Doctor warns of women’s health crisis facing Tasmania over treatment costs

A women’s health expert warns Tasmania faces a crisis as endometriosis and PCOS sufferers struggle with poor Medicare rebates and limited specialist access.

A women’s health expert has pleaded with the government to improve Medicare rebates, warning that Tasmania is “in a women’s health crisis” with endometriosis and polycystic ovarian syndrome sufferers facing poorer access to treatment than other states.

Owner, Director and GP at The Bubble, a women’s health clinic, Dr Natasha Vavrek is fighting to make women’s health services more accessible, with Tasmania suffering from a severe lack of specialists and high appointment costs.

Owner, Director and GP at The Bubble, Dr Natasha Vavrek. Picture: Supplied

“I don’t think there is a real appreciation for what a crisis we are in at the moment,” Dr Vavrek said.

“Conditions like endometriosis and polycystic ovarian syndrome are lifelong and chronic, right now we are creating a two class system where there are people who can afford to manage their conditions and the people that can’t.”

Endometriosis is a condition where tissue similar to the endometrium lining grows outside of the uterus.

It is painful and chronic, characterised by severe pelvic pain and period pain and fatigue.

“To manage endometriosis it doesn’t just take multiple investigations, but also multiple treatments,” she said.

Often the only way to properly diagnose the condition is through a surgical procedure called a laparoscopy.

Expert urges Australian government to improve Medicare rebates for Endometriosis and Polycystic Ovarian Syndrome

Then there is Polycystic Ovarian Syndrome (PCOS) which a metabolic and hormonal condition characterised by excess androgens, ovarian cysts and insulin resistance.

“PCOS is actually just as serious as endometriosis,” Dr Vavrek said.

“These women have insulin resistance and with that there is an increased risk of diabetes which we know is a huge issue in rural areas of Australia.”

The condition can also increase the risk of endometrial cancer, stroke, heart disease and mental health issues.

Access to treatment for women in rural areas of Tasmania is particularly difficult, with the small amount of GPs available, so busy they don’t have time to conduct long appointments to dive deeper into symptoms.

“Women’s health conditions take a lot longer in the consult rooms and longer consults do not have adequate rebates available to patients.”

One of the biggest obstacles these women face is the cost of ongoing condition management.

Dr Vavrek explained that these two conditions are “extremely multifaceted” and “need to be tackled through a team approach”.

“If you are going to be seeing four different people such as your GP, gyno, physio, psychologist and/or more, those costs are going to absolutely skyrocket.

“For women with endometriosis and PCOS the best way to improve access and affordability for women’s health is to improve Medicare rebates in general.”

Another significant issue for these women is access to fertility specialists.

“With both of these conditions fertility issues can be huge,” Dr Vavrek said.

“Accessibility to fertility specialists is almost only available south of the state in Hobart.”

She explained that a lot of women who want to be mums living rurally will miss out.

“They have to make the decision as to whether they can take days off work to go down to Hobart for treatment.”

The tiny device has an “exquisite” ability to select and direct the best sperm to achieve a pregnancy. Image: NeoGenix

The greater economic burden on these women and their families not only affects their ability to conceive but can impact mental health.

“They need to be able, at the drop of a hat, leave everything for procedures such as egg collection.”

Both conditions are chronic and do not have a cure, meaning management is life long and expensive.

Dr Vavrek said that it’s not just those in rural Tasmania who are struggling.

“We are in a crisis at the moment in terms of women’s healthcare, the whole of Tasmania is really suffering,” she said.

The clinic owner and seasoned GP explained that medical training in women’s health in Tasmania is generally rushed and not focused on.

At the beginning of her training she was told that women’s health was all about “tears and smears”.

“I was taught that women were hysterical,” she said.

“That the best way to manage a menopausal patient was to get them out of the room as quickly as possible.”

Although recognition and treatment for women’s health conditions has improved since then, for many living in Tasmania, she said there is still huge room for improvement.

“We still have a long way to go but we are talking to more and more young doctors, who actually have an interest in women’s health and want additional training.”

Fundamentally, Dr Vavrek said better training and Medicare rebates would directly improve access for women who are struggling.

“It just comes down to affordability for patients and whether they can even manage it all.”

Originally published as Doctor warns of women’s health crisis facing Tasmania over treatment costs