Comment: Prof Ken Harvey’s resignation from La Trobe University


The following is an amalgamation of a couple of comments written on the Paging Dr forum board.  This was in relation to the high profile and controversial resignation of Prof Ken Harvey from La Trobe University, following the announcement of the $15 million deal between Swisse and the university.

It is one thing to fund research into CAM. For this to be scientific, one must have a scientifically sound a priori reason why you are doing the human research in the first place.

It is quite another thing for a single manufacturer to fund a research institute that will effectively be set up to investigate its products that it already markets to the general public.

Continue reading

Comment: GP co-payments? Don’t save on primary care


The following is a comment to the online article, “GP co-payments? Don’t save on primary care” written by GP blogger, Dr Edwin Kruys.

Dear Edwin,

Great article. I agree with your premise.

Regarding individuals valuing the services they receive from the GP more with co-payment, we should recognise that this is a complex question. We should recognise that many GPs already privately bill. Continue reading

Comment: Empirical evidence, not eminence, and certainly not dogma


The following is a comment/letter to the editor to the online article, “Some catalysts for debate on statins“, published in Medical Observer.  This article covered two somewhat opposing perspectives by Prof Kerryn Phelps, and Prof James Tatoulis to the controversial ABC Catalyst program on the role of lipids and statins on health.  The shorter online response was published on 20 November 2013, and an expanded version was published in the final volume of Medical Observer in 2013.

Empirical evidence, not eminence, and certainly not dogma.

What we know about empirical evidence is that conjectures and suppositions extrapolated from cherry-picked data points, pathophysiological rationale, or anecdote, are often misleading and not “useful” – insofar as being able to make correct predictions of the future.

Continue reading

Comment: Scaphoid fractures. Thumbing through the research


The following is a comment to the online article “Scaphoid fractures. Thumbing through the research“, written by Dr Robin Park on the FOAM4GP website.  This was a very readable summary of some of the evidence behind the management of scaphoid fracture assessment in the general practice context.

Dear Rob,

Another fantastic post and summary!

Before I give my 2c on this clinical scenario, I like to reflect on the Dave Sackett vision of EBM – that it is the combination of best external evidence, patient values and expectations, and clinical expertise. The research evidence (of which the majority in this scenario has not been in the primary care setting) needs to be applied in a critical manner, appropriate to the context and setting in which care is provided. Continue reading

Comment: To statin or not to statin?


The following is a comment to the online article, “To Statin or not to Statin? – That is the question” by Dr Robin Park.  This article is a very readable summary of a number of practical questions about statins for GPs.

Great summary Rob!

A few comments… The evidence for the benefit of LFT and CK monitoring for statins is poor, and the rationale for doing so is questionable in light of the accumulated safety data for statins. An argument can perhaps be made for baseline LFT (even in otherwise fit and well people), but the utility of a baseline CK is rather low in someone not at high risk of myopathy. Stopping a statin in someone who is at mod/high CVD risk, due to an asymptomatic rise in CK, probably does more harm than good. Continue reading