Are our patient consent rules making it harder to train the next generation of doctors? 

An article in The Conversation argues that the strict requirement for patients to content to the involvement of junior doctors in their care is hindering medical training.  

Author and Associate Professor of Primary Health Care and General Practice at Otago University, Dr Ben Gray says it’s limiting hands-on learning, especially in critical situations. 

He told Kerre Woodham the interpretation of the rules has narrowed over time, and doesn’t include situations where patients are unconscious or distressed. 

Gray says it means students potentially won’t have the chance to learn about those patients and how to treat them, if they can’t get consent.  

LISTEN ABOVE 

Are our patient consent rules making it harder to train the next generation of doctors?&nbsp;
An article in The Conversation argues that the strict requirement for patients to content to the involvement of junior doctors in their care is hindering medical training. &nbsp;
Author and Associate Professor of Primary Health Care and General Practice at Otago University, Dr Ben Gray says it’s limiting hands-on learning, especially in critical situations.&nbsp;
He told Kerre Woodham the interpretation of the rules has narrowed over time, and doesn’t include situations where patients are unconscious or distressed.&nbsp;
Gray says it means students potentially won’t have the chance to learn about those patients and how to treat them, if they can’t get consent. &nbsp;
LISTEN ABOVE&nbsp;

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Kerre Woodham Mornings Podcast

Ben Gray: Otago University Associate Professor of Primary Health Care and General Practice says patient consent rules may be hindering medical training

https://api.omny.fm/orgs/7784f840-c291-422a-924b-ad9000bbad71/clips/222f50e3-dc2b-4c72-803d-b44a001b817d/transcript

The Blues are celebrating their 30th anniversary with their inaugural Blues Hall of Fame. 

It’ll honour the legends, stories, and defining moments that have shaped the club since its inception in 1996. 

The first class of inductees will be honoured at a formal lunch today. 

Former All Blacks coach and Blues board member John Hart told Kerre Woodham that initially, while they catch up on history, the Hall will focus on the players and coaches. 

But after that, he says, the ‘Guardians’ class will be added, which honours people like managers, administrators, supporters, or sponsors.  

LISTEN ABOVE 

The Blues are celebrating their 30th anniversary with their inaugural Blues Hall of Fame.&nbsp;
It’ll honour the legends, stories, and defining moments that have shaped the club since its inception in 1996.&nbsp;
The first class of inductees will be honoured at a formal lunch today.&nbsp;
Former All Blacks coach and Blues board member John Hart told Kerre Woodham that initially, while they catch up on history, the Hall will focus on the players and coaches.&nbsp;
But after that, he says, the ‘Guardians’ class will be added, which honours people like managers, administrators, supporters, or sponsors. &nbsp;
LISTEN ABOVE&nbsp;

John Hart: Blues Board Member on the inaugural Blues Hall of Fame

https://api.omny.fm/orgs/7784f840-c291-422a-924b-ad9000bbad71/clips/74e8be53-47d1-4049-a79e-b44b000cb45c/transcript

Obesity related illnesses, as you well know, cost this country a fortune. The direct healthcare costs of obesity, well, they estimated it at $2 billion per year, per year, and that was in 2021, so it'll be a hell of a lot more now. It's more difficult to calculate the total economic impact that obesity has on this country. Estimates range between $4 to $9 billion per year. It depends whether you include lost productivity and how you quantify the loss of quality of life. If you are chair bound and you're in your 20’s, how do you calculate the cost of that? Cardiovascular disease linked closely to obesity costs New Zealand a minimum of $13.8 billion.  

We're looking for hundreds of millions at the moment to try and balance the books with the Budget coming up – look at the billions being spent on healthcare costs. Type 2 diabetes, that costs an estimated $2.1 billion annually. Over two in three adults and nearly one third of children in New Zealand are overweight or obese, placing a severe strain on the health system. So it costs the country a lot. It would make a meaningful difference reducing the numbers of people who are obese and then see that obesity is triggering all kinds of health conditions. The cost in terms of New Zealanders not being able to live their lives, fulfil their potential, that too is staggering. So if there is a way to fix it, why wouldn't we fix it? If somebody said there's a pill for that, you'd take it. 

And indeed, turns out there is. Pharmac thinks we can and should solve the problem through medication. It has added the semaglutide drug to its list of medicines suitable for future funding. In a decision released yesterday, the drug funding agency confirmed it had added Wegovy, as you know it, to its list of options for investment. The options for investment includes all the medications Pharmac would fund if the budget allowed. It's currently unfunded, and if you want to buy it yourself, Wegovy costs someone about $400 a month. The order of Pharmac's list isn't made public for commercial reasons, as Radio New Zealand writes, but if chosen, the drug would be available to people with a BMI of more than 50 and also to those with a BMI of more than 35 with at least two comorbidities.  

There is a cure for obesity, but there will be a group of people, and you might be one of them as you're standing or sitting here listening to me, who don't want to fund obesity drugs despite the clear cost benefits, because you see fat as being a moral failing, and fat people as being inferior beings. You think it's simply a matter of willpower. There were no fat people during wars, food was scarce, and that's the end of that. Pull up your socks, go for a walk, say no, put down the fork, problem solved. Despite the fact that medical experts and psychiatrists say it is way more complicated than that. The ads we're running for weight loss drugs at the moment on this station give an indication of what it's like to see food as a reward and as an enemy. It's the voice chatter that Oprah Winfrey talked about when she went on Ozempic. She said the medication stopped the constant mental chatter about what to eat, what to resist, the constant negotiation about food, which was a feeling she'd experienced for 50 years. The okay, well, if I have an egg for breakfast, that's protein, that's good, but then there's the toast and that's carbs, should I try and put it on say a rice cracker? That doesn't feel very nice. Okay, I've been for a walk so I can reward myself with a piece of cake. Constant. And that's what the ads give an indication of, that's what Oprah Winfrey was talking about. She had an aha moment when she realised that overeating doesn't cause obesity, it's obesity that causes overeating. It is not a moral failing. And I know that when you exercise and when you restrict your food, you lose weight. I've done it before. I'll do it again. I'm in and out like an accordion – I can still hear the chatter sometimes, other times I let it go.  

But for some people, the chatter is so great that they simply don't have the option of going for a walk. Some people can't tie their own shoelaces. It's a psychological illness rather than a physical one. And that's what the experts say, that's not just me. And I know you feel smuggety smug smug smug smug when you're out there running in the early morning and having your chia and your sliced berries and that's your bag, or your marinated vegetables for breakfast, and you're feeling super fit. I used to feel smuggety smug smug smug too when I'd go for my early morning marathon training runs and you knew that people were lying in bed at 7:30 in the morning. Now I think, bloody who was the fool? But you go on feeling smug, you go on feeling smug and feeling superior, and in the meantime, there is a solution to a problem. It's a problem that affects a significant proportion of people. Some people can put down the fork, some people can reset their minds themselves. Great. Others need more assistance. As with many psychiatric illnesses, some people need to have their brain rebooted. And if we can do that and save ourselves billions, why would we not do that? 

Obesity related illnesses, as you well know, cost this country a fortune. The direct healthcare costs of obesity, well, they estimated it at $2 billion per year, per year, and that was in 2021, so it'll be a hell of a lot more now. It's more difficult to calculate the total economic impact that obesity has on this country. Estimates range between $4 to $9 billion per year. It depends whether you include lost productivity and how you quantify the loss of quality of life. If you are chair bound and you're in your 20’s, how do you calculate the cost of that? Cardiovascular disease linked closely to obesity costs New Zealand a minimum of $13.8 billion. &nbsp;
We're looking for hundreds of millions at the moment to try and balance the books with the Budget coming up – look at the billions being spent on healthcare costs. Type 2 diabetes, that costs an estimated $2.1 billion annually. Over two in three adults and nearly one third of children in New Zealand are overweight or obese, placing a severe strain on the health system. So it costs the country a lot. It would make a meaningful difference reducing the numbers of people who are obese and then see that obesity is triggering all kinds of health conditions. The cost in terms of New Zealanders not being able to live their lives, fulfil their potential, that too is staggering. So if there is a way to fix it, why wouldn't we fix it? If somebody said there's a pill for that, you'd take it.&nbsp;
And indeed, turns out there is. Pharmac thinks we can and should solve the problem through medication. It has added the semaglutide drug to its list of medicines suitable for future funding. In a decision released yesterday, the drug funding agency confirmed it had added Wegovy, as you know it, to its list of options for investment. The options for investment includes all the medications Pharmac would fund if the budget allowed. It's currently unfunded, and if you want to buy it yourself, Wegovy costs someone about $400 a month. The order of Pharmac's list isn't made public for commercial reasons, as Radio New Zealand writes, but if chosen, the drug would be available to people with a BMI of more than 50 and also to those with a BMI of more than 35 with at least two comorbidities. &nbsp;
There is a cure for obesity, but there will be a group of people, and you might be one of them as you're standing or sitting here listening to me, who don't want to fund obesity drugs despite the clear cost benefits, because you see fat as being a moral failing, and fat people as being inferior beings. You think it's simply a matter of willpower. There were no fat people during wars, food was scarce, and that's the end of that. Pull up your socks, go for a walk, say no, put down the fork, problem solved. Despite the fact that medical experts and psychiatrists say it is way more complicated than that. The ads we're running for weight loss drugs at the moment on this station give an indication of what it's like to see food as a reward and as an enemy. It's the voice chatter that Oprah Winfrey talked about when she went on Ozempic. She said the medication stopped the constant mental chatter about what to eat, what to resist, the constant negotiation about food, which was a feeling she'd experienced for 50 years. The okay, well, if I have an egg for breakfast, that's protein, that's good, but then there's the toast and that's carbs, should I try and put it on say a rice cracker? That doesn't feel very nice. Okay, I've been for a walk so I can reward myself with a piece of cake. Constant. And that's what the ads give an indication of, that's what Oprah Winfrey was talking about. She had an aha moment when she realised that overeating doesn't cause obesity, it's obesity that causes overeating. It is not a moral failing. And I know that when you exercise and when you restrict your food, you lose weight. I've done it before. I'll do it again. I'm in and out like an accordion – I can still hear the chatter sometimes, other times I let it go. &nbsp;
But for some people, the chatter is so great that they simply don't have the option of going for a walk. Some people can't tie their own shoelaces. It's a psychological illness rather than a physical one. And that's what the experts say, that's not just me. And I know you feel smuggety smug smug smug smug when you're out there running in the early morning and having your chia and your sliced berries and that's your bag, or your marinated vegetables for breakfast, and you're feeling super fit. I used to feel smuggety smug smug smug too when I'd go for my early morning marathon training runs and you knew that people were lying in bed at 7:30 in the morning. Now I think, bloody who was the fool? But you go on feeling smug, you go on feeling smug and feeling superior, and in the meantime, there is a solution to a problem. It's a problem that affects a significant proportion of people. Some people can put down the fork, some people can reset their minds themselves. Great. Others need more assistance. As with many psychiatric illnesses, some people need to have their brain rebooted. And if we can do that and save ourselves billions, why would we not do that?&nbsp;

Kerre Woodham: If there's a fix for obesity-related costs, why wouldn't we use it?

https://api.omny.fm/orgs/7784f840-c291-422a-924b-ad9000bbad71/clips/36f97756-1dc3-48d2-84ff-b44a01897437/transcript

Guess what? New Zealand's in economic trouble. I know, I know, who would have thought it? Well, we did. You know it, I know it. We've known it for a very, very long time, right from the very start when Labour began throwing money around. There were the Cassandras coming on the radio saying, “Oh, you're going to have to pay it back. All very well and good now, probably the right thing to do, but at some point we're going to have to pay it back." 

“The outlook is negative, so it indicates that there is a chance of a downgrade.” 

Okay, and what does that mean? Well, it's not just national pride, it means that it will cost us more to borrow money, which will add even more to our outstanding debt. And it's all very well and good for Finance Minister Nicola Willis to start putting the brakes on now. As has become common these days, the Budget will be no surprise. You know the details of the Budget pretty much before it's announced. But I would argue her budget is a budget that should have been presented three years ago. She told Mike Hosking this morning that getting the books back in order is more important than ever. 

“We have to be very careful about the choices we make. And gone are the days, I think, when political campaigns will be about what new spending program you can design to dish out more lolly in a creative way. We're now in a time where the task for sensible leaders is to say, “What are the investments required to drive the things that will support growth, living standards, and affordability into the future?" And that's why, of course, we've made that decision. Actually, the Fees Free program, it doesn't cut it in this new age. It's not delivering results. That is investment that should be made elsewhere in things that really matter. And there have been choices like that throughout this budget process.” 

Good, but I would argue the tax cuts were a dumb choice. It was an election bribe. Spending on capital infrastructure, which is an investment in the future, that's not dumb spending. Silly tax cuts that made no meaningful difference to people's lives, I'd say that was a dumb choice. National came in saying that they had the answers, they had the lever, they knew which levers to pull to get the economy back on track. I think they made some dumb choices along the way, and this is the Budget that should have been delivered in Nicola Willis's first term as Finance Minister.  

They are streets ahead of a Labour-Greens coalition in terms of economic prudence. I mean, there is just absolutely, absolutely no choice if you're looking for economic prudence. Labour hasn't even got a plan, hasn't even released the plan – at least the Greens have released a plan. You might not agree with it, but they do have a plan. Labour, no, they're waiting till after the Budget and let's see what miracles they can put up. But how the hell are they going to pay for pay equity, which is going to cost billions and billions of ongoing dollars? If they promise that, then that should be enough to consign them to oblivion. 

Guess what? New Zealand's in economic trouble. I know, I know, who would have thought it? Well, we did. You know it, I know it. We've known it for a very, very long time, right from the very start when Labour began throwing money around. There were the Cassandras coming on the radio saying, “Oh, you're going to have to pay it back. All very well and good now, probably the right thing to do, but at some point we're going to have to pay it back."&nbsp;
“The outlook is negative, so it indicates that there is a chance of a downgrade.”&nbsp;
Okay, and what does that mean? Well, it's not just national pride, it means that it will cost us more to borrow money, which will add even more to our outstanding debt. And it's all very well and good for Finance Minister Nicola Willis to start putting the brakes on now. As has become common these days, the Budget will be no surprise. You know the details of the Budget pretty much before it's announced. But I would argue her budget is a budget that should have been presented three years ago. She told Mike Hosking this morning that getting the books back in order is more important than ever.&nbsp;
“We have to be very careful about the choices we make. And gone are the days, I think, when political campaigns will be about what new spending program you can design to dish out more lolly in a creative way. We're now in a time where the task for sensible leaders is to say, “What are the investments required to drive the things that will support growth, living standards, and affordability into the future?" And that's why, of course, we've made that decision. Actually, the Fees Free program, it doesn't cut it in this new age. It's not delivering results. That is investment that should be made elsewhere in things that really matter. And there have been choices like that throughout this budget process.”&nbsp;
Good, but I would argue the tax cuts were a dumb choice. It was an election bribe. Spending on capital infrastructure, which is an investment in the future, that's not dumb spending. Silly tax cuts that made no meaningful difference to people's lives, I'd say that was a dumb choice. National came in saying that they had the answers, they had the lever, they knew which levers to pull to get the economy back on track. I think they made some dumb choices along the way, and this is the Budget that should have been delivered in Nicola Willis's first term as Finance Minister. &nbsp;
They are streets ahead of a Labour-Greens coalition in terms of economic prudence. I mean, there is just absolutely, absolutely no choice if you're looking for economic prudence. Labour hasn't even got a plan, hasn't even released the plan – at least the Greens have released a plan. You might not agree with it, but they do have a plan. Labour, no, they're waiting till after the Budget and let's see what miracles they can put up. But how the hell are they going to pay for pay equity, which is going to cost billions and billions of ongoing dollars? If they promise that, then that should be enough to consign them to oblivion.&nbsp;

Kerre Woodham: This is a Budget that should've already been delivered

https://api.omny.fm/orgs/7784f840-c291-422a-924b-ad9000bbad71/clips/a2a68126-2c9d-4556-b06f-b44a00079fc2/transcript

Ben Gray: Otago University Associate Professor of Primary Health Care and General Practice says patient consent rules may be hindering medical training

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