Medication complication a bitter pill
Illustration: Simon Letch
PICTURE two nights before Christmas 1990. A hot, dry summer in Sydney, a dearth of organ donors and a 50-year-old professor connected to a pump that, with the aid of helium and very skilful medical staff, is keeping him alive. It's 9pm and he is told, after being ill for about three years, that a donor heart is on its way.
Recently I celebrated 22 post-operative years as a heart transplant recipient. Yes, St Vincent's Hospital, Sydney. One of the many factors contributing to my survival is the amazingly effective medications I need to take each day. I know they cost the government much more than I pay but you would think that after 22 years back at work for a minimum of 40 hours a week and still paying a high Medicare levy, that same government might make it easier to obtain that medication.
Many of the people transplanted about the same time as me went on disability pensions and many have passed on. I went back to work after six weeks, and I was a 50-year-old at the time.
Two of my anti-rejection drugs, and one that battles the cancerous skin condition which is a side-effect of the first two, can be prescribed by my GP and dermatologist respectively, and there's the rub. The doctors concerned have to interrupt their schedule to spend up to 30 minutes on the phone to a clerk (yes, a clerk) in Canberra who questions them regarding the time and results of my last blood tests and transplant clinic check (I only need to visit the clinic annually). Once the clerk is satisfied that the patient knows how to use the drug (I've been doing this for 22 years), they give the doctor an authority number to write the prescription that I can then obtain. Phew. In Britain, GPs prescribe all of these drugs without the circus and for free, as I was over 60.
All I've managed to achieve post-operatively is: train about 20 post-graduate students, deliver healthcare to people in seven different countries, act as an educational consultant to developing countries, remarry and help raise a beautiful step-daughter and promote organ donation around the world. Oh, and pay a lot of tax.
In case my blood is not boiling enough, I ask why does the Australian government subsidise the training of doctors and other health professionals, make them do such rigorous postgraduate studies and continuing professional development and then, in effect, say they can't be trusted? Particularly a specialist dermatologist who, I suggest, would know more about the need for a skin medication than a clerk.
Could it not be made easier?
Dr Greg Doran