Dr. William Theodore Hodge: pioneer surgeon-apothecary in early-twentieth-century Western Australia

In 2008 I chanced upon the lonely grave of Dr. William Theodore Hodge, buried in 1934, in the Derby Pioneer and Aboriginal Cemetery. He turned out to be the founding doctor of the practice in which I have worked for the past thirty years. Dr. Hodge migrated from England in 1896. He was the first western trained doctor to work in the Perth suburb of Claremont and in the wheat-belt town of Kellerberrin. He was an innovative and inventive modern doctor who became a legend in the Kimberley where he died tragically, on the day prior to his retirement, at the age of seventy-five. His story is illustrative of the life and medical practice of a pioneering doctor in metropolitan, rural, and remote practice in Western Australia at the end of the nineteenth and the early years of the twentieth centuries.

The repeating history of objections to the fortification of bread and alcohol: from iron filings to folic acid

The fortification of staple foods has eliminated many deficiency diseases. Despite this, "tampering" with people's food always provokes opposition, much of it from health professionals. Opposition is often based on self-interest, tunnel vision and theory rather than research. A historical perspective of the patterns of objections to fortification and its outcomes may help resolve the anxieties and opposing ethical positions of advocates and opponents of fortification.

Remove the tooth, but don't stop the warfarin

BACKGROUND

Dentists rely on general practitioners to manage a patient's warfarin dose before uncomplicated dental extraction.

OBJECTIVE

This article compares common practice of warfarin management with the available clinical evidence.

DISCUSSION

Common practice lags more than 20 years behind clinical evidence to the detriment of patients, and with medicolegal consequences for doctors.

Educating the good GP--the 33rd William Arnold Conolly Oration

'Special training is required for doctors in general practice and this was, and is, the main aim and objective of this college and we resent any suggestion that standards in general practice should be any different from the standards in other branches of medicine'. Dr Mony Kent-Hughes.

Medical career choice and practice location: early factors predicting course completion, career choice and practice location

AIMS

The overall aim of the study was to identify the factors that best predict medical career choice and practice location.

METHOD

A longitudinal, cohort study was conducted. This followed 2 cohorts of students, numbering a total of 229 students, who commenced medical studies at the University of Western Australia in 1984 and 1989. Data concerning the students' sociodemographic backgrounds, admission scores and personality characteristics were collected in Year 1. Regression analyses were performed to identify the student characteristics that best predicted course completion, a choice of general practice 4 years after graduation and a rural location of practice.

OUTCOMES

We found that students who had lower university admission scores and who were less outgoing were less likely to complete the course. Students who were male, had a father in medicine and were more creative and abstract in their thinking and more conscientious and rule-bound were more likely to choose a specialist career. A rural background was found to be the most important predictor of both rural general and specialist practice.

A patience of professors

The 1973 inquiry into the "Expansion of Medical Education in Australia" resulted in the appointment of nine professors of "Community Practice". We (the foundation professors) have been leaders in a reform movement within medical schools and general practice and have had to fight hard for the right and resources to do the job for which we were appointed. Our most significant accomplishment has been to broaden the orientation of medical education beyond hospitals and laboratories to the community and those in the community who are underserved. Although small in numbers, our discipline fights above its weight and is essential for medical school accreditation by the Australian Medical Council.

The tasks of general practice. A new kind of GP?

BACKGROUND

The Department of Health and Aging is driving a reform of general practice to encompass primary care and population health. Although these new ideas are quite old they have rarely been comprehensively applied.

OBJECTIVE

To develop an up-to-date conceptual framework of the comprehensive tasks of general practice.

DISCUSSION

This framework can help the 'new kind of general practitioner' (and those in training) in deciding which elements of the 'new primary health care' they can, or will, encompass.

General practice research in Australia, 1980-1999

There has been a nearly fivefold increase in the amount of Australian general practice research published in 1990-1999 compared with the previous decade. The university departments of general practice and other university departments have been responsible for most of the research. GPs were involved in at least 60% of all of the research reviewed. Half of the research was found to be clinically pertinent to the front-line GP. The National Health Priority areas, introduced in 1994, were poorly represented, but it is probably too soon for this research to be published. There has also been little research on rural general practice. This review provides a starting point for classifying general practice and primary healthcare research in the future.

Is Australian rural practice changing? Findings from the National Rural General Practice Study

The National Rural General Practice Study (NRGPS) was the first comprehensive national study covering rural and remote general practitioners throughout Australia. It was undertaken in 1996-1997 and drew on data from existing sources such as the Australian Bureau of Statistics and the Australian Institute of Health and Welfare, together with a postal survey of general practitioners in rural and remote areas. There was a 75% response rate to the survey, which covered professional issues, personal and social issues, personal background, patient issues, recruitment and retention programs and changing health services. Overall, the study findings confirmed those of previous individual State-based studies in the early 1990s and showed that there had been some changes since those previous studies. In particular, access to continuing medical education has improved, the rural medical workforce appears to be ageing, the proportion of women rural doctors is increasing and the projected length of stay in rural practice is decreasing. Whereas in the early 1990s the projection for rural doctor numbers was continuing decline, the NRGPS projected overall numbers in rural practice as staying approximately the same over the next 5 years. In the light of these trends, the challenge is to implement targeted initiatives that improve the recruitment and retention of rural and remote general practitioners.

Differences in teaching about the acute sore throat within one medical faculty

OBJECTIVES

To examine the consistency of teaching about the acute sore throat in four departments in one medical faculty, and to determine whether there is agreement between what is taught and the evidence-based literature.

DESIGN

Cross-sectional study.

SUBJECTS

71 undergraduates and 15 postgraduate general practice registrars and four lecturers.

RESULTS

Differences were identified in teaching about the diagnostic value of a throat swab, a full blood count and clinical scoring, as well as on the use of penicillin in suspected streptococcal pharyngitis. Only one department based their teaching on the evidence-based literature. No department discussed issues of cost-effectiveness. Half of the students identified discrepancies in the teaching about the sore throat and were initially confused by them.

CONCLUSION

One method of resolving disagreement between teachers from different disciplines is to rely on the evidence-based literature. This type of study can be useful in curricular development and in correcting teaching inconsistencies within a faculty.