with champions — South Australia’s health leaders mingle at the annual President’s Breakfast
year that was
AMA SA Council and committees’ advocacy achievements in 2024
SA’s strategic focus on payroll tax in 2025
Ahpra considers assessments for older doctors
South Australian medicos captured at recent Flinders University, RACS and Pakistani Medical Association of SA celebrations
of the
in
President Dr John Williams test-drives new
is produced by Australian Medical Association SA
Australian Medical Association South Australia Inc.
Level 7, 431 King William St, Adelaide SA 5000
PO Box 685, Fullarton SA 5063
Telephone: (08) 8361 0100
Email: medicsa@amasa.org.au www.ama.com.au/sa
Membership: membership@amasa.org.au
President Dr John Williams: president@amasa.org.au
CEO Nicole Sykes: nsykes@amasa.org.au
Editorial
Medical Editor: Dr Roger Sexton editor@amasa.org.au
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ISSN 1447-9255 (Print) ISSN 2209-0096 (Digital)
DISCLAIMER: Neither the Australian Medical Association South Australia Inc. nor any of its servants and agents will have any liability in any way arising from information or advice that is contained in medicSA. The statements or opinions that are expressed in the magazine reflect the views of the authors and do not represent the official policy of the Australian Medical Association South Australia unless this is so stated. Although all accepted advertising material is expected to conform to ethical standards, such acceptance does not imply endorsement by the magazine. All matter in the magazine is covered by copyright, and must not be reproduced, stored in a retrieval system, or transmitted in any form by electronic or mechanical means, photocopying, or recording, without written permission. Images are reproduced with permission under limited license.
AMA SA Council
President: Dr John Williams
Vice President: A/Prof Peter Subramaniam
Immediate Past President: Dr Michelle Atchison
Chair: Dr Karen Koh
Ordinary Members
Dr Vikas Jasoria
Dr Emily Kirkpatrick
Dr Bridget Sawyer
Dr Nimit Singhal
Dr Krishnaswamy Sundararajan
Dr Hannah Szewczyk
A/Prof William Tam
Dr Isaac Tennant
Specialty Group Representatives
Anaesthetists: Dr Louis Papilion
Dermatologists: Dr Karen Koh
Doctors in Training Representative: Dr Hayden Cain
Emergency Medicine: Dr Cathrin Parsch
General Practitioners: Dr Chris Moy
Intensive Care: Dr Raj Ramadoss
Ophthalmologists: A/Prof Michael Goggin
Orthopaedic Surgeons: Prof Edward (Ted) Mah
Paediatricians: Dr Patrick Quinn
Pathologists: Dr Shriram Nath
Physicians: Dr Andrew Russell
Psychiatrists: Prof Tarun Bastiampillai
Surgeons: Dr Christopher Dobbins
Regional representatives
Southern: Dr Jerida Keane
Northern: Dr Alice Fitzpatrick
Public Hospital
Doctors Representative: Dr Clair Pridmore
AMA SA Board
Dr John Williams (Chair)
A/Prof Peter Subramaniam
Dr Shriram Nath
Dr Bridget Sawyer
Prof Tarun Bastiampillai
Prof Edward (Ted) Mah
Ms Megan Webster
‘Decisions
are made by those who show up’. It’s a favourite line of former AMA SA President Dr Chris Moy, who used to like quoting (fictional) US President Josiah Barlet in emphasising that to influence an outcome, you must participate in the process.
This year has demonstrated yet again the truth of this maxim. Across the AMA, at local, state and national levels, we have influenced, changed, reformed and updated ideas, actions, policies, plans and even legislation because we have been part of the process. And our achievements bear witness to the power of this participation.
Our work this year has demonstrated, time and again, that the outcomes of decisions – the actions, the reforms, the changes – come about by those who show up and make sure those decisions mean something. In the case of AMA SA, it means the members of our Board, Council and committees, who give their time to attend meetings and provide their knowledge and expertise to trigger and support our advocacy. In particular, I would like to recognise the contribution of the late Dr Tom Turner, whose dedication to the AMA and our profession was evident over many decades and is being honoured with a special award (for more, see page 66). We appreciate, too, the input from AMA members who explain how a policy, law or reform is (or isn’t) having optimal ramifications for their work.
And so we come to the end of a year in which we continue to make known what payroll tax will mean for health care in this state. We argued vehemently, on the basis of international evidence about impacts on patient safety and warnings about anti-microbial resistance, against pharmacy prescribing of UTI
medication and other forms of ‘scope creep’. We watched as much of our work to decriminalise abortions was threatened, before (some) common sense prevailed. With our doctors in training, we have been working with SA Health to establish procedures and protocols to minimise bullying, and simplify the reporting of it, in our training hospitals. Internally, the work of CEO Nicole Sykes has been instrumental in establishing a strategic plan that is now a roadmap for how AMA SA will serve its members in 2025 and beyond, and building a team to perform that service.
Most memorably, perhaps, from a personal perspective, I have been able, with the support of Board, Council and the Secretariat, to ‘take to the road’. I have heard first-hand the challenges facing our rural colleagues in many areas of the state. These trips have been a highlight not only of my presidency, but of my professional career. Plans are afoot to continue my road trip next year; please keep an eye out for dates and times for visits to the Mid North in the new year.
As we approach the end of another calendar year, I find myself astonished, yet again, at how quickly 12 months passes and how much can occur in that period. My sincere thanks go to Nicole, the Board and Council, our committees and our staff for consistently ‘showing up’ throughout a busy year. And I urge all doctors to ‘show up’ alongside us next year – we have much to do.
president@ amasa.org.au
‘DECISIONS ARE MADE BY THOSE WHO SHOW UP.’
AAs we approach the end of 2024, I would like to take a moment to reflect, with gratitude, on a year filled with collaboration and progress. It has been a significant year for AMA SA, and as its CEO I am both proud and thankful for our collective achievements.
At the heart of our progress lies our newly formed team, whose wealth of knowledge and experience are already bringing tangible benefits to our membership and the broader medical community. From driving new initiatives to improving member services, the impact of this team is clear, and I am constantly inspired by the commitment to upholding the values of AMA SA and the determination to find ways to evolve and improve our offerings for the profession we represent.
I also wish to acknowledge the outstanding leadership of our President, Dr John Williams, who continues to juggle the demands of a busy regional practice while contributing so much to health in the state. I daily witness his unwavering focus on adding value for our members, taking a collaborative approach to represent the voice of medical professionals throughout South Australia. It is through the selfless work of leaders such as John that AMA SA remains at the forefront of advocating for and supporting healthcare professionals across our state.
Our President and our team are ably supported in our work by a large group of dedicated volunteers who give their time generously across various AMA Committees, Council and Board. There is so much work behind the scenes - often unseen – that is vital to our work and our outcomes. Whether it’s through providing expertise within their respective areas, their work at events, their involvement in advocacy, or their commitment to supporting our strategic direction, their contributions are invaluable. Together, they form the backbone of AMA SA, and I extend my appreciation to all. If any of our members are interested in contributing further, please watch out for opportunities early in 2025 as we have a few exciting roles that will become vacant due to the completion of tenures.
We have listened to your feedback, and in addition to our advocacy achievements we have focused operationally to ensure our members are receiving value. Highlights include:
• strengthening AMA SA’s foundation through improving our governance, introducing policies and procedures and establishing committees to better support the Board and Council and represent our membership
• formulating and launching a strategic plan focused on authentic engagement and support across all membership segments
• finding modern, centrally located office space, accessible to members and suited for events at level 7, 431 King William Road (from January 2025)
• developing a comprehensive educational and events calendar
• updating communication strategies to deliver information in a coordinated approach across multiple platforms.
My annual wrap wouldn’t be complete without special mention to the business partners that have played an instrumental role in our success this year, and I sincerely thank our colleagues at Hood Sweeney, Norman Waterhouse and Avant for their ongoing support. We have worked closely with these partners to deliver advocacy results and a series of educational events. Our combined efforts have allowed us to provide even more value to the medical community in South Australia and have a bit of fun along the journey with skilled knowledgeable professionals and genuinely good people.
To our members, volunteers, and professional partners, I extend my sincere thanks for your ongoing support of our team at AMA SA. Your commitment drives us forward and ensures that we can continue to advocate for a stronger, more resilient healthcare system.
Wishing you all a well-deserved Christmas and we look forward to working closely with you in 2025. Together, we are making a difference.
Explore our open committee positions and learn how you can make genuine impact.
AMA SA is seeking dedicated individuals who share our commitment and passion for driving change.
• Committee chair
• Representative from Central Adelaide Local Health Network (CALHN)
• Representative from Women’s and Children’s Health Network (WCHN)
• International Medical Graduate (IMG) representative
4 positions available
This committee ensures AMA SA can identify and act on matters affecting the professional and personal lives of junior doctor members.
• Doctor in Training representative 1 position available
Play a critical role in supporting and advocating for IMGs, recognising their importance to the Australian healthcare system.
• Representative from regional / rural areas
• Representative from the outer metropolitan area – can be either owner or contractor 2 positions available
Play a pivotal role in providing a platform to influence and support general practice in regional and outer metropolitan areas.
Application Deadline 30 January
If you are motivated to contribute to any of these roles or would like more information please express your interest by sending your application to abrown@amasa.org.au
Scan me for more details & how to apply
Positions available with online and in-person attendance options. If you are interested in joining a trial meeting, please get in contact.
As we approach Christmas and New Year, it is a good time to reflect on the past 12 months, predict what lies ahead, and consider what you may want to spend more or less time on.
It may help if we ask some critical questions.
What have I given up to practise medicine?
Is my family has learning to live without me? Is my health suffering through ignoring ageappropriate screenings and good lifestyle habits?
Has my aerobic fitness declined over time? Am I satisfied with my nutrition, alcohol, exercise and sleep quality?
Is this my career doing me harm?
Do I have orthopaedic symptoms related to my poor posture, sedentary work, vitamin D deficiency and sarcopenia, fatigue, under-hydration and hypoventilation and ‘CO2 narcosis’?
Is my workload giving me burnout (exhaustion, cynicism and thoughts of quitting medicine) and a lack of clinical variety?
Have I lost contact with family and friends?
Am I working in the evenings and associating too much with doctors?
Have I tested the patience of my partner and family with excuses that work is more important than home life?
Am I financially over-committed and living beyond my means?
Does my working week suit my true interests and passions?
Does my work give me: a sense of achievement?
contact with people? the feeling of being valued and appreciated and that my opinion and advice matters to others?
choice of work and control? an interesting working week?
Acquired Needs Theory (McLelland) highlights how important our medical work is to so many of us, and how it meets our need for these things. Does your work currently provide this for you?
Then there are the existential needs that underpin higher levels of work and life satisfaction. These include: having someone to love and someone who loves you too waking up in the morning with something important to do that help others feeling in control, able to choose what to do having something to look forward to.
By posing these questions, we can at least contemplate changes to the way we live and work and realise we have more control that we may realise.
I hope this helps you reflect and look to 2025 with purpose.
I thank all the contributors this year and the medicSA Editorial Committee and the AMA SA team members who work so hard to bring these editions to you. Please enjoy reading this issue – and a relaxing summer.
AMA SA President Dr John Williams welcomed colleagues and friends to his end-of-year President’s Breakfast celebration at Plant 3 Bowden on 29 November.
The event was attended by members of AMA SA’s Board, Council and committees and representatives of AMA SA’s partners Hood Sweeney, Avant and Norman Waterhouse.
Dr Williams was also pleased to welcome other special guests including the Health Minister Chris Picton and Shadow Minister for Regional Health Services Penny Pratt.
‘This event is always a wonderful way to celebrate the year – and to see face-to-face some of the people with whom we work closely,’ Dr Williams said.
‘It’s always an honour and privilege in this job to speak to doctors across the system.’
There was special acknowledgement for the late Dr Tom Turner, who died in September after almost a decade of service on AMA SA’s History Committee. He was posthumously awarded an Outstanding Achievement Award, which was accepted by his wife Jan and daughter Jane.
Dr Williams praised Dr Turner and the many other volunteers on AMA SA’s Council and committees who work to strengthen the organisation’s advocacy.
He also thanked Minister Picton for his ongoing collaboration.
‘On the rare times that our ideas misalign with those of the state and federal governments, we appreciate that they kindly take our calls and at the very least listen to the AMA,’ Dr Williams said.
‘Our advocacy will continue in 2025 as we work together for the improved health and wellbeing of all South Australians.’
AMA SA CEO Nicole Sykes applauded Dr Williams’ leadership and dedication.
‘As our first regional President, your early flights and tireless efforts - always carried out without complaintstand as a testament to your commitment,’ she said.
‘Your supportive and quietly relentless approach to governance to move the AMA as a business to a position of strength has set a high standard.
‘I would like to pay tribute to the immense impact you have made and the unwavering support you give to me and the team which provides the platform for us to thrive in our roles.’
For more photos go to AMA SA’s website.
Discover AMA SA’s comprehensive program of events coming up in 2025. Event dates will be released in January but here is a sneak peak of what’s in store.
A morning of inspiration and celebration as we honour South Australian Women in Medicine driving change. Hear from a leading panel of women as they share their experiences and network with other professionals over breakfast.
Join us for an elegant evening at the 2025 Gala Ball as we celebrate the advocacy of our outgoing President, Dr John Williams, and warmly welcome his successor. Enjoy a night with fine food, entertainment, and the company of colleagues.
Don’t miss your chance to connect with Dr John Williams as he passes through your local regions with events in Murray Bridge, Clare, Port Pirie and Victor Harbor.
Take control of your financial future. Join us to learn about personal finance, budgeting, superannuation, property investment, tax strategies and more.
Preparing for retirement requires planning. A guide tailored for doctors covering finance, pensions, superannuation, assets, staffing and the process of closing or selling your practice.
Unlock the secrets to a successful private practice with our essential guide. We cover topics like financial planning, business advisory, practice structures, cybersecurity and marketing.
A dynamic speed mentoring session where you’ll have the opportunity to connect with mentors as well as receive invaluable financial tips to maximise your income.
Webinars
We host frequent webinars covering a range of topics including cybersecurity, payroll tax and crucial industry announcements and updates. Stay informed in our expert led sessions.
Keep an eye on our events page for details on upcoming AMA SA events: ama.com.au/sa/events Have a particular event you would like to see? Please get in contact: membership@amasa.org.au
Australia’s parliament has approved ‘world-leading’ laws to keep children under 16 off social media. But experts say age restrictions are just part of the solution and that further action is needed to support those who’ve been exposed to psychological harm.
Australia is leading the push to introduce age restrictions on social media. The world is watching.
Australia’s Parliament has passed laws to ban children under 16 from social media.
The legislation is designed to keep children safe from the physical and mental harms of excessive social media use and includes penalties for online platforms that do not comply.
‘Social media is doing harm to our kids and I’m calling time on it,’ Prime Minister Albanese told a news conference in November.
‘If you’re a 14-year-old kid getting this stuff, at a time where you’re going through life’s changes and maturing, it can be a really difficult time and what we’re doing is listening and then acting.
‘The onus will be on social media platforms to demonstrate they are taking reasonable steps to prevent access. The onus won’t be on parents or young people.
‘I want Australian parents and families to know we’ve got their backs.’
South Australia’s government announced separate legislation to restrict access in May 2024. Under its proposal, children under 14 would be banned from social media and teenagers aged between 14 and 15 would require parental consent.
Although governments at all levels seem eager to mandate swift change, questions about the practicality of introducing social media age restrictions persist. There are also concerns about users’ privacy and the unintended impacts of curtailing young people’s access to streams of information and communication.
A parliamentary inquiry into the influence of social media on Australian society is examining the issue from all perspectives.
‘SOCIAL MEDIA IS DOING HARM TO OUR KIDS AND I’M CALLING TIME ON IT.’
Photography: asbCreative
South Australian Premier Peter Malinauskas has been one of the loudest voices calling for social media age restrictions. Writing for medicSA, he argues that Australia can’t afford to get it wrong.
For a long time there seemed no need for the government to pay much attention to social media.
We could believe any concerns over access to smartphones and 24/7 social media were overblown; the tech equivalent of a grumpy dad sneering that pop modern music was far better in his day.
That was then. But now, after over a decade of research, the results are in. And they’re sobering.
We know for a fact that social media has changed childhood and adolescence, sometimes for good –but also for ill, and that is no longer something we can ignore.
The data backs up what parents have been saying: young people have been experiencing a dramatic decrease in their happiness and wellbeing, over the exact same period which social media has been easily and privately accessible via the astonishing spread of the smartphone.
regulations in our pubs and speed limits on our roads: to minimise the harm to society at large.
But it’s more than that. We all want our children to enjoy healthy, happy childhoods. We want them to realise their potential to enjoy a better standard of living, and more satisfying lives.
Parents need to be aware of what social media is doing to themselves, and to their children. And young people need to know what social media is doing to them – especially the generations that have never known a time without smartphones.
And why not give it a try? How does putting some guardrails in place do any harm to our young people, besides getting them away from screens for a little while?
I’m proud that all high schools in the state of South Australia, public and private, will be resourced to deliver their students age-appropriate, evidence-based education programs on social media and online safety.
‘WE CAN EMBOLDEN OTHER GOVERNMENTS TO FOLLOW OUR EXAMPLE’
To be clear, parents will always be the ultimate arbiters of what is best for their own children, but pitting their very best intentions against the global tech industry is an impossibly onesided battle.
It is the duty of government to even those odds and set the groundrules for the same reasons that we have licensing
We will be the first in the country to implement such programs, but I have no doubt that we won’t be the last. And make no mistake: we can’t afford to fail.
This is world-leading stuff, but if we get it wrong, we hand every government on the planet a perfect excuse to put social media regulation in the too-hard basket.
But if we get this right, and successfully ensure that tech companies act with the same level of accountability demanded of every other industry, then we will do more than just help generations of young Australians: we can embolden other governments to follow our example.
That’s what the stakes are with our social media strategy: we have an opportunity before us to not only significantly change our country for the better, but the world.
With the health and happiness of our kids at stake, there’s no excuse for not at least giving this a red-hot go.
The South Australian Premier invited AMA SA representatives to attend the Social Media Summit in Adelaide in October. The meeting brought together a diverse panel of experts who want to make digital spaces safer for children and young people. Many agree there’s a need for action beyond age restrictions.
A leading US psychologist has warned Australia must rein in the social media ‘monster’ created by America.
Dr Jonathan Haidt, the best-selling author of The Anxious Generation, gave the opening video address at the national Social Media Summit at the Adelaide Convention Centre on Friday 11 October.
He said the US had passed two ‘terrible’ laws in the 1990s that allowed the internet to expand without any guardrails.
‘We created monsters. We need you to slay them or at least tame them,’ Dr Haidt said.
‘Thank you for leading the way in cleaning up the mess that America made for the world.’
The Social Media Summit was staged over two days, one day each in Sydney and Adelaide. It brought together doctors, digital experts, child safety advocates and politicians with a common goal: to protect children and young people from the dangers of social media.
South Australian Premier Peter Malinauskas issued a rallying call to attendees as he explained why he’s so passionate about legislating social media age limits.
‘This is the moment to achieve action,’ Premier Malinauskas said.
The Director General of the Australian Security Intelligence Organisation (ASIO), Mike Burgess, said social media is increasing the rate at which children can be radicalised by terror groups.
‘The internet is the world’s most potent incubator of extremism,’ Mr Burgess said.
‘(Social media) platforms are not generating new, superior threats, but almost certainly they are amplifying, accelerating and aggravating existing ones.’
The Australian Medical Association in South Australia (AMA SA) was represented at the summit by its CEO Nicole Sykes and the Chair of AMA SA’s Doctors in Training Committee, Dr Hayden Cain.
‘WE CREATED MONSTERS. WE NEED YOU TO SLAY THEM.’
‘The eyes of the world are on us, which means the eyes of every tech company are on us as well. We cannot risk the future of our children.’
As a registrar working in Renmark, Dr Cain says he’s seen the toll social media can take on young, vulnerable minds.
‘The damage caused by social media is varied and pervasive.
I see a huge volume of mental health issues in children,’ he says.
‘We have a duty of care and the current systems don’t meet that duty of care. That’s why I support legislation that puts the onus on social media companies to make sure children aren’t using inappropriate and unsafe platforms.’
Dr Cain says beyond age restrictions, governments at all levels have a responsibility to help those who are already
grappling with the consequences of long-term exposure to social media.
‘Mental health care should be affordable and easily accessible no matter where patients live in Australia, but right now there are too many barriers and the efficacy of treatment varies,’ he says.
‘Improving access requires a multi-pronged attack. Medicare reform will help, but we need a complete system review to improve access, quality and affordability for all.
‘As well as supporting those who have been harmed, we also have a responsibility to offer safe and appealing social media alternatives for young people who are losing access to something they’ve grown up with.’
Ms Sykes agrees that introducing age restrictions is only one part of the solution.
‘It’s fantastic that the Australian and South Australian governments are taking action to mitigate damage to future generations, but we can’t forget the current generation,’ she says.
‘Further action is needed to ensure children who are already dealing with body image issues, anxiety, depression and a myriad of other mental health conditions have timely and affordable access to the help they need.’
AMA’s Public Hospitals Report Card: Mental Health Edition, which was released on 31 October, suggests there’s a dire need for mental health funding.
South Australia has 27.9 specialised mental health beds per 100,000 people and the number of mental health-related ED presentations in the state remains higher than the national average, indicating an unmet gap in community care.
‘The rising number of children presenting with severe and complex mental health conditions is adding more pressure on
the health system at a time when it’s struggling to cope,’ Ms Sykes says.
‘AMA SA is working in tandem with our federal counterparts to help our governments understand that we need to increase specialised mental healthcare capacity in hospitals and fund alternatives for GP-led community care models.
‘Funding mental health care and services should be on the basis of need and demand, not a competition between sectors and specific conditions.’
Generations of children are growing up with smartphones at their fingertips and for some this early exposure is causing lasting harm.
Dr Kim Le knows firsthand the dangers of digital dependency. He was in his 30s and working as a child psychiatrist in Adelaide when he became hooked on video games.
One of the organisation’s lead researchers, Dr Aliza Werner-Seidler, told a parliamentary inquiry into social media that heavy use of social media is linked to higher symptoms of depression, insomnia and eating disorders.
‘I essentially became addicted to Pokemon GO,’ Dr Le says. ‘I grew up playing the original games and the nostalgia pulled me in.
‘A year later I was still hooked. When I took my own medicine and tried banning myself from the app, I only lasted a week before reinstalling it.’
Dr Le says his experience has given him insights about the risk to children who’ve grown up using smartphones and tablets.
‘We’re seeing a whole generation of kids who’ve been affected,’ Dr Le says. ‘We’ve moved away from a playbased childhood to a screen-based childhood.’
Dr Le says there’s a clear correlation between frequent social media use and mental health harm. He refers to a millennial study which followed a cohort of children who were born in the year 2000.
‘It’s cross-sectional data, so we don’t know what causes what, but there is a relationship there and that is consistent with other research that has been done in Australia and around the world,’ Dr Werner-Seidler said.
Dr Le says a range of factors contribute to social media dependency, including family dynamics, self-esteem, selfregulation and social competence. He supports the push to enforce age restrictions.
‘WE’VE MOVED AWAY FROM A PLAY-BASED CHILDHOOD.’
‘The research found that by age 15, girls who used social media the most had the lowest self-esteem and the highest levels of anxiety and depression,’ he says.
‘It’s very hard growing up with social media nowadays because you’re not only comparing yourself to your peers at school, but to people all over the world. It’s just too overwhelming.’
A recent study of 4,000 Australian teenagers by the mental health organisation the Black Dog Institute substantiates the link between social media use and mental health issues.
‘Between the ages of 12 and 15 your frontal lobes are going through a massive growth spurt. We really want to protect kids’ brains up until that age,’ he says.
‘Tech companies aren’t properly enforcing agreed upon age restrictions. If we don’t step in now and treat it as a medical responsibility, who’s going to regulate them?’
Dr Le admits he still plays Pokemon GO ‘semi casually’. He says the game doesn’t have the hold over him it once did, but that his story demonstrates that even those with a deep understanding of digital addiction can be overwhelmed.
Dr Kim Le is a child psychiatrist specialising in digital addiction.
A leading South Australian psychiatrist says a coordinated effort is needed to support children already dealing with social-media related mental health conditions – and general practitioners have an important role to play.
South Australia’s Deputy Chief Psychiatrist and AMA SA member Associate Professor Melanie Turner has been central to the conversation about the internet and its impact on young minds.
A/Prof Turner is one of the state’s most respected child and adolescent psychiatrists. She contributed to the independent legal review that sets out a legislative framework for age restrictions for social media users in South Australia.
‘What I really want is a ban on the inappropriate social media: content about self-harming behaviours, eating disorder behaviours, harm to others and material that exposes children to extreme and dangerous groups,’ A/Prof Turner says.
people for mental illness treatment to continue their work.’
She encourages GPs to check in with young patients about their social media habits and ask them how they would react if access was limited or removed.
‘THESE NEGATIVE EXPERIENCES ARE THE NORM.’
‘Right now we don’t have any filters that can restrict that material. Social media is a huge open doorway, and I support the ban for social media for children under 14 while we have our current social media setting.’
A/Prof Turner says social media has become a ‘pervasive’ part of children’s lives and is causing significant harm.
She says she has patients terrified to go to school because of what she describes as relentless cyberbullying.
She’s also seen a significant increase in the number of young people highly distressed after their intimate photos were shared with classmates.
‘Children can’t escape school or school bullying because it follows them on social media sites and chat rooms,’ she says.
‘It’s important to recognise that most of these negative experiences are the norm, not the exception. If children are on social media, they are being exposed to all these things.’
A/Prof Turner says an ongoing and coordinated approach is needed to ensure children with social media-related mental health conditions can access care.
‘Supporting multiple approaches to mental health care, including access to psychology, psychiatry and GPs, is important,’ she says.
‘Allowing longer GP consults and increasing their Medicare rebate would allow more GPs who see many
‘Often children can’t separate themselves from their phones, so they become anxious if their phones are not charged or they can’t find them. They can even become quite irritable and aggressive,’ A/Prof Turner says.
‘I talk to them as I would talk to a patient dealing with addiction. I ask questions like, “how do you cope if you don’t have your phone? What if your phone was off for two hours? What would that be like?”’
A/Prof Turner says there are several red flags that may indicate a child may benefit from treatment.
‘If someone is following a site that encourages or promotes disordered eating and they then start to display disordered eating we need to act on that reasonably quickly,’ she says.
‘Also, there are a number of sites that promote suicide techniques and some of these are incredibly graphic and persuasive.
‘If young people are talking about looking at those sites, we must treat that like we do our other contagion risks for suicide and stop their access immediately.’
Dr
Melanie Turner is South Australia’s Deputy Chief Psychiatrist and an AMA SA member.
Social media age restrictions will affect all account holders, not just children. Professor Paul Haskell-Dowland explains whether it’s possible to establish a system that will work.
Most social media platforms require users to be at least 13 years old to register. Users self-report their age, which means they can enter fake birth dates. The system is only as reliable as the honesty of the person entering their details.
Age verification is a more rigorous approach. This requires a user to provide some form of identity that can be verified against a trusted source. In a social media setting, it’s more effective but much more contentious.
The easiest approach would be to use the Australian Government’s digital identity app MyGov ID. MyGov ID would verify a user’s age and identity. The app would then generate a reference code that could be entered into a social media platform to confirm
a user’s age without sharing any personal information. From a technical perspective, this system is relatively straight-forward to establish.
It should be very safe and secure. Because a government app is performing the age verification, users won’t have to share their personal data with individual social media companies. This reduces the risk of personal data being breached. With any identification scheme there will be concerns about government surveillance or overreach, but most of these are unfounded.
All social media users, including adults, would have to verify their age on registration. Verification would also need to be retrospective, which means existing accountholders would have to go through the process.
Social media companies don’t want this. It creates a barrier to registration and the reality is, no matter what they say, they want kids on their platforms because they’re the next generation of customers who will make content and consume advertising. However, I don’t think there will be major pushback. Publicly they will want to demonstrate that they want to protect children. They know this is not an argument they’re going to win.
There will always be ways to evade controls; we’ve seen that with alcohol age restrictions, too. A child could ask an older sibling or friend to set up an account for them. They could also use technical means, like Virtual Private Networks (VPNs) or the TOR network, to tunnel out of Australia into a different country with less stringent controls and set up a social media account there. Of course, some kids
will try to get around it, but it will have a very big benefit for the majority of kids who will comply.
It will happen, but I think it will take time. There will be a lot of fuss about privacy and people losing their rights, but ultimately what we’re talking about is a relatively low barrier to entry. I think it’s worth losing a little bit of liberty to safeguard children.
Professor Paul Haskell-Dowland is Associate Dean for Computing and Security at Perth’s Edith Cowan University.
The world’s biggest social media companies claim they care about creating safe spaces for children.
The minimum age for using most platforms is officially 13, although children can easily bypass that due to the lack of robust age verification systems. In response to growing global pressure, some companies have taken voluntary steps to increase safety.
Meta, the company that owns Facebook and Instagram, has introduced ‘teen accounts’ for Australian users under the age of 16.
These accounts have the strictest privacy settings and allow parents to introduce daily usage limits and restrict app access during specific hours.
There’s a ‘sleep mode’ that prevents notifications between 10 pm and 7 am.
New anti-bullying features aim to prevent offensive language in comments and messages.
Meta says AI tools are being developed to detect underage users by analysing behaviour and content creation. This technology is due to be trialled in early 2025.
The short-form video platform TikTok sets default privacy settings for users under 16.
Users under 18 are subject to a 60-minute daily time limit and require a password for further access. The ‘restricted mode’ filters inappropriate content.
In 2022 TikTok introduced a ‘family pairing’ mode that allows a parent to link their account to their child’s account.
Snapchat is a multimedia instant messaging app that allows users to send photos and videos.
Users under 18 cannot add users who aren’t among their contacts and are barred from using payment features. There’s also a family centre that allows a parent to link their child’s account to their own.
Despite these settings, safety issues persist. Critics are concerned that the disappearing nature of messages can lead to risky behaviour. There’s also a ‘snap map’ feature that can reveal a user’s location if not properly configured.
Social media has blurred the boundary between school and home and often it’s up to teachers to intervene when a child’s safety or mental health is affected. One South Australian principal says age restrictions will give educators a buffer period to provide better support.
Saint Ignatius’ College principal Lauren Brooks says the rise of social media seemed sudden, driving an ‘immediate and severe shift’ in student behaviour.
‘Almost overnight, it became a platform where children felt emboldened to say things they would never dare to in person –cruel, hurtful things,’ she says.
‘Good, kind kids suddenly became fearless, hiding behind a sense of anonymity and detachment.’
‘THEY NEED HELP TO WITHDRAW, DETOX AND RESET’
Ms Brooks recalls a 14-year-old girl who became the target of a vicious online attack that spiralled out of control.
‘By the time the next school day began, the post had essentially gone viral, and the damage was done –irreversibly.
‘What broke my heart wasn’t just seeing this young girl shattered and humiliated, it was the painful realisation that no matter how much support we provided, those lies and images were already etched into the permanent landscape of the internet.’
Saint Ignatius restricts students from using their mobile phones during the school day and teaches social media literacy as part of the curriculum. But Ms Brooks says technology is evolving so quickly it’s hard to keep up.
‘In many ways, it feels as if we have been swimming against the current. New applications and platforms emerge that change the scope of what education is required to help our kids stay safe.
‘I do believe age restrictions will give educators more space to be discerning and intentional in our approach.
‘They will provide a buffer period – a space to support young people as they transition into responsible and healthy online use, instead of trying to intervene after harmful behaviours and habits have already become ingrained.’
Ms Brooks acknowledges that social media can provide positive and connective experiences, but says in many ways it’s left children feeling more alone.
‘Kids are not the problem,’ she says. ‘The addictive nature of social media is the problem.
‘As a society, we have given our kids an addictive substance and now we are watching in slow motion the damage that addiction is causing.
‘It’s not their fault, but they need help to withdraw, detox, and reset, and to find the boundaries – to remember the parts of life that keep us human in this digital world.’
The national debate on social media age restrictions has lacked one perspective: that of those who will be impacted the most.
The Australian Government’s decision to ban children from social media appears to have broad popular support. A Guardian Essential poll released on 4 June suggests two-thirds of Australian voters agree the age limit should be raised from 13 to 16.
But this research fails to capture the perspectives of the children who will be directly impacted by the ban.
Dr Justine Humphry, a senior lecturer in digital cultures at the University of Sydney, says young people’s opinions have been underrepresented.
‘Largely, young people are being left out of the debate and their experiences are not being represented,’ Dr Humphry says.
‘Parents and children access quite different digital worlds. When adults make decisions on their behalf, they’re not necessarily familiar with the specificity of the digital experience young people have.’
Dr Humphry and her colleagues set out to correct the record, conducting a study of young people aged 15 to 17 and their parents.
Their study found that 72% of young people and 86% of their parents expressed support for more effective age limitations. However, when the teenagers were asked follow-up questions in focus groups, they became more circumspect.
‘Young people voiced concerns about breaches of privacy that might result from having to share sensitive data with social media companies or third parties,’ Dr Humphry says.
Dr Dana McKay, Associate Dean of Interaction, Technology and Information at RMIT University, says the answer isn’t restricting social media access, but making those public digital spaces safer.
‘Banning children from social media is a blunt instrument that ignores the social benefits children get from having direct communication with their friends,’ Dr McKay says.
‘While there are risks inherent to social media, these risks could be addressed by regulating social media, minimising advertising, and detecting and addressing harmful interactions.’
Dr Samantha Schulz, a senior sociologist of education at the University of Adelaide, says education also plays a part.
‘Prohibiting young people’s access to social media may provide short-term protection but is no replacement for the critical and social literacies we should have been valuing in Australian schooling for decades,’ Dr Shulz says.
‘All young people deserve and require critical digital literacy education.’
Leading mental health organisations ReachOut, Beyond Blue and Black Dog Institute have jointly welcomed the Australian Government’s new duty of care regulations which hold social media companies accountable for the safety of their users.
The regulations place a legal responsibility on social platforms to take reasonable steps to prevent foreseeable harms and adopt safety-by-design principles.
Executive Director and Chief Scientist of Black Dog Institute Professor Samuel Harvey says the government has an ongoing responsibility to make sure the new approach leads to better outcomes for children.
‘These changes are being made to improve the mental health of young Australians – we need to embed research and evaluation from the start to understand the effects of these changes and whether they are having their intended impact.’ ‘PARENTS
‘They’re also worried about feeling isolated and not being able to reach out and find vital information or access communities independently.’
‘A key step now for Australia is to make sure we are set up to properly evaluate these changes,’ Prof Harvey says.
From payroll tax to scope of practice - and myriad other medical and public health issues – the Australian Medical Association in South Australia is leveraging the power of its diverse and dedicated members to drive better outcomes for doctors, their patients and the health system as a whole.
AMA SA President Dr John Williams outlines his concerns about the danger of expanding pharmacists’ prescribing powers.
On 25 September – World Pharmacist Day – South Australian Health Minister Chris Picton staged a press conference with the Pharmacy Guild announcing a significant expansion of pharmacists’ prescribing powers.
He revealed that work is underway to increase pharmacists’ scope of practice for several conditions, including ear infections, wound management, musculoskeletal pain, nausea, vomiting, gastro-oesophageal reflux, rhinitis and skin conditions such as shingles and psoriasis. The program is due to start in early 2026.
‘THERE IS NO SUBSTITUTE FOR HIGHQUALITY GP CARE.’
Minister Picton had called me just five minutes earlier to inform me of this significant expansion in
pharmacists’ prescribing scope. I made it clear to him then, and in many subsequent media interviews, that expanding pharmacists’ scope of practice is an ill-advised policy decision that puts patients at risk.
As I have repeatedly said, pharmacists play a very important role in our health system and are well trained for dispensing and managing medications, but there is no substitute for highquality GP care.
GPs are trained for 10 to 12 years so we can perform our roles of diagnosis and decision-making. Because of this training we are highly skilled in identifying the difference between, and understanding the appropriate treatment for, common complaints and other more serious health conditions.
Pharmacy prescribing for urinary tract infections (UTIs) was introduced in South Australia in March. Within the first six months, more than 4,000 women had accessed UTI pharmacy services.
But unlike GPs, the pharmacists treating these women are not trained to take their patients’ full medical history and are not required to run diagnostic tests on urine samples. This is a worrying oversight that can lead to over-prescribing of antibiotics or other complications stemming from misdiagnosis.
Proponents of expanding pharmacists’ scope of practice often argue that it’s more convenient for patients and that it alleviates pressure on general practice. The counter to that is that no one wins – medically or economically – if we cut corners with patient care.
South Australians should ask if they want a quick, possibly risky, fix to the problems involved in accessing primary care or if they want genuine investment in building our GP workforce, at the same time integrating more nursing and allied health staff in general practices.
The AMA here and across the country has called for funding to support models of care in which GPs work with a team of professionals – including pharmacists – to provide appropriate and timely care to patients. That’s what our patients want, and that should be our objective.
Payroll tax caused a seismic shift in the medical landscape. AMA SA’s Committee of General Practice chair Dr Bridget Sawyer reflects on what’s changed, AMA SA’s advocacy work and the organisation’s next steps.
Every year brings change and new challenges for doctors. For many of us, the biggest challenge during 2024 can be summed up in two words: payroll tax.
It’s been almost six months since the tax came into effect and already it’s having a discernible impact on some doctors’ capacity to care for patients and stay in business.
Despite popular myth, many practices operate on slim margins and have had little option but to pass on the cost to the public. AMA SA members tell us the average cost of a non-bulk-billed private consultation has increased by $10 to $20 as a direct result of the payroll tax. Many practices have introduced a ‘double tap’ system of payment to cover the tax and the administrative burden that comes with it.
‘IT’S VITAL WE OPERATE STRATEGICALLY.’
We all wish we didn’t have to inflict this added financial burden on patients during a cost-of-living crisis. It’s a decision none of us take lightly. For many practices the only
alternatives would be operating at a loss or closing. Either would be a terrible outcome for patients and the health system more broadly. I worry, as do many colleagues, that vulnerable people may choose to delay seeing their GPs because of the extra cost. We know that without early access to primary care many will become sicker and eventually seek care in overcrowded public hospitals or wait on the ambulance ramps outside.
In the lead up to the implementation of the tax, and in the months since, AMA SA has been working to help the South Australian Government understand these concerns. And our advocacy has yielded results. In May, AMA SA secured a commitment from the Treasurer that specialists in private practice would not be assessed for payroll tax over the past five years. South Australia is the only state that offers this retrospective protection for non-GP medical specialist contractors in private practice. AMA SA has also secured exemptions for GPs paid from rural hospitals.
Our work is far from over. AMA SA President Dr John Williams and our CEO Nicole Sykes meet regularly with senior representatives from government, RevenueSA and RACGP. It’s vital we operate strategically and collaboratively to keep our seat at the table with these groups, so we can influence legislation and decision-making in a way that leads to the best possible outcomes for all AMA SA members and our patients.
Recently, payroll tax became a significant issue in the lead-up to Queensland’s October election. Before polling day, AMA Queensland negotiated with both major parties to secure bipartisan support for a payroll tax exemption for general practice. It’s clear that collaboration achieves results.
The political landscape in South Australia is different, but with our own state election looming in 2026, it’s important to recognise the need to operate strategically as we chart our next steps.
Dr Bridget Sawyer Chair, AMA SA Committee of General Practice
Research showing older doctors are more likely to be the subject of notifications has prompted a Medical Board of Australia proposal for regular health checks for those aged over 70, writes chair Dr Anne Tonkin.
Health challenges increase with age, affecting doctors in the same way as the rest of the community. Unfortunately, doctors are often reluctant patients, and we don’t always seek the care we need.
The Medical Board of Australia has always wanted doctors to look after themselves. Our code of conduct (‘Good medical practice’) encourages every doctor to have a regular GP. We fund drs4drs, a network of doctors’ health advisory and referral services that are independent, free, safe, supportive and confidential. Ahpra’s complaints data and published research demonstrates strong evidence of a decline in performance and patient outcomes with increasing practitioner age, even when the practitioner is highly experienced. Doctors aged over 70 are 81% more likely to be the subject of a notification for any reason than those under 70. When it comes to health impairments, the rate of notifications is more than three times higher for doctors aged over 70 compared with younger colleagues.
Notification rates relating to physical illness or cognitive decline are 15.5 times higher for older doctors than for doctors aged 36 to 60 years (incidence rate ratio = 15.54), according to a comprehensive review of Australian complaints records. These concerns are also reflected in the type of complaints reported to Ahpra, with 52% more notifications for issues relating to clinical care, 141% more for communicationrelated issues, and 162% more for issues related to pharmacological or medication, for doctors over 70.
‘We are looking for effective and practical ways to support late-career doctors’
In light of this, the Medical Board is looking at ways to safely extend the practice of late-career medical practitioners while managing preventable risks to patient safety.
We recently consulted on three options:
Keep the status quo and do nothing extra to ensure late career doctors are healthy and able to provide safe care.
Introduce an extensive and detailed ‘fitness to practise’ assessment for all doctors aged 70 and older, to be conducted by specialist occupational physicians.
Introduce general health checks with a GP for latecareer doctors aged 70 and older, to support early detection of concerns with the opportunity for managing these before the public is at risk.
Our preference was option three, which reflects public health-screening measures. Early detection means early management, which can mean preventing avoidable risks.
Importantly, one thing is definitely not on the table: a mandatory retirement age. We value the experience of latecareer doctors and want individuals to stay healthy and safely in the workforce until they choose their next chapters.
Another important fact: the results of general health checks would be confidential between the doctor and their treating practitioner and would not be provided to the Board routinely.
We are now taking our time to consider the feedback in the nearly 200 submissions we received from organisations, individual doctors and the community.
If the Board decides to adopt any of the options, we will prepare a regulation impact statement for health ministers’ consideration and approval. We are not in a rush.
If you’re interested, please read the Consultation Regulation Impact Statement on our website.
Dr Anne Tonkin is chair of the Medical Board of Australia.
Standardised physical and psychological health checks throughout a doctor’s career would avoid the potentially humiliating effects of an over-70
assessment, writes Dr Roger Sexton.
The Medical Board of Australia (MBA) has sought consultation with the wider profession about its proposal to require late-career doctors (70 years and over) to undergo medical assessments every three years.
As MBA Chair Dr Anne Tonkin has outlined, the proposed options included a general health assessment and/or a fitness to practise assessment, the details of which have not been determined at the time of writing.
This action arises in the setting of the MBA – a statutory board established by an act of parliament – having a mandate to protect the public from unsafe medical practitioners and to uphold standards of medical practice.
The proposal aims to ‘keep late-career doctors in safe practice, while protecting patients from risk caused by undetected or unmanaged health issues’.
It’s been said that some doctors may retire early, rather than undergo these assessments, which would exacerbate already problematic workforce shortages. But in my view, we should all be undertaking health checks throughout our professional lives – continuing, not starting, when we reach the age of 70.
For context, some numbers. As of June 2024, Australia had around 142,000 registered medical practitioners with 8,400 doctors over 70. Of these, 6,900 were practising. Older doctors made up 5% of the doctor workforce in Australia; less than 1% are aged over 80.
In 2023, there were 485 Ahpra notifications of older doctors, compared to 189 in 2015.
‘Prevention is better than cure.’
The MBA consultation comes as the result of external studies of medical competence in ageing doctors, and places particular emphasis on studies of neurocognitive loss. It highlights how physical and cognitive impairment can lead to prescribing errors, poor record-keeping and disruptive behaviour.
Through my previous roles on the Medical Board of SA and with medical indemnity provider MIGA, and now in doctors’ health, I have developed a strong sympathy for preventive medicine. I have seen and promoted the value of regular health checks for all doctors along the entire career continuum.
Assessments that are protocolised, such as those we conduct at Doctors Health SA, should include thorough history-taking and physical examination, pathology and radiology, an exploration of lifestyle habits, and a discussion about the doctor’s workplace, work practices and ‘working week’. Confidential discussions can also explore personal and domestic, financial and medico-legal stressors.
This is not a ‘standard’ checkup; it is very thorough and allows time to investigate areas that can be mitigated before they lead to a complaint – whatever the doctor’s age.
For the older clinician, errors are more likely to occur when the doctor (at times with dated knowledge and bedside manner) is working full-time and seeing too many patients each hour – and may not appreciate that community attitudes about their role have moved on. But an assessment may reveal some cognitive decline that is not incompatible with continuing clinical practice, provided there are changes to the doctor’s work schedule and the clinic’s operations. Fewer patients and fewer hours, ideally in a supportive grouppractice environment in which there is some peer review of clinical work, may be the solution. Similarly, discussions with practice colleagues can help a doctor carefully select the type, complexity and age of patients they see.
Older doctors work for many reasons: financial difficulties (perhaps due to divorce or gambling), the absence of social connections or meaningful non-work interests, no succession planning at work, or disengagement from family or a spouse. Working under these conditions may ultimately lead to a complaint – an awful way for a successful and caring doctor with a lifetime of service to the community to end their career.
Being proactive and having thorough health and professional assessments throughout our lives can allow doctors to modify our medical and personal lives and manage our exits with grace and dignity.
Prevention is better than cure. It all starts with a checkup.
Dr Roger Sexton is the medical director of Doctors’ Health SA.
Dr Emily Kirkpatrick, Ordinary member
The AMA SA Council meeting on 7 November 2024 covered significant topics, including ongoing challenges in the healthcare sector to access care, bullying escalation concerns raised by the AMA SA Doctors in Training Committee, clinicians’ scope of practice, the sustainability of the private sector, and ongoing management of the AMA collection of medical artefacts. The artefacts include paintings and other art, instruments, machines, books, documents and photographs donated by the public and AMA members over many decades.
The Council was delighted to welcome the formation of the AMA SA International Medical Graduates Committee. November 2024
The agenda included discussion of the broad viability of general practice. The Council noted the release on 5 November of the Australian Government’s report, Unleashing the Potential of our Health Workforce - Scope of Practice Review, and, with current healthcare demands, the need to have a clear focus on how doctors’ and other practitioners’ roles and role boundaries may affect patient safety.
The Council acknowledged the enduring legacy of the AMA, recognising the AMA History Committee’s diligent efforts in preserving key events, contributions and artefacts, and maintaining a rich historical narrative that connects the AMA’s past to its present initiatives. A heartfelt tribute was paid to Dr Tom Turner, a stalwart and most recently chair of the History Committee, whose recent death marks a significant loss to the organisation and to the community after his tireless work in dermatology.
The Council also addressed ReturnToWorkSA (RTWSA) fee calculations. Feedback from general practitioners, orthopaedics, anaesthetists and plastic surgery specialists highlighted significant discrepancies between RTWSA rates and the actual costs of private practice in South Australia. Compared to other states, South Australia lags in fee structures, creating financial pressures exacerbated by increasing administrative demands. AMA SA will continue to advocate for reform to accurately reflect fair and sustainable remuneration for practitioners, ensuring the viability of medical services within the private sector.
Dr Emily Kirkpatrick is an AMA(SA) Councillor, SALHN board member and managing director of EKology Health.
Referring doctors must be available at all hours to receive and inform patients of urgent medical test results, writes AMA SA Council member and pathologist Dr Shriram Nath.
As a pathologist – as a doctor – I have a duty to my patients to report test results accurately and soon. In our health system, that means conveying the results to a patient’s GP or other specialist as soon as is practicable, with the understanding that the doctor will inform the patient in a timely manner.
Sometimes, though, ‘timely’ isn’t good enough. Sometimes tests reveal information that can change a life or hasten a death. As doctors, we must all do what we can to relay that information as quickly as possible. Urgently. Immediately.
And that’s where the system today isn’t always supporting patients as it should. Changes to the way doctors work, and when they work, mean we pathologists and other test providers can’t always contact a clinician with results.
A GP may work one day a week. A multi-clinic practice may nominate one practice manager as the contact for sites in several towns or suburbs. The result can be a delay in finding a doctor – the doctor – to receive and discuss results with a patient.
Nine times out of 10, this doesn’t matter. Sometimes, though, a delay of even hours could be catastrophic.
persuade her to go directly to the Royal Adelaide Hospital. The patient was able to have treatment at the RAH, and lived. Another case was my own patient. I received a call from the pathology lab while I was driving in the northern suburbs. Post-chemotherapy blood tests indicated he had thrombocytopenia and could bleed. We could not contact the patient over the phone but fortunately were driving in the area that evening and could try to door-knock him at his house. What I didn’t know was that he’d recently changed his address. Fortunately (again), his job meant triple-O responders could help locate him. He was reached and travelled safely to hospital and lived another day.
I’m thankful I was in a position to drive to these patients and ensure they received the test results and could act accordingly. But there must be a better, more reliable way. Some colleges, such as RACGP and RACP, have standards and guidelines about how urgent results can and must be shared, but perhaps the standards haven’t kept pace with changing trends in practice operations and management and the rapid increase in the number of doctors who work parttime.
As doctors, we understand the need for work-life balance. But we are doctors, and we have each taken an oath that requires us to serve and care for our patients.
There have been laments from pathology colleagues that it is now more difficult to reach practitioners after hours or during weekends. Some pathologists resort to calling patients themselves and help direct the patient to the nearest emergency service if the referring doctor is not available to receive the critical results.
‘A delay of even hours could be catastrophic’
It was a Saturday afternoon when I received a call from the laboratory that abnormal cells had been seen on the blood film. The diagnosis was an acute promyelocytic leukaemia, which meant the patient needed to go to hospital immediately. Without treatment, she would probably die within 24 hours. I couldn’t reach the GP or anyone in the clinic. The after-hours number was for the local hospital, which had no records of the patient; the covering doctor was reluctant to take the results. I was unsuccessful in trying to reach the patient by phone myself. So, along with my wife, we drove into the country to deliver the results in person. The patient wasn’t home. I reached out to a neighbour, who, fortunately, was the person who had noticed the patient’s bruising and changes to her colour and convinced her to see her GP on a Saturday morning.
The mobile services in areas outside Adelaide are patchy. With the neighbour’s help, we contacted the patient by climbing a hill near their farm. The neighbour helped us
Sometimes, the police and ambulance are involved in welfare checks, if the referring doctor and the patient do not answer the phone. It wastes vital minutes and hours that could make the difference in the patient’s health outcomes. It is stressful for everyone involved.
This has become more frequent rather than exception to the rule.
All referring clinicians should have and follow a standard like the RACGP ‘Criterion
GP 2.2’ that requires medical practices to ‘manage seriously abnormal and life-threatening results identified outside of normal opening hours’. Each practice must have a process so pathology and diagnostic services can contact it in urgent circumstances so information about patients can be delivered. Doctors must understand what is expected from them, at any or all hours of the day or night, if they receive urgent and life-threatening results.
AMA SA is now looking into this issue and will refer it to AMA Federal Council for action. We all know bad news is best delivered by the doctor who has reviewed and is familiar with the patient, and we doctors must do everything we can to make this process as simple as possible.
Dr Shriram Nath is an AMA SA Board member and Councillor.
The global health impact of commercial gambling is far worse than previously realised, according to a Lancet Public Health Commission involving Australian and international experts.
A systematic review conducted by the Commission, results of which are published in the November 2024 edition of The Lancet Public Health, estimated that 448.7 million adults worldwide will experience at least one adverse personal, social or health outcome linked to gambling.
Of those, around 80 million will suffer a gambling disorder or problematic gambling.
In dollar figures, the Commission found global net gambling losses will reach US$700 billion annually by 2028, much higher than previously thought.
Monash University’s Associate Professor Charles Livingstone was involved in the Commission and says the findings underscore the need for stronger regulatory control in Australia.
‘Both online betting, boosted by close connection with football and other sports, and electronic gaming machine gambling continue to grow at a rapid pace here, despite escalating concerns of ordinary people,’ he says.
‘There is a desire for change and to rightly treat gambling as a serious public health issue, given the extent and nature of harm.’
Recent research conducted by the Grattan Institute confirms Australians lose on average $1,635 a year, much more than anywhere else in the world.
In September, AMA SA President Dr John Williams joined Flinders University gambling addiction experts and AMA SA members Prof Malcolm Battersby and Prof Michael Baigent to publicly call for the Australian Government to take national action to ban gambling advertisements.
In August they jointly wrote to all members of the Australian and South Australian parliaments asking them to use their positions to personally lobby the Prime Minister and other Federal Government decision-makers about the need for stronger regulation.
‘This latest research confirms that gambling has become a global industry expanding at a rapid rate,’ Prof Battersby says.
‘There is an urgent need for gambling reform. At the federal level, we need a complete ban on gambling advertising. At state and territory levels, pokies should be restricted to casinos and phased out everywhere else.’
Western Australia is the only state that limits the installation of poker machines to the confines of its casino. South Australia has about 12,700 machines spread across hotels, clubs and the SkyCity Casino.
‘A major concern is that there is a direct link between gambling and the current cost of living crisis,’ Prof Battersby says.
‘The people in the most disadvantaged communities have the highest losses with a predominance of pokies in these areas.’
Last year an all-party parliamentary inquiry into online gambling made 31 recommendations including banning gambling advertising and establishing a national regulator for online gambling.
The Australian Government continues to delay its decision on those recommendations.
‘Too
SC argue that all governments must agree to raise the minimum age of criminal responsibility to 14.
It is not uncommon for political expediency to trump solid evidence-based policy. But it is particularly galling when this occurs at the expense of children, many of whom come from the most disadvantaged backgrounds.
A recent report card on Australia’s youth justice system found egregious breaches of human rights in the child justice system. The report highlighted the gross overincarceration of children from First Nations peoples, and decried the preventable deaths of young people in custody.
That report, from Australia’s National Children’s Commissioner Anne Hollonds ‘Help way earlier!’
How Australia can transform child justice to improve safety and wellbeing, was formally launched at Parliament House on Thursday 10 October. It is sobering stuff.
There is overwhelming evidence that contact with the justice system in early adolescence, let alone spending time locked up, condemns a child to a lifetime of disadvantage. The ‘lucky country’ is failing our children, many of whom are already victims of life’s lottery, having experienced violence, abuse, disability, homelessness, poverty and drug or alcohol misuse.
Australia’s peak medical and legal bodies agree this national tragedy must be urgently addressed.
Evidence of the impact incarceration has on a child’s mental well-being and physical and personal development is not new; it has been raised with our governments through numerous inquiries, including two Royal Commissions, an investigation by the Productivity Commission, considerations by the Standing Council of Attorneys-General, parliamentary committee hearings, and now by the Children’s Commissioner.
As a community we are constantly misunderstanding the problem one confined to the criminal justice system alone — building more detention facilities, tougher policing, stricter bail laws, and longer sentences, all propelled by harmful media rhetoric and political grandstanding.
But evidence shows this doesn’t work to keep our children or communities safe.
A first, fundamental step should be a committed, clear, accountable and coordinated joint response from all governments - such as the establishment of a national taskforce for reform of child justice systems, as recommended in the Commissioner’s report.
All levels of government must work together, including at national cabinet, to support developmentally and culturally appropriate health, education, and rehabilitative-based alternatives to the criminal justice system for our children.
All governments must agree to raise the minimum age of criminal responsibility to 14 years of age - which refocuses attention on prevention and diversion - and work to address the disproportionately high rates of incarceration of Aboriginal and Torres Strait Islander children.
Locking children up does not make our community safer. Relying on incarceration and policing, rather than care, compassion and community-led support is like putting a band-aid on a gaping wound and wondering why it won’t stop bleeding.
THE ‘LUCKY COUNTRY’ IS FAILING OUR CHILDREN
This column first appeared in The Canberra Times on Tuesday, 15 October.
New AMA President Dr Danielle McMullen leads a federal organisation that achieved many successes in 2024.
At its national conference in August, the AMA launched its new Vision for Australia’s Health — a blueprint for a healthier country. The Vision was developed following extensive consultation with doctors.
The AMA led national and state-based efforts to push through reforms to limit access to vapes. The vaping reforms began on 11 January. At our national conference Minister for Health and Aged Care Mark Butler acknowledged the AMA’s role in getting the legislation over the line.
The AMA made progress on our campaign for a sugar tax, with the House of Representatives Standing Committee on Health, Aged Care and Sport’s Inquiry into Diabetes in Australia delivering a landmark recommendation supporting a sugar tax on all soft drinks to help address the nation’s obesity and diabetes rates. The AMA made a submission to the Inquiry and appeared as a key witness.
As the Food Standards Australia New Zealand Act is reviewed, the AMA has joined other groups to advocate for better food labelling standards. As a result of this advocacy, key changes to the Health Star Rating (HSR) system in Australia have been announced, with health ministers agreeing to FSANZ exploring options to mandate the HSR.
The AMA welcomed the release of federal government reviews into general practice incentives, after-hours primary care and health workforce distribution, each of which has been the subject of AMA campaigns for many years.
In September the AMA succeeded in having reforms to GP chronic disease management items delayed to allow time for further discussions about funding for the items. The AMA remains strongly committed to the reforms being introduced in 2025.
In April, the AMA launched its report card on public hospitals that revealed planned surgery wait times were the longest on record, with emergency departments (EDs) strangled by access block. With the support of the state bodies, including AMA SA, the AMA wrote to all health ministers highlighting the need for all governments to take action against the logjam. The logjam campaign has already led to additional Commonwealth funding for public hospitals of more than $13 billion.
In late October, the mental health report card was released, revealing that patients in some states are waiting record times in public hospital EDs before they are found beds.
In late 2023, the AMA hosted a workshop on the private health system from which a key outcome was the need to explore sustainability issues in the private hospital sector. This year the government conducted a financial viability health check of private hospitals, which the AMA President joined through the CEO’s forum. Almost 2,000
AMA members contributed to this work through a member survey.
Years of AMA advocacy on prostheses list reforms resulted in the win to retain general use items
AMA intervention led to health insurer HCF fixing a problem that had prevented surgical assistants with limited or provisional Ahpra registration from accessing HCF’s Medicover scheme.
The introduction of a known gap scheme at nib, commencing in October, followed the AMA’s ongoing calls for national consistency in schedules and known gap arrangements.
The AMA has long been calling on insurers to provide known gap arrangements, and to offer consistent rebates to patients across all states and territories, as part of its advocacy including through the AMA’s Private health insurance report cards
An International Medical Graduate Working Group (IMG-WG) has been formed to guide the AMA’s support for work participation and career progression for IMGs. This follows outcomes of the AMA Rural Medical Training
Summit, where IMGs told the AMA they need more assistance to provide appropriate supervision, create support networks and build fair employment and training systems.
The introduction of 60-day dispensing followed a concerted campaign by the AMA to introduce the PBACrecommended change. Doctors are now able to write 60day prescriptions for close to 100 additional medicines for health conditions such as diabetes, epilepsy, breast cancer and menopause.
In May we lodged a submission to proposed amendments to the Poisons Standard opposing the down-scheduling of sildenafil. The AMA submission highlighted that the prescription of sildenafil requires a comprehensive medical assessment to address the causes, contraindications and potential risks. In September an interim decision was made to not amend the Poisons Standard in relation to sildenafil.
The AMA was quick to engage with governments when the IV fluid shortage first came to light. Our advocacy on IV fluid shortages led to the establishment of the National Response Group which meets each Monday with the AMA President in attendance.
AMA SA Councillors, alongside our President, VicePresident and CEO, serve to discuss and recommend action related to the issues that affect our profession and membership.
With constant media attention on ramping at hospitals, AMA SA Council in 2024 resolved to focus on the vital pillars of our health system, especially supporting primary health care in general practice. Payroll tax dominated Council’s discussions, with the rollout occurring in July. We heard from CEO Nicole Sykes and our President Dr John Williams regarding their negotiations with the Health Minister, the Treasurer and Revenue SA. Several concessions were won, including a five-year retrospective amnesty for medical specialists in private practice, and for contracted general practitioners. Council will continue to discuss this important issue for doctors as we look at its impact on practices and their patients.
Another matter requiring Council’s attention included federal AMA constitutional reforms. AMA SA is committed to ensuring our state voice is heard at the federal AMA level, and making sure that members were aware of the
pros and cons of any constitutional changes was paramount. We welcomed Federal AMA leadership candidates Dr Danielle McMullen and Associate Professor Julian Rait in June to discuss their joint platform and, with their successful elections at the national conference, congratulate them on their elevation to the AMA presidency and vice-presidency respectively.
During the year, Council welcomed new members Dr Chris Dobbins, Associate Professor Michael Goggin, Dr Isaac Tennant, Dr Alice Fitzpatrick and Dr Jerida Keane. We also voted via secret ballot to appoint new AMA SA Board members Dr Bridget Sawyer, Dr Shriram Nath, Prof Ted Mah and Prof Tarun Bastiampillai. They will contribute to efforts to achieve AMA SA’s strategic plan targets. I was elected Council Chair in September and my aim is to facilitate open and respectful discussion, and to assist with membership engagement and committee member induction.
Dr Karen Koh Chair, AMA SA Council
This year has been a period of change and collaboration for the AMA SA Doctors in Training (DiT) Committee. The committee again analysed the Medical Training Survey to generate our annual Hospital Health Check report, comparing junior doctors’ experiences of various workplace issues at each LHN in South Australia and highlighting hospitals’ strengths and weaknesses. Once again, one of the standout concerns has been that despite the concerningly high percentage of DiTs who report having directly experienced bullying, harassment or discrimination, for a multitude of reasons very few DiTs report it. It is because of this that the committee has started a project that we hope will culminate in the development of a uniform and fit-for-purpose bullying reporting pathway that can be deployed at each hospital. We believe this will be valuable both for junior doctors and LHN leaders who are legally accountable for their employees’ safety at work.
The DiT committee was lucky enough to have been invited to both the National Single Employer Model (SEM) Conference in the Riverland and the Social Media Summit in Adelaide. Each event provided a platform for the discussion of issues highly relevant to DiTs in South Australia, with the SEM conference occurring shortly before the Premier’s announcement of an expanded SEM trial for GP trainees in the state.
If AMA SA is to continue to represent our members and advocate for the health of South Australians, growth and change are required. At the start of 2024 the DiT Committee worked with both the AMA SA Council and the other subcommittees to develop AMA SA’s new strategic plan. The committee also reviewed, streamlined and improved our own governance structures. We look forward to further progress and a successful contribution to AMA SA’s objectives for members, colleagues and the health system in 2025.
Dr Hayden Cain Chair, AMA SA Doctors in Training
The AMA SA Road Safety Committee is the only dedicated road safety committee under the auspices of a state AMA branch in Australia and has been in existence for more than 20 years.
During 2024 the committee has continued its advocacy that aims to reduce the unacceptable level of loss of life and serious injury on our roads.
The statistics demonstrate that our cause remains as urgent as ever. At time of writing, 81 people have lost their lives on South Australian roads in 2024 and 768 have been seriously injured.
The statistics demonstrate that our cause remains as urgent as ever.
Our activities in 2024 contributing to our advocacy efforts included meeting representatives of SAPOL about our concerns about rural road speed limits and enforcement and blood alcohol levels, and how AMA SA can work with SAPOL, government departments and Optometry Australia to ensure our state’s ‘fitness to drive’ assessment process supports the safety of all road users.
In August, we wrote to Transport Minister Tom
Koutsantonis expressing our concerns about the proposal to legalise privately owned mobility devices and recommending a robust safety framework should this legislation be passed, and later met the DIT Director of Road Safety Policy and Reform Sarah Clark about this and other road safety issues.
Other advocacy efforts included:
• contributing to the DIT Motorcycle Training and Assessment policy and the new safety handbook (April)
• meeting Opposition Assistant Road Safety spokesperson Tony Pasin regarding federal road safety issues such as legislation relating to new technologies, and road safety data transparency and sharing
• joining the Federal AMA in writing to Federal Transport Minister Catherine King regarding making new safety technologies in vehicles mandatory
• sending a letter to all federal members of parliament supporting the Australian Automobile ‘Data Saves Lives’ Campaign urging greater sharing of road trauma data.
My thanks go to all members of our committee for volunteering their time this year, and to our supportive Secretariat staff.
Dr Monika Moy
Chair,
AMA SA Road Safety Committee
The
AMA SA Committee of General Practice continues to meet regularly to advocate on behalf of South Australia’s general practitioners and to provide support and feedback
to the AMA SA Council and President Dr John Williams.
Our Terms of Reference have been updated to be consistent with the changes introduced across the AMA SA organisation following the implementation of the new strategic plan.
The committee membership has changed with the resignation of Dr Richard Try (Mt Gambier GP and regional representative) and the welcome involvement of new members Dr Seshu Boda and Dr Mark Williams. It is
pleasing to see interest from AMA members in joining the committee.
After six years as chair, I am stepping back from this role while mentoring Dr Alex Main, who has been elected as co-chair for the next 12 months.
Committee members continue to be active in a variety of areas. I would like to congratulate Dr Ayaz Aslam, who has been elected as the AMA SA representative on the Federal AMA International Medical Graduates (IMG) committee.
As a committee we welcome feedback and are open to AMA members attending our meetings as observers. Please contact me or the AMA SA secretariat if you are interested.
Dr Bridget Sawyer Chair, AMA SA Committee
of General Practice
After six months as AMA SA’s media and communications advisor, Ben Terry reflects on how the organisation seizes media opportunities and shapes the public’s understanding of health and the medical profession.
Some jobs you ease into. That certainly wasn’t my experience at AMA SA. I started my role as media and communications advisor on 29 May. One day later SA Health declared a systemwide ‘code yellow’. My learning curve was suddenly a lot steeper.
‘I’M ACUTELY AWARE OF THE RESPONSIBILITY THAT COMES WITH MY ROLE.’
The health system was in crisis. Hospitals were creaking under the pressure of winter viruses, hundreds of medical staff were sick with COVID-19 and every public hospital in Adelaide was operating over capacity. Doctors and patients needed a strong, united and trusted organisation to be their voice. Enter AMA SA.
Guided by our President Dr John Williams, the AMA SA communications team of two honed our key messaging, wrote press releases and managed media requests. As
a television journalist of almost 20 years, I was used to navigating breaking news, live reports and rolling deadlines, but this was a different type of pressure. I was grateful that AMA SA’s senior policy, media and communications advisor Karen Phillips was there to steer the ship, giving me the freedom to learn on the job while generously sharing her knowledge and experience.
The ‘code yellow’ would last more than two months. As the strain on doctors intensified, John became a regular media contributor, frequently featuring in The Advertiser, on ABC Radio Adelaide and on the nightly TV news. His regular media appearances gave AMA SA a platform to raise concerns about another bubbling issue: payroll tax.
Members were concerned that the tax, and the subsequent impost on patients, would create a barrier to primary care. Our job in the comms team was to make the public aware of the links between payroll tax, the increased cost of
consultations with GP and non-GP private specialists, and the added pressure on a health system already at breaking point.
Our approach has been effective. As I write this, our payroll tax campaign has been one of our most successful this year with coverage reaching a cumulative potential audience of 2.3 million people across South Australia and beyond. Unfortunately, media attention doesn’t always translate into the outcomes we might like and AMA SA’s work on this issue continues.
Securing media coverage is only one part of my job. Karen and I, and our colleagues in the membership team, also work hard to ensure we communicate effectively with AMA SA’s members about all the issues that matter to them. This communication takes many forms, including electronic newsletters, social media posts and the magazine you’re reading right now. It’s our goal to reach members and other medical professionals on the platforms they use.
Social media has been a big focus for the team this year. In the past six months we’ve reinvigorated our accounts on LinkedIn, Facebook and Instagram. As our content has increased, so too has our engagement. On LinkedIn alone our followers have increased by 264% in the past six months. Reactions, comments and reposts are up by as much as 600%. If you’re not already on our pages, please give us a follow here:
Despite the benefits of digital media, face-to-face communication remains the most effective. It’s why John wanted to embark on a tour of regional centres during his term: to hear first-hand from doctors their concerns and challenges and to offer reassurance that they’re not alone. It’s been a privilege to accompany John on some of his rural visits this year and to help AMA SA articulate what we’ve heard. If the AMA exists to give doctors a voice, it’s my job to ensure that voice is clear. The Australian Medical Association
is one of the most trusted organisations in the country and I work to preserve that trust, whether I’m communicating with the media, the public or our members.
AMA SA members also have the power to use their professional platforms and networks to spruik the benefits of our organisation and the important work we do. As the only organisation representing all doctors, AMA is uniquely placed to shape the public conversation and drive positive change for medical professionals, their patients and the broader health system. Effective communication is an essential part of our collective mission.
Ben Terry is AMA SA’s media & communications advisor.
Media statements in recent weeks related to:
Pharmacy scope creep
Payroll tax and the link to the hospital crisis
Mental healthcare failures in public hospitals
The worsening GP shortage
Urgent care clinics fragmenting care
Sub-acute care in hotels
Gambling advertising
Ban on insurers using genetic tests
Calls for greater regulation of
AMA SA President Dr John Williams has covered thousands of kilometres during his rural tour of the state. As the end of 2024 approaches, he reflects on what the tour has achieved and what lies on the road ahead.
Working in rural medicine is tough. We do our best to provide quality care, but it’s difficult to get vital services to our patients. Resources are stretched thin and we face constant pressure and constant change.
These challenges impact our patients, too. Despite our best efforts, we know that people who live in rural and remote areas often have less access to medical care and poorer health outcomes than those living in the city. That must change.
As the first AMA SA president based in a regional area, I’ve made it my personal mission to ensure regional doctors have a greater say in the decisions and policies that impact them and their communities.
The rural tour allows me to connect with those clinicians in their areas and better understand the barriers they’re facing, so I can make a difference for them.
The tour started in the Adelaide Hills in May. Since then, I’ve visited the Riverland, the Limestone Coast and Kangaroo Island. Our CEO Nicole Sykes has joined me for much of the tour.
Each region has its own unique challenges but everywhere I go, similar themes emerge.
The elephant in the room is Medicare. After years of inadequate indexation, the Medicare rebate no longer bears any relationship to the actual cost of providing high-quality services to patients. Doctors are crying out for reform and investment and the
AMA has been advocating for this at both the national and state levels.
Payroll tax is another recurring concern. The added financial burden imposed by this tax is adding pressure on practices already operating in the margins. Both publicly and during our regular meetings with the Health Minister, AMA SA has warned the South Australian Government that it could force some practices to close. South Australia can’t afford to lose any GPs, especially in rural and remote areas where access to care is already limited.
Recruiting and retaining doctors is also an issue that’s cropped up frequently. Colleagues have told me they’re worried about the ageing workforce and the difficulty attracting and keeping younger doctors in regional communities.
By advocating for fair pay and access to benefits, AMA SA has helped secure a clinical workforce that delivers world-class care to regional areas. This is a significant achievement – but of course there’s more to do.
I already highlighted doctors’ concerns about Medicare and payroll tax. Our advocacy on these issues will continue.
The insights I’ve gained during the tour have strengthened my voice. When I speak with the Premier or hold a press conference, I can be confident that I’m speaking on behalf of the doctors I’ve met.
AMA SA works hard to represent the views and interests of the doctors we represent and there’s plenty of evidence that our advocacy achieves results. Our work with the Rural Doctors’ Association of SA in negotiating the rural GP agreement has improved pay for more than 330 rural GPs and GP registrars. I’ve also championed the single employer model of training that allows GPs to be hired by SA Health as salaried employees for up to four years during their training, giving them continual access to entitlements like annual leave and sick leave.
More generally, there are two problems that need urgent attention. First, we need more data so we can understand why patients are sick, what we can do to keep them well and which areas need additional resources the most.
We also need better communication and connectivity across the system. We need our GPs, hospitals and allied health providers to talk more and share more data, so patients have continuity of care across the network. The different parts of our system can’t operate in a vacuum.
There’s still a lot of ground to cover. I look forward to meeting colleagues in the Murraylands, Fleurieu Peninsula and Clare early next year.
If you live in those regions, I encourage you to keep an eye out on our website for tour dates. Alternatively, please contact our team to express your interest at membership@ amasa.org.au
This is a chance for doctors to shine a light on your regions and have a say in the future of our profession.
lifeline
A health giant has teamed with local doctors to help save Western Hospital from closure.
hen Western Hospital announced it was going into voluntary administration in January there was an immediate outpouring of public concern.
Alarmed about the loss of vital medical services, patients formed a community action group and more than 11,000 people signed a petition to save the hospital.
Almost 12 months on, there’s relief for residents who had come to rely on Western Hospital’s surgical and acute medical services. Amplar, owned by Medibank Group, has joined with a consortium of doctors to buy the hospital and
It will operate as the Western Adelaide Private Hospital, providing short-stay clinical care with a focus on joint replacements, orthopaedics, ophthalmology, gastroenterology and general surgery.
The Joint Replacement Clinic is part of the consortium that bought the hospital. Owners Dr Jegan Krishnan and Dr Sunil Reddy say they’re optimistic about the future of healthcare in the western suburbs.
‘This partnership means more than just an acquisition –it’s an investment in the community’s health,’ Dr Krishnan says.
‘We’re thrilled to bring gap-free joint replacement services to this community, helping more people regain their mobility without financial strain.’
What became Western Hospital opened its doors in 1974 as the Henley Private Hospital.
‘Western Hospital has a rich history, and we’re honoured to help secure its future,’ Dr Reddy says.
‘With our shared vision, we’re ready to build on this legacy by making high-quality, affordable care a reality for more patients.’
Dr Reddy says he looks forward to providing affordable specialised medical care at the site. He says the hospital will alleviate pressure on the public system, undertaking 4,000 elective surgeries over the next four years.
South Australian Health Minister Chris Picton says it’s a good result for both private and public patients.
‘We will be working with the hospital to use its spare capacity to help reduce public surgery waiting lists,’ he says.
‘This is also excellent news for private patients in the western suburbs who will be able to receive surgery at their local hospital.’
- This article is sponsored content.
‘We’re ready to build on this legacy.’
It is my honour and privilege to write my last article as the 2024 Flinders Medical Students’ Society president. This year has proved to be a busy one, as we navigated a stacked social calendar, reaccreditation advocacy and now the handover to a new committee.
To finish of the year, we were pleased to send 24 of our students to Flinders University’s 50th anniversary gala dinner. We had the opportunity to meet past graduates, learn more about our medical school’s history, and network with our peers and college staff. It is a privilege to have such a close-knit relationship with our university and it was a special moment to celebrate.
At our Annual General Meeting we reflected on our achievements this year. The FMSS Mission statement is:
them were free to attend. Many thanks to AVANT, MIGA and Wright Evan’s Partners for their ongoing support, as well as some of our new partners, RACGP, RGPSA, BMJ and OSceBank.
We held inaugural events including a paint and sip evening and a sports nights for our undergraduate students. There was also a ‘Disabilities in Healthcare’ evening featuring speakers from medicine and allied health professions which helped to broaden our peers’ perspectives.
'THIS YEAR HAS PROVED TO BE A BUSY ONE.'
‘FMSS is dedicated to developing a unified, positive culture within Flinders Medicine. We endeavour to engage, educate, support and advocate for our student body and wider community.’
I was fortunate to have led a team that upheld this mission statement and worked hard to achieve our society goals, including increasing engagement with our undergraduate pathway students (affectionately known as the ‘clinscis’).
It was our aim to make our events as affordable as possible and with the help of our sponsorship partners we lowered ticket costs at almost every event we held this year - many of
This year the ‘President’s Award for Outstanding Contribution to the Society’ went to Jared Evans and Lauren Hammond. Both of these members demonstrated utmost commitment to their roles and led the way in their events and advocacy.
In 2025, FMSS will be celebrating its 50th birthday with the incoming president, Angelina Arora, leading the way. It is my pleasure to hand the reins to her and I look forward to seeing what the incoming committee will achieve.
The only thing left for 2024 is GradWeek! I am excited to join my peers in celebrating our milestone achievement, and can’t wait to see what we all do in the future.
Thanks for following along with FMSS’s 2024 journey.
Grace Mackenzie FMSS President 2024
Since the last edition of medicSA, the Adelaide Medical Student’s Society (AMSS) has been very busy. At the end of August we staged our annual MedBall. The theme this year was MedGala: Notes on Camp, with people dressing up in glitter, sparkles and colours and having the opportunity to take photos with ‘celebrities’ (in the form of cardboard cutouts). The night also featured a performance from a local drag queen and guests had a chance to meet and take photos with her after the show. The night was a huge success and lots of fun.
This was followed by our annual MedRevue, Scooby Doo: A Med School Mystery, the next weekend. Written by students, it featured amazing medical students’ talents –singing, acting, dancing and playing music.
In early October we ran a Mock OSCEs session for our years 4 and 5, giving them an opportunity to practice their OSCE skills and receive valuable feedback before exams. This involves hundreds of students donating their time and knowledge as SPs, examiners and marshals, and is a huge point of pride for us in the AMSS.
The semester ended with a joint event with the law, engineering and dentistry students’ societies. The ‘Suits, Scrubs and Spanners’ event was a fun way for us to meet and mingle with students from other degrees, and branch out of the medical bubble.
exam season with years 1-5 having a mix of OSCE and written examinations. If you were to stop by the Adelaide Health and Medical Sciences Building (AHMS) you would see dozens of students busy studying alone and in groups. We wish everyone luck!
‘BEING A PART OF THE AMSS HAS BEEN A VERY SPECIAL EXPERIENCE.’
As I write this in early November we are moving into final
Those of us in sixth year are lucky to have an exam-free year and are now making sure we have finished all our assignments and competencies before the end of the semester, while busily gathering our forms and documents for our jobs as interns in 2025. There is a mix of excitement, nerves and – for many – trepidation but we are looking forward to finally working and starting our medical careers ‘for real’. We are also all very excited for our upcoming graduation season, marked with our annual GradWeek. This is a packed week with a variety of events including lawn bowls, a quiz night, an open mic, a ball and more. It ends with a garden party on the morning of our graduation/declaration ceremony, when family are invited to celebrate this occasion with us. This year we are very excited to have the first combined Graduation and Declaration Ceremony, so students can celebrate together before heading to different hospital sites.
I have loved my medical student experience over the last six years and cannot believe it is finally coming to an end. I have met so many incredible people and made lifelong friends, and I am excited to see what we all do with our careers and lives. Being a part of the AMSS has been a very special experience that I will always cherish and I am so grateful to have had the opportunity to represent the students this year.
Laura Kelly AMSS Acting President 2024
Daylight savings, warmer weather and the air filled with both the smell of blooming flowers and the complaints of those who suffer from hayfever. It’s nice to actually see a bit of the sun after a day at work, isn’t it?
I write this as I conclude my general medicine rotation at the Royal Adelaide Hospital – a rotation experienced by most trainee doctors in South Australia at some point in their careers – and look to soon begin my final rotation of the year in hepatobiliary surgery.
Due to a number of factors – our ageing population, the increasing dependence on hospitals as our GP network thins, and the RAH’s role as a major referral centre – working general medicine has truly been a Sisyphean task. For every discharge home, stepdown in care or interfacility transfer, another patient emerges to take the place of whoever has just left. Thankfully, unlike Sisyphus, I am blessed with a great team of
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doctors around me, a genuine interest in the work I do and an appreciation for the benefit my work provides to each patient. I’ll take that over boulder pushing any day.
I have been particularly thankful this rotation for the number of excellent clinical role models afforded to me. The two consultants who have led my team – Dr Peter Avina and Dr Alice O’Connell – demonstrate excellent clinical acumen, showcase a genuine care for the patient and the junior doctors under their lead, and somehow manage to be both thorough and efficient at the same time. My registrar and resident medical officer Dr Amy Hughes and Dr Ben Khoo have likewise modelled a genuine care for patients and a constant drive to empower the patient’s family during the healthcare journey. In a busy world in which updating a patient’s loved ones can often seem unimportant compared to the patient’s medical progress, they help remind me of the importance of communication.
The broader camaraderie among the general medicine junior doctors is also much appreciated on my busiest days. While I continue to find it ludicrous that an office of four computers is supposed to support five teams of three doctors apiece (plus students), it is nice to share stories and debrief in our shared space.
‘The worst part of burnout is how it saps the joy from life.’
I have enjoyed this rotation, but I will look back on it as a time where I experienced a low point of my year –suffering a (thankfully mild) case of burnout. While this dip in energy and mood is particularly common for me around October/November, there were a number of important factors that ultimately led to this outcome.
Although our overall hours aren’t the worst I’ve worked, the general medicine roster is particularly gruelling when it comes to days worked consecutively. Don’t get me wrong – I know that being able to work the odd Friday half-day before a full weekend back on the wards is a significant improvement on the schedule of doctors who have gone before me. But the routine rostering of an eight-day stint followed by a single day off (and then back to work all over again) does get taxing after a while. Unfortunately, I partly have myself to blame for exacerbating the stress of my schedule further: additional commitments such as full weekends lost to an ALS 2 course and moving house turned a busy work period into an impossible life schedule.
The worst part of burnout is how it saps the joy from life. There is a profound difference between a tired doctor who still enjoys their work, laughs with their colleagues and appreciates the humanity of their patients, and a doctor who is overtired and overworked, their empathy and passion fatigued. I found myself in survival mode, only able to focus on the most basic of routines and needs – neglecting to nurture important relationships in my life as a consequence – as I told myself that things would get better if only I could hold on. Thankfully I can conclude this story with a happy ending, though I cannot take credit as the author of this change. My
wife – in her wonderful empathy – was able to break down the walls of fatigue in my mind and enable me to talk about the emptiness I was feeling. Only by acknowledging that my meagre coping strategies were not working was I able to begin the process of recovery.
I also shared my emotions with a close church friend – himself a paramedic – who spoke from personal experience about the importance of taking the time to resolve burnout properly rather than attempting to soldier on. This conversation empowered me to take the small yet effective step of taking a day off to reset, using it for leisure and recharge rather than for life admin, and return much more refreshed than before.
These steps provided me with enough energy to begin appreciating the small joys in life once more, a process that over time has healed my ability to show gratitude, empathy and genuine interest in others.
I hope my experiences may act as a both a warning and story of reassurance to others. I encourage each of you to be aware of the signs of empathy fatigue and constant exhaustion, to express your emotions to others, and to take a day or two to recover when you truly need it. None of these steps can completely resolve the impacts of work and study demands placed on many junior doctors today, but they can go a long way to making this meaningful calling more compatible with a healthy life.
Medicine is a fantastic career. Let’s all look after ourselves (and each other) to ensure we can continue to appreciate it for the marvel it truly is.
Dr Isaac Tennant
Medical
intern, Royal Adelaide
Hospital & AMA SA Counsillor
Monash University-led research, believed to be the first of its kind, has used blood tests and MRI scans to show that the effects of traumatic brain injuries (TBI) can last decades.
Involving researchers from the University of Melbourne and Austin Health, the Monash-Epworth Rehabilitation Research Centre (MERRC) TBI Ageing Study integrated a range of techniques to understand the enduring consequences of moderate to severe TBI.
AFL draftees have shown changes to their hip joints early in their playing careers, in new research that could reveal why elite athletes have higher levels of hip osteoarthritis.
Researchers from La Trobe University studied 58 pain-free male AFL draftees, finding that nearly half showed hip joint changes on magnetic resonance imaging (MRI) and 20% had a particular hip bone shape called cam morphology.
La Trobe Hip and Knee Research fellow and lead author in the paper Dr Joshua Heerey said while it was known that elite athletes were at greater risk of hip osteoarthritis than non-athletes, it was not yet known when the condition first developed.
Dr Heerey said that this was the first study that used MRI to examine hip joint changes in elite AFL draftees.
The MRI changes did not cause pain or affect the performance of the draftees, but could hold the key to understanding why elite athletes are more likely to develop hip osteoarthritis.
'This is an important discovery because it was once thought that MRI hip joint changes did not start until well after AFL players had finished their playing careers.
They included imaging to measure the integrity of the brain microstructure, blood biomarkers to determine ongoing brain pathology, and cognitive tests to understand how blood markers might be linked to a person’s cognitive health and clinical condition.
The researchers say it is one of few global studies on participants with moderate-severe TBI due to a single incident who have also been living with their injury for an average of 22 years, as opposed to experiencing repetitive injury.
Senior author Professor Sandy Shultz, from the Monash School of Translational Medicine, said the finding of chronic pathology in the brains of traumatic brain injury survivors, and the ability to identify this with imaging and blood tests, provides a foundation to develop treatments that may prevent or slow evolving pathology and improve recovery.
First author Dr Gershon Spitz said the findings supported the hypothesis that the effects of a moderate-severe TBI could be felt decades following the initial injury.
‘We found that elevated levels of blood biomarkers are related to poorer brain microstructure and poor cognition,’ Dr Spitz said.
‘Traditionally, TBI was viewed as an isolated event with a fixed recovery trajectory. Over the last decade, TBI has been redefined as a chronic, ongoing health condition. This redefinition is a crucial first step in overhauling our healthcare models, which presently allocate the bulk of resources to the immediate post-injury phase and leave long-term symptoms inadequately treated.’
Dr Spitz said further work was needed on the connection between blood biomarkers and symptoms/improvement. ‘We need to see whether the biological signatures of possible ongoing neuropathology can also tell us about people who may be at higher risk of experiencing progressive decline in functions like memory,’ he said.
‘Plasma biomarkers in chronic single moderate-severe traumatic brain injury’ (Brain, 2024)
'We found these MRI hip joint changes were quite common in elite male AFL draftees, but not necessarily causing them pain or affecting their performance. This highlights the complex relationship between MRI findings and pain in athletes.
'While these initial studies are a breakthrough in discovering when hip joint changes first occur, further long-term studies are needed to examine the importance of these changes in hip osteoarthritis development in male AFL players.'
La Trobe Principal Research Fellow and Richmond Tigers AFL head physiotherapist Dr Anthony Schache said the study provided AFL sports medicine practitioners working with a sound understanding about the hip joint changes typically found in young, asymptomatic players.
‘Are hip joint imaging findings associated with symptoms and early hip osteoarthritis features in elite male Australian Football League draftees?’ (Science and Medicine in Football, 2024)
Researchers from Flinders University and the University of South Australia have unveiled a promising new strategy to treat the most aggressive forms of prostate cancer.
The groundbreaking study explores the role of a novel drug, CDKI-73, to tackle drug-resistant prostate cancer that defies conventional therapies.
Prostate cancer is the most commonly diagnosed cancer in Australian men and causes more than 3,300 deaths each year. The disease frequently evolves into aggressive forms that do not respond to standard hormone therapies.
The study, led by Associate Professor Luke Selth from Flinders University and Professor Shudong Wang from University of South Australia, investigated the potential of targeting a protein called CyclinDependent Kinase 9 (CDK9), which plays a crucial role in the growth and survival of prostate cancer cells.
‘CDKI73 blocks aggressive prostate cancer growth’
The researchers tested whether an inhibitor of CDK9, CDKI-73, could overcome the cancer’s resistance to current treatments.
‘Our research demonstrates that CDKI73 potently blocks the growth of prostate cancer, even aggressive subtypes of the disease that are resistant to current treatments,’ says A/Prof Selth.
‘Importantly, CDKI-73 targets cancer cells specifically without harming normal cells and its potential as an oral capsule makes it an attractive treatment option.’
The study examined the effects of CDKI-73 using an array of prostate cancer models, including patient tumour samples, which revealed not only the effectiveness of the inhibitor but also provided new insights into its mode of action.
CDKI-73 is currently being investigated in Phase 2 clinical trials in patients with relapsed and therapyresistant acute myeloid leukaemia, an aggressive blood cancer.
‘CDK9 inhibition inhibits multiple oncogenic transcriptional and epigenetic pathways in prostate cancer’ (British Journal of Cancer, 2024)
Early exposure to antibiotics can trigger longterm susceptibility to asthma, according to new research from Monash University.
The research team isolated a molecule produced by gut bacteria that could be trialled as a simple treatment, in the form of a dietary supplement, to prevent children at risk of asthma from developing the disease.
The research led by Professor Ben Marsland found a molecule, called IPA, which is crucial to long-term protection against asthma.
‘We know that recurrent use of antibiotics early in life disrupts a person’s healthy gut microbiota and increases the risk of allergies and asthma. We have discovered that a consequence of antibiotic treatment is the depletion of bacteria that produce IPA, thus reducing a key molecule that has the potential to prevent asthma,’ Prof Marsland said.
‘The use of antibiotics in the first year of life can have the unintentional effect of reducing bacteria which promote health.
‘We now know from this research that antibiotics lead to reduced IPA, which we have found is critical early in life as our lung cells mature, making it a candidate for early life prevention of allergic airway inflammation.’
Working in mice predisposed to develop asthma, the research team found that - when given antibiotics in early life - the mice were more susceptible to house-dust mite-induced allergic airway inflammation and this lasted into adulthood. Asthma is commonly triggered by exposure to house dust mite.
‘Antibiotic-driven dysbiosis in early life disrupts indole-3propionic acid production and exacerbates allergic airway inflammation in adulthood’ (Immunity, 2024)
Private practice offers many personal and professional benefits, but there are potential challenges to consider, writes Hood Sweeney’s Lisa Hickey.
hether you aim to build your own medical practice from the ground up or buy into an established one, private practice can provide the flexibility to shape your professional path over the next five, 10 or 20 years.
It can be financially rewarding, offering the potential for higher income and the opportunity to directly benefit from the success of your practice. It also allows for personalised patient care, fostering stronger patient relationships and satisfaction.
Still, it is essential to consider the challenges, including the need for effective business management and navigation of regulatory requirements. By planning and understanding the financial stages and practice structures, medical professionals can successfully transition into private practice, achieving both professional fulfillment and financial stability.
When considering starting a new practice or buying in, it is important to liaise with accountants and lawyers experienced in medical practices as they can provide advice to help you make informed decisions.
Understanding the different financial stages and planning accordingly is crucial for a successful private practice. Each stage of your financial journey, from initial setup to growth and eventual retirement, requires consideration and strategic planning.
Early on, it’s essential to establish a solid financial foundation, including securing funding, managing start-up costs, and establishing efficient accounting systems.
As your practice grows, the focus turns to optimising cash flow, investing in technology and staff, and planning for expansion. Regularly reviewing and adjusting your financial strategies ensures that your practice remains financially healthy and can adapt to changing circumstances.
As you approach the later stages of your career, planning for succession and retirement becomes paramount. This includes evaluating the value of your practice, exploring options for selling or transitioning ownership, and ensuring your retirement plans are well-funded.
Choosing the appropriate practice structure for your needs and objectives is critical for the success and sustainability of your private practice.
The simplicity and cost-effectiveness of operating as a sole trader makes this an attractive structure for many. However, it comes with drawbacks, such as high marginal tax rates and a lack of flexibility and asset protection, which can expose your personal assets to business liabilities.
Partnerships of individuals allow for shared income and responsibilities, with each partner’s share of income included in their individual tax returns. While this can
facilitate collaboration and shared decision-making, it also introduces joint and several liability, meaning each partner is personally liable for the business’s debts and obligations. This can become complex if there are disputes or partners exit the business.
A company offers the benefits of lower company tax rates and asset protection, shielding personal assets from business risks. However, this structure involves additional costs and regulatory requirements, such as compliance with ASIC regulations, ATO Single Touch Payroll reporting and payroll tax implications, which can increase the administrative burden.
Trusts provide a flexible structure that can offer significant tax benefits and asset protection. They are often used as service entities to manage income distribution efficiently. Trusts can be discretionary, unit, or hybrid, allowing for tailored solutions to meet specific needs. This flexibility makes trusts a popular choice for those looking to optimise their tax positions and protect their assets while maintaining control over how income is distributed.
‘It’s essential to establish a solid financial foundation’
Understanding the pros and cons of each practice structure can help inform your decision.
When considering joining an established practice, it’s essential to ensure there is a structured process in place. This includes having clear protocols and systems for daily operations, financial management, and patient care. A wellstructured process not only enhances efficiency but also provides a solid foundation for the long-term success of the practice.
If possible, try before buying. This allows you to experience the practice environment, culture, and operational dynamics firsthand, so you understand what you are getting into.
It’s crucial to understand how the practice is valued and what you are buying. This involves a thorough evaluation of the practice’s financial health, patient base, reputation and potential for growth.
Always plan for contingencies in case things go wrong. This includes having a clear exit strategy, understanding potential risks and being prepared for unforeseen challenges. By planning for contingencies, you can mitigate risks and ensure a smoother transition into the practice.
Establishing an appropriate structure at the beginning is vital for the success of your private practice. Choose a structure that aligns with your goals and provides the flexibility and protection you require. Keep it simple and ensure you fully understand your chosen structure to avoid complications later.
Having a clear business plan, along with detailed budgets and cash flow projections, is essential for guiding your practice’s growth and ensuring financial stability. Formal documentation and registrations are also vital to comply with legal and regulatory requirements. This includes setting up separate investment and operating structures to protect your assets and streamline financial management.
Disclaimer: Information contained in this article is of a general nature only and does not constitute financial or taxation advice.
Lisa Hickey is Director of Health Team, Accounting & Business Advisory at Hood Sweeney.
Collaborative robots or ‘cobots’ are rapidly reshaping workplaces across Australia and the healthcare sector is no exception. The technology has the power to increase efficiency and reduce physical workplace risk, but less is known about the hidden psychosocial risks employees might be facing. Professor Herman Tse from Monash University explains how cobots are changing healthcare.
How are cobots used in healthcare?
Cobots play diverse roles in the healthcare sector. In surgical settings, devices like the da Vinci Surgical System assist with minimally invasive operations, enhancing precision and control. For rehabilitation, systems like the Lokomat support patients in regaining mobility by guiding them through repetitive exercises that would be challenging to perform manually. Additionally, logistics cobots such as TUG autonomously transport supplies and medications within hospitals, simplifying tasks for nursing staff.
Supplied: Da Vinci Surgical System in use
My research suggests employees are concerned about role ambiguity, especially how their duties and role might change when working alongside cobots. They also had worries about job security, fearing that increased automation could reduce the need for human workers. The study was primarily focussed on manufacturing, but the insights are relevant in healthcare as cobots take on the routine tasks of health professionals.
Yes. As cobots become more advanced, reliable, and cost-effective, their presence in healthcare environments is expected to increase significantly. A report from MarketsandMarkets in 2023 forecasts that the healthcare robotics market will expand from $5.9 billion (USD) in 2021 to $13.8 billion (USD) by 2026. This surge is driven by innovations in AI, machine learning, and sensor technology.
By taking over routine responsibilities, cobots can allow health professionals to focus on complex decisionmaking, participate in intricate procedures, and build stronger relationships with their patients. However, this
‘COBOTS CAN SIGNIFICANTLY IMPROVE THE QUALITY AND CONSISTENCY OF CARE’
transition will require doctors to learn new skills, including how to operate cobots and analyse the data they produce. We might also see a shift in the doctor-patient relationship, with patients relying on cobots for certain aspects of their care.
On the positive side, cobots can significantly improve the quality and consistency of care, particularly in fields such as rehabilitation and patient monitoring. However, there is a downside: patients may feel they are engaging more with machines than with actual caregivers, which could lead to feelings of disconnection. To address this, it’s crucial for healthcare providers to use cobots in a way that enhances human interaction instead of replacing it.
Professor Herman Tse is a Professor of Leadership at Monash Business School.
GRIP is a specialised hand and wrist surgery practice for adult and paediatric patients. With onsite, experienced hand therapists, we offer streamlined operative and non-operative care of the highest standards.
Dr Paul van Minnen and Dr Nicholas Smith are Plastic and Reconstructive Surgeons who dedicated their private practice to hand and wrist surgery of all complexities.
Our hand surgeons diagnose and treat conditions involving the hand, wrist and forearm with the aim to restore function and form.
Our hand therapists provide occupational and physiotherapy services, exclusively dedicated to the care and rehabilitation of the hand and wrist.
GRIP Hand Therapy is available at 4 convenient locations: Adelaide, Beverley, Hope Valley and Morphett Vale. A GP or Specialist referral is not required.
Health practitioners are bound by certain legal and professional obligations when using social media, including in their private lives. Although they have a right to freedom of expression, their online activities must not present a risk to the public or involve the abuse and discrimination of others. Ahpra’s guidelines help doctors navigate what they should and shouldn’t do.
When sharing information, including comments or photos, doctors must not inadvertently disclose patient information. It’s important to remember that while individual pieces of information may not breach confidentiality, the sum of published information could be enough to identify a patient.
Comments on social media that reflect or promote personal views about social and clinical issues might affect someone’s sense of cultural safety or could lead to a patient or client feeling judged, intimidated or embarrassed.
Practitioners must always treat patients with respect and communicate effectively, courteously, professionally and respectfully with and about other health care professionals. This applies to any comments made in a social media context. Grievances with work colleagues or patients are best resolved privately. Language and tone used on social media that are suggestive, overly familiar or do not reflect a professional relationship could breach professional boundaries and the Code of Conduct.
Doctors must ensure any comments on social media are consistent with the codes, standards and guidelines of their profession and do not contradict or counter public health campaigns or messaging. A registered health practitioner who makes comments or endorses or shares information which contradicts the best available scientific evidence may give legitimacy to false health-related information and breach their professional responsibilities.
The National Law and Advertising guidelines also apply to advertising in social media. Making false claims about the effectiveness of a treatment could be considered a breach of the law.
Limit your social media use for mental wellbeing.
Social media companies deliberately design their apps and algorithms to keep users scrolling, so switching off can be a challenge for children and adults alike. Australian youth support service ReachOut has five useful tips for limiting use, which can be helpful for people of any age.
Keep social media apps away from your home screen or hide them in folders to avoid overindulging. Turn off notifications for specific apps in your settings, so you’re not constantly tempted to get sucked into the social media time vortex.
Using an app to reduce your time on other apps might sound counterproductive, but there are many apps and features designed to help you limit how long you spend on social media. The Forest app, for example, allows you to establish a period when you commit to not using your phone. Daywise enables you to schedule times for receiving notifications so they’re not a constant distraction.
Pick a screen-free hobby and commit to spending an hour on it once a week. During hobby time, switch your phone to ‘do not disturb’ mode (or turn it off completely) so you’re not distracted.
Leave your phone out of reach when you sit down to dinner. Place it on the charger or in your bag (or someone else’s) rather than keeping it in your pocket, so you’re not tempted to glance at it.
Pause screen-related activities at least an hour before bedtime and try leaving your phone on the charger outside your bedroom. Sharing your bed with a bright and shiny phone is a guaranteed way to interrupt your sleep.
RICHARD HAMILTON MBBS, FRACS, Plastic Surgeon, wishes to notify colleagues that his private clinic Hamilton House Plastic Surgery is fully accredited under the rigorous Australian National Standards (NSQHS) for health care facilities and also by QUAD A (American Association for Accreditation of Ambulatory Surgery Facilities International).
Richard Hamilton continues to practise Plastic and Reconstructive Surgery at Hamilton House, 470 Goodwood Road, Cumberland Park, with special interests in skin cancer excision and reconstruction, hand surgery and general plastic surgery.
He also welcomes patients considering cosmetic surgery, who now by government regulation, require a referral from their General Practitioner.
A “See and Treat” service is also available for urgent skin cancer patients and patients travelling from rural areas, with convenient, free, unlimited car parking at the premises.
Richard also consults fortnightly at Morphett Vale, and monthly at Penola and Victor Harbor. He is available for telephone advice to GPs on 8272 6666, and readily accepts emergency plastic and hand surgery referrals.
Referrals can be faxed to 8373 3853 or emailed to admin@hamiltonhouse.com.au
For all appointments phone Richard’s friendly staff at Hamilton House on 8272 6666. www.hamiltonhouse.com.au
Our growing reliance on social media may be infiltrating our dreamssometimes in unsettling ways.
Flinders University researcher Reza Shabahang has found that emotionally charged interactions online, particularly bad ones, can even lead to nightmares.
‘Negative experiences within social media, such as cyberbullying, trolling, online harassment, and cyberstalking, can induce substantial stress,’ Mr Shabahang says.
‘This heightened distress can culminate in nightmares that echo these adverse social media experiences, akin to experiencing nightmares following a traumatic event.’
Mr Shabahang has developed a new scale, the Social Media Nightmare-Related Scale, that can quantify how social media could contribute to our nightmares. His research was in part motivated by his own unpleasant dreams.
‘As I recall, I once experienced a social media-related nightmare in which my personal information was shared by someone on social media,’ he says.
‘Continuous engagement with social media can blur the boundaries between our waking experiences and our subconscious, enabling these experiences to manifest in our dreams.’
The research suggests technology-related nightmares are still relatively rare but are likely to become more common as emerging tools like artificial intelligence and virtual reality become more entrenched in our daily lives.
Mr Shabahang says the best way to avoid social media-induced dreams is to scroll with purpose and avoid excessive or ‘problematic’ usage.
‘Mindful engagement with social media helps users gain awareness of why they are on social media, how their emotions are being affected, and when they need to log out to maintain their psychological, cognitive, and emotional balance,’ he says.
‘Such a routine can reduce the negative influence of social media on dreams thereby potentially securing better quality sleep.’
‘SOCIAL MEDIA CAN BLUR THE BOUNDARIES BETWEEN OUR WAKING EXPERIENCES AND OUR SUBCONSCIOUS.’
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Stefanie Magliani
Strategic exposure to artificial light can significantly improve night shift workers’ sleep quality and work performance, according to a major study from Flinders University.
The research published in the journal Sleep found the use of circadian-informed lighting, where artificial lighting is synchronised to natural biological rhythms, accelerated body-clock adjustment and improved alertness and performance.
Flinders University researcher and lead report author Alisha Guyett says the findings are very promising for shift workers and their employers.
‘The overarching benefits of circadianinformed lighting on sleep and alertness are very clear from this study,’ Ms Guyett says.
‘Our findings suggest that strategic lighting interventions can likely be used to enhance the performance, sleep, safety and well-being of nightshift workers exposed to inadequate light during their work shift.’
Groundbreaking South Australian research could be a game-changer for doctors working the night shift.
Professor Peter Catcheside says the research is relevant for doctors who need to maintain alertness in challenging night shift environments. Like most things, he says, the timing is key.
‘Knowing when to use and when to avoid light is the trickiest part of all this,’ Prof Catcheside says.
‘Ideally, workplace design would have considered and installed lighting with circadian influences in mind.
‘There are various apps and software tools that try to estimate when the circadian (low point) in performance and safety is most likely to occur.’
‘Strategic lighting can be used to enhance performance’
The trial, which is among the first in-laboratory studies of its kind, took place under tightly controlled conditions at the Flinders Health and Medical Research Institute.
It involved 19 adult participants being exposed to two different lighting scenarios for a period of eight days, to compare how their body clocks adjusted and how they performed in a series of tasks.
Research teams assessed key circadian measures including melatonin levels and core body temperature, along with other outcomes including cognitive performance and sleep.
Over four consecutive simulated night shifts, the circadian-informed lighting shifted participants’ body clocks around one hour faster per day compared to the standard lighting.
Flinders University senior sleep health researcher
Avoiding bright light towards the end of the shift and during the post-shift commute improves sleep.
Workplaces can install lighting systems ranging from basic consumer lights through to sophisticated lighting control systems to enable daily cycling adjustment of light spectrum and intensity to suit workers’ circadian systems.
Portable light therapy glasses can be used if light intensity can’t otherwise be easily manipulated.
Regional South Australians have received additional support for their health needs, thanks to a new donation to the Royal Flying Doctor Service SA/NT.
The RFDS aircraft VH-FNH has been rebranded to reflect an important sponsorship arrangement that will offset the costs of running the plane.
It was unveiled at a dedication ceremony during the organisation’s annual general meeting event in Mount Gambier in October, in loving memory of the late Glenda Kidman.
The late Mrs Kidman and her husband John, who took part in the dedication ceremony, have been long-term benefactors to Limestone Coast organisations.
Before Mrs Kidman’s death almost two years ago, she and John committed to continuing their support of the RFDS.
‘Glenda’s motto was “lots of little things make big things happen”,’ Mr Kidman said.
Wakefield Orthopaedic Clinic has provided high-quality, specialised orthopaedic care in South Australia since 1991. We specialise in prevention, treatment and rehabilitation of orthopaedic conditions and work alongside sports medicine, physiotherapy and rehabilitation specialists to get you mobile again.
ORTHOPAEDIC SURGEONS
BENJAMIN ALLEN
BEN BEAMOND
COLLIE BEGG
SAMUEL BENVENISTE
SCOTT BRUMBY
DAVID CAMPBELL
NICHOLAS CHABREL
RICHARD CLARNETTE
ANDREW COMLEY
WILLIAM DUNCAN
CHI KANG GOOI
PETER LEWIS
BASEL MASRI
RORY MONTGOMERY
MARK RICKMAN
MICHAEL SANDOW
CHEN TU
ARTHUR TUROW
Flinders University celebrated 50 years of delivering medical training to generations of doctors at a spectacular event at Adelaide Oval on 19 October.
South Australia’s Governor, the Honourable Frances Adamson AC, attended the event alongside Flinders alumni and current medical school graduates.
Artist Brad Blaze was on hand to produce some of his signature artwork, which was auctioned to raise important funds for Indigenous Medical Student Support. Guests were also treated to a special performance by renowned rap artist J MILLA.
Dr Summaya Balouch and Dr Amna
The Pakistani Medical Association of South Australia (PMASA) held its Annual Gala at Adelaide Oval on 7 September.
PMASA President Dr Rehan Hassan said the event was a celebration of professional excellence and cultural unity. Guests were presented with pins symbolising the bond between Pakistan and Australia and the flags of both nations lit up the digital billboard at Adelaide Oval.
Greens Senator Mehreen Faruqi and the Consul General of Pakistan in Australia, Syed Moazzam H. Shah, presented two awards recognising academic achievement and exceptional contributions beyond medicine.
PMASA also announced a new scholarship program to remove financial barriers for medical students.
Four-time Olympian and former Adelaide 36ers’ coach Phil Smyth delivered the Anstey Giles Lecture at the Royal Australasian College of Surgeons’ RACS SA Annual Dinner at the National Wine Centre on 1 November
About 80 guests saw Emeritus Professor James Toouli receive the Sir Henry Newland Award for his outstanding contribution to surgery and the state of South Australia over many years.
Škoda’s Superb SportLine and Kodiaq RS deliver on power and prestige, writes AMA SA President Dr John Williams.
On a long road trip, it’s the little things that help you go the distance and Škoda’s attention to detail certainly makes for a comfortable and easy ride.
I had the privilege of test driving two of the latest models when I visited the Limestone Coast for my rural tour in August: the Škoda Superb SportLine Wagon and the Škoda Kodiaq RS SUV.
The 2023 Superb SportLine is sleek and sporty –surprisingly so for a wagon. With a 2.0-litre turbocharged engine delivering 206 kW, it’s powerful enough to handle the open road with ease. I’m told it can accelerate from 0 to 100km/h in less than six seconds (although I didn’t put that to the test).
The Superb’s lower stance provides a stable and smooth ride, and advanced safety features such as lane assist and blind-spot detection offer peace of mind on the longstretches of highway.
Inside, the cabin is refined and spacious. The front and rear seats are heated and there are several clever little touches like a refrigerated centre console and an umbrella hidden in the door cavity. There’s a cordless charger for your smartphone and you can sync with the navigation system and music player without any hassles.
The 2024 Škoda Kodiaq RS SUV shares many of the
same high-end functionality elements, including a digital cockpit and a well-designed infotainment system. In terms of comfort, the higher driving position provides a commanding view of the road and the front sports seats ensure excellent support. This SUV can also be transformed into a seven-seater if you don’t mind forsaking a little luggage room to accommodate extra passengers. On the road, the Kodiaq is slightly less powerful than the Suburb: its 2.0-litre engine delivers 180kW of power. We
stuck to the bitumen, but this model can also switch to offroad mode, which includes driving assist for difficult terrain. Both vehicles offer a winning combination of comfort, control and power. Personally, I preferred the Superb because of its responsiveness and high-end sporty feel, but if you’re travelling off-road or in a larger group, the Kodiaq’s the way to go.
Vehicles supplied by Jarvis Skoda Adelaide.
1932 – 2024
MB BS MRCP (London) FRCP (Edin)
General practitioner, dermatologist, AMA SA History Committee chair and website manager
Thomas, fondly known as Tom or Dr Tom, entered medical school at the University of Adelaide just before his 17th birthday in 1949. While he would always remind us, his family, of the lost year due to cardplaying distractions and sporting injuries, he was for his long and rich life a successful and dedicated medical professional, and always the most generous family man. Tom wholly embraced the principles of compassionate, patient-centred care. In 2021 he wrote a memoir of his time at Adelaide Medical School, saying: ‘The charge sisters helped me find ways to be kind to patients’.
During his intern year at the Royal Adelaide Hospital in 1957, Tom met indigenous rights advocate Lowitja O’Donohue, also born in 1932 and one of the first indigenous nurses to train in Adelaide. At an art show in 2015 these two octogenarians recognised each other and embraced warmly, sharing stories of the old days.
Tom undertook locums in Penola, St Peters and Hindmarsh
before joining Dr Vernon Odlum in general practice, at the tender age of 26, in the first year of his 66-year marriage to Jan, and with baby number one on the way. He worked from a surgery extension to the newly built family home in Fulham. In his memoir Tom comments about a practice he learnt from Vern: ‘First ask the patient “What do you think is wrong?”. You have to find out what is on their mind before you can hope to attend it.’
As is the case today, general practice was very hard work, but very different in practice. Tom performed ‘the occasional appendicectomy’ and ‘large numbers of tonsillectomies’. He saw lots of rashes and delivered many babies, as many as one a week. In 1968, with Jan and his four young children, he left to complete his dermatology training at Amersham General Hospital with Dr Daryl Wilkinson and Dr Angus Robson, sitting final exams in Edinburgh. Upon his return to Adelaide he established a private dermatological practice at North Terrace House, Hackney, and obtained his FRCP. He entered honorary dermatological practice at the Adelaide Children’s Hospital (now WCH), rising to Head of the Department. Though busy professionally, Tom found time to assist at St David’s Church Burnside and was chairman of the Board of Pembroke School between 1980 and 1985.
Tom was an enthusiastic historian who embraced retirement with a passion for furthering his IT skills and chairing committees, notably with the History Committee of AMA SA. A website documents the AMA’s emergence from its BMA origins, provides an account of South Australian medical practitioners who served in conflicts, offers facts and reflections on indigenous and multicultural aspects of medicine in South Australia, and redresses the record on the recognition of female doctors. All of this is freely accessible to the public, of interest not only to AMA members but historians, archivists and genealogists.
Tom’s colleagues on the committee speak highly of his dedication to the mission to ‘collect, collate and document the trail-blazing doctors and ground-breaking activities in South Australia’. Tom was nominated for an AMA SA Outstanding Achievement award for his untiring work.
Colleague Dr David Evans says: ‘Tom’s personality, his generosity, his foresight, rugged determination, his pleasure in making good things happen, and his friendliness were a total inspiration’. These qualities were also present in his life as a family man: husband, brother, uncle, father, grandfather and great-grandfather. Tom was very much loved and will be greatly missed.
-Jane Turner Goldsmith is one of Dr Turner’s four children.
Dr John Williams with Dr Turner’s daughter Jane Turner Goldsmith and wife Jan Turner
Dr Turner was posthumously awarded the AMA SA Outstanding Achievement Award at the President’s Breakfast on 29 November.
The award recognises members who have consistently contributed to the AMA SA by going above and beyond the ordinary standard of service and setting a strong positive example. It was accepted by Dr Turner’s wife Jan and daughter Jane.
Dr Turner was nominated by AMA SA Administration Officer Sharyn Kerr who worked with him in her role as Minutes Secretary of the AMA SA History Committee. Her nomination was endorsed by AMA SA Past President Dr Peter Joseph AM who also serves on the History Committee.
In submitting her nomination, Ms Kerr highlighted Dr Turner’s dedication as a volunteer on the History Committee for nearly a decade and his work developing the committee’s website.
‘I witnessed firsthand his exceptional commitment to preserving the history of AMA SA,’ Ms Kerr said.
‘He had a remarkable ability to recall, research, and curate anecdotes, biographies, and historical data.
‘His efforts in developing a comprehensive website that documents the history of the British Medical Association in Australia and the Australian Medical Association since their inception in South Australia are truly commendable and deserving of recognition.’
Ms Kerr’s nomination received unanimous support from AMA SA Councillors at their November meeting.
AMA SA President Dr John Williams described Dr Turner as generous and kind.
‘He helped document, record and preserve the rich history of the medical profession in South Australia,’ Dr Williams said.
‘He will remain an important part of AMA SA’s history, and his memory will endure.’
CBE LLD MB BS FRCS FRACS FACMA Rural GP, surgeon, medical administrator
Clarence Rieger was born in North Adelaide to immigrant parents in 1897. Educated in state schools, he was awarded a government bursary and graduated in medicine at Adelaide University.
After working as a resident medical officer at the Adelaide Hospital in 1920, Dr Rieger became Acting Medical Superintendent at Broken Hill Hospital and then entered general practice in Zeehan, Tasmania.
In 1923 Dr Rieger married Bessie Main. They went on to have three children, including Tony, who followed in his father’s footsteps and became a surgeon, as later did his grandson Nicholas.
At the end of 1925 Dr Rieger moved to the Eyre Peninsula. He left in 1931 to work and study in England.
Returning to Adelaide in 1934 Dr Rieger became a suburban general practitioner with a special interest in surgery and was an honorary surgeon at the Adelaide Children’s Hospital.
In World War II he joined Second AIF, serving from 1942 to 1946 and working as a specialist surgeon (including two periods in New Guinea) with the rank of major.
At the end of the war Dr Rieger resumed his position at the Adelaide Children’s Hospital. In 1958 he became president of the hospital and chairman of its board of management, with his outstanding contribution recognised in the naming of the new ‘Clarence Rieger Building’ in 1964.
Always active within the BMA (which in 1962 became the AMA), Dr Rieger became President of the South Australian branch from 1949 to 1951.
In 1962 the first Australian Medical Congress was held in Adelaide and Clarence Rieger was chosen as president.
In 1967 – and now a Commander of the Order of the British Empire – Dr Rieger was elected President of the Australian AMA and a year later as President of the BMA (UK) – the only Australian to have achieved this distinction. He received the AMA’s highest individual honour, its Gold Medal.
He was knighted in 1969.
In 1979 AMA members contributed to the commissioning of a portrait of Sir Clarence by Sir William Dargie. Until 2019 this was exhibited in the Council Room of Newland House, the then headquarters of the South Australian branch of the AMA.
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Decanting can be useful for a couple of reasons. Firstly, it allows an older red wine to be separated from any sediment that may have developed in the bottle. I find the easiest way to do this is by standing the bottle for a day or so before drinking, to allow sediment to settle to the bottom of the bottle, then opening and pouring the wine slowly and smoothly into a jug or glass decanter. As soon as you see sediment coming out of the bottle, stop pouring.
Wine sediment is a combination of tartrate crystals and tannin and can be quite bitter. Removing it allows you to enjoy all the mature flavours of the wine without any unwelcome intrusions. Having decanted the wine, I’d advise giving the bottle a rinse with filtered water and pouring the wine back into the bottle and resealing it. This is because the process of decanting oxygenates the wine, which accelerates development. This process of decanting a wine and then putting it back into the bottle is called double decanting.
Older red wines, decanted and left to stand for hours, quickly lose much of their delicate aroma, which simply volatilies. This leaves us with not much to smell, and therefore little flavour. This is because our olfactory senses – which begin in our nose – are the greatest contributor to our sense of taste. Double decanting older reds, just moments before drinking, will give them a bit of a kick along without destroying them.
With a younger wine I’ll typically double-decant it a few hours before drinking (if I can wait that long!) and when the time comes to drink it, it has usually ‘opened’ substantially. Despite being resealed, the wine still opens and softens, thanks to the oxygen trapped in the solution. I reckon this is the most gentle and effective means of bringing out the best in your wine.
-Phil Manser, winedirect
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AMA SA offers support and services for every stage of your career.
Join the most trusted doctors’ organisation in Australia and benefit from our professional networks, business tools and the advocacy that helps doctors, patients and the entire health system.
If you are a public medical professional your AMA SA membership can be fully claimed back through your professional development allowance.
For more information, v isit: ama.com.au/sa/membership-benefits
Leverage AMA’s powerful advocacy for doctors of all specialties and stages, from doctors in training to hospital doctors, private specialists and general practitioners. AMA SA is your voice.
Access a range of resources like the AMA Fees List , industrial and workplace relations support, a free subscription to the Medical Journal of Australia, and discounts on AMA’s CPD Home
AMA will help you stay connected. Networking leads to new opportunities, collaborations, and knowledge-sharing. It’s not just who you know, it’s who others know. Networking is powerful.
Access educational, business and networking events and webinars on a variety of topics, plus discounted entry to other events and conferences.
As a member you receive a free AMA career service, including a CV checkup and career consult to support your career.
Receive 10% discount on accounting services at Hood Sweeney, 5% discount on standard legal services at Norman Waterhouse Lawyers and discounts at Officeworks and more.
Members benefit from discounts on brands like Amex, Endota Spa, winedirect, Qantas & Virgin Lounges, plus offers across car dealerships including BMW, Jarvis Skoda and Audi.
You can also access Blue Light Card discounts on everything from fuel and food to holidays, technology, and fashion at The Iconic, Woolworths, Samsung, Expedia, Hello Fresh and more.
ama.com.au/sa/join-the-ama
AMA is the unified voice advocating for all doctors. Join