Issue 47 / 12 December 2011

FOR the next 4 weeks, your email inbox will be missing its usual intriguing Monday morning message from MJA InSight: we’re taking a short break until mid January.

At the risk of burdening you with another bragging Christmas letter, we would like to remind you of some of the issues during the year that particularly interested and engaged you based on responses to our comments, stories and polls.

Alternative medicine, allied health and medical ethics were the topics that seemed to ruffle the most feathers in 2011, as you’ll see from this short guide to the past 12 months of MJA InSight.

On the first month of InSight, our regular blogger, Jane McCredie, called for a less emotive discussion on circumcision, prompting a variety of highly emotive responses from readers.

On the second month of InSight, MJA editor Dr Annette Katelaris cautioned that urgent action was needed to address antibiotic resistance. Respondents said the issue was “as important as climate change”, with registrars blaming consultants, consultants blaming registrars, and everyone blaming the government and the public.

On the third month of InSight, the role of physician assistants was hotly debated, with some claiming they would take medical students’ training placements, and others arguing they would allow doctors to focus on the important stuff.

On the fourth month of InSight, an article merging two of medicine’s most contentious issues, vaccinations and alternative medicine, attracted the most reader responses of the year. Some readers asked the existential question “What is evidence, anyway?”, while most applauded the author’s campaign against unsubstantiated chiropractic claims.

On the fifth month of InSight, physician assistants again raised their controversial heads, after the University of Queensland prematurely scrapped its PA course. A news story on medical misconduct also sparked a barrage of responses, many about doctors’ romantic relationships with patients.

On the sixth month of InSight, there were passionate responses to an article about a clinical trial in a Catholic hospital, as readers thrashed out the thorny topic of the place of religious dogma  in medical care. Meanwhile, a poll asking “Should patients be able to access Medicare rebates if they are cared for by a registered midwife who does not have a collaborative arrangement with an obstetrician?” had readers almost equally divided (57% voted “No”).

On the seventh month of InSight, there was rumbling throughout the medical fraternity as the two sides of the alternative therapy debate lined up. A poll asking “Is it ethical for doctors to prescribe non-evidence-based complementary and alternative therapies?” came down in favour of the negative (76%) but the comments on our news story about alternative medicine revealed strong feelings in both camps.

On the eighth month of InSight, our diverse readership was revealed in the posts responding to a comment about the psychology behind the anti-vaccination movement. In true web-forum style, contributors ranged from Harry the poodle (by proxy) to a retired professor.

On the ninth month of InSight, the coming of spring heralded a collective concern about climate change as our commentators urged us to consider the health, rather than the political aspects. They did not go unchallenged.

On the tenth month of InSight, mandatory reporting of impaired health professionals had us up in arms, with a poll revealing that many do not support continuation of the rule (74% voted “No”). In the same month, InSight uncovered evidence that there might have been some warning of the spate of febrile seizures that led to the withdrawal of Fluvax for children in 2010, as the most up-to-date data had been omitted from the vaccine’s product information. The story was mentioned in a senate estimates hearing and the PI is since being updated.

On the eleventh month of InSight, there was only support for the message that women with menopausal symptoms might just benefit from hormone replacement therapy, although the audience was divided on whether men should be considered in this equation.

Finally, on the twelfth month of InSight we surveyed our readership, receiving almost 1000 responses. You told us what you like and don’t like, and gave us some great ideas for content and format improvement.

With a flexible new design planned in the first half of next year, we hope that you will continue to read, contribute to and interact with our site when the seasonal upheaval is over. Until then, you are free to join the rest of the population, bumbling through Christmas and New Year with absolutely no InSight in sight.

Dr Ruth Armstrong is the medical editor and Sophie McNamara is the news editor of MJA InSight.

Posted 12 December 2011

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