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Tracking the changes in medicine for 25 years
TUESDAY 3 July, marks exactly 25 years since Medical Observer first landed in the mailboxes of Australian GPs, with a mission to provide the latest clinical and medico-political news, without fear or favour.
On that day, the Hawke government was in power and its health minister Dr Neal Blewett had, just three years earlier, reintroduced a universal public health insurance system similar to the Whitlam government’s Medibank – now called Medicare.
A plough through the medical news at that time unearths an interesting mix of issues, some of which have moved on, with great gains in public health – for example, in tobacco control and HIV medicine – and some of which, like GP remuneration, have marked time.
In 1987, like today, our clinical stories reflected the issues GPs were facing at the time including the HIV/AIDS epidemic, repetitive strain injury, anorexia and bulimia, irritable bowel syndrome, peptic ulcers, cervical cancer, back injuries, toxoplasmosis and PTSD.
Many clinical issues were swept up in ground-breaking national public health campaigns, which were a hallmark of the 1980s.
These included the world-leading ‘Grim Reaper’ HIV/AIDS campaign, as well as smoking cessation, drug and alcohol, road trauma and youth suicide campaigns.
These largely successful initiatives (with the arguable exception of drug and alcohol) were joined by national government and community action to deal with blood lead levels in pregnant women and babies, antibiotic compliance, SIDS and the various hypotheses as to its cause, mesothelioma, legionnaires’ disease, chlamydia, assisted reproduction technology, MRSA and toxoplasmosis, among others.
In that year, not enough was being done about abysmal child immunisation rates, which were just above 50% and which now in 2012, following introduction of government and GP division programs in the 1990s, are among the best in the developed world (but now under threat from this year’s federal budget cuts to the GP practice incentives program).
In the political arena, the hot topic occupying doctors was government control of the medical profession.
This affected both primary and hospital care, sparked to a large degree by the introduction of Medicare, and brought with it VMO strikes, bulk billing and its effect on GPs’ incomes and business models, the spectre of “geographic provider numbers”, and a decline in private health insurance participation.
There was also the landmark Doherty Report into medical training, which recommended against the compulsory GP training that had been lobbied for by the RACGP (and which was introduced soon after as part of vocational registration, and reinforced in the mid-90s with the controversial “provider number” legislation).
In public health, the late 1980s saw sweeping changes to the way national campaigns were structured and funded in Australia through the National Better Health Program, which delivered a raft of strategies, including the National Aboriginal Health Strategy (1988), the National HIV/AIDS Strategy (1989) and the National Women’s Health Program (1989).
The 25 years since 1987 have seen vast changes in medicine and provided a fascinating ride for MO and its various editors, medical editors, journalists and production staff.
The secret of success for any publication is to always remember who its readers are, and for its journalists and contributors to have a clear idea of who they are writing for – an approach that’s always front of mind here at MO.