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Preference: Obstetrics and gynaecology and women's health

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For the welfare of the community

Family Doctor Week
Queensland – Dr Colin Owen

Described by those who know him as a hero of the bush, Dr Col Owen has been practising medicine in Inglewood, South-West Queensland for half a century. For three years before that, he was practising in the even more remote Charleville.

A Life member of AMA, a founding President of both the Rural Doctors Association of Queensland and the Rural Doctors Association of Australia, and a founding Fellow of the Australian College of Rural and Remote Medicine, Dr Owen is a well-qualified GP at the Inglewood Medical Centre.

“I have been practising here for 50 years and six months,” he said. “I’m getting the hang of it.”

The town of Inglewood has a population of 1200, but the practice has a catchment of 3000-plus because it serves the region and locations around it as well.

“On a quiet day I might see 30 patients and on a busy day it could get up to 60. It depends on the season,” Dr Owen said.

“I have been involved in treating five generations of patients. That’s really amazing, and for me that is pretty special. You really get to know them. And it is important medically, to be involved in the health care of a community and generations of the same families for so long.

“I once did obstetrics, surgery and anaesthetics here and I have delivered many children. I have delivered the children of children I have delivered.

“My last delivery, the mother said to me ‘do you remember delivering me too?’ and I said ‘yes’, but then her husband said ‘you delivered me too’. I didn’t remember that one, but it turns out that I delivered both the mother and the father of the baby I was delivering then.”

Dr Owen knows only too well that being a family doctor in a small regional community, means you are much more than the local GP.

“You have got to be part of the community when you practise medicine in a small place like this,” he said.

“You know what’s going on and you get involved. But you’re not just a part of the community, you have to be a leader in certain areas.

“You have to be an advocate for the health of the community and lead on a number of issues for the community’s welfare.”

CHRIS JOHNSON

 

 

[Correspondence] Canadian Women in Global Health #CWIGH: call for nominations

A groundswell of attention and support for the need to recognise and advance women’s leadership in global health has arisen since the issue was brought to light in 2014 by Ilona Kickbusch. She launched a Twitter campaign asking people to nominate women working at the forefront of global health around the world.1 Subsequently, the Women in Global Health organisation was formed to advance gender equality in global health leadership, and many similar initiatives and chapters have developed.

[Correspondence] Author gender in The Lancet journals

Despite substantial advances in recent decades, gender inequality persists in many scientific fields,1 including medicine2,3 and global health. In an upcoming theme issue on women in science, medicine, and global health,4 The Lancet will focus on helping to understand and remove women’s disadvantage in these fields. Nevertheless, dedicating a few words to women’s representation in The Lancet journals is worthwhile. Here, I present a snapshot of the gender of the authors who publish in The Lancet journals.

[Comment] Sexual and reproductive health and rights for all: an urgent need to change the narrative

The world has made remarkable progress since the 1974 World Population Conference in Bucharest and the 1984 International Conference on Population in Mexico. The link between population and development was affirmed at the 1994 International Conference on Population and Development (ICPD) in Cairo with the adoption of the Programme of Action, which brought a sharper focus on women and introduced new concepts such as sexual and reproductive health and reproductive rights. ICPD also gave prominence to reproductive health and women’s empowerment.

[Comment] Addressing the unfinished agenda on sexual and reproductive health and rights in the SDG era

The autonomy and empowerment of women are essential not only for their own health and wellbeing but also for those of their families and communities and, ultimately, for sustainable development. Sexual and reproductive health are, in turn, fundamental for women’s full participation in society. Recognising this, in 1994 in Cairo, Egypt, the International Conference on Population and Development (ICPD) formally recognised that reproductive rights were linked to human rights already protected under international law, created a definition of reproductive health that explicitly relied on the ability of individuals to decide if, and when, to reproduce, and compiled a list of essential elements of reproductive health care.

Fish skin used to create new vagina

 

A novel reconstruction procedure using skin from a freshwater fish has been used to create a vagina for a Brazilian woman born with Mayer-Rokitansky-Kuster-Hause (MRKH) syndrome. Women with MRKH have a congenital malformation resulting in the absence of a uterus, cervix and ovaries, as well as vaginal hypoplasia in its upper portion.

Jucilene Marinho, 23, who was only diagnosed with MRKH at the age of 15, had the neovaginoplasty procedure at the Federal University of Ceara in northeastern Brazil. It involved creating an opening where the vagina should have been using an acrylic mould lined with the skin of a Brazilian freshwater fish, the tilapia.

The procedure using fish skin is considered to be less invasive and painful compared with the more conventional method of using skin grafts from the patient’s groin area. The fish skin, which is rich in collagen, is descaled and undergoes a cleaning and sterilisation process which leaves behind a light-coloured gel. Once inserted using the mould, the fish skin stimulates cellular growth and the formation of blood vessels and is eventually absorbed into the human tissue that lines the vaginal tract. The mould remains in situ for 10 days to ensure the newly created vaginal walls do not close up.

Ms Marinho, who suffered severe depression after her diagnosis, is the first of four patients to undergo neovaginoplasty incorporating tilapia skin. She spent three weeks in hospital and suffered some minor internal bleeding following the procedure, but was eventually able to have enjoyable sexual relations with her boyfriend.

The use of tilapia skin was initially pioneered in severe burn victims. In addition to its high levels of collagen type 1, the fish skin stays moist longer than gauze, and does not need to be changed frequently in burns patients, doctors found. Around 200 burns victims have now been treated with tilapia skin.

Candidate profile – Dr Gino Pecoraro  MBBS FRANZCOG

Nominating for the position of AMA President

My name is Dr Gino Pecoraro and I’m asking for your vote in the AMA National Presidential election.

Australia’s stressed healthcare system needs an upgrade. The ideal time for change is now, with Government reviewing the MBS and private health insurance value and affordability.

Our largely State-funded public health facilities are struggling to meet increasing demand and need ongoing additional funding. Private sector access is increasingly more expensive with non-indexed Medicare and PHI rebates causing greater out of pocket costs. 

Some form of indexation (ideally one supported by the AMA) must be embedded in legislation. In this way, rebates can start to reflect the true cost of accessing services and keep medical care affordable.

Ensuring our GPs are adequately paid will help them give patients the time needed to deliver quality care and disease prevention. Ultimately, this will keep patients out of already crowded hospitals and save the health system money.  

Similarly, PHI providers need to understand that their moves towards managed care models will not be tolerated and that patient choice of doctor and hospital must be protected in all policies.

Decreased demand for public hospital outpatient and inpatient services means money can be redirected to other areas e.g. emergency department waiting times and chronically underfunded mental health services.

Medical student numbers have radically increased without an increase in the number of postgraduate training positions. No more medical schools are needed. What students and doctors-in-training really need are an increase in the number of fully-funded postgraduate training positions. These positions need to be in the disciplines and locations where shortages exist. Relocation support needs to be provided for these doctors and their families. 

The AMA President is expected to be the public face of the organisation and deliver our members’ policies to parliamentarians, the medical profession and the general public. 

My extensive experience in medical politics is what makes me the best candidate, and includes:

  • Senior roles with RANZCOG (Council, Board and Examinations);
  • Ongoing association with the University of Queensland;
  • 2010 Queensland AMA President and Board Member; and
  • Current Federal Council representative for Obstetrics and Gynaecology.

I have been instrumental in the Federal Council’s formation of the Council of Private Specialist Practice, developed to serve a previously underrepresented part of our membership. I have acted on the AMA’s behalf to put a stop to the National Maternity Services Framework, which had been formed without a single doctor on the committee. I continue to represent the AMA on multiple Government committees.

An AMA President must be an effective communicator. I’m a seasoned media performer with 25 years’ experience encompassing print, radio, television and online platforms.

I continue to write columns for newspapers and magazines as well as having produced and presented State and national television shows. I have experience in live breakfast, drive and talkback radio.

My eight years’ experience on Federal Council means I fully understand the workings of both our organisation and the Government departments we seek to influence.

* See other candidate profiles on this site. 

 

 

[Comment] The gendered system of academic publishing

Gender is a sociocultural and economic concept and an institutionalised system of social practices that translates into different experiences and uneven advantages for men and women at the individual, organisational, and societal levels.1 This system manifests as the persistent gender pay gap, endemic sexual harassment,2 and the proverbial glass ceiling limiting women’s representation and advancement in social and economic life. Academia, including academic publishing, is not immune to this gendered system of social practices.