News in brief: Cardiologist numbers increase revealed by AHPRA; Two thirds of statin patients not meeting LDL-C targets; Speciality training colleges’ ‘dirty secret’

Tuesday, 30 Nov 2021

Cardiologist numbers increase revealed by AHPRA

The cardiologist workforce has grown by an additional physicians over the last five years, with 1625 medical practitioners now registered in the specialist physician category of cardiology field of practice, according to the latest statistics on medical registration released by AHPRA.

The figures show that numbers of cardiologists have increased from 1324 registered in 2016.

As well as the adult medicine cardiologists there are also 58 specialists in paediatric cardiology field of practice and 213 cardiothoracic surgeons.

The locations of practice of cardiologists include 23 in the ACT, 527 in NSW, 10 in the Northern Territory, 327 in Queensland, 131 in South Australia, 29 in Tasmania, 421 in Victoria, and 106 in WA.

Overall, there are 130,476 registered medical practitioners in total in Australia, and 11,114 practitioners registered as specialists.

Two thirds of statin patients not meeting LDL-C targets

In Australian patients using statins, only 36% achieved LDL-Cholesterol target levels as defined by current lipid-lowering guidelines (i.e., LDL-C≤ 2.0 mmol/L), even after two years of therapy, a study has found.

The retrospective review of medical records for 61,407 primary care patients found that the median LDL-C level was 2.3 mmol/L (IQR = 1.8 – 2.8), and the proportion of patients achieving target levels would only be 7% and 18% for people at very high (i.e., ≤ 1.4 mmol/L) and high risk (i.e., ≤ 1.8 mmol/L) of cardiovascular disease, respectively. Patients were more likely to achieve LDL-C targets if they were had a longer duration or higher intensity of statin therapy, if diagnosed with type 2 diabetes (OR 2.07), stroke (OR = 1.58) or chronic heart disease (OR = 1.67), but less likey to achieve target levels of they were diagnosed with dyslipidaemia (OR = 0.59), hypertension (OR = 0.91) and current smokers (OR = 0.71).

Amgen Australia provided funding for the study published in Current Problems in Cardiology.

Specialty training colleges’ ‘dirty secret’

Training colleges, consultants, and hospital executives have been blamed for enabling ongoing abuse and overwork of registrars, in an article about specialty training written by an anonymous junior doctor deploring what they describe as medicine’s ‘dirty secret’.

Published in mainstream newspapers this week, the article entitled ‘Distressed doctors don’t bend, so they break’ describes a training regime that encourages mental distress and suicide among registrars who are given a heavy workload and responsibilities but no support from senior doctors or management.

“They are the first to arrive at the hospital and the last to leave. You are told not to make waves, to keep your head down, to get through it. You are often working unsupervised with vast responsibilities and unsupportive distant supervisors. The less you complain, the more you’re willing to endure, the more attractive and hireable you become. Troublemakers do not get hired,” it says.

The article says the current approach by training colleges is flawed because “the focus has been on coping with abuse rather than ending abuse.’

“The medical fraternity needs to host a meaningful discussion about how to fix our training system to provide more support for doctors and improve their wellbeing. Workload is an issue but the crux of the problem is the lack of support from those in authority,” it concludes.

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