Doctors resort to YouTube training videos

Doctors are turning to YouTube for training to insert long-acting reversible contraceptives like the Mirena, top women’s health expert Dr Orna McGinn says.

There is no competency-based training scheme for primary care clinicians to insert subsidised intra-uterine devices, despite them being 20 times more effective than the most common form of contraceptive in New Zealand – the birth control pill. ‘‘It is absolutely mandatory that if you are doing an invasive surgery ... you should have been trained,’’ McGinn, an

Auckland GP who is the clinical director of primary care at Auckland District Health Board women’s health, said. There was a competency-based training programme in Britain where clinicians had to complete 12 procedures, she said.

A competency standard was in development, led by the Ministry of Health, but in its absence GPs ‘‘had to do their best and were ... doing training over YouTube videos’’, McGinn said.

Family Planning also performed the procedure as well as providing training but it was ‘‘disrespectful’’ to those seeking the procedure that there was no formal training scheme. There were also long waits for doctors to access Family Planning training, McGinn said.

‘‘My colleagues want to be trained, it has just not been easy to get. If you haven’t gone through a rigorous training programme, you will get complications.’’

Dr Jane MacDonald, senior research fellow at Victoria University’s centre for women’s health research, said the sector had ‘‘no idea how GPs are getting their training in this area. It is very ad hoc’’. She called for a formal training system and more funding.

The free contraceptives are inserted into the uterus and release the hormone levonorgestrel but it costs about $150 for insertion and removal at general practices, which is a barrier for patients. Funding for contraception in primary care can depend on patient age, ethnicity or address, or the primary health organisation to which the doctor’s practice belongs.

General practice doctors struggled to access training for the vital service, Dr Bryan Betty said.

Contraceptive funding also varied and was inequitable, said Betty, who is the medical director of the Royal College of General Practitioners. The college was working with the Ministry of Health on a competency training programme but it would not address the funding issues, he said.

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