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Kogarah Town Medical Centre has glaring shortcomings in many of the areas mentioned above - a very pertinent and alarming example is the proper way to get a urine sample - they just hand you a container - no information on how to get a proper midstream urine sample, avoiding contamination, getting the sample to the pathology lab before it gets too old - the added complication when it's a young child - drop it in next day and reception says "Take it down to the nurse", go down there, nurse says you need the patient file, back to reception... who knows when it will get to the lab. Actually, a recent example in this ongoing syndrome started when my 3½ year old daughter had "frequent urination", 3 - 4 times an hour, mainly in the morning, for about a week. Take her down , specifically requested Dr Estrada Campbell, who from experience is the best doctor they have (Drs Desai and Moryosef are particularly hopeless, which is common knowledge among parents in the area through word of mouth). So it was even more disappointing / alarming when I gave her the story and she immediately suggests antibiotics - just has to be a UTI - I say hold your horses - what about the rush to prescribe antibiotics, long-term effect on the immune system - how about we wait for the urine test results. I obviously don't want to start antibiotics if there is no infection, remembering there are no other symptoms - no fever or anything - she's not uncomfortable. Roll up 3 days later for the results, Dr Campbell ducts out with some pharmaceutical sales rep to the nearby coffee shop - forced to use Dr Mikail a part-time doctor instead. Urine results are clear - she can only suggest a blood test to check sugar levels - the immediate result finger pinprick machine gives a normal reading of 3.5 After that Dr Mikail has no specific idea what it could be - just puts it down to generalities - "little children have these things sometimes" - has no idea how long it might last. I go home and start Googling - then there it is - Pollakiuria - good old Google throws up some excellent webpages - Extraordinary Daytime Urinary Frequency Syndrome or just Frequent Daytime Urination - a not uncommon problem in 3 to 8 year olds - no known cause - may be related to stress - may take anywhere from a few weeks to several months to disappear - no treatment necessary - best not to make a big deal about it, may go away faster that way, which is a lot easier to do when you are enlightened. How come none of these doctors know about Pollakiuria - I would have gone away and after several more weeks of no improvement - forced to get a referral to an expensive urologist - and if they happen to not know about Pollakiuria - may be a rush to some of those traumatic tests which terrifies even adults, let alone small children who need to be sedated, as they start pumping water up you. How typical are these doctors - it borders on malpractice - how about a total shake up of the medical profession - the way they do things - systems and procedures. If you complain you probably get the cold shoulder - why not look at it constructively - the present system doesn't work - too many doctors are just running as many patients through as fast as they can - because we have a free Medicare national health system - and they get their money anyway. If we had to pay for it directly from our pockets we would all be putting a lot more time into pooling our knowledge on who the best doctors are in the distict. If doctors don't know on the spot, how about they all have an Internet connection on their desk and do a quick Google. How about they print off some hard copies of relevant information for further reading - especially when many patients, as well as doctors, don't speak English as their first language - Google even has a translation option. And how about out in the waiting room, along with magazines, have a stack of photocopies on how to take an MSU (midstream urine sample) even a poster on the wall too, and the address of the nearest pathology lab so you can drop in the fresh sample yourself! Why not start by fixing one medical centre as a role model, then start on the rest. * * * My partner's 16 year old has always got stomach problems. So his mother gets a referral to a Dr Jeffrey L. Engelman - his business card, picked up from the reception desk, shows he is a Gastroenterologist and Endoscopist - the visit (18 Aug '06) lasted about 5 minutes - cost us $195 (no private health fund) - he basically just started setting up about $800 worth of tests - presumably the ones where they stick a camera down your throat and hopefully it doesn't pierce a hole in anything. Not once during the initial consultation did Dr Engelman ask about his diet - if Dr Engelman had, he would have learnt that the teenager has grown up on junk food - doesn't eat fruit or vegetables... It would have been extremely helpful if he had asked, and then ordered as an authority on the subject - that the teenager should cut back on the junk food, start eating fruit and vegetables, otherwise down the track he might be facing daibetes, a liver transplant (if he can find a donor), lots of time off work, lots of medical bills, etc, etc. - which would have also helped get the message across to his mother. How can Dr Engelman come to a conclusion that such intrusive and expensive tests are the first step (wasn't even interest in seeing a standard preliminaryblood test). Why didn't he ask more questions - find out about the patient's junk food history - stipulate a strict healthy diet, and then say come back and see me in 6 months and if still no improvement we will do the tests? My guess: Dr Engelman's wife's credit card is out of control. My advice: try to find a stomach specialist with different techniques to Dr Engelman. Why not give the teenager and his mother a pamphlet on looking after the old digestive system - showing in graphic, easy to grasp detail, how important it is, otherwise, these are some of the uninviting patient case studies of what will happen. * * * Dr Gregory Cario Obstetrician and Gynaecologist Hurstville St George Hospital - Under Review - not good better to go to RHW Randwick Hospital For Women - Dr Cario pushes exessive expensive private non-public surgery e.g. "do you straight away for $8000 endometriosis cystitis fibrosis cyst on ovaries" Dr Sue Sidhom GP Allawah Carlton |
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