Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Friday, May 30, 2025

This Is An Apparently Common And Sadly Frustrating Story. Looks Like A Happy Ending!

This appeared last week:

‘I was alive but not living’: The chance discovery that saved Lilli chronic pelvic pain

By Kate Aubusson

May 25, 2025 — 5.00am

“What did you do to me?” is not a phrase doctors want to hear from a patient after surgery. But for vascular surgeon Laurencia Villalba, it became a welcome pattern among her female patients with varicose veins.

“I’d answer, ‘I fixed your leg’, and they would say, ‘but the pelvic pain is gone too’,” said associate professor Villalba, an honorary fellow at the University of Wollongong’s faculty of Science, Medicine and Health.

Persistent pelvic pain affects between 15 and 25 per cent of Australian women. But research into the poorly understood, complex and multifactorial causes is underfunded, leaving an estimated 50 per cent of cases undiagnosed.

“So, I started looking more closely and asking more questions, and I soon realised that a lot of my patients had chronic pelvic pain that had not been diagnosed, or treated or even investigated,” Villalba said.

Pelvic congestion syndrome (PCS) is among the chronically under-researched contributors to chronic pelvic pain. It’s characterised by damage to the major veins that run through the pelvis, restricting blood flow and causing pressure to build up. Some studies suggest this may contribute to 30 to 40 per cent of chronic pelvic pain cases where no other cause (such as endometriosis) can be identified.

One promising treatment is stenting, which involves inserting a small mesh tube to open a narrowing or blocked vein. The technique is more commonly associated with repairing the arteries of cardiovascular patients.

A recent study, led by Villalba, followed 113 women (aged 17 to 88) with a blockage in an iliac vein – major veins running from each leg through the pelvis – who underwent stenting after suffering severe pelvic pain, some for up to 25 years.

Before stenting, the women’s median pain score was seven out of 10 (10 being the most severe).

After the procedure, almost every patient (all but two) reported her pain had lessened significantly six to 12 months later; most (73 per cent) reported the pain had disappeared completely, as reported by Villalba and her co-author, associate professor Theresa Larkin, in the journal Venous and Lymphatic Disorders.

“Women who once struggled to sit, work, exercise and have intercourse, [and who] experienced immense pain, have been given back their lives and their freedom,” Villalba said.

The study also found:

  • The women’s pelvic pain had not returned at a median follow-up of five years.
  • Of the 31 women who still experienced pelvic pain after stenting, their median pain score had dropped to below three out of 10.
  • Twelve patients became pregnant and gave birth after receiving their stents (some had multiple pregnancies).
  • There were no stent-related pregnancy complications, and no recurrence or pain or worsening of pain during or after their pregnancies. 

In 2020, a succession of gynaecologists told 17-year-old Lilli Staff that her debilitating pelvic pain was normal.

Two years later, and more than 80 kilometres from her home near Wollongong, a Sydney gynaecologist diagnosed her with stage 4 endometriosis (the most severe form of the condition) and polycystic ovary syndrome.

“I had lesions everywhere,” said Staff, now 22.

Surgery to remove her endometriosis lesions offered some relief, but her pain soon escalated.

“I had an excruciating pain in my pelvis, through my back and left leg. I would lose feeling in my leg and have to drag it around like a dead weight,” she said.

Staff was diagnosed via ultrasound with May-Thurner syndrome: her left iliac vein had been compressed by an artery in the pelvis.

Staff was referred to a vascular surgeon in Melbourne, who said she needed a stent, but he would not perform the procedure.

“He said I was too young, and I may want to be pregnant in the future, but I was welcome to find another vascular surgeon who would do it,” Staff said.

The evidence base for stenting to treat chronic pelvic pain is still emerging. The practice relies on small studies, such as Villalba and Larkin’s, without large randomised controlled trial data. The lack of large-scale trials and research investment is a familiar scenario for pelvic pain treatment overall.

Stenting was approved only in the 1990s for patients with coronary heart disease, who are typically decades older than these women.

“We don’t have 50 years of data on stenting, and we are giving them a permanent implant that they have to look after for the rest of their lives, so we need to do this carefully and follow up with patients forever,” Villalba said.

For Staff, the first surgeon’s refusal was heartbreaking.

“I was 20 years old and couldn’t go to university. I was at home in bed every day. I was alive but not living.”

Then her mother found Villalba.

“[Villalba] said I would be on blood thinners for the rest of my life, but I couldn’t keep living like this,” Staff said.

A normal-sized vein is 14 to 16 millimetres wide. Staff’s iliac veins had narrowed to 3.5 millimetres, with extensive scar tissue. Villalba inserted a stent 15 centimetres long and 16 millimetres wide.

“I pretty much felt better immediately,” Staff said. Roughly 18 months later, she has graduated, and her quality of life has improved immeasurably.

Villalba said it was “unbelievably disturbing that a lot of these patients have had many, many years of pain and have been completely dismissed”.

She recalled a patient whose husband left her because he didn’t believe that she experienced severe pain for hours after intercourse.

“It is not uncommon for me to hear women who have been told, ‘It is all in your head’, or ‘You need to learn to live with the pain’, when doctors can’t find a reason for the pain,” she said.

Ideally, chronic pelvic pain patients would be managed by a multidisciplinary team that may include pain, gynaecology, colorectal, gastroenterology and urology specialists, physiotherapists and psychologists.

This is not available for many, said Dr Jason Chow, a gynaecologist, pain specialist and clinical lead at the Royal Hospital for Women’s pain service.

“We’re all in these siloed specialities, and pain is often multifactorial,” Chow said. “We really need to take a holistic approach to a patient’s pain.”

Identifying the patients who may benefit from stenting was key, said Villalba, who first refers patients to explore potential gynaecological causes of the pain.

Not everyone with blocked pelvic veins experiences pain, and stenting is not always appropriate for those who do, Villalba said.

Patients were asked to keep a pain diary for six weeks and are encouraged to trigger their pain by performing certain activities such as walking up several flights of stairs, repetitive exercise for more than 30 minutes or having intercourse.

“[Pelvic pain linked to vein obstruction] is not random,” Villalba said. “It is influenced by gravity and exercise.”

Associate Professor Sarah Aitken, deputy chair of the Royal Australasian College of Surgeons’ vascular board, said the stenting study was an important step in highlighting a treatment that may relieve some symptoms, “but this is still a big area of unprioritised research”.

Aitken said patients assessed for vascular causes of pelvic pain had often endured a protracted and traumatic search for a diagnosis, in which myriad other potential causes had been ruled out.

“Or someone sees a vein and goes, ‘that must be the cause’, without considering other factors,” she said. “Villalba’s work has gone a long way in trying to provide a framework for understanding whether [a patient’s pain] could be venous or something else, but we are still very early in this process.”

Here is the link:

https://www.smh.com.au/healthcare/i-was-alive-but-not-living-the-chance-discovery-that-saved-lilli-chronic-pelvic-pain-20250512-p5lykh.html

I have nothing to add, hoping the post will increase awareness of and hope for the problem!

David.

Thursday, May 29, 2025

The NT Government Really Should Get On With Euthanasia Law Reform For The Sake Of Its Citizens!

This appeared last week:

Three decades after the NT first legalised voluntary assisted dying, Territorians are still waiting on change

25 May, 2025

The Northern Territory is the only Australian jurisdiction without voluntary assisted dying (VAD) legislation. (ABC News: Lewi Hirvela)

In short:

Sunday marks 30 years since the Northern Territory first legalised voluntary assisted dying, before the law was overturned by federal parliament in 1997.

The NT is now the only jurisdiction in Australia where the practice has not been legalised, with the Australian Capital Territory passing legislation last year.

What's next?

The matter has been referred to an NT parliamentary committee due to report back in September, as some Territorians say they have waited long enough.

Warning: This story contains graphic details of health conditions. 

After four-and-a-half years of medical treatment, the cancer that originated in his lungs is still spreading, while a tumour in his neck bleeds a half-a-litre of blood a week.

At 62 years old, with every medical avenue exhausted, his options are limited.

"I'm looking forward to an agonising number of weeks," he said.

"If I have a fall I'll possibly bleed out here at home. Otherwise I can admit myself to hospital and bleed out there."

Steve, who has asked for his surname not to be used, was in his thirties when the Northern Territory became the first Australian jurisdiction to legalise voluntary assisted dying (VAD) in 1995.

The legalisation was short-lived.

In 1997, federal parliament passed a bill, introduced by Liberal MP Kevin Andrews, that overturned the law and prevented both of Australia's territories from legalising VAD until 2022.

As of 2025, the Northern Territory is Australia's only state or territory without VAD legislation, with the ACT passing laws last year.

At his home in Weddell, a suburb in Darwin's rural area, Steve questions why the process is taking so long.

"I just want the choice to be able to go in my own time, without all the pain that I know I'm going to face. No mess, no fuss basically," he said.

With weeks to live, Steve will admit himself to hospital when the time comes and "try [to] pass as quickly as he can". 

"Without VAD that's the only option I have, except for taking my own life, which I don't really want to do," he said.

Faith the 'elephant in the room'

In 1995, then-chief minister Marshall Perron brought the Rights of the Terminally Ill Bill before the NT parliament.

He said he found his government debating two main groups in opposition — the NT Council of Churches and the Australian Medical Association (AMA).

"The AMA were simply saying that this had never been done before, that these matters should be left to doctors," he said.

Philip Nitschke, a former physician and high-profile VAD advocate who has rallied the medical community to support the practice, said he found the AMA took a "paternalistic" approach to what was a personal issue.

"The argument was that doctors don't end lives, doctors save lives, [and] if you start ending lives it will destroy the so-called doctor-patient relationship," he said.

Thirty years later the AMA has shifted its stance, updating its position statement on VAD to focus on regulation rather than opposition.

The NT Council of Churches, Mr Perron said, was "a different kettle of fish".

In 1995, the group argued VAD was antithetical to foundational Christian values, a position it continues to hold.

The Australian Christian Lobby has repeatedly voiced its opposition to VAD over the years and has implored the current NT Country Liberal Party (CLP) government to consider whether there is demand for such legislation.

The NT's Catholic Bishop in Darwin, Charles Gauci, said he opposed the practice, believing that it was "not an ethical way to go", but had sympathy for people who felt the need to use it.

"We need to provide loving, palliative care for the dying person and their families," he said.

Charles Darwin University senior lecturer Devaki Monani, who in 2023 sat on the expert advisory panel tasked with consulting NT communities on potential VAD legislation, said religion remained a concern for some.

"A lot of people came up to me after the consultation and said 'look, I'm Christian and VAD is at crossroads with my belief systems'," she said.

"It was a big elephant in the room for a lot of community members."

Consultation the key word in 2025

In December 2022, a 25-year ban on the territories' rights to legislate VAD crumbled.

The Restoring Territory Rights Bill, spearheaded by Darwin-based MP Luke Gosling and Canberra MP Alicia Payne, passed the federal Senate, overturning "Andrews bill".

But change has been slow to eventuate in the NT. 

The former NT Labor government was criticised for inaction when it said in 2023 it would not progress VAD legislation until at least 2024, after the territory election.

In July 2024, an expert advisory panel commissioned by Labor handed down its final report recommending the government bring back VAD in the NT.

Progress has since stalled again, with the CLP government, elected in August, citing a lack of community consultation for not yet drafting legislation.

Chief Minister Lia Finocchiaro has emphasised the importance of including Indigenous Australians in the consultation process. 

"Aboriginal people are very important stakeholders in this conversation," she said this month.

"The original report was consulted on up and down the Stuart Highway in the main towns, it wasn't taken out to remote communities."

Lia Finocchiaro wants to consult more widely with Aboriginal people. (ABC News: Pete Garnish)

Dr Monani said the expert advisory panel's process had included remote Indigenous residents. 

"All communities across the territory were given the opportunity to contribute, and Indigenous communities did so too," she said.

According to its final report, the advisory panel held 10 consultation sessions with communities, including the remote towns of Nhulunbuy and Wadeye, and 47 consultations with health, education, community and faith organisations over an eight-month period.

It found 73 per cent of Territorians believed a person should be able to choose when they die. 

The report also made several findings on "cultural issues relevant to the NT", including the importance of cross-cultural communication and trauma-informed care.

Committee to start consultation

In May 2025, 30 years after the Rights of the Terminally Ill Bill was legislated, independent MLA Justine Davis brought forward a motion urging the NT government to implement VAD.

On the same day, the government tasked the parliament's Legal and Constitutional Affairs Committee with consulting communities across the Northern Territory on VAD and, if recommended, providing drafting instructions for a new law.

The committee will be required to report back by September 30. 

"Today marks a significant victory for people in the Northern Territory," Ms Davis said on the day.

"This decision will bring much needed relief for those who are suffering."

But for Steve, while that news is welcome, any change that comes will be too late. 

"I wish it had been available for me but that's not possible. So I just hope the baton will be carried on and people in future won't suffer," he said.

Here is the link:

https://www.abc.net.au/news/2025-05-25/nt-vad-years-on-30-years/105326852

This is a really frustrating saga that one would have hoped would have been over by now. Hard to believe there are not some anti-democratic Catholic Church inspired hold outs obstructing sensible progress!

David.

Wednesday, May 28, 2025

Vaccine Deniers Are A Total Blot On The Medical Profession’s Value And Importance, And Should All Be Struck Off!.

This appeared last week:

One pioneered vaccinations, the other attacks them. Still, they share so much

Two medical men — one lauded by their peers, the other a hugely diminished figure addressing fringe anti-vaxxer rallies around the world — played crucial roles in the history of vaccination, albeit in very different ways.

Michael Gannon

25 May, 2025

Vaccination is a triumph of medical science. Every year tens of thousands of lives are saved and millions more enriched by prevention of disability and disease.

A World Health Organisation study published in The Lancet 12 months ago estimated that poliomyelitis virus vaccinations, the variations developed separately by Albert Sabin and Jonas Salk, have saved 150 million lives.

In recent years we have seen the introduction of human papillomavirus vaccine, which sits at the heart of a global strategy to reduce the incidence of cervix cancer – a result of groundbreaking research led by Ian Frazer at the University of Queensland.

Early in 2025 maternal vaccination against respiratory syncytial virus was added to Australia’s National Immunisation Program.

This is a parable of two men and the enormous impact they have had on the world.

Norman Gregg was born in Sydney in 1892. He was an outstanding cricketer and scholar at Sydney Grammar School, winning a scholarship to the University of Sydney to study medicine.

Immediately after graduating, he left Australia for the battlefields of France, serving as a captain in the Royal Army Medical Corps where he was awarded the Military Cross for gallantry in the field.

On returning home he was employed as a resident medical officer at Royal Prince Alfred Hospital before training in ophthalmology. After completion of his specialist training, he enjoyed a distinguished career, dividing his professional time between private and public specialist practice in Sydney. He was awarded a fellowship of the Royal Australasian College of Surgeons.

In 1940 there was a major rubella (German measles) outbreak in Sydney. The following year Gregg reported in the literature the unusual occurrence of congenital cataracts in 78 babies. Most of the mothers of these babies reported rubella infection early in their pregnancies. Gregg correctly surmised that viral infection early in pregnancy had caused the congenital defects.

A year later he co-authored a paper describing congenital heart defects and deafness as other features of congenital rubella syndrome.

Gregg was knighted by Queen Elizabeth II in 1953. The award recognised his notable contribution to public health, having laid the epidemiological groundwork for the eventual development of a vaccine against the RNA virus in 1969. Tragically, this was too late to prevent 20,000 cases of congenital cataract that followed a rubella outbreak in the US in the mid-1960s.

Gregg died in Sydney in 1966, not long before the rollout of the new vaccine.

Not all careers are so inspiring.

Andrew Wakefield was born in Buckinghamshire in 1956, excelled in schoolboy rugby and trained in Medicine in London, going on to be awarded a fellowship of the Royal College of Surgeons in 1985 and being appointed to the Royal Free Hospital.

In 1998 Wakefield was the lead author of a paper in The Lancet linking the measles, mumps, rubella vaccine with a novel syndrome of autism and bowel disease. Predictably, Wakefield’s paper spiked an immediate drop in the uptake of MMR vaccination in Britain and a rise in the number of cases of measles.

The British health secretary ordered the Medical Research Council to investigate Wakefield’s claims, finding no evidence to support his work. Concerns were immediately raised about the integrity of the research. Serious allegations were made about the falsification of data.

Eventually, 10 of his 12 co-authors withdrew their support for Wakefield’s claim of a link between autism and MMR vaccination. Wakefield left the Royal Free in 2001.

After the longest investigation in its history, the General Medical Council struck Wakefield off the medical register in 2010, having found him guilty of serious professional misconduct, to have been dishonest, having acted in his own financial and personal interest, and failing to act in the best interests of children.

As observed in a subsequent appeal to the courts: “There is now no respectable body of opinion which supports the hypothesis that MMR vaccine and autism are causally linked.”

Unfortunately, the faith that a significant minority of the world’s population have in vaccination programs had been shaken. It served to add to the distress of many parents of children with autism spectrum disorder. To this day, it sits at the centre of claims made by those who, for a whole variety of reasons, oppose vaccination.

Two men, both distinguished schoolboy sportsmen, both training in prestigious medical schools, both going on to qualify as surgeons, both appointed to famed hospitals in their largest city in their country, both working in medical research. One lauded by their peers, having made a fascinating contribution to epidemiology and human health, the other a hugely diminished figure addressing fringe anti-vaxxer rallies around the world.

Researchers across Australia and the world continue work on vaccines against malaria, chikungunya, Group A streptococcus and enterotoxigenic E. coli. Their painstaking work will ultimately bear fruit.

I spend a lot of time with my vaccine-hesitant patients. It is often exhausting. But it is worth it. Sure, it could be spent addressing other areas of health anxiety or illiteracy. But it is necessary to try to overcome the harmful misinformation that spreads freely on the web and social media.

The misery and disease from those who spread anti-vaccination lies come at a cost. Doctors like me stand on the shoulders of giants such as Salk, Sabin, Frazer and Gregg. We and the populations we serve have so much to be grateful for.

Michael Gannon is a consultant obstetrician and gynaecologist with 18 years’ experience as a specialist. He has delivered more than 5000 babies. He served as president of the Australian Medical Association from 2016 to 2018 and is president of leading professional indemnity provider MDA National.


This column is published for information purposes only. It is not intended to be used as medical advice and should not be relied on as a substitute for independent professional advice about your personal health or a medical condition from your doctor or other qualified health professional.

Here is the link:

https://www.theaustralian.com.au/health/medical/one-pioneered-vaccinations-the-other-attacks-them-still-they-share-so-much/news-story/b2a25f7663466c67eb933f444c0d0863

It is hard to argue that vaccination is not the greatest single health innovation of the last few hundred years when one considers the millions of children who have been saved from all those awful diseases of childhood (and adults) – whooping cough, measles, mumps, diphtheria, tetanus, cholera and so on!

Fortunately the obvious good and positive outcomes of vaccination have convinced all of the benefits other than the true “lunatic fringe”!

We should all be grateful to those who fought the walls on ignorance and distrust those years ago to make children, and adults, so much safer!

It is really an amazing scientific success story!

David.

Tuesday, May 27, 2025

This Is A Good List Of Thinking Points To Help Make You Smarter!

This appeared last week:

7 ways to be a great thinker

Here are the daily habits of highly intelligent people.

Simon Kuper Contributor

May 25, 2025 – 8.17am

Most people are getting dumber. Largely because of the smartphone, we’re in an era of declining attention spans, reading skills, numeracy and verbal reasoning. How to buck the trend?

I’ve charted seven intellectual habits of the best thinkers. True, these people exist in a different league from the rest of us. To use an analogy from computing, their high processing power allows them to crunch vast amounts of data from multiple domains.

In other words, they have intellectual overcapacity. Still, we can learn from their methods. These can sound obvious, but few people live by them.

Read books. A book is still the best technology to convey the nuanced complexity of the world. That complexity is a check on pure ideology. People who want to simplify the world will prefer online conspiracy theories.

Don’t use screens much. That frees time for books and creates more interstitial moments when the mind is left unoccupied, has freedom to roam and makes new connections. Darwin, Nietzsche and Kant experienced these moments on walks. The biochemist Jennifer Doudna says she gets insights when “out weeding my tomato plants” or while asleep.

Do your own work, not the world’s. The best thinkers don’t waste much time maximising their income or climbing hierarchies. Doudna left Berkeley to lead discovery research at biotech company Genentech. She lasted two months there.

Needing full scientific freedom, she returned to Berkeley, where she ended up winning the chemistry Nobel Prize for co-inventing the gene-editing tool Crispr.

Be multidisciplinary. Prewar Vienna produced thinkers including Freud, Hayek, Kurt Gödel and the irreducible polymath John von Neumann. The structure of the city’s university helped.

Most subjects were taught within the faculties of either law or philosophy. That blurred boundaries between disciplines, writes Richard Cockett in Vienna: How the City of Ideas Created the Modern World. “There were no arbitrary divisions between ‘science’ and ‘humanities’ – all was ‘philosophy’, in its purest sense, the study of fundamental questions.”

Hayek, for instance, “trained at home as a botanist to a quasi-professional level; he then graduated in law, received a doctorate in political science from the university, but … spent most of his time there studying psychology, all before becoming a revered economist.”

Breaking through silos goes against the set-up of modern academia. It also requires unprecedented processing power, given how much knowledge has accumulated in each field.

But insights from one discipline can still revolutionise another. The psychologist Daniel Kahneman won the Nobel Prize for economics for his findings on human irrationality.

Be an empiricist who values ideas. During the Second World War, Isaiah Berlin was first secretary at the British embassy in Washington. His weekly reports on the American political situation were brilliant empirical accounts of the world as it was.

They mesmerised Winston Churchill, who was desperate to meet Berlin. (Due to a mix-up, Churchill invited Irving Berlin for lunch instead. The composer was baffled to be asked by Churchill himself, “When do you think the European war will end?“)

In March 1944, Isaiah Berlin returned from Washington to London on a bomber plane. He had to wear an oxygen mask all flight, wasn’t allowed to sleep for fear he would suffocate, and couldn’t read as there was no light.

“One was therefore reduced to a most terrible thing,” he recalled, “to having to think – and I had to think for about seven or eight hours in this bomber.” During this long interstitial moment, Berlin decided to become a historian of ideas. He ended up writing the classic essays The Hedgehog and the Fox and Two Concepts of Liberty.

Always assume you might be wrong. Mediocre thinkers prefer to confirm their initial assumptions. This “confirmation bias” stops them reaching new or deeper insights. By contrast, Darwin was always composing arguments against his own theories.

Keep learning from everyone. Only mediocrities boast as adults about where they went to university aged 18. They imagine that intelligence is innate and static. In fact, people become more or less intelligent through life, depending on how hard they think.

The best thinkers are always learning from others, no matter how young or low-status. I remember being at a dinner table where the two people who talked least and listened hardest were the two Nobel laureates.

Here is the link:

https://www.afr.com/world/europe/7-ways-to-be-a-great-thinker-20250525-p5m1y6

This, I find, is a very good list of approaches to improving insight and understanding although I really do find screens pretty useful in keeping up with the madness that surrounds us these days!

How important do you rate screen time in your battle for insight and understanding? I find it vital which is why I may not understand much! Who knows?

David.

Sunday, May 25, 2025

It Is Hard To Believe That Donald Trump Is Not The Worst Thing To Happen To The US This Century…

This appeared last week:

Trump’s war on Harvard is un-American

The trigger-happy firing range that is the present administration has put America’s universities squarely in the crosshairs.

The Trump administration told Harvard on Friday it can no longer enrol international students. Bloomberg

Simon Schama

May 23, 2025 – 3.51pm

So many enemies: spineless judges, moaners about due process; fake news merchants; the Fed; Canadians (nasty); Europeans, same (except for Italy and Hungary); environmental hoaxers; regulators of shower pressure; cancer-causing windmills; tariff-haters; Venezuelans; the Cheneys. But the worst of the lot? Not even close. Professors! Radical left lunatics, or those soft on them, which is the same thing. Let’s see how they like it when the money tap turns off.

The trigger-happy firing range that is the Trump administration has put America’s universities squarely in the crosshairs. The more liberal the faculty, the heavier the hit: billions in federal grants stripped from Harvard, hundreds of millions from other Ivy Leaguers. [On Friday, the administration told Harvard it can no longer enroll international students.]

The purported reason for going full Mr Potter on America’s great universities is antisemitism. Has the harassment and abuse of Jewish students been a serious problem, especially since October 7? Yes. Have anti-Zionist chants crossed a line into outright Jew-hatred? Absolutely. Are colleges doing something about it? Yes; grade of B+.

But does kneecapping science departments by choking off their research funding persuade River-to-Sea chanters to pipe down? Hardly. Coming to the aid of campus Jews was always a pretext. Forgive us if we doubt that presenting the subjection of higher education’s independence to an ideological purge, labelled “defence of the Jews”, will work as an antidote to antisemitism.

Connoisseurs of oxymorons might enjoy the imposition, on pain of financial strangulation, of “viewpoint diversity” on colleges deemed to have undergone “ideological capture”.

But anyone doubting that the “existential terror” described by Christopher Rufo, the zealot of the campaign against universities, as his goal has been the main point all along need only look at the closing speech of the National Conservatism Conference in November 2021, delivered by JD Vance. He was then campaigning, bankrolled to the tune of $US15 million ($23 million) by his former boss Peter Thiel, for an Ohio Senate seat.

Among the Republican audience, there might have been some inconveniently recalling Vance’s withering attack on the political and moral credentials of one Donald Trump. What could be better, then, by way of demonstrating his true conversion, than descanting on America’s “fundamentally corrupt” universities, institutions so irredeemably rotten that Vance had concluded it was necessary to abandon one of the cherished truisms of the American dream: a four-year college education.

“Ladies and gentlemen,” he warned, “we are giving our children over to our enemies, and it’s time we stop doing it.” All that happened in the grove of academe, Vance went on, was that students would “learn to hate their country and acquire a lot of debt in the process”.

His peroration, to which, he said, he had given much thought, would feature, for his mic drop, a pearl of wisdom from “the great prophet and statesman” Richard Milhous Nixon.

Speaking in December 1972 to Henry Kissinger (the most professorial member of his cabinet and sometime member of the Harvard faculty), Nixon had mused that “the professors are the enemy” – words Vance had clearly taken to heart. Their evil twin was, of course, the press. But Nixon returned to his mantra. “The professors are the enemy. Write that on a blackboard 100 times and never forget it.”

Which, evidently, Vance has not. But pinning the ills of America on a free press and a college education would have surprised the Founding Fathers, whose Declaration of Independence Trump will be commemorating next year, its 250th anniversary.

“Washington’s first address to Congress declared that ‘knowledge is in every country the surest basis of public happiness’.”

As the Founders saw it, the great driver of freedom was knowledge. Two decades before independence, the lawyer and essayist William Livingston insisted in a journal called The Independent Reflector that “knowledge among a people makes them free, enterprising and dauntless; but ignorance enslaves, emasculates and depresses them”.

Whatever difference arose between Washington, John Adams and Jefferson following independence, it was a shared truism of the governing class that the very existence of the US as a free republic was conditional on a well-informed citizenry.

Washington, whose first annual address to Congress in 1790 declared that “knowledge is in every country the surest basis of public happiness”, envisioned a national university in the capital that would rise above party factions in the ennobling pursuit of truth; though neither college nor partisan peace would be realised during his lifetime.

In 1779, Thomas Jefferson (who would make sure that his role as “Father of the University of Virginia” would be inscribed on his tombstone) championed a Bill for the More General Diffusion of Knowledge. Its purpose would be to “illuminate ... the minds of the people at large” – excluding, of course, women and the enslaved – “and more especially to give them knowledge of those facts ... [that] they may be enabled to know ambition under all its shapes”.

The 1780 Constitution of the Commonwealth of Massachusetts, primarily drafted by Adams, committed itself to “The Encouragement of Literature” so that “Harvard-College in Cambridge” would be the institution through which the diffusion of “wisdom and knowledge” ensured the health of the body politic.

As Richard D Brown’s important history The Strength of a People: The Idea of an Informed Citizenry in America, 1650-1870, points out, all of America’s first four presidents (including James Madison) assumed that the security of the republic depended on the “equation of virtue and knowledge”.

A century later, Calvin Coolidge might assert that “the chief business of the American people is business”, but a rich stream of ideas flowing from the learned optimism of the Founders, through the creation of land-grant colleges and the “brain trust” administrations of Franklin Roosevelt, assumed that professors were not the “enemy” but a resource that was indispensable for the good of the nation. The true enemy of American democracy was not professors, but ignorance.


This was by no means a universal view. For all his pride in the University of Virginia, Jefferson, who dedicated himself to a “crusade against ignorance”, lamented all the baseless slanders that came his way in the cacophony of politics. “So many falsehoods have been propagated,” he wrote, “that nothing is now believed and ... for want of intelligence they may rely on, [the people] are become lethargic and insensible.”

It would not be the last time that the defenders of empirically confirmed truth would find themselves on the back foot. One of the great books of American history, the Columbia history professor Richard Hofstadter’s Anti-Intellectualism in American Life, published in 1963, shortly after the Red Scare, chronicles the populist equation of highbrow with un-American. Hofstadter warns that, however tempting, the denigration of intellect ought not to be reduced to “eggheads and fatheads”.

For all the high-minded nostrums of the Founders, America’s sense of its calling in the world was at least as much shaped by Christian evangelism as Enlightenment reasoning. The sovereignty of the feeling heart would have its way over the reflecting mind.

Ralph Waldo Emerson could inspire the Phi Beta Kappa class at Harvard in 1837 by holding up “the true scholar” as “the only true master” who would “resist the vulgar prosperity that retrogrades ever to barbarism”.

But beyond Harvard Yard, multitudes would heed Billy Sunday, the early 20th-century revivalist preacher, when he warned that “thousands of college graduates are going as fast as they can straight to hell. If I had a million dollars I’d give $999,999 to the church and $1 to education ... When the word of God says one thing and scholarship says another, scholarship can go to hell.”

“The demand for lockstep obedience is exactly why autocracies of knowledge always end up damaged by their intellectual self-harm.”

As the US flexed its military muscle and flowered economically, two more foes of excessive cerebration joined the fray. When, in 1828, Andrew Jackson soundly defeated the incumbent president John Quincy Adams, the son of the second president and himself a passionate believer in the federal government’s role in creating and funding scientific institutions, the Jacksonites attributed their victory to their hero being a man of action rather than a man of learning.

The choice, they said, was between “John Quincy Adams, who can write” and “Andrew Jackson, who can fight”.

Half a century later, in the gilded age of the robber barons, the enfeebling intellectual, all brain and no backbone, alienated from the instinctual life of regular folk, ignorant of practical business, and milquetoast in their patriotism, became a dependable attack line.

The great exception to being classified one way or the other was Theodore Roosevelt, overlooked by Donald Trump in favour of his peculiar fixation with William McKinley. But then Roosevelt saw his trust busting as a natural projection of the rough-riding man of action.

Brain trusts came into their own again when Teddy’s distant cousin Franklin recruited two Columbia academics – the economist Rexford Tugwell and Raymond Moley, a professor of law, to the White House. Their influence on presidential decision-making was pounced on by the Republican foes of the New Deal as another example of out-of-touch professors imposing alien socialism on the American people. While FDR was contemptuous of the caricature, it worked well enough to push Tugwell out of government in 1936.

But even before Pearl Harbour, the need for scientific knowhow in fighting a likely war brought the professors back to the White House. In June 1941, and in response to a proposal by the MIT engineer Vannevar Bush, Roosevelt established the Office of Scientific Research and Development. Bush was its head, reporting directly to the president.

The results of its work – mass production of penicillin for battlefield wounded, proximity fuses that transformed anti-aircraft fire, and, not least, the Manhattan Project – made an unarguable case for the partnership between government and university-based research science.

Though given only a minor role in Christopher Nolan’s Oppenheimer, Bush was famous enough to feature on the cover of Time magazine. Largely forgotten now beyond histories of science, he was one of the 20th century’s most remarkable visionaries, not least for his conviction that peacetime federal governments had an obligation to fund basic scientific research, liberated from the demands of commercial profit.

In the summer of 1945, Bush wrote two essays, both of which pointed to the future. The shorter piece, As We May Think, published in The Atlantic Monthly, was devoted to his invention, the “memex” (short for “memory expansion”): a machine that would transform the capture of information by storing an infinity of microfilmed documents while providing “associative trails” that foreshadowed, albeit in analogue, the hyperlinks of the world wide web.

The longer essay, Science, the Endless Frontier, was in effect a response to FDR, who in November 1944 had written to Bush that “new frontiers of the mind are before us” and asked him to think about how the momentum of wartime breakthroughs could be sustained in peacetime, in particular “the war of science against disease” and the “discovering and developing scientific talent in American youth”.

Bush argued that since colleges were “the wellsprings of knowledge and understanding”, they should be parties to research contracts with the government that would provide the necessary stability of funding for sustained experimental work. This would guarantee the “free play of free intellects working on subjects of their own choice, in the manner dictated by their curiosity for exploration of the unknown”.

The National Science Foundation, created by Congress and signed into law by President Harry S Truman in May 1950, owed much to Bush’s eloquence and vision – though its governance was not what he wanted. Instead of a director appointed by a board dominated by scientists, the head of the agency would be picked by the president. Nonetheless, Bush’s ambition to bring science from the wings “to the centre of the stage” had been achieved and, in the decades that followed, became spectacularly fruitful in world-changing breakthroughs and Nobel prizes.


It is this partnership of knowledge that is currently suffering brutal collateral damage from MAGA’s culture wars and the chainsaw massacre of expertise enacted by DOGE. The continuity of funding that Bush saw as a condition of experimental freedom has been smashed. The National Institutes of Health has already lost 1200 of its staff, with threats of many more layoffs. Good Friday was not so good for the more than 400 recipients of grants from the NSF who had their funding cancelled.

Tellingly, research projects dealing with disinformation, climate science or anything attempting to advance science in under-represented groups have been singled out for punishment. The cuts have been partly based on a Senate report last October in which, among other conclusions, the term “biodiversity” was misinterpreted to imply deference to the now taboo DEI.

The crudeness of these exercises in political conformity is exemplified by the freezing of invaluable peer-reviewed journals such as Emerging Infectious Diseases, CHEST, specialising in asthma and pulmonary disease research, and the Morbidity and Mortality Weekly Report.

A letter sent by Ed Martin jnr, the interim attorney-general for DC, to the New England Journal of Medicine, demands answers to six questions, satisfying the authorities that “alternative views” are accommodated in their pages. But this is, in effect, DEI for Robert Kennedy jnr’s dubious version of science, ignoring the strict peer-reviewed standards to which all journals adhere.

The demand for lockstep obedience to the party line is the purest Sovietism and it is exactly why autocracies of knowledge always end up damaged by their intellectual self-harm.

Science is not the only casualty of the war on knowledge. President Trump has let it be known that he wants no “negativity” in the Smithsonian Institution’s historical museums. History must now be mobilised in the service of national self-congratulation while the tanks roll down the Mall on the military parade the president is orchestrating for his 79th birthday treat.

But that is not what my trade’s founders had in mind at all. And one of them, a military man, Thucydides, wrote his History of the Peloponnesian Wars as an exercise in Athenian self-criticism, building as he does to the hubris-heavy catastrophe of the expedition to Syracuse.

In doing so, he laid down the rules of our professional code of practice. History is neither an exercise in vain self-glorification, nor is it penitential polemic; rather, and most simply, the retrieval of evidence in pursuit of the truth.

But though the Founders would all have read the Greeks, it’s a reasonable bet that the 47th president has passed them by. So instead of reflection on the significance of 1776, we will be getting a National Garden of American Heroes, some 250 statues that are by definition an entirely dumb personification of history.

Just this month the National Endowments for the Humanities and for the Arts have both been informed that 85 per cent of their grants have been cancelled and that funds supporting countless projects of research and artistic expression across America would be diverted to the garden to meet the bill, reportedly coming in at between $100,000 and $200,000 per statue.

Among Trump’s original pick list, there is one unlikely hero (at least for the president). Alphabetically sandwiched between Susan B Anthony and Louis Armstrong is Hannah Arendt, historian, philosopher and author of, among many other things, a powerful essay on Truth and Politics.

You must hope that her statue will feature the obligatory cigarette together with an ironic smile, knowing that she provides a plinth text that Donald Trump is bound to appreciate.

“Truth, though powerless and always defeated in a head-on clash with the powers that be, possesses a strength of its own: whatever those in power may contrive, they are unable to discover or invent a viable substitute for it. Persuasion and violence can destroy truth, but they cannot replace it.”

Here is the link:

https://www.afr.com/world/north-america/trump-s-war-on-harvard-is-un-american-20250523-p5m1on

All I can say is that I find it really  terrifying to have the power of the US in the hands of such an ill-suited individual. He really is a global menace!

David.

AusHealthIT Poll Number 795 – Results – 25 May 2025.

Here are the results of the recent poll.

Do You See Any Value In Having A Blood Test To Diagnose Alzheimer's Disease Available?

Yes                                                                      8 (47%)

No                                                                       9 (53%)

I Have No Idea                                                   0 (0%)

Total No. Of Votes: 17

Clearly a pretty much split vote.

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

Pathetic voter turnout – answer must have been too easy. 

0 of 17 who answered the poll admitted to not being sure about the answer to the question!

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

David.

Friday, May 23, 2025

Technology Throws Up A Really Difficult Dilemma! To Track Or Not!

This appeared last week:

Opinion

When does tracking become stalking? Tell your kids. There’s one key warning sign

Julia Baird

Journalist, broadcaster, historian and author

May 16, 2025 — 7.30pm

“Don’t you ever want to, like, disappear?” I asked my 18-year-old daughter this week.

She looked at me, puzzled: “What do you mean?”

“Like drop off the map, not be tracked, have no one know where you are.” I was thinking of my own backpacking days, full of narrow escapes and all kinds of peril but so free. I’d call home collect, I wasn’t a blinking dot on anyone’s map, I just disappeared inside the belly of Europe. Dyed my hair red, did stupid things, danced in subterranean clubs, slept in boatsheds and on beaches, rode motorbikes in Greece, crashed motorbikes in Greece, all that stuff.

“No,” she shrugged.

We had been talking about the new research showing how young people are used to being surveilled. The theory is that it starts with their parents (hands up, all of you on Find My ... or Life360), then runs on to relationships, which can leave them vulnerable to controlling partners.

eSafety Commissioner Julie Inman Grant believes that tracking by well-intentioned parents wanting to keep kids safe has “anaesthetised young people to this whole idea of being monitored or surveilled”. Her research shows double the number of men (one in five) than women (one in 10) think constantly texting to find out what their partner is doing, and with whom, is a sign of care.

Griffith University PhD student Maria Atienzar-Prieto told the Herald this kind of coercive control has been normalised because “it starts in the family home”.

Every kid – and adult – needs to understand what coercive control looks like, how deceptive or dangerous it can be, and what they must do to avoid or leave those relationships.

But young people live in a world of surveillance now – they know where their mates are, often their parents, almost always their boyfriends or girlfriends. So, when we warn them, again, about the perils of the technology we use ourselves, we are in danger of inviting a lecture on parental hypocrisy.

Young people often understand the technology better than we do – how to deny access once you have broken up with someone; freeze or pause your location; hide away for a bit. (This, of course, can be a red flag in a relationship – is your partner cheating or just out of Wi-Fi range?)

The most important thing to teach kids is how to identify when affection – “Where are you? Did you get home OK? Are you hurt?” – turns to creeping control – “Where are you now? Why didn’t you return my calls? Why are you home so late? Who were you with?” on a loop.

Tracking kids can be reassuring if they are out late or travelling alone. But surely if we are to address how to protect kids from abusive lovers who follow them across digital maps, then we need to ask some hard questions of ourselves about when and how we need to track them too.

I only relatively recently linked up with my kids, now 16 and 18, on a tracking app. I’ve tried to be careful in using it for protection, not nosiness.

This is partly because of one cautionary Black Mirror episode – Arkangel – that has stuck with me for a long time. In it, a three-year-old girl, Sara, goes missing, and her mother Marie is terrified. After finding her, Marie, a single mother, decides to enrol Sara in a trial where a chip is planted in her brain. This technology allows Marie to see through her daughter’s eyes and hear through her ears, wherever she is, also providing location details. It was also designed to censor any stressful sights, preventing Sara from seeing anything that might elevate her pulse rate (a bit dangerous in case of emergency?).

The two clash over the use of the technology as Sara grows older, then it becomes intrusive – Marie eventually sees her daughter snorting cocaine and having sex with her drug-dealing boyfriend and freaks out. She begins to intervene, finding the boyfriend and telling him to back off, hiding contraceptives in smoothies. The episode ends with Sara hitchhiking out of town.

In some ways, the story is crudely told, but the idea that there are obvious dangers to too closely monitoring (thereby controlling) your teenage children has stayed with me. It was directed by Jodie Foster and written by Charlie Brooker, who said becoming a father made him sympathetic to helicopter parenting.

Executive producer Annabel Jones said it was based on chip implants pets have, telling Variety: “I have heard that there are some children that are getting them now, so this is just an exaggeration of that. We wanted to find a really good idea of how that could go terribly wrong.” Is the message then, “if you love it, let it go?” Does a child have a right to privacy, or does a parent’s need for reassurance on safety trump it in all circumstances? And do we all agree on what safe is? Who assesses vulnerability?

It’s difficult for parents to stem the tsunami of images, videos and other content that kids can see when they are still too little to understand; porn, violence, predatory invitations, in a world where sexual assault is obscenely common. It’s understandable to feel inadequate and fearful.

But a lucrative industry has grown up to cater to, to fuel, both parental anxiety and stalkers in the eight years since Arkangel aired – wearable tracking devices, spyware for remote reading and controlling of phones, smartwatches, even clothing with trackers. AirTags, smart tags, tiles.

It’s the secretive stuff that worries me most. If someone is being harassed by an ex or acquaintance, the phone is one mechanism they can actually control – unless spyware is involved.

You can be tracked with hidden patches or pockets ironed or stuck on to clothes or items. One girl found a tracker sewn into overalls she ordered from Shein. A variety of trackers can be attached to cars – under number plates, in seatbelt buckles, in fuel caps.

Yes, educate your kids about phones. And let them educate you. But remember, the technology is a means, a mechanism, which will shift in form over time.

The problem, ultimately, is the controlling behaviour.

Julia Baird is a journalist, author and regular columnist.

Here is the link:

https://www.smh.com.au/technology/when-does-tracking-become-stalking-tell-your-kids-there-s-one-key-warning-sign-20250516-p5lzpk.html

Here is a 21st Century problem if ever I saw one. Of course you want to know where the kids are and that they are alright! But can to track them to ease your anxiety and do you tell them you are, or not!

This is way above my pay grade and I have no idea what the right answer is and for what circumstances!

Interested in views from readers….

David.

Thursday, May 22, 2025

Sometimes Simple And Cheap Is The Best! We Should Have Guessed This Outcome In Advance…

This appeared last week:

$10m was spent on these melanoma scanners. Doctors were better at detecting cancer

By Liam Mannix

May 17, 2025 — 4.31pm

A huge and much-hyped government investment into 3D skin cancer scanners has hit an unexpected snag after early data showed the scanners performed no better than a simple skin check from a GP – and may lead to overdiagnosis.

The new data has stunned researchers, who are debating whether this represents a blip that will be ironed out as the tech improves or a cautionary tale about the promise and perils of shiny new medical technology.

The Australian Cancer Research Foundation spent about $10 million in 2018 to set up 15 3D full-body cameras across Australia. The Queensland-based research centre established to run the network received another $25 million in federal government research funding, as well as funding from the camera’s manufacturer.

The scanners, each of which cost about $500,000, use dozens of cameras to generate a 3D image of a person, tracking the location of each mole and blemish.

When the first machines were installed in Australia in 2017 as part of a separate project, a glowing press release said the tech would “revolutionise melanoma detection”.

That revolution is not yet here.

In a study published earlier this year in JAMA Dermatology, researchers found adding the cameras to usual care led to a lot more lesions being cut out from volunteers’ skin – but no more melanoma being detected compared to standard skin checks. And the scanners added $945 per patient in healthcare costs.

“This study is like a cautionary tale,” said one leading melanoma researcher, working on a related project and granted anonymity to speak freely about the trial. “These are very costly devices. And they might not work if you don’t implement it properly. And you’re just wasting lots of money and potentially doing harm.”

“It does present a challenge for us going forward,” said Professor David Whiteman, a researcher at QIMR Berghofer and co-author of the study. “It does temper the enthusiasm a little for just how we go about dealing with skin cancer and its detection in Australia.”

Others disagree. Professor H. Peter Soyer heads the Australian Centre of Excellence in Melanoma Imaging & Diagnosis and led the study. “I still think our original vision, 3D total body imaging supported by AI … will basically lead to an improvement,” he said. “I have no doubt about it.”

Melanoma is Australia’s national cancer. We have the highest incidence rate in the world. More than 18,000 cases are diagnosed every year, and more than 1300 people die.

The cancer effects melanocytes, the pigment-producing cells responsible for skin’s colour, and occurs mainly in people with fair skin.

UV radiation from the sun is capable of directly altering the DNA code within these cells. Damage the code in genes crucial to controlling growth, and the cell can enter a frenzy of uncontrolled growth. If the new tumour grows deep enough, it can access the bloodstream and spread to our organs or brain.

That makes it a highly survivable cancer if it is detected early and cut out. Five-year survival rates for melanomas detected at stage 1 – when the cancer remains a single skin spot – are greater than 99 per cent.

If the cancer is detected at stage 2 – the cancer is at least a millimetre thick – that rate drops to 73 per cent. By stage 4, five-year survival rates plummet to 26 per cent.

Hence the interest in a screening program, which could theoretically pick up melanomas before they have a chance to spread. Late last year, the federal government committed $10.3 million to develop a road map.

But screening is harder than it would first appear. Diagnosis is somewhat subjective. Your skin is like a tapestry, painted with scars and freckles and moles – scientists call them naevi – that are not cancerous. And melanomas do not all look the same; there can even be disagreement among experts about which marks are benign and which cancerous. The accuracy of a visual test from a doctor ranges between 40 and 70 per cent.

“We are confronted with millions, really, of lesions on the skin that have to be assessed. And it’s very, very difficult for the practitioners to discriminate which are the nasty ones because there are no rewards for getting it wrong,” said Whiteman.

An effort to screen hundreds of thousands of Germans for melanoma led to no long-term reduction in cancer mortality; other screening studies have come to similar conclusions.

And then there’s the overdiagnosis problem. Melanoma was once a rare tumour but is now the third-most-commonly diagnosed in the US – an increase some refer to as an epidemic – yet there has been no actual increase in melanoma deaths.

This suggests, to some, we are cutting out way too many ‘could-be’ melanomas. “We are living in a fee-for-service society. If in doubt, cut it out,” said Soyer.

This is why the Australasian College of Dermatologists does not recommend melanoma screening.

“It is a waste of time. It’s not cost-effective. You stir up the worried well. They’ll have more procedures, so potentially there’s going to be more harm,” said incoming college president Dr Adrian Lim.

All of which brings us back to the 3D scanners.

The melanomas we really want to spot, and quickly, are the ones that are growing. What if you could quickly map out every spot on someone’s skin, and compare them, year-on-year, to spot malignancy? That’s the promise of Canfield Scientific’s VECTRA 360 system.

The patient steps inside the imager, where 92 cameras snap photos of every inch of exposed skin. A computer knits them together into a digital avatar, with each spot able to be analysed by a dermatologist – or an AI. And you can do it quickly, important if you’re going to screen millions of people.

In 2018, the Australian Cancer Research Foundation handed Soyer and his team $9.9 million to roll out the scanners – the only 3D cameras approved by Australia’s health regulator. “This is a significant game changer,” Soyer said in a 2021 video uploaded to Canfield’s YouTube channel. “This will allow us to detect your potential melanoma much, much earlier.”

Soyer has received consulting payments from Canfield Scientific since 2018, but the company was not involved in design or review of the study. The arrangement was “declared in all presentations and publications”, he said.

With all that promise, why are the early results so disappointing? Theories abound.

First, the study compared a 3D camera plus standard skin testing to just standard skin testing, so the intervention group was very heavily scrutinised. That could explain why so many extra moles were excised.

Why did the cameras not pick up more melanomas? Maybe because current skin checks work very well. “We have a very high bar,” said Lim.

The study also did not use the ability of the scanners to show a change in skin spots over time, a crucial melanoma symptom. “I do think that’s a key factor,” said Professor Anne Cust, who leads development of the skin cancer screening road map for Melanoma Institute Australia. And the machines may improve if AI is used to scan the data.

Soyer argues the results actually validated the technology because they “demonstrated that 3D imaging could identify skin lesions that should be reviewed by a dermatologist or clinician for appropriate treatment and diagnosis.”

But it may simply be the case machines are no better than a trained doctor. “That’s our default position – that this is the challenge we’re going to really struggle to overcome,” Whiteman said. “The computer has got to do better than that. And, at the moment, it does not seem like it can.”

Here is the link:

https://www.smh.com.au/national/10m-was-spent-on-these-melanoma-scanners-doctors-were-better-at-detecting-cancer-20250516-p5lzue.html

What a fascinating outcome from a supposedly high-tech study! I am sure in time we will work out a way to automate screening, given how important it is to both screen and screen accurately!

Watch this space I guess!

David.

Wednesday, May 21, 2025

There Is Only A Small Chance Administrators and Clinicians Can Really See Each-Other’s Perspective!

This appeared a few days ago!

Put patients first: let’s fix the conflict between hospital administrators and doctors

Patient safety should never come second to cultural problems in the health care sector.

Steve Robson

Hospital administrators and doctors must co-operate better in the interests of patient safety.

12:00 AM May 17, 2025

A series of stories in The Australian have revealed, in shocking detail, how widespread dysfunction in relationships between public hospital administrators and specialist doctors is putting patients’ lives at risk around the country.

Workplace conflict is rarely productive, but in our health system it has the potential to be catastrophic.

Our public hospitals can be dangerous places. There should be no excuses for accepting risk to patients as a consequence of cultural problems between healthcare workers and those who administer our hospitals.

I was given the responsibility of analysing the recent national doctors’ survey, undertaken by the Australian Salaried Medical Officers’ Federation – ASMOF. The findings of the survey were deeply concerning.

Only one quarter of responding doctors described their relationship with hospital administrators as respectful. More than two thirds of those doctors felt that health bureaucrats had little or no understanding of the clinical work of frontline doctors.

Perhaps most worrying of all, a staggering 75 per cent of hospitals doctors reported that they felt uncomfortable reporting safety concerns due to fear of retribution.

More than half of the public hospital specialists in the survey reported being aware of colleagues who had suffered retribution after raising concerns with management.

Australia’s public hospitals have never been under greater pressure. Already challenged in meeting demand before Covid-19, the post-pandemic landscape has left record waiting lists for surgery and other medical procedures, overwhelmed public hospital specialist clinics, and swamped emergency departments.

Emergency departments around the country are being swamped.

There is no prospect of demand on our public hospitals reducing any time soon. Indeed, with a deluge of chronic conditions such as diabetes and mental health problems and challenges in securing GP appointments, our hospitals will face only greater and greater demand.

The only way we can ensure that Australians continue to have access to a world-class health system is with our public hospitals working at maximum efficiency and with a top-class healthcare workforce. There is no plan B for millions of Australians.

Workplace safety and high-performing healthcare staff are not luxuries. The Australian Commission on Safety and Quality in Healthcare estimates that more than 10 per cent of all activity in public hospitals is the result of mistakes and adverse events. That represents billions of dollars wasted from an already cash-strapped hospital system.

If we are to minimise the risk of harm and medical mistakes, maximise the efficiency of our health system – and protect Australians – then improving the relationship between those who run our hospitals and those who provide the clinical care is not optional.

Doctors and fellow healthcare workers must feel safe in reporting safety and other concerns to hospital management.

Australians want to trust the care they receive in our public hospitals. They also want to have surgery in a timely manner, specialist clinic appointments before their conditions deteriorate, the best emergency department experience possible, and safe care when they do end up admitted to a hospital.

For these things to happen it is critical the health workforce is functioning at a peak, not burnt-out, frazzled and working in a hostile environment. Safety must be first and foremost and no doctor, nurse, or other hospital worker should be fearful of raising concerns for fear of reprisal.

Doctors and hospital workers should be able to raise concerns about process without fear of reprisal.

Ongoing negotiations of the National Health Reform Agreement offer the perfect vehicle to address these issues. Incentives to smooth out relationships between managers and healthcare workers should be baked into the final agreement. The Federal Health Minister should expect – indeed, demand – proof from state and territory counterparts that dysfunctional relationships are repaired. Australians expect no less.

Spending on health is the single biggest item on every state and territory health budget, and hospitals are the largest cost. With so many demands on the public purse, Australians have a right to expect that the health workforce is functioning at the highest level possible.

Righting the ship so that often-toxic relationships between hospital administrators and senior doctors are fixed must be a high priority. Every dollar spent on our public hospitals should yield the maximum benefit for Australian patients. Patient safety should be our prime goal.

Dysfunctional hospital workplaces put everyone at risk and are a drag on our economy at the worst possible time.

Steve Robson is professor of obstetrics and gynaecology at the Australian National University and former president of the Australian Medical Association. He is a board member of the National Health and Medical Research Council and a co-author of research into outcomes of public and private maternity care.

Here is the link:

https://www.theaustralian.com.au/health/medical/put-patients-first-lets-fix-the-conflict-between-hospital-administrators-and-doctors/news-story/b0047f3c769ef9d7e1f49d0906332216

What an amazingly naïve comment!

The clinicians and the administrators have fundamentally different drivers, interests and KPIs!

I am lucky enough to have been on both sides of these arguments and it really is a matter of perspective and motivations. Good clinicians know that they need good administrators to support them and administrators have no purpose without great clinicians to support.

The bottom line is that if both groups do their jobs well pain is minimized and success pretty much guaranteed! Basically it is a false and pretty silly dichotomy!

The class acts on both sides of the fence understand the game and just get on with their jobs!

Friday evening drinks can be a good way to sort most irritants out I have noticed! – but sadly it can be problematic with people needing to drive home! I am still not sure how to manage that issue! (Have partners come and pick people up at end of day?)

David.