

“Scaling this has been really hard. It’s a concierge service. Really fundamentally, our members get feedback on how they’re doing their gym routines and workouts at a granular level,” Doyle said.

“They might say ‘hey I’m struggling with a sore shoulder, and I’m travelling for a week, how should I modify my gym routine?’ – and that is not an easy thing to scale.

“The best care is very human and manual, and that is hard to scale and expensive to scale, so we need to find a way to do that.”

Compound’s program architect, Dan Cable, wrote in an email to customers that it had been a “challenging launch period” for the start-up.

“We are extremely grateful that you joined Compound so early while much of our offering was still a prototype,” the email said.

“There’s a tension between launching early and delivering a high bar with a very manual experience while also rebuilding the underlying op-model, so we’ve decided to pause operations by the end of the year so that we can set up for relaunch in H2 2025.”

That tension between taking the time to deliver a reliable product and not missing the boat is not unique to Compound and is persistent throughout the health app sector.

Another Australian app, Bright, said it had sold more than 2500 “early access” passes to users globally, half of whom are based in the US. Described as the “last health app you need”, it connects meal logging, sleep tracking, heart monitoring and more into one subscription. Bright is charging $99.99 for its early access pass, which gives users lifetime access, and it will cost $299.99 a year at public launch.

Described as the “last health app you need”, the Bright app connects meal logging, sleep tracking, heart monitoring and more into one subscription.

Bright was slated to debut in the App Store this month, but founder and chief Bryan Jordan said it would now come in October after a few more weeks of “adding some final polish.”

“Bright is a super app for health for everybody that’s affordably priced,” Jordan said. “First impressions count on the App Store, and if we want to be the ‘last health app’ then we have a high bar to cross at the start.

“We’ve mostly self-financed the $3.5 million we’ve brought in because we haven’t been satisfied with terms made by venture capitalist investors ... Self-financing means our development has been slower than we’d like as we ran a software agency in parallel and reinvested the $1 million in profit to develop Bright.

“‘Moving fast and breaking things’ is appropriate if you’re first to market, but if you’re last to the party, then we need to make sure the party only starts when we arrive.”

In what is already shaping up as a highly competitive space, Jordan said he remained sceptical of the business model of the likes of Compound, given how expensive its subscription is.

“I’ve yet to hear from independent doctors, surgeons or specialists advocating for consumers to spend $1000 per month to monitor their health, and I’ve yet to read any supporting literature from reputable medical journals,” he said.

“I find it surprising that with these programs, there isn’t a discussion on the consequences of ‘too much medicine’... Following the science and not the trend has always brought better patient outcomes.”

Doyle responded that Compound’s $1000 monthly price tag could be attributed to its extensive diet planning and exercise regimes.

“People do spend $1000 per month on those things,” he said, adding that once Compound scales up, it would more likely cost about $200 a month without medication.

“If we can build it for the first 10,000 people over the next year, then for a million people after that, I think the cost of delivering the service is going to come down as AI agents and [large language models] play a greater role. I see this as something we can scale to millions of patients over the next five years.”

Another high-profile player is Everlab, which has received $3 million in venture capital funding from European fund b2 Ventures, as well as local funds Ten13, Flying Fox, and AfterWork Ventures.

Everlab’s business model is an annual subscription of $250 a month, or $3000 a year, for its “preventative health membership”, billed upfront. The company also takes a deposit of $299 to experience the program before committing.

The start-up said it had worked with 300 customers to date. It pairs customers with doctors, consolidates the customer’s historical health data, and then uses AI models to assist clinicians with a diagnosis.

Everlab chief Marc Hermann said the combination of rising chronic disease rates alongside an ageing population was placing immense pressure on the healthcare system.

Hermann said where Compound had largely marketed to young men who could be described as “tech bros” interested in optimising their performance, Everlab’s focus had been on targeting ordinary middle-aged individuals.

”Most of our customers are middle-aged working professionals,” Hermann said. “This is a demographic that has seen friends and family struggle with their health. They’ve heard about friends having sudden heart attacks or receiving an unexpected cancer diagnosis. Or they’ve simply seen their parents grow old and their quality of life diminish.

“For this customer, there are many things we can do to intervene and course correct.”

One Everlab customer, Andrew, is 61 and a former managing partner of a consulting firm. He says he started the Everlab program six months ago, and it found disproportionately high levels of visceral fat. This led to recommendations including a personalised diet plan with calculated protein intake for body size and a sleep assessment.

“I now have someone who collects and analyses all my existing and future health data. From the analysis has flowed a set of additional tests that have led to a range of positive outcomes.” Andrew said.

While the race to build Australia’s “health app of the future” continues apace, Michael Clements, vice president of the Royal Australian College of General Practitioners, warns of several concerns.

The apps could provide false reassurance. If patients have made bad health choices and an app tells them they’re OK, it could lead to a false sense of security. He also warned of “incidentaloma,” a medical term in which patients find something they weren’t looking for in the first place, often leading to unnecessary testing and treatment.

“There certainly has been harm where people have had complications from surgeries or complications from biopsies and procedures looking at things that were never even being looked for in the first place,” Clements said.

“We actually already know what makes healthy people. We know that keeping physically active, keeping outdoors, keeping engaged with people and humans and social interaction, having a balanced diet heavy in vegetables, fibre and nutrients, these are what work.

“The evidence is clear that people get their best health care from a GP that knows them and that the longer you have a relationship with a GP, the longer you do live. And these businesses really do need to be accountable for the risk of harm that they’re giving to their patients.”

Here is the link:

https://www.smh.com.au/technology/would-you-pay-1500-a-month-for-a-health-app-20240926-p5kdr7.html

I wonder if the price here is being set at such a level that you would not follow all the advice for fear of financial loss?

I am sure many would find the cost a motivating factor for use once they had paid!

What do you think would be a fair maximum for an app subscription?

David.

 

AusHealthIT Poll Number 766 – Results – 29 September 2024.

Here are the results of the poll.

Are We Devoting Enough Resources Into Addressing Female Health Problems?

Yes                                                                                  10 (37%)

No                                                                                   15 (56%)

I Have No Idea                                                                 2 (7%)

Total No. Of Votes: 27

A fairly clear vote,  with the feeling more could be done in women’s health.

Any insights on the poll are welcome, as a comment, as usual!

Not a bad voting turnout. 

2 of 27 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many special thanks to all those who voted! 

David.

This Is A Great Tale About A Man Who Gave Us A Great Deal That I Had Never Heard Of!

 

This appeared last week:

George Berci: The forgotten, humble doctor who changed surgery for all mankind

Alan Howe

20 September, 2024

The cursory shortlist of Melbourne University alumni on its website is a curious document. It lists a comedian of whom I’d never heard, Gillian Triggs, whose calamitous years as president of the Australian Human Rights Commission resonate still, and Germaine Greer, whose dreary prose once littered bookshops.

I called the university to ask about the death of George Berci. They had never heard of him.

But there he is, in capital letters in the Faculty of Melbourne Handbook 1969 as: Reader in Experimental Surgery, GEORGE BERCI, M.D. (Szeged).

Others named that year include Frank Macfarlane Burnet, the virologist who won a Nobel prize for medicine in 1960, Gustav Nossal, who led the world in the study of the formation of antibodies and immunological tolerance, and David Penington, who helped make Australia the leader in responding to the threat of HIV and promoted the idea of needle exchanges – a world first.

Berci changed more lives than all of them. He quietly pioneered the art of non-intrusive surgery, inventing laparoscopy so that our organs could be comprehensively examined, treated and repaired via a keyhole insertion through the skin.

The instruments and techniques he developed – and the decades he spent teaching their use – changed modern medicine the world over, saved lives, extended them, and made medical intervention less painful and perilous. He was an inventor, understood how surgical instruments might be improved, and a esteemed conductor of medical “orchestras” thankful that fate had cast them into his orbit.

None of which was a surprise. For generations, the Berci family business was making music.

He began to revolutionise surgery in Melbourne where he arrived in 1956 from Hungary after that country’s attempted revolution was murderously suppressed by the Soviet Union’s Nikita Khrushchev.

Stepping from a ship at Melbourne’s Station Pier, he spoke not a word of English. (Another young Hungarian arrived there that same year and neither could he speak English, but Gab Kovacs would go on to pioneer IVF.)

Berci set out to learn 100 English words a day every day. Within a year he knew more than most native speakers and certainly enough to interest Melbourne University and the Royal Melbourne Hospital. He was soon suggesting new technology to make crudely invasive surgical procedures easier and more comfortable for all concerned. No longer would doctors slice a large access point to examine your colon, prostate, oesophagus, bladder or kidneys.

Through laparoscopic techniques the gallbladder, spleen and appendix could be removed. Urological and thoracic surgery was greatly simplified, the hernia and colon could be repaired and gynaecological disorders rectified with remarkably fast recovery times. Modern car mechanics use similar techniques. A “waterproof HD Endoscope USB type-C borescope inspection snake camera” was on eBay yesterday for $13.22.

The large fixed-imaging equipment bearing a television camera would in time give way to small, flexible tubing with a minute camera at its tip relaying images to a screen in the surgery that many doctors at once could examine. The modern endoscope was born. At this stage not all Australians had a television.

Later, Berci would develop a low-radiation fluoroscope for live X-ray imaging.

In 1967, he was lured to Cedars-Sinai Medical Centre in Los Angeles where he worked the rest of his life, turning up to his office this year at the age of 103.

He was a humble man whose background rumbled deeply from the tectonic clashes instigated by Germany from the 1930s and could so easily have become an almost anonymous statistic of hate.

But he survived, sought an education his family could afford, and not the indulgence of music – his father and grandfather had both been recruited from Hungary to the Vienna Philharmonic Orchestra when he was a child and he had taken violin lessons from the age of three (“I missed a lot of soccer games,” he would recall).

The family fled Austria, returning to Hungary where he was arrested and recruited to a labour camp of 5000 young men for two years (wearing a yellow star to denote his religion) and forced into building defensive lines across the mountains. It was cold and they were barely fed. Many died. Being transferred to Auschwitz they changed trains in Budapest. “It had been bombed and everyone had disappeared. We escaped … an interesting moment.”

His father and grandfather had been consumed by the Holocaust, but his mother survived. Australia was still a decade away. Berci contracted Covid last month.

His family recall him inserting scopes into violins and cellos marvelling at what happened there: “It was amazing,” he said.

George Berci, surgeon and inventor. Born, Szeged, Hungary, March 14, 1921; died, aged 103, in Los Angeles, August 30.

Here is the link:

https://www.theaustralian.com.au/science/george-berci-the-forgotten-humble-doctor-who-changed-surgery-for-all-mankind/news-story/61d32b79f0ce8c5fe138e88cf9b3325f

What a fantastic story about someone about whom I know absolutely nothing – to my shame!

What a fabulous and inventive contribution!

David.

My Alma Mater Seems To Have Got Itself Into A Right Pickle – As They Say!

This appeared last week!

Sydney Uni to review complaints system as Jewish students call on Scott to resign

By Christopher Harris

September 21, 2024 — 6.26pm

The University of Sydney’s complaints system will be the focus of an external review after a senate inquiry looking at the treatment of Jewish students unearthed a trove of complaints and vice chancellor Mark Scott was forced to admit he “failed”.

This year, the university has been home to a pro-Palestinian encampment which was infiltrated by radical Islamist group Hizb ut-Tahrir and it was singled out as among the worst places to be a Jewish student at a senate inquiry into antisemitism at Australian universities on Friday.

Speaking at the inquiry, Scott conceded he had “failed them and the university has failed them”.

A university spokeswoman on Saturday said an external review would look at the institution’s complaints handling system.

“Many of the testimonials in the submissions shared to the inquiry were deeply moving and were not issues that had come through our system, highlighting the need to make sure our students and staff feel secure when seeking support and lodging a complaint,” she said.

“When the encampment ended, we recognised there was more to do, and this is why we have commissioned an independent external review of our relevant policies and processes.

“This process will include an assessment of our complaints handling procedures to ensure our community feels safe and comfortable to make a complaint.”

Australasian Union of Jewish Students vice-president Zachary Morris said on Saturday that despite students raising complaints of antisemitism with Scott and the university, little had been done so far and he called for Scott to resign.

“When we would lodge a complaint, they said there wasn’t enough information or would only act if there was footage. It has been like pulling teeth,” Morris said.

“If you say you’re going to remove the swastikas, can you actually go do that? Not just say you’re going to do that. His position is no longer tenable,” he said.

One submission from second-year veterinary student Dror Liraz said: “I have suffered the encampment, calls for intifada (by students, professors, and politicians on campus), harrowing graffiti and daily harassment from those trying to spread anti-Jewish sentiment.

“But my experience is comparatively an untroubled one. I have heard stories of students stalked to class, doxed, threatened in exams and yelled at by an auditorium full of antisemites.”

Scott’s admission of failure on Friday was met with scepticism from Jewish groups who say words and platitudes about antisemitism are not matched with concrete action to address it on campus.

The Tertiary Education Quality and Standards Agency said universities across Australia had received 598 complaints related to encampments and protests since Hamas’ October 7 attack killed some 1200 people. Israel’s subsequent attacks in Gaza to eliminate Hamas have killed more than 40,000 Palestinians.

Executive Council of Australian Jewry co-chief executive Peter Wertheim said the admission of failure was an essential first step towards righting any wrong.

“But there needs to be evidence that the nature and the extent of the failure are fully understood and that the appropriate conclusions have been drawn.

“If that were the case, we would have also had a proper public apology and a detailed commitment to take corrective action. University leaders have to date been a rich source of bland platitudes, but have fallen woefully short when it comes to practising what they preach.”

Here is the link:

https://www.smh.com.au/national/sydney-uni-to-review-complaints-system-as-jewish-students-call-on-scott-to-resign-20240921-p5kcdq.html

This looks to me like things are pretty much out of control and that we are going to see some heads roll pretty soon as a clean up is attempted.

Might be a few fun-filled weeks as this spirals out of control!

Watch this space.

David.

You Were Never Going To Stamp Out A Highly Profitable Enterprise By Banning It!

This appeared last week:

Vape-flation: prices have surged, but retailers are still flouting the ban

By Millie Muroi

September 21, 2024 — 4.50pm

Illicit vape prices have surged in the two months since a nationwide ban on their sale outside pharmacies began, fuelling concerns about a lucrative black market as shops across the country continue to stock the devices.

This masthead visited a dozen tobacco and convenience stores across Sydney and found all had vapes available: some on display in glass cases, most pulled out from beneath the counter.

Some were brazenly advertising vapes. Others had scratched out the word on their signs but had vast selections for sale when queried.

Pulling out a box with 5000 puffs, one seller said: “This one is $60. Last year, I used to sell three for $60.”

Asked why vapes had become so expensive, they said, chuckling, “because they’re illegal”. None of the sellers approached by this masthead asked for proof of age to purchase.

Vapes, which may have cost as little as $3 each from factories in China, were offered to this masthead in Sydney this month for between $40 and $60.

It illustrates the challenge ahead for Health Minister Mark Butler as he implements his world-leading vape ban.

Under the new laws, the only legal vapes are pharmacy products that have limited nicotine and come in menthol, mint or tobacco flavours, designed for people who want help to quit smoking.

All retail, such as convenience stores or petrol stations, were banned from selling vapes from July 1. Butler introduced penalties of up to $2.2 million and seven years’ jail for retailers who flout the rules by selling single-use vapes in a range of fruity or sweet flavours, which are popular among young people.

The final phase of the laws will come into effect in October, when over-18s will be able to buy vapes from a chemist without a prescription after consulting with a pharmacist. The Pharmacy Guild of Australia declined to comment on the price of prescription vapes that will be available in pharmacies.

Butler said state authorities had been ramping up their enforcement activity, conducting raids across the country, and high schoolers were reporting vapes were harder to find.

The Therapeutic Goods Administration and Australian Border Force (ABF) have seized 5.2 million devices so far this year, with an average street value of about $30 each, after Butler introduced tougher laws at the border in January.

“My message to those continuing to sell vapes is we are deadly serious about enforcing this ban,” Butler said. “Vape stores across the country are winding up their leases and closing their doors.”

An ABF spokesperson said those raking in profits from illegal vapes included organised crime groups involved in the illicit tobacco trade .

Experts are calling for more restrictions on access to vapes after health data revealed several primary school children were suspended over e-cigarette use.

International suppliers were actively seeking ways to sidestep border controls, they said, with high levels of misdeclaring and misdescribing vapes as household goods or gym equipment.

Between October 2022 and April 2023, the ABF seized just 3 per cent of the up to 28 million illicit vapes that came into the country. The increase in seizures in recent months probably indicated that stockpiles were running low and importers were trying to bring more vapes into the country, the spokesperson said.

Butler has invested significant political capital in making sure the ban works, warning that vapes are a cynical ploy from Big Tobacco to hook a new generation on nicotine.

The ban is opposed by the Coalition, which instead backs a strictly regulated consumer model that would sell vapes like cigarettes.

Shadow health minister Anne Ruston said Labor’s prohibition approach was not working. “Kids are still being targeted by a thriving and dangerous black market,” she said.

“That is why we have committed to moving to a regulated approach if elected.”

Australian Medical Association president Professor Steve Robson said that while “isolated retailers” were flouting laws, the effects of the ban were heading in the right direction.

“Illegal vapes will be stamped out by the end of the year with any luck,” he said.

Roy Morgan data shows 7.1 per cent of Australian adults, or 1.5 million people, vaped in July – about 300,000 fewer than the same time last year, and down from a peak of 9.2 per cent in December.

However, Deakin University criminologist and forensic psychologist David Bright said restrictions on vapes could push consumers towards cigarettes and tobacco.

Butler also said there had been a crackdown on vaping advertising. Since July 1, 118 warnings have been issued to advertisers promoting vaping goods, and since the start of the year, more than 8000 requests have been made to digital platforms to remove advertisements. About 58 websites have been, or will be, blocked from public view.

Here is the link:

https://www.smh.com.au/politics/federal/vape-flation-prices-have-surged-but-retailers-are-still-flouting-the-ban-20240913-p5kad1.html

Talk about pushing it up hill with a pointed stick! A ban , with essentially no enforcement, was never going to work and now we have the worst of both worlds, with vapes being sold at fantastic mark ups behind the counter!

A real policy win!

Surely the next step is just to legalise vapes – like cigarettes etc. -  and use price – via an excise – to regulate the volume.

I reckon the Government is ‘snookered’ – what do you think?

David.

This Is A Really Very Sad and Disturbing Report. Surely We Can Do Better! I Also Wonder Why My Experience Of Things Is So Different To This?

It appeared last week:

Health

One in 20 Australian adults found to have suffered reproductive coercion and abuse

Australian Study of Health and Relationships finds 3.9% of women aged 16-69 had experienced contraceptive interference and 4.9% forced abortion

Natasha May

Sun 22 Sep 2024 06.00 AEST

One in 20 Australian adults have experienced reproductive coercion and abuse.

That is among the findings of the Australian Study of Health and Relationships, released this week, the first time researchers in Australia have estimated the national prevalence of behaviour used to control a person’s reproductive autonomy.

Reproductive coercion and abuse (RCA) can include interference with contraception by a partner, forced contraception or sterilisation, and control of pregnancy outcomes by forced abortion or forced pregnancy.

Questions about these experiences were added to the country’s largest and most comprehensive study of sexual and reproductive health, conducted once a decade.

Dr Allison Carter, the group leader of the Sexual Health and Reproductive Equity (SHARE) Research Group at the Kirby Institute, presented preliminary findings around RCA prevalence from the third ASHR this week at the International Union Against Sexually Transmitted Infections (IUSTI) world congress in Sydney.

From analysing the survey data collected between 2022-2023 from a nationally representative sample of 14,540 people aged 16-69 years, the researchers found that, among women, 3.9% had experienced contraceptive interference, 2.7% had experienced forced sterilisation or contraception, 4.9% had experienced forced abortion and 1.9% forced pregnancy.

“In all likelihood, it’s probably an underestimation because we know people tend to under report experiences of violence, and also people might not recognise what’s occurring to them,” Carter told Guardian Australia.

“It might come in the form of emotional manipulation or more subtle insidious pressure to get pregnant and to keep a child when you may not want to.

“It might involve more overt threats to keep this child, otherwise ‘I’m going to leave the relationship’ – and if it’s a situation where a female partner has less social and economic power and are dependent on that relationship, they might feel intense pressure.”

It can also be overt or actual physical violence – for example, in the case of forcing a woman to choose a particular pregnancy outcome such as abortion, she said.

While RCA was primarily committed by partners, women did also commonly experience perpetration from their parents, with nearly one in five (19%) women who reported forced abortion saying it was perpetrated by their parents.

The prevalence of RCA rose drastically among socioeconomically marginalised men and women including people in contact with the justice system, people with a history of substance use, individuals with disability, those who experience violence, and gay and bisexual people.

For example, one in four women who had been in prison had experienced contraceptive interference (25.3%) and forced abortion (24.9%), while 15.2% of men living with a disability had experienced contraceptive interference.

The rate of men who reported partner interference with contraception was 8.4% – more than double the proportion of women – while 2.2% had experienced forced vasectomy.

However, Carter cautioned that to understand the data’s significance, researchers are still carrying out further qualitative research interviewing study participants to better understand people’s lived experience.

She also highlighted that when men experience partner interference with contraception, it is occurring through deception, for example a woman lying to a partner about using the pill. While that was not a healthy relationship dynamic, it could be different from the fear and control which characterises RCA among women, she said.

“A lot of the reasons behind women’s deception are rooted in women’s lesser social and economic status, and so if we want to talk about prevention, we really need to be talking about addressing disadvantage,” Carter said.

RCA has strong associations with intimate partner and sexual violence, although it can occur in isolation, making it trickier for healthcare professionals to pick up on “because there’s no other red flags”.

The findings also showed RCA was associated with a range of physical, mental and sexual reproductive health outcomes. “So it’s not just limited to reproductive health, but in effect it can affect all aspects of your life,” Carter said.

“Disagreements about whether or not to have a child are very common, and one person they want it and another may not – that’s normal. What’s important though is that people are able to navigate those disagreements in healthy way.”

Dr Kari Vallury, a research fellow at Griffith University with a focus on reproductive coercion and abuse, said having national prevalence data on the topic for the first time was “incredible”.

Vallury said it was also the first time ever in a national study anywhere in the world that “all four directions of RCA” have been measured – coerced or forced pregnancy or contraception, as well as pressure to end or continue pregnancy. “Historically forced abortion has been left out and it’s only measured contraceptive interference.”

Vallury said previously data has shown a 15% prevalence of RCA among pregnancy options counselling clients, “which you would expect to be high given the cohort but now we can really compare that and have a look at what’s happening in the whole community”.

Here is the link:

https://www.theguardian.com/australia-news/2024/sep/22/one-in-20-australian-adults-found-to-have-suffered-reproductive-coercion-and-abuse

I really do wonder about the sources of such statistics as what they report really does not accord with my life experience. Either I am very sheltered or very lucky!

I would be curious to hear from people who have life experience that confirms what is written above!

David.

We Really Could Improve The Gender Balance Of The Research We Undertake and The Work We Do To Address Gender Differences.

This appeared a day or so ago…

Health Minister Mark Butler mum on government’s response to damning menopause report

Health Minister Mark Butler dodged a series of questions in a tense interview after the release of a damning report into women’s healthcare.

Jessica Wang

September 22, 2024 - 11:22AM

NewsWire

Health Minister Mark Butler has declined to say how the government intends to respond to a damning report that found both the health system and workplaces were failing women.

Released on Wednesday, the report made 25 recommendations, including giving menopausal women flexible work arrangements, and giving extra training to GPs and increasing the time medical students spend on menopause and perimenopause - with the current curriculum only allotting for an hour of education during a five to six-year course.

The senate committee also called on the government to consider paid gender-inclusive reproductive leave, plus a national awareness campaign on the condition, and for menopause to be taught in schools as part of the curriculum.

It also said there needed to be urgent action taken to address shortages of menopause hormone therapy, and reforms to the Pharmaceutical Benefits Scheme to make the drug cheaper and more accessible to women who needed it.

While Mr Butler acknowledged it was an “important inquiry,” and said some of the findings were “shocking,” he wouldn’t commit to whether the government would implement the recommendations.

“This is now one of two really important inquiry reports the Senate has delivered to us around women’s health, and together, they tell a pretty shameful story of women not being taken seriously in the health system about their symptoms,” he told ABC Insiders host David Speers.

“Also our treatment regimes, our PBS medicines … the hormone replacement therapy just not keeping pace with best practice.”

Asked if he would specifically consider the recommendations to ensure flexible work arraignments for women, Mr Butler appeared to dodge the question.

“The report was only delivered in recent days, so we’re going to go through it carefully, but it’s been a really important inquiry,” he said.

“They are complex conditions that need really complex support.”

He said he would be working with Minister for Women Katy Gallagher and Assistant Minister for Health and Aged Care Ged Kearney to consider the findings.

Women, on average, go through menopause between the ages of 45 to 55, which can include the rapid onset of symptoms like hot flushes, vertigo, brain fog, headaches, anxiety and depression.

Throughout the committee, multiple women reported being disregarded by medical professionals with one woman telling the committee: “I’ve been gaslit and misdiagnosed, had symptoms ignored and dismissed, told they’re all in my head or it’s stress, told to exercise, take a holiday, have a glass of wine”.

Here is the link:

https://www.news.com.au/lifestyle/health/health-problems/health-minister-mark-butler-mum-on-governments-response-to-damning-menopause-report/news-story/ba00ba50a1cb59edf87c2088cc034601

There are a range of uniquely female illnesses and physiological differences that are not properly considered as often as may be helpful.

These run all the way from various female malignancies to optimum symptom control for menopausal patients and their carers.

There is also to tendency to apply research done exclusively on blokes to females as well. This may be right sometimes but totally inappropriate in other circumstances. For example do cancers of the same organ always behave the same in males and females? I suspect not!

All that is needed is awareness to make sure we get that balance of effort and funds appropriate and not assume all studies done on boys transfer seamlessly to girls!!!!

Pretty obvious but I wonder how often the implications are just ignored or missed? The reason(s) that the balance is not always correct at present could be the subject of many books!

David.

AusHealthIT Poll Number 765 – Results – 22 September 2024.

Here are the results of the poll.

Is It Way Overdue That Universities Are Abandoning Face-To-Face Lectures?

Yes                                                                                    5 (28%)

No                                                                                   10 (56%)

I Have No Idea                                                                 3 (17%)

Total No. Of Votes: 18

A very clear vote, from those who bothered. People seem to like face-to-face teaching!

Any insights on the poll are welcome, as a comment, as usual!

A moderately disconnected voting turnout. 

3 of 18 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many special thanks to all those who voted! 

David.

I Know Government Moves Slowly, But This Lot Have Raised Taking Your Time To An Art Form!

This appeared last week

More privacy reforms urgently needed but not expected before election

Noah Yim and Alexi Demetriadi

12 August, 2024

The nation’s Privacy Commissioner says further reform in privacy legislation is “urgent” and “much needed” but those changes are unlikely to happen before the next election, due by May next year.

This comes after the Albanese government on Thursday introduced its first tranche of amendments to the Privacy Act.

The introduction of criminal penalties for doxxing – the malicious publication of personal information – has largely been welcomed by members of a WhatsApp group of 600 Jewish creatives who had been victim to doxxing earlier this year and prompted the new criminal ­penalties.

Privacy Commissioner Carly Kind welcomed the government’s first tranche of amendments but stressed the need for more reform.

“We are eagerly awaiting the second tranche of privacy reforms, dealing with much needed reforms including a new positive obligation that personal information handling is fair and reasonable,” Ms Kind said.

“The coverage of Australia’s privacy legislation lags behind the advancing skills of malicious cyber actors.

“Further reform of the Privacy Act is urgent, to ensure all Australian organisations build the highest levels of security into their operations and the community’s personal information is protected to the maximum extent possible.”

Attorney-General Mark Dreyfus has flagged the government will make more amendments. The Australian under­stands this is not expected before the next election.

Coalition legal affairs spokeswoman Michaelia Cash said the opposition would “closely examine” the bill.

She drew attention to a few areas: new costs for businesses, the role of class action law firms, and the bill’s interaction with anti-money laundering and counter-terrorism financing laws.

“The Coalition has only seen the bill for the first time today and we will now examine it in detail,” she said.

“We recognise the need for appropriate reform, but privacy is both highly technical and far-reaching.”

A spokeswoman for the WhatsApp group of 600 Jewish creatives welcomed the “positive” step taken by the government to stop “horrific Jew hatred” that had “swept” Australia. “These attacks against Jewish Australians have often been fanned by online agitators who have so far faced no consequences for their appalling actions,” she said.

In February, the names, mobile numbers, professions and photographs of creatives in the group were exported from the WhatsApp chat by a New York Times reporter who then passed the 900-page document to a person who was the “subject of a story”.

The proposed provisions would not be retrospective and therefore unable to address that incident.

“The lessons of history show that what starts with the Jews rarely ends with the Jews,” the group’s spokeswoman said.

Stuart Cohen, another of those doxxed, said the legislation’s enactment “could not come soon enough” and would protect not just Jewish people but all Australians.

“The impact of my name appearing on the list was limited but this doxxing has had a really terrible impact on many friends, family and associates who have been accused of all sorts of heinous crimes for which none are guilty,” he said.

Here is the link:

https://www.theaustralian.com.au/nation/more-privacy-reforms-urgently-needed-but-not-expected-before-election/news-story/d6a4328a46f07a2141dd80fecd53e89d

As best I can tell the ‘bad guys’ are inventing evil things to do to people faster that they can be legislated against!

A hopeless situation!

David.

Here We See More Signs Of The Stress The Private Health Care System Is Under.

This appeared last week:

Insurers deny caving in to Healthscope demands

Michael Smith Health editor

Sep 13, 2024 – 5.37pm

Private health insurers deny that they caved in to public pressure from hospital operator Healthscope to give it more money, accusing the private equity-owned group of launching an “unethical” advertising campaign that had been a “dismal failure”.

Medibank Private, NIB and HCF have agreed to out-of-cycle funding payments in the “tens of millions of dollars” in the past three weeks following intense lobbying from debt-laden Healthscope, which owns 38 private hospitals.

On Friday, the insurance lobby denied that the payments revealed in The Australian Financial Review were in response to Healthscope’s advertising campaign launched last week singling out three other insurers, including Bupa, which it accused of “bleeding it dry” by underfunding its hospitals.

Healthscope is owned by Canadian investment giant Brookfield.

“Out-of-contract payments have not occurred in response to Brookfield and Healthscope’s heavy-handed US-style campaign,” said Rachel David, the chief executive of Private Healthcare Australia, an industry body representing big insurance companies.

“The Brookfield campaign has been designed to pressure health funds into unsustainable, above-inflation contracts that would drive up the cost of health insurance for millions of Australians working hard to contribute to their own healthcare in a cost-of-living crisis.”

On Friday, Healthscope welcomed the funding injections but accused the insurance lobby of hyperbole and personal attacks.

‘Hyperbole and personal attacks’

“We’ve been in constructive dialogue with a number of health insurers, who have recognised the serious issues at hand for private hospitals and engaged with finding sensible solutions,” Healthscope chief executive Greg Horan said. “The insurers’ lobby group has offered no ideas or solutions, just hyperbole and personal attacks.”

Health funds said they had been making out-of-contract payments to private hospitals to help with financial difficulties for the past two years. Those payments are rarely disclosed, although Medibank said last month that it had contributed $63 million in additional funding across the sector.

On Friday, the insurers were keen to distance their latest payments from Healthscope’s campaign, although they did not say what specifically triggered the funding injection.

Sources said Healthscope had wanted insurers to tip in more than they agreed, demanding indexation gains that would have locked insurers into funding increases in the future. Insurers rejected that request, instead offering one-off payments as a consolation prize.

Even before it launched the campaign on September 4, Healthscope had been aggressively lobbying insurers to give it more money. In negotiations with them, it warned that it would be forced to close hospitals without financial help, something insurers want to avoid as well.

Dr David said the public campaign had caused distress for people planning treatment in Healthscope hospitals, including pregnant women booked to give birth, cancer patients, and people relying on mental health services. If a hospital operator goes out of contract with an insurer, patients often have to pay more for their treatment.

“It’s deeply unethical that they are threatening these vulnerable people with extra fees. There is no need to bring consumers into contract negotiations with health funds,” Dr David said.

“The Healthscope campaign has been a dismal failure, with minimal engagement from consumers. This is undoubtedly an embarrassment for Brookfield and its investors. This is not how we do business in Australia.”

Mr Horan hit back, saying Healthscope’s Protect Your Hospitals campaign focused on the insurers that were refusing to fund patient care fairly. He said thousands of health fund members participated in the campaign, which included advertisements radio and newspaper advertisements and on social media. He said nurses and hospital teams had also supported the campaign.

Bupa declined to comment on Friday, but sources said the insurer was still in talks with Healthscope and had previously made out-of-cycle payments. The Australian Health Service Alliance, which represents not-for-profit insurers being targeted in the Healthscope campaign, said it continued to work with Healthscope.

“The Australian Health Service Alliance (AHSA) and Healthscope entered into a new, two-year agreement earlier this year, which includes more than 20 of the nation’s not-for-profit health funds. The agreement is valid up until 2026,” AHSA chief executive Andrew Sando said.

Unexpected cost inflation

Ramsay Health Care, Australia’s biggest healthcare operator and one of the few profitable private hospital owners, declined to comment when asked if it was seeking similar payments. Although this was unlikely as it was in a better financial position, the company has previously brought health funds back to the table early or out of the normal contract cycle because of unexpected cost inflation.

Relations between hospital operators and insurers are more strained than usual because of cost inflation and a federal government review of the industry that has put the spotlight on the challenges facing the sector.

Last month, the country’s largest non-profit provider with 10 hospitals, St Vincent’s, reached a last-minute agreement with NIB after threatening to walk away and leave the insurer’s customers paying higher prices.

UnitingCare Queensland, which owns and operates four private hospitals, threatened to walk away this week from its contract with the Australian Health Service Alliance, a large buying group representing 22 not-for-profit insurers.

In 2022, Bupa and Ramsay hospitals failed to reach an agreement on how to cover costs. Bupa has more than 4 million customers.

Here is the link:

https://www.afr.com/companies/healthcare-and-fitness/insurers-deny-caving-in-to-healthscope-demands-20240913-p5kact

The bottom line here is that pretty much all health care costs are rising much more quickly than inflation and funding will become increasingly stretched! What this has to mean that both sides will have to give a little or get better and cheaper at what they do.

With the way healthcare is going the pressure can be assumed to be relentless!

David.

The Aged Care System Looks To Be About To Get A Fire-Cracker Up Its Backside To Start Meeting Patient Expectations!

I am afraid cold custard and a 2 hour wait to be taken to the toilet will not cut it anymore.

Aged care concessions cost $5b in revenue

Phillip Coorey Political editor

Sep 13, 2024 – 5.42pm

The Albanese government sacrificed about $5 billion in budget savings in return for securing the Coalition’s support for the aged care reforms announced this week, according to sources in both camps.

The reforms, which will require retirees to pay more for both home and residential care from July 1 next year, increase the use of means-testing and therefore have the greatest impact on part-pensioners and self-funded retirees.

These voters are key to the Coalition’s support base and, from the outset, Opposition Leader Peter Dutton and shadow health minister Anne Ruston told the government the package as originally proposed would never pass muster among Coalition MPs.

Consequently, Senator Ruston and Mr Dutton won a raft of demands, including exempting existing residents in aged care homes and those on the waiting list for home care, from the new fee structures.

Another key concession was to insist on a cumulative lifetime contributions cap for home and residential care of $130,000. The current cap is $79,900, but the initial proposal was to have no cap on home care and a $184,000 cap on residential care.

When the reforms were unveiled on Thursday, the government said the net saving to the aged care budget over the next 11 years would be $12.6 billion. But a government source familiar with the process said the figure would have been about $5 billion more had it not been for the concessions. A Coalition source said it was “billions”.

Nonetheless, over the longer term, the savings will start to increase as no one in the system will be exempt. The annual aged care bill is $36 billion and rising.

The exemptions differ between the two care modes. Anyone in a residential facility before the July 1, 2025 start date will be carved out, and anyone already on a home care waiting list on Thursday – the day the reforms were announced – will come under the old regime.

Under the new funding model, a full-pensioner will pay, at the most, $300 more a year for residential care, a part-pensioner $700 extra, while a self-funded retiree would be on the hook for up to $13,400.

As for home care, a full-pensioner will pay 5 per cent of their independence costs and 17.5 per cent of their everyday living costs.

Depending on their income and assets, part-pensioners and Commonwealth Seniors Health cardholders will pay between 5 per cent and 15 per cent of their independence costs, and between 17.5 per cent and 80 per cent of their everyday living costs.

Self-funded retirees will pay 50 per cent and 80 per cent of the respective costs. Everyday living services include cleaning and gardening. Independence supports could include help with showering, dressing and taking medications.

The reforms have been overwhelmingly welcomed by the aged care sector, but there has been some pushback from self-funded retirees.

Margaret Walsh, the acting national president of Australian Independent Retirees, who was on the aged care taskforce which advised on the reforms, told the ABC: “I felt I was pretty much the lone voice, particularly for independent retirees.

“We had other people representing pensioners. I think that I was the only one, and I was certainly overruled on most things.”

When Mr Dutton sought approval for the deal from his party room on Thursday, about 12 MPs who spoke in protest did so on behalf of self-funded retirees.

Aged Care Minister Anika Wells said asking people to pay a bit more was essentially for their own good.

“When a person arrives at residential aged care, let’s be honest, it’s not something that people look forward to ... in fact, over the past few years, people have been dreading it,” she said.

“Lots of people have said to me, ‘I’d be happy to pay a little bit more if I could get a higher standard of aged care’.

“What I hope is that when that moment comes ... they arrive to an aged care facility that has a new wing being built and that the room they have has an ensuite.”

Here is the link:

https://www.afr.com/politics/federal/aged-care-concessions-cost-5b-in-revenue-20240913-p5kaad

To me the problem with the aged care system has been that even if people were prepared to pay more for something better than cold custard such services were very hard to find and get access to.

The system seems to rely on all the patients being passive and uncomplaining and to be able to just lump them all together out of sight but with pretty pathetic services.

The ‘baby-boomers’ are hot going to wear this and are going to demand much better and more focused care I suspect (know) and will be willing to pay to get it. It will all cost a lot more than at present....

I suspect the next decade will be a period of dramatic change in aged care – see if I am not right!

David.

Interesting To See AI Actually Being Used In Some Clinical Situations. Just Amazing Stuff!

This appeared last week:

AI is just what the overworked, burnt-out doctor ordered

By Angus Delaney and Kayla Olaya

September 14, 2024 — 1.51pm

Shorter wait lists for surgery, more time with patients and reduced burnout for workers are some of the benefits that doctors believe are possible through the use of artificial intelligence in healthcare.

AI tools have been developed to record and document doctors’ consultations with patients, produce formal reports and slash clinicians’ paperwork, and advocates claim the technology could transform a healthcare system in crisis.

But some experts and industry bodies have urged caution when using AI, which remains largely untested.

Melbourne orthopaedic surgeon Ilan Freedman is an early adopter, using AI to save him an extra 90 minutes a day in his practice. Without the distraction of note-taking, he says he is more focused on his patients.

Freedman says the tech could have far-reaching benefits for the health system, by freeing time and effort that would allow more consultations and operations. It could also be transformative on the home front, as the Clayton-based medico spends more time with his family and is no longer stuck in the office after hours.

“Because I don’t need to allocate admin time, I can get the work done in less time,” said Freedman.

“For me, I’m not seeing more patients overall, but I’m seeing … the same number of patients in much less time.

“I think everyone [other surgeons] I showed it to basically has adopted using it.”

Joel Freiberg, the founder of Australian tech start-up Medow Health, was inspired to develop a medically specific AI scribe after watching his father, a respiratory physician, stay late at work completing paperwork.

Currently, Medow Health’s user base is increasing by 50 per cent every month, as word spreads in the medical profession of AI’s possibilities.

Freiberg said clinics commonly had months-long wait lists for patient consultations and his AI tool would help reduce those wait times.

“Doctors are spending 30 per cent of their time on data entry … if you cut that in half you can see three to four more patients a day and cut those wait times,” he said.

“We all sit in the doctor’s office waiting for an hour, many times they’re doing their reporting ’cause they don’t want to forget what they said.”

Freiberg’s AI is currently only used in private clinics, but the developer wants to take the technology into the public system, and believes it could reduce Victoria’s backlogged elective surgery wait list.

In June, 58,722 Victorians were on the waiting list for planned surgery, according to the Victorian Agency for Health Information, and the real figure is larger, as many patients were waiting for an initial consultation.

While advocates are not suggesting the technology replaces a real-person consultation, some in the health system urge caution with how widely AI is used.

“There’s very little research evidence around these scribes,” said Farah Magrabi, a professor of biomedical and health informatics at Macquarie University.

“There are issues where the scribe could be basically summarising it incorrectly.

“This AI has the potential to really solve a lot of problems for doctors, and other health professionals as well, who are burdened by documentation, but they need to clearly understand how it’s working.”

The Royal Australian College of General Practitioners in July released advice on AI scribes, and noted the potential benefits, such as reducing administrative burden, improving patient satisfaction and decreasing doctor burnout.

But the potential for errors in scribes and the risks of a data breach that would expose sensitive medical information are among the drawbacks. Also, there is limited data on how well the scribes work.

The Australian Medical Association’s guidelines on AI support the use of the technology only when there is appropriate ethical oversight and where it is “used to benefit patients’ health and wellbeing”. The association has also raised concerns about a patient’s rights and a doctor’s clinical independence.

Dr Michael Bonning, the association’s chair of public health, said AI that accelerated administration work could reduce surgery wait times, but “we still need more of these doctors available to our system ... and [to] fund our health system effectively”.

More immediately, Bonning said, the value lies in reducing doctor fatigue and staff turnover.

“The level of burnout we are seeing is significant, [AI] does something about that,” he said. “I think about it as being transformative … we are at a time where the demands on the system are overwhelming.”

Everything considered, Bonning is hopeful AI could make a big difference.

“I believe in the value of technology being rolled out … and to ensure it meets all of those practical and ethical standards and recognise this can make our lives easier,” he said.

Here is the link:

https://www.smh.com.au/national/victoria/the-doctor-will-see-you-sooner-ai-could-reduce-healthcare-burnout-20240911-p5k9pv.html

And here is the link to the AI-co-pilot.

https://www.medowhealth.ai/

I have to say I find it just amazing that these technologies have been integrated and packaged in such a way that they can now be made available to clinicians for routine use.

The web-site warrants a close review to see just how fast things are moving. I am reminded of Arthur C. Clarke’s comment about ‘any sufficiently advanced technology seeming like magic’. This sure comes close – and is worth a close review!

I am afraid my Luddite tendencies are beginning to emerge. This is plain scary!

David.

It Looks Like At Least One University Has Decided Packed Lectures Are Pretty Much A Waste Of Time!

This appeared last week -  and is simply a ‘beat-up’. No one is actually furious I am sure!

‘Furious’: Adelaide University becomes first major Aussie uni to ditch face-to-face lectures

Staff have been left outraged by the decision, which will see students having no face-to-face teaching at all.

Brielle Burns

September 14, 2024 - 10:21AM

Labor committed to growing number of Australian university students

Education Minister Jason Clare says the Albanese Labor government will provide extra funding to encourage more Australian students to go to university.

A major Australian university has ditched face-to-face lectures entirely in a move which has reportedly outraged staff.

Adelaide University, which will launch in 2026 as a multimillion-dollar merger between the University of Adelaide and the University of South Australia, announced “most students” will no longer attend face-to-face lectures, which will be gradually replaced “by rich digital learning activities”.

“These activities will deliver an equivalent learning volume to traditional lectures and will form a common baseline for digital learning across courses, providing a consistent experience for students,” a post on the University of Adelaide website reads.

“These asynchronous activities will be self-paced and self-directed, utilising high-quality digital resources that students can engage with anytime and anywhere.”

The university stated courses will have a “common digital baseline”, with the proportion of digital learning expected to increase by 2034.

Other activities such as tutorials and workshops “may be delivered on-campus to create a rich cohort experience, or in instances where digital delivery provides the best outcomes for students, through the online learning space”, it noted.

Dr Andrew Miller, division secretary of the National Tertiary Education Union’s (Nteu’s) South Australia branch demanded the university reverse the decision, revealing staff are “furious”.

“We were promised the new university would be co-created with staff, students and community stakeholders,” he told The Guardian.

“This decision sidestepped that commitment. Co-creation means giving agency and empowerment to collectively build the university.”

Dr Millier, who claimed the decision was made without the proper involvement of staff, said staff should have their own say in learning outcomes.

“Flexibility [between online and face-to-face] ordinarily works both ways – some learners benefit tremendously from face-to-face learning with a specialist academic present while there are other independent learners that benefit from more remote digital engagement.”

Dr Alison Barnes, the national president of the Nteu, further slammed the “outrageous” move, arguing the shift to an online model adds to the “death of campus life”.

“Having lectured most of my adult life … I think about how many students have approached me before or after lectures to raise academic issues, things they haven’t understood about material or want extra help with,” she told the publication.

A spokesperson for Adelaide University said the move away from face-to-face lectures is not new.

“Universities have been increasingly responding to student needs for flexible delivery over the years,” they said in a statement student newspaper Honi Soit.

“Lectures are passive learning activities that can be delivered online to maximise flexibility for students without impacting learning quality.”

News.com.au has contacted the University of Adelaide for comment.

Here is the link:

https://www.news.com.au/finance/work/careers/furious-adelaide-university-becomes-first-major-aussie-uni-to-ditch-facetoface-lectures/news-story/fa62e5dcad7006a2f980df5c5bf027e3

Large lectures are really a very inefficient way passing on knowledge, which has to be the fundamental purpose. Better to be talking with and discuss the information with small groups in interactive formats etc., maybe having watched some form of interactive A/V education prior. I am sure this is what is now actually happening!

This said – there are situations where the public lecture can be a very useful forum – especially when followed by questions and discussion – or when a speaker has a point of view to put, and wants to present an organized argument or set of ideas!

It would be hard to think that these plans are little more than a cost-cutting exercise! What do you reckon ‘flexible delivery’ really means?

All this said, I reckon the idea of ‘staff outrage’ is pretty confected!

Bottom line – there is a time and place for all sorts of pedagogy from one on one up!

David.

 

AusHealthIT Poll Number 764 – Results – 15 September 2024.

Here are the results of the poll.

Have You Seen Ward Based Use Of Computer Terminals For Clinical Information Recording At Your Local Hospital?

Yes                                                                                 21 (75%)

No                                                                                     4 (14%)

I Have No Idea                                                                 3 (11%)

Total No. Of Votes: 28

A very clear vote, many have seen terminals in use at the ward level in hospitals.

Any insights on the poll are welcome, as a comment, as usual!

A moderately disconnected voting turnout. 

3 of 28 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many special thanks to all those who voted! 

David.