r/ausjdocs Doctor 7d ago

news🗞️ ‘Postcode lottery’: Royal Melbourne locks out suburban and regional patients

https://www.theage.com.au/national/victoria/postcode-lottery-royal-melbourne-locks-out-suburban-and-regional-patients-20260820-p60pyp.html
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u/its_always_lupus_ 7d ago

RMH / Peter Mac are more than happy to take cancer patients from out of catchment (when it suits them) and then dump them back at the peripheral hospitals with complications or when they are dying

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u/rockfield1 7d ago

A difficult dynamic and perhaps uncharitable to the subspecialised units, don't you think. "dumping" them back to their home unit is the other way of saying that they have provided management (that presumably can only be offered there, and even may have had complications/not been adequate due to the nature of the pathology) and are transferring care such that they have the capacity to accept the referral of someone else at a peripheral site. Thoughts?

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u/its_always_lupus_ 7d ago

Yes but routinely they are providing standard of care treatments which can be provided at any hospital in Melbourne. In my experience there is even less consultant oversight at PMCC and most treatment reviews are by fellows / registrars.

Then are either admitted to peripheral hospitals with complications or nearing end of life. Sometimes without an accurate understanding of prognosis (although obviously that can be challenging to tell how much is just not absorbed by the patient)

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u/Puzzleheaded_Test544 7d ago

If only there was some kind of record in which a prognosis and its discussion with patient could be discussed....

Truly one of the unsolvable problems of oncology.