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I completely agree with Dr Smith about lawyers dictating "clinical guidelines". Would they like it if we told them how to do their job, and to disregard all that they had learned?
Dr Rosemary Toalster
UQ Health Service  

These guidelines are completely unrealistic. It would take me all day to see a single patient!
Mimika  

Well, well, looks like the chefs at the RACGP don’t like it when someone else comes up with their own cookbook. Memo RACGP: your accreditation standards are a cookbook too. No guidelines or book can ever allow for all circumstances in all patients, nor can risk ever be totally eliminated. This is why clinical judgement is the key asset of doctors. Sadly whilst the most vital, it is the least appreciated. Still perhaps we can all be replaced with trained monkeys who will use the latest guidelines, algorithms and government approved "best practice".
Joe Kosterich      

Cookbook medicine? How dare they! Only the RACGP can dictate professional standards and clinical competency! Outrageous!
'dr kos1nsk1'  

Despite possibly good intentions, there is so much wrong with these. A quick perusal of these guidelines show that Avant has misrepresented and misquoted the Australian Cancer Network Clinical Practice Guidelines to "support" and "validate" the items in the Avant checklist. There is a mish-mash of general "good practice governance" items which have nothing to do in particular with melanoma, along with what appear to be specialist oriented opinions, rather than evidence based conclusions.  
One particularly jarring recommendation is this: "When GP diagnosis is not possible, images of patients with multiple lesions requiring whole body skin checks are referred to professional mole imaging clinics, where they are available." In Victoria, this means MoleMap, a private company run by dermatologists, some of who reportedly participated in the couple of consultation meetings run by Avant in Melbourne. Such clinics may well prove useful, but there is no body of evidence as yet to support this as a recommendation.
Most of the other recommendations are supported by Grade C evidence or worse. The only Grade A evidence for melanoma diagnosis from the Australian Cancer Council Guidelines is for doctors to be trained in and use dermoscopy - and this barely rates a mention, let alone emphasis.
I can see expert witnesses having a field day with this!
Dr Jeff Keir
Ballina, NSW