Kategorie: Vorsorge

Billshock hurts. Like when you walk into the doctor expecting to pay $200, but walk out with a bill for more than double. It’s an unpleasant experience that can leave you feeling uneasy about the financial side of your healthcare. 

Australians spent a total of $241.3bn on health goods and services in 2021-22 (the most recent data) according to the Australian Institute for Health and Welfare. That’s $9365 per person, per year – and that figure is going up. 

It’s a lot of money, and it’s a lot of money to shell out when you’re not prepared for it. 

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How does it happen?

Let me share my story. I’m in the process of diagnosing and managing a slightly obscure disorder called temporomandibular joint disorder (TMJ). In short, it causes jaw and facial tension, leading to migraines and other horrible things. So far I’ve seen multiple GPs, dentists and now a few specialists. The latest of which was unable to help me. 

The initial consult was around $200, with about $100 taken care of by Medicare. When I booked the receptionist mentioned that anything additional would cost extra. Of course. 

But when I went to pay, the bill was more than $400. The doctor hadn’t mentioned any extra charges. Shocked, I said, “Sorry, the quote was for a little over $200.” 

The receptionist looked at me like I was silly and calmly explained a camera I had jammed up my nose cost another $200. Ouch on a few levels. 

Before you start in the comment section, yes, I know, these costs are necessary, it’s your health, and you need to care for yourself. 

But what are the guidelines on letting patients know about these costs, and when – because sometimes, sadly, dinner on the table has to take precedence. 

What do the rules say?

The Australian Health Practitioner Regulation Agency (AHPRA), a body that deals with best practices for medicos in the country has strong guidelines on informed consent and financial dealings. The most relevant of these are:

• Ensure that your patients are informed about your fees and charges in a timely manner to enable them to make an informed decision about whether they want to proceed with consultations and treatment.
• When referring a patient for investigation, treatment or a procedure, advising the patient that there may be additional costs, which patients may wish to clarify before proceeding. 

The Australian Medical Association (AMA), another peak industry body, has a guide on ‘informed financial consent’, but similar to AHPRA, it puts it on the patient to clarify costs. 

“The AMA is strongly committed to fee and billing transparency and publishes extensive information to support fully informed financial consent between doctors and their patients,” President Professor Steve Robson said.

“The AMA supports and actively encourages full transparency of doctors’ fees and for doctors and patients to discuss fees as early as is practical.”

It does also note there are a range of circumstances where a doctor might find it difficult to provide full informed financial consent i.e. if someone needs emergency care.

The Royal Australian College of General Practitioners said it’s a complex issue for GPs, who won’t know what issue a patient will present with, or what treatments are required until after the examination. 

“A GP can’t know what all the costs involved in an illness will be ahead of time, and in a complex medical investigation, a GP might have to explore several potential issues before a diagnosis. It’s vital to continuously communicate with patients on these kinds of issues,” President Dr Nicole Higgins said.

“Our guidance for GPs and practice staff and position statement emphasises the importance of being transparent about any out-of-pocket costs. 

“Sometimes those may be down to an external service, such as pathology, but with the cost of materials growing faster than Medicare patient rebates, some practices may have to pass those costs onto the patient to keep their doors open.

“The important thing is that GPs and practice staff are comfortable having conversations with patients to prevent bill shock.” 

What can you do if you are in financial strife?

I contacted my specialist, just out of curiosity to find out what their process was after my appointment. They dodged the question and claimed everything was done according to standard. And they’re technically not wrong. 

The onus, according to the AHPRA and AMA, is on the patient to ask. It seems difficult, especially mid-consult, but don’t let that put you off; you’re within your rights to engage the doctor on costs.

Victorian Health Complaints Commissioner, Adjunct Professor Bernice Redley encourages discussion early on in the consultation period and cost transparency.

“It is expected that health consumers are fully informed about any fees or charges and provide consent when making decisions about their health care,” she said.

“Generally, information about fees or charges is provided up-front, and options discussed early in the consultation or at the time when a fee becomes apparent.”

She also said there are options for recourse if you’re unable to pay, or if you believe the complaint should be escalated.

“Patients are encouraged to discuss their concerns, including costs, with their health provider in the first instance,” she said. 

“If their concerns are not addressed to their satisfaction, they can raise a complaint with their provider or the health service. Information about how to make a complaint should be easily accessible at the service or on their website.

“If the patient’s concerns email unresolved, they can escalate their concern to the Health Complaints Commissioner. If the complaint relates to an individual registered health practitioner, they can make a notification to the AHPRA.” 

How can you avoid bill shock?

To avoid bill shock the AMA encourages you to ask the following questions:

• What are your fees?
• Are there any fees for other doctors?
• Will I have any out-of-pocket expenses?
• Is your fee an estimate only?
• Can I have an estimate of your fees in writing?
• If the costs change, when will you let me know?
• Should I contact my health fund?

As for me, – well I’m just going to have to wear the costs, no matter how badly the situation has gotten up my nose –  but next time at least I’ll be better informed.

‘Intuitive intimacy’ is tipped to be this year’s big dating trend, so what is it exactly and could it be healthier to seek than sex? Relationship and sex therapist Christine Rafe joins host Felicity Harley to discuss…

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To hear today’s full interview, where she takes a deep dive into all things intimacy…search for Extra Healthy-ish wherever you get your pods.

For more on Christine, see via @goodvibesclinic or their website here. You can listen to Chrisine’s last Healthy-ish chat on sleep divorce here. 

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On social: Via Instagram at @bodyandsoul_au or Facebook. Or, TikTok here. Got an idea for an episode? DM host Felicity Harley on Instagram @felicityharley. 

In print: Each Sunday, grab Body+Soul inside The Sunday Telegraph (NSW), the Sunday Herald Sun (Victoria), The Sunday Mail (Queensland), Sunday Mail (SA) and Sunday Tasmanian (Tasmania). 

Everyone is talking about intimacy right now (and no, not just Esther Perel), so what is it, how do you cultivate it and can it be repaired after infidelity? Sex and relationship therapist Christine Rafe takes a deep dive into intimacy. 

WANT MORE FROM CHRISTINE?

For more on Christine, see via @goodvibesclinic or their website here. 

WANT MORE BODY + SOUL? 

Online: Head to bodyandsoul.com.au for your daily digital dose of health and wellness.

On social: Via Instagram at @bodyandsoul_au or Facebook. Or, TikTok here. Got an idea for an episode? DM host Felicity Harley on Instagram @felicityharley. 

In print: Each Sunday, grab Body+Soul inside The Sunday Telegraph (NSW), the Sunday Herald Sun (Victoria), The Sunday Mail (Queensland), Sunday Mail (SA) and Sunday Tasmanian (Tasmania). 

The doctor sighs, checking his watch distractedly. 

“Look,” he says, assuming the slightly impatient air of a parent talking a toddler down from a tantrum, “I know that, to you, it feels like you’re in a lot of pain, but the objective signs aren’t really there.”

Doubled over in pain like a woman in labour, Sally – my best friend of over two decades – looks up at him through tears.

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“What does that even mean?” I ask, thinking I must have misheard.

“Her blood pressure is normal. Her heart rate is 90 bpm – a little elevated, as the normal resting heart rate for your age is between 60-80bpm – but not what we’d expect to see with the kind of pain she is describing.”

“I know it’s hard,” he said, turning his attention back to Sally, “but I think maybe if you calmed down a bit your symptoms might ease.”

Five hours earlier, Sally – 32 at the time – had called me at 2am, barely able to speak through the agony. Her left ovary, on which she’d had surgery to remove a cyst two weeks prior, felt like it was being stabbed from the inside. 

I’d driven her to the emergency room of a Sydney hospital. There, over the next several hours, despite being told about the recent surgery (and the fact that her surgeon had mentioned ovarian torsion – a condition in which the ovary twists in on itself – as a potential complication of the procedure), the doctor on duty had refused to send her for an ultrasound or provide any pain relief stronger than paracetamol.

“But I have a resting heart rate of 40 bpm,” Sally tells the doctor through gritted teeth, eyes still closed, “I remember because doctors always comment on how low it is.”

What the doctor was about to say in response we’ll never know, because at that point, overwhelmed by pain, my friend vomited violently for the third time that night.

Finally – perhaps swayed by the ‘objective’ sign of pain on display – the doctor agrees to give her a shot of morphine. 

An hour later, woozy but still in agony, we tell the doctor the morphine hasn’t touched the sides, begging him to investigate for a torsion.

“I’ll give your surgeon a call,” he eventually agrees, “although I highly doubt it’s a torsion – that level of pain would be astronomical.”

“Honestly, it felt like I was in some kind of horror movie,” Sally recalls of that night, “nothing I could say would move the needle and get him to take me seriously.”

After a few more hours and a call to Sally’s surgeon – who thankfully, advises the doctor to get her an ultrasound immediately – my friend is diagnosed with – you guessed it – ovarian torsion.

She’s rushed via ambulance to the women’s hospital to undergo emergency surgery. She loses part of her left ovary and fallopian tube. A complaint she files with the hospital after her recovery gets a response weeks later: “We investigated and found no neglect or wrongdoing.”

Sally’s experience is horrifyingly commonplace. Historically and currently, women’s pain is overlooked at alarming rates in the medical profession. 

On average, a woman with endometriosis will suffer for seven to 10 years before receiving a diagnosis. Almost without exception, she’ll be told her pain is “normal” by several health professionals before they even investigate. 

PMDD – another crippling and under-diagnosed condition – is often written off as ‘normal’ mood changes before menstruation, rather than a complex and (as usual in the world of women’s health) under-researched hormonal condition.

And this is not just anecdotal evidence – several studies have shown that gender bias in medicine regularly overlooks women’s pain. A 2022 study found women waited, on average, 29 minutes longer than men to be evaluated for a heart attack when presenting to hospital with symptoms. Another study found that women who presented to the emergency department with pain of any kind were 25 per cent less likely than men to be given opioid pain relief, but more likely to be referred for psychiatric assessment. 

The gender pain gap has been consistently proven to be a threat to the health and safety of women worldwide. 

Now, an initiative from Health Victoria aims to work towards closing that gap.

Submissions for the Australian-first Inquiry Into Women’s Pain opened last week after a survey found two out of five Victorian women suffer from chronic pain. 

“[The survey findings] won’t be a mic drop moment for the majority of Victoria’s population,” Premier Jacinta Allen told body+soul, “because every woman has either experienced it for herself or knows someone who has. But now we have the evidence to prove it.”

The aim of the inquiry, which will hand down a final report in December this year, is to “provide recommendations to inform improved models of care and service delivery for Victorian girls and women experiencing pain in the future.”

“It’s time we stopped treating women’s health like some kind of niche issue,” says Premier Allan. 

“We deserve to have our pain believed and relieved.”

For Sally, for whom the traumatic hospital experience still rankles seven years later, the inquiry is an important step in the right direction. 

“In my experience, it’s so entrenched in medical culture to devalue women’s pain, which is why this inquiry is so important in calling out the unconscious gender bias at play,” she says.

“Hopefully,  it can start to shift things in a meaningful way – because too often throughout history women have been treated as ‘hysterical’ rather than legitimate patients deserving of proper care and treatment.”

Addiction is a complex and multifaceted issue, impacting millions of lives around the world. While the causes of addiction can vary widely, a key question often arises: Do some individuals have a predisposition to addiction, and can possessing what’s often termed an ‚addictive personality‘ make you more likely to struggle with addiction?

The concept of an ‚addictive personality‘ is a widely debated and somewhat controversial one. It suggests that certain personality traits, behaviours, or genetic factors can make an individual more susceptible to developing addictive behaviours, such as substance abuse or compulsive behaviours like gambling or sex addiction.

Having certain personality traits does not guarantee that an individual will develop an addiction. It does, however, increase their vulnerability. The development of addiction is influenced by a combination of factors, not just someone’s personality. 

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The genetics of addiction

One important factor in the predisposition to addiction is genetics. Research has shown that genetics can play a substantial role in an individual’s likelihood of developing an addiction.

If addiction runs in your family, you may be at a higher risk due to shared genetic factors. Specific genes can influence the body’s response to substances like alcohol, drugs, and nicotine, making some people more vulnerable to addiction than others. One study estimates that heritability for addictions ranges between 0.4 (hallucinogens) to 0.7 (cocaine). 

However, having these genetic predispositions does not guarantee that someone will become addicted; it merely increases the risk. For example, a person with a family history of alcoholism may be at greater risk of developing an alcohol use disorder.

Still, their likelihood of developing this addiction also depends on their choices, behaviour, and the environment in which they are exposed to alcohol. Conversely, someone with a family history of addiction may choose not to engage in addictive behaviours due to their environment and personal choices.

Behavioural and environmental factors

Beyond genetics, an individual’s behaviour and environment play a significant role in their predisposition to addiction. People with certain personality traits, such as impulsivity, sensation-seeking, and risk-taking, may be more likely to engage in activities that can lead to addiction.

Additionally, individuals who grow up in environments with easy access to drugs or alcohol, neglectful parents, or experience trauma, stress, or a lack of positive social support, may also be more vulnerable to addiction.

The role of dopamine

Dopamine, a neurotransmitter in the brain, is often associated with feelings of pleasure and reward. Many addictive substances, including drugs and alcohol, can trigger the release of dopamine in the brain, creating pleasurable sensations. Some individuals may have differences in their dopamine systems that make them more susceptible to addiction, as they may require more stimulation to experience the same level of pleasure or reward.

It’s important to note that substance abuse usually begins with impulsivity and a person seeking a positive reward and turns into addiction when it switches to compulsivity and a person attempting to avoid negative consequences. 

Understanding and preventing addiction

Recognising that addiction is a complex interplay of factors can be empowering. It means that individuals can take steps to reduce their risk of developing an addiction. Education, awareness, health coping mechanisms and early intervention with a health professional can all help to prevent addiction. 

If you or someone you know is struggling with addiction, seeking professional help is essential for recovery and a healthier future.

Dr Ashwini Padhi is a psychiatrist at South Pacific Private – Australia’s leading treatment centre for trauma, addiction and mental health.

If you think you or someone you know needs help, please call Lifeline on 13 11 14 or beyondblue 1300 22 4636. 

Originally published as 3 reasons you’re more likely to develop an addiction

It was only weeks ago that King Charles III, reigning monarch of the United Kingdom and the Commonwealth, underwent treatment for benign prostate enlargement. 

Now, a new statement released by the palace on behalf of the King has revealed another, far more serious diagnosis– cancer. While the details of the King’s diagnosis, such as type and stage, have not yet been disclosed to the public, the Palace’s transparency is an example of the King’s modern approach to monarchy. 

“His Majesty has chosen to share his diagnosis to prevent speculation and in the hope it may assist public understanding for all those around the world who are affected by cancer,” the statement says.

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Weeks ago, the 75-year-old King’s routine procedure was reported as a byproduct of the natural ageing process, giving his loving family and loyal subjects little to worry about. The public was informed the monarch would be admitted to a private London hospital for treatment, resuming his regular public duties shortly thereafter. 

However, as the palace’s latest statement says, the King’s cancer diagnosis was picked up during the treatment for his enlarged prostate, prompting a swift response from medical staff and Palace operations. 

“During the king’s recent hospital procedure for benign prostate enlargement, a separate issue of concern was noted. Subsequent diagnostic tests have identified a form of cancer,” the statement shares. 

The King, who was seen enjoying a church service in Sandringham on Sunday, began ‘regular treatments’ on Monday as an outpatient. Given his healthy lifestyle, and the early detection of his condition, the Palace is hopeful the King will respond well to treatment and will resume his pubic duties in due course. 

The Royal Family’s response

The King’s sons, Prince William and Prince Harry, were reportedly informed of their father’s diagnosis prior to the public statement being released. Prince Harry, who renounced his official duties as a senior member of the Royal Family along with his wife Meghan Markle in 2020, is said to be travelling back to the UK to see the King. 

His oldest son, Prince William, is currently temporarily withdrawn from public duties to support his wife, Catherine Princess of Wales, who is recovering from abdominal surgery. 

It is understood the wider members of the family will step up and take over the King’s public commitments while he undergoes treatment for his cancer. 

What happens when a monarch is ill?

Unlike cashing in one of your token sick days in the office, taking time off is a little more complicated when you’re the country’s head of State and Church. But, like any well-oiled institution, the British royal family has an operational system in place for such an event. 

While the King’s public duties will be postponed or taken over by other members of the family, he will continue his constitutional role as head of State in a private capacity, such as Privy Council meetings and official paperwork. 

Why can’t you stop drinking coffee? Why do you freak out in a lift? Dr Jen Martin is Associate Professor in Science Communication Biosciences from the Uni of Melbourne and shares the science behind your weird – and perfectly normal – habits. 

WANT MORE FROM DR JEN?

For more on Jen’s book Why Am I Like This? (Hardie Grant, $27.99) see here and for more on Jen, see here. 

WANT MORE BODY + SOUL? 

Online: Head to bodyandsoul.com.au for your daily digital dose of health and wellness.

On social: Via Instagram at @bodyandsoul_au or Facebook. Or, TikTok here. Got an idea for an episode? DM host Felicity Harley on Instagram @felicityharley. 

In print: Each Sunday, grab Body+Soul inside The Sunday Telegraph (NSW), the Sunday Herald Sun (Victoria), The Sunday Mail (Queensland), Sunday Mail (SA) and Sunday Tasmanian (Tasmania). 

Why is it tough to do absolutely nothing? Dr Jen Martin is Associate Professor in Science Communication Biosciences from the Uni of Melbourne and delves into the science behind our strangest thoughts. 

WANT MORE FROM DR JEN?

To hear today’s full interview, where she sheds light on your strangest habits…search for Extra Healthy-ish wherever you get your pods.

For more on Jen’s book Why Am I Like This? (Hardie Grant, $27.99) see here and for more on Jen, see here. 

WANT MORE BODY + SOUL? 

Online: Head to bodyandsoul.com.au for your daily digital dose of health and wellness.

On social: Via Instagram at @bodyandsoul_au or Facebook. Or, TikTok here. Got an idea for an episode? DM host Felicity Harley on Instagram @felicityharley. 

In print: Each Sunday, grab Body+Soul inside The Sunday Telegraph (NSW), the Sunday Herald Sun (Victoria), The Sunday Mail (Queensland), Sunday Mail (SA) and Sunday Tasmanian (Tasmania). 

“Will you write an article about menopause?” I have been asked this incessantly of late. And, I get it — truly, I do. I’m female, 52, and a journalist; what else could I possibly be required to opine about? Alas, I am forced to reply: “Sorry, I’d have loved to, but I’m not actually there yet.” The shame, the ignominy, the 40-plus years and counting of entirely useless mess and pain.

We are told to dread the Change, to fear its impact both physical and mental, and beware the prejudices it can foster. Frankly, I’ve got menopause envy. For the Big M has gone from being the hot and bothered affliction that dare not speak its name to a veritable social requirement, certainly in the meno-positive metropolitan environments in which I operate. 

My inbox is crammed with invitations to get involved with themed panels, protests and empowerment parties, parliamentary meetings and product launches. I can’t seem to order a coffee without someone bending my ear about adding collagen for vaginal atrophy, or how matcha might be better for post-meno bones. Far from being taboo, menopause has become compulsory bonding banter.

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Still, it’s not even this that has made me meno-jel. I just want my periods to stop. Now. Immediately. I know menopause — officially the state following 12 bleed-free months — can be accompanied by attendant health issues. However, it is perimenopause, that pre “a clear year” phase in which hormones crash and surge, hot flushes storm, and rages rage, that presents much of the trauma. And it’s perimenopause that I presume I’m in now, that final flush of fecundity representing fertility’s last-chance saloon.

Basically, I’m on the receiving end of the worst of both worlds: the corpse-like perma-knackeredness of a woman staggering towards her mid-50s with the physical and mental angst of a teenage girl. My periods hurt. My mood plummets, my head and belly ache, my energy is on the floor. Mid-cycle is also rough, meaning I’ve just recovered from one pall when another descends.

As an extra sting in the tale, extended menstruation can also make you ill. Hit menopause much earlier than the 51-year-old average and you’ll miss the benefit of oestrogen’s protective effect on bone density and cardiovascular health. Much later, and lingering oestrogen exposure can increase the risk of breast and uterine cancer.

You may argue that I’m not far off the average. Perhaps, but no one else I know of my vintage is in the same boat, my cycle shows no sign of diminishing, and I resent every last second of its stay. My mother and sisters all stopped bleeding bang on 40. Why I continue to share a cycle as regular and active as my 18-year-old niece’s I couldn’t tell you. “Maybe you started later?” medics attempt to console me. I was 11. Forty-one years, and for what? I’ve never wanted kids. Forty-one times 12 opportunities for fainting, leaking, pain, dizziness and distraction. 

Sure, I’d like the wise-woman, zero f***s, “I am at peace and all-seeing” vibe of post-period existence. But, basically, I’d settle for “not still in danger of getting knocked up”. Either way, I’ve had enough. It’s time to give up my painkillers and hot water bottle, my tampons and torpor, for freedom, liberty, calm. Mother Nature, I implore you, give this old girl a break.

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Known as jelquing, the pud-plumping phenomenon has quickly grown in popularity on sites like TikTok and Reddit.

More intense than the usually repeated jerking of the Johnson practised by most males and considered to be harmless or even healthy, jelquing involves firmly pressing a thumb and index finger at the base of a semi-erect member, then dragging forward — much like you’d do when attempting to squeeze the last bits out of a toothpaste tube.

The idea is that these aggressive motions cause micro-sized tears inside the third leg’s tissue that, when healed, come back slightly larger.

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But doctors say practitioners of the radical new form of so-called self-abuse should expect to feel a little prick of disappointment.

“Doing these sort of exercises can create permanent damage to your penis,” warns Dr Rena Malik.

“You can create penile numbness by damaging the nerves to the penis,” she added, warning that the approach does “more harm than good,” and can also cause painful bruising and issues with local arteries and veins.

A blog post on the erectile dysfunction medicine site Hims, which was reviewed by Dr Mike Bohl, warns that jelqing can also induce Peyronie’s disease.

It’s better known as an ailment that causes excruciating and curved erections by scar tissue. Adding insult to injury, Peyronie’s penises are also shorter while erect, according to the Mayo Clinic.

Jelquing joins the recent pseudo-remedy of shocking the penis to enhance performance — another move decried by critics.