Doc, I have a cauliflower on my scrotum.

It wasn’t always like this…

Once everyone had their own GP and they were well trained and competent to remove things that had to be cut out.

When a doctor graduates from medical school he is dangerous. When he begins his first day at the hospital where he first works, he has enough confidence to treat but enough ignorance to do damage.  With the shortage of available health staff, the government threatens to inflict health students on the public. In an insult to experienced teachers the government also threatens to let student teachers teach in schools.  The idiom “blind leading the blind” will reach new heights, the blind treating the blind, the blind teaching the blind.

Everyone is complaining that it is very hard to get a good family doctor even though the cities are full of GPS.

It’s like Abraham’s plea to God before the destruction of Gomorrah, “Lord will you spare the city if I can find one good GP?”

The objections are common; they are working part time; they are never there, you can’t get in to see the same one; they don’t seem to care, and worst of all they don’t seem to know anything.

On the other hand, the outback and the country are bereft of them.

Here is an example of the sorts of things people might be complaining about. One day about two years ago a man came to see me. He was very embarrassed. “I have a cauliflower growing on my scrotum and It leaks at the end into my trousers, so people think that I am peeing myself.”

When he dropped his pants there was a pedunculoma (large skin lesion) on the end of a long stalk about 9 cm in length attached to the bottom of his scrotum. Because the circulation of the structure was becoming compromised the end was dying off and it was leaking.  What I mean by this is that these abnormal structures have a blood supply but when they are too long the blood vessels cannot reach the end.

These things are rare at that size. They are really giant skin tags that assume the shape of cauliflowers and not to be mixed up with cauliflower scrotum which is a sexual infection.

“How long have you had this?” I asked.

“Two years.”

 “Have you shown it to doctors before?”

‘Yes. Six.”

“What did they say?”

“They said I should get it removed but they wouldn’t do it.”

“They said I should get it removed but they wouldn’t do it. They said it needed a general anaesthetic through the public hospital. The hospital told me it would take me two years for it to be removed because of the waiting time for operations. The time keeps getting put back, but they told me it was not urgent.”

“Two years? I said.

Then I sent him down to my theatre and fifteen minutes later the long cauliflower and stalk was lying in a Petrie dish on the way to pathology and he was happily on his way home with stiches in his scrotum.  His misery had been relieved in minutes. They can grow quite large. I have removed one from a thigh the size of a baby’s head. It’s not difficult.

There is worse. A friend returned recently from Africa after working in the jungle training rangers and he was full of gut parasites. Ivermectin is a wonder drug for these parasites, one of the great discoveries of the last century.

He went to see a doctor, an overseas medical graduate.  She refused to prescribe the drug to him and said she was banned from doing it.

“Nonsense,” said the next GP he went to who gave him a double dose and cured him. This last doctor was so gracious and competent he asked at the reception desk if she could be his doctor but no, she too would be moving on soon.  

Dissatisfaction continues to grow. The number one topic of conversation wherever you go is that a good GP is as rare as hen’s teeth.

It wasn’t always like this. Once everyone had their own GP and they were well trained and competent to remove things that had to be cut out.

Fear pervades everything now.

What are they afraid of?

It’s not just that they are badly trained, though many of them are, it is also because they don’t want to do surgical things or take risks. They are afraid they will be sued or complained about or prosecuted by the medical authorities.

It must be said that refusing to treat gut parasites or remove gangrenous lesions borders on negligence.

The rules regarding complaints against doctors have been changed. Once the medical authorities would only report a complaint against a doctor if it had been proven but now, they can publicise it as soon as they receive it, even heresay.

Also, medical authorities have now linked their websites to internet search engines so any adverse findings against a doctor (even trumped up ones) including those that are many years old will be put up on search engine results to control the narrative about who’s good and who’s bad in medicine.

As previously reported in blogs on this website, these medical bureaucracies have succeeded in driving the brilliant neurosurgeon Charlie Teo out of the country. Congratulations.

Compare the treatment metered out to doctors to that metered out to politicians.

Tanya Plibersek is currently a minister in the Federal Labor government. Her husband is Michael Coutts-Trotter, a highly placed, highly talented public servant, secretary of the New South Wales Department of Premier and Cabinet. No one doubts his integrity. In 1985 he was sentenced to nine years jail for importation of heroin. His is a great success story but imagine if every time he appeared in newspapers or online, the details of the criminal judgement against him was publicised. Justly there would be outrage. No so for doctors.

Medical authorities have now linked their prosecution results to the name of every doctor they have persecuted and make sure that this follows him or her for the rest of their lives.

Be assured this is not as they claim for the protection of patients because patients don’t read this material and take no account of it when they see a doctor. The sole purpose of it is to attempt to undermine the credibility of doctors who speak out.

This threat of public ostracism to other doctors is what makes them scared, and this is how the authorities attempt to silence their critics. If you gag the doctors who are speaking out, dangerous flaws in our health system will not be corrected, making it unsafe for all of us.

So where are the good GPs? They are retiring in large numbers even in the cities.

They have left the outback and the country areas of Australia. This scarcity of doctors is dangerous, unfair and an indictment of the Government and medical authorities. The people in the outback of this country feed us and mine our minerals.

By the way, the Voluntary Assisted Dying Act has been passed.

The State Government which has failed the people of the outback so badly with medical care will now be paying to fly doctors to the outback to help people kill themselves.

If you have a cauliflower on your scrotum or other part of the body good luck.