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Fallout from minister’s comments intensifies as GPs stay home
A growing number of GPs with very minor ailments are unsure as to whether they should go into work as a result of Jenny Mikakos’ ‘dog whistling’.
Minister Mikakos said she was ‘flabbergasted’ that Dr Chris Higgins had presented to work ‘flu-like symptoms’. (Image: AAP)
Chair of RACGP Victoria Dr Cameron Loy told newsGP he has had personal contact with at least nine GPs who have called in sick as a direct response to Victorian Health Minister Jenny Mikakos, who criticised a Melbourne GP for going to work after returning from a trip to the US with minor cold-like symptoms.
The GP in question, Dr Chris Higgins, had initially hesitated to test himself as he did not meet the Victorian Government’s own criteria, but decided to do one ‘for sake of completeness’.
Dr Loy said the minister’s comments that she was ‘flabbergasted’, combined with references to the Australian Health Practitioner Regulation Agency (AHPRA) becoming involved, amounted to ‘dog-whistling’ and only served to confuse GPs already dealing with conflicting messages and inadequate supplies of personal protective equipment (PPE).
‘Minister Mikakos’ comments managed to completely unsettle the general practice community over the weekend and people who are low risk, maybe even no risk – they’re getting a snuffle – and they’re not coming in because they don’t want to be “flabbergasted”,’ he said.
‘I completely understand why GPs today are anxious about their status and are choosing to stay at home with the slightest sniffle. My problem is that that direction from the minister was so poorly defined that we are seeing doctors staying home when they probably don’t need to.
‘If the minister was going to say something like that publicly, it needed to be followed up by details about what that actually means for the general practice sector.’
newsGP has spoken to a number of GPs whose practices have been directly affected by Minister Mikakos’ comments.
Dr Karyn Alexander told newsGP she was one of four doctors who called in sick at her Altona North Clinic as a direct result of the comments.
‘We had 13 doctors rostered on today and four of us had to call in sick … so we’re basically down a third of the doctors,’ she said.
‘It’s been pandemonium … and I just feel that we’re being vilified.’
Dr Alexander said the comments likely have put Victoria’s primary healthcare system under increased pressure and contributed negatively to a public health response that has already struggled with mixed messages and a lack of access to equipment.
‘Overall, I’d say it’s been one big huge muddle,’ she said.
‘It’s just a mess. I’m not going to point the finger at any one person, but I wish that we could have had statements that were clear and coming from one source from the beginning.’
Another GP, Dr John Kramer, said two doctors had not come into work due to viral upper respiratory symptoms, even though his Woolgoolga-based clinic on the mid-north coast of NSW had not had a single confirmed coronavirus case in the area.
He told newsGP Minister Mikakos’ comments had contributed to the further fraying of the public health response to the virus.
‘I think she’s a disgrace. I’ve written directly to Daniel Andrews saying we’ve got no confidence in her. She should apologise or resign,’ he said.
‘It’ll only get worse because doctors generally, especially those in Victoria, will have no confidence in her.’
Dr Kramer said Minister Mikakos has exacerbated an already frustrating situation. His practice is yet to receive any PPE and the nearest hospital is 30 km away, meaning he is unsure what will happen to his patients should coronavirus spread to his area.
Minister Mikakos has attempted to defuse the situation and posted a lengthy social media post on Sunday night which addressed GPs’ concerns, defended her comments and insisted that her thoughts are with doctors ‘during this anxious time’.
‘There has been some significant misreporting on social media about the comments made by Victoria’s Chief Health Officer and I when we announced the case which I would like to clarify,’ she stated.
‘Most importantly, I did not name the doctor, despite calls from some for me to do so. We will always respect a patient’s privacy.
‘As we have been doing with each of our confirmed cases, we have identified potential locations of public exposure. For this reason, it was necessary to name the medical practice he worked in.’
Dr Higgins is one of eight GPs who works at the Toorak clinic, in Melbourne’s south-east, named in the media release announcing the confirmed case.
Minister Mikakos also denied suggesting Dr Higgins should be referred to AHPRA and insisted that current guidelines regarding testing are clear.
‘I did not refer the doctor to AHPRA for disciplinary action, nor did I say I would. I referred to seeking AHPRA to assist in providing advice to doctors about how they could better identify risks,’ she stated.
‘I also note commentary about whether or not the clinical guidelines were followed. I won’t comment on a specific case but generally, the DHHS [Department of Health and Human Services] advice is that doctors should exercise clinical judgement in determining whether a person travelling to any country with diagnosed cases potentially should be tested.’
Current guidelines set by the Communicable Diseases Network Australia and approved by the Australian Health Protection Principal Committee refer to ‘travel to (including transit through) a country considered to pose a risk of transmission in the 14 days before the onset of illness’.
Nine countries feature on that list; however, the US is not one of them. The Victorian DHHS has updated its own guidelines to include ‘international travel in the 14 days before the onset of illness’, but this occurred on 9 March, several days after Dr Higgins’ tested positive and Minister Mikakos made her comments.
Dr Loy said it is ‘bonkers’ that Dr Higgins may have been faced with differing guidelines had he been in a different state and GPs are suffering from politicians making statements that were ‘ahead of what’s actually taking place on the ground’ and designed for primetime news bulletins rather than assisting health practitioners.
‘We need a consistent message across the nation. The coronavirus is not going to be interested in state and territorial borders,’ he said.
‘The comments in particular on the Victorian Health Minister’s social media on the weekend suggest she’s already losing the confidence of the general practice sector.
‘She has a small window in which to repair that. We want to be part of this public health response, but the commentary from the politicians is not helping.’
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