Doctor Q Summer 2024

SU M M E R 2024

Meet plastic and reconstructive surgeon A/Prof Richard Lewandowski Working with new Liberal Government What a year! 2024 achievements

Independent. Concise. Evidence based.

For over 45 years, Australian health professionals have trusted Therapeutic Guidelines as the leading point-of-care clinical resource. The guidelines remain solely funded by subscribers and are written by leading Australian experts for the wider healthcare community.

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Contents Reports 5

Editor’s desk

7

President report

8

AMA Queensland scorecard

9

CEO report

10

AMA Queensland in the media

37

Committee of General Practice update

39

Committee of Doctors in Training update

68

AMA Queensland Foundation update

Current Issues 18

2025 and a new state government

19

Fluoride decision abandons vulnerable Queenslanders

20

Health checks for late career doctors

22

Ahpra agrees to leave fee relief

23

Doctors and their role in tackling family violence

29

Managing and responding to violence in the medical workplace

38

Research round up

44

The foundation of Queensland medicine

Snapshot of 2024 achievements

30

Scope of practice review – the Good, the Bad and the Ugly

40

Resident Hospital Health Check

People & Events

62

All about you

64

Dr Matt Young – The stars that align

65

How much wine?

66

Discover Canada

70

InPrint

Business

Features 24

Lifestyle

32

Criminalising wage theft

34

Key changes every employer should know

49

Minimise your tax to maximise your wealth

51

Total and permanent disability

53

The importance of retroactive dates in indemnity insurance

55

Gifting money for a first home purchase

56

Are you on top of your practice’s privacy law obligations?

12

Women in Medicine Breakfast

14

Annual International Conference

59

Time is money: why early retirement planning matters

16

Member Networking Brisbane

61

Get to know Doctors’ Health Fund in under three minutes

17

Member Milestones

36

Doctors’ Health in Queensland’s Annual Wellness Day

42

Member Profile: A/Prof Richard Lewandowski

46

2025 events calendar

14

Annual International Conference

40

Resident Hospital Health Check

12

Women in Medicine Breakfast Summer | Doctor Q

3

Advertise with AMA Queensland Deadlines for Doctor Q Autumn 2025 - 1 February Winter 2025 - 1 May Spring 2025 - 1 August Summer 2025 - 1 November Our Connect enews goes out fortnightly.

Contact us for dates and rates.

Find out more Advertising and sponsorship Contact us: advertising@amaq.com.au or 07 3872 2222

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Doctor Q | Summer

Board of Directors Dr Nicholas Yim* President Dr Emilia Dauway* Vice President, Chair of Council Dr Eleanor Chew OAM* Chair of Board, Member Elected Director

Dr Sarah Coll Member Elected Director

Dr Ben Wakefield* Member Elected Director

Dr Erica Gannon* Member Elected Director

Craig Allen Skills Based Director Grant Dearlove Skills Based Director *on Board and Council

Council Dr James Allen Greater Brisbane Area Representative Dr Sanjeev Bandi Capricornia Area Representative Dr Sharmila Biswas Part-Time Medical Practitioner Representative

A/Prof Geoffrey Hawson Senior Doctors Representative

A/Prof Katie Panaretto Specialist Representative

Dr Wayne Herdy North Coast Area Representative

Dr Bhavesh Patel Specialist Representative

Dr Sandra Hirowatari General Practitioner Representative

Dr Rachael PeryJohnston Greater Brisbane Area Representative

Dr Kimberley Bondeson Greater Brisbane Area Representative

Dr Lee Jones Committee of General Practice Chair

Dr Maria Boulton Immediate Past President

Dr Sharon Kelly Committee of Consultant Specialists Chair

Dr Lisa Fraser General Practice Representative Dr Erica Gannon Specialist Representative Dr Alison Green Greater Brisbane Area Representative A/Prof Paul Griffin Full-time Salaried Medical Practitioner Representative

A/Prof Alka Kothari Greater Brisbane Area Representative Lachlan McMillan Medical Student Representative A/Prof Ewen McPhee AM General Practice Representative Dr Robert Nayer North Area Representative

Paul Kulpa General Manager AMA Education and Training Institute

Editor: Michelle Ford Russ

Phone: Address: Email: Website:

The election in October brought in the first LNP state government since 2015. They made good on their promise to get exempt GPs from payroll tax almost immediately.

This has been an incredibly hard-fought battle and we look forward to working with the new government to ensure doctors have their say on further advocacy.

While we celebrated our 130th anniversary this year, we will make history in 2025! Thank you all for your membership and our team looks forward to working on your behalf next year.

Have a lovely festive season and let’s hope the rain holds off long enough for us to all enjoy a day at the beach!

Dr Fiona Raciti General Practitioner Representative Dr Mikaela Seymour Doctors in Training Representative Dr Shiven Singh Gold Coast Area Representative Dr Sally Sojan Downs and West Area Representative Dr Ben Wakefield Greater Brisbane Area Representative

Obituaries The following AMA Queensland members have recently passed away. Our sincere condolences to their families.

Dr Colin Mitchell FURNIVAL Surgeon Late of St Lucia Member for 33 years

Dr Elise Witter Committee of Doctors in Training Chair

AMA Queensland Secretariat Dr Brett Dale Chief Executive Officer Filomena Ferlan General Manager – Corporate Services

Editor’s desk

Erin O’Donnell General Manager Policy

Check out all the features in our Member Portal Have you jumped on to have a look at our Member Portal?

When you first log on, you will be asked to complete your profile to be included in the Member Directory, just like these members below.

07 3872 2222 PO Box 123, Red Hill QLD 4059 amaq@amaq.com.au ama.com.au/qld

Follow us Disclaimer – All material in Doctor Q remains the copyright of AMA Queensland and may not be reproduced or transmitted in any form without permission. While every care is taken to provide accurate information in this publication, the material within Doctor Q is for general information and guidance only and is not intended as advice.

Readers are advised to make their own enquiries and/or seek professional advice as to the accuracy of the content of such articles and/or their applicability to any particular circumstances. AMA Queensland, its servants and agents exclude, to the maximum extent permitted by law, any liability which may arise as a result of the use of the material in Doctor Q.

If you have any troubles accessing the Member Portal, please email us on membership@amaq.com.au or call 07 3872 2222.

Member Portal

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Tasmania 7 TO 13 A PR I L 2025

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Join us on the Apple Isle for the AMA Queensland Trans-Tasman Conference, for members who like to travel a bit closer to home. We are thrilled to hold the first of many conferences in Australia, New Zealand and surrounding areas, with support from our corporate partner Orbit World Travel.

This family-friendly conference is a great chance to get away and visit the beautiful island state of Tasmania, known for its gourmet food, beautiful landscapes and unique wildlife while learning key issues facing the profession.

The CPD-accredited activity is for all doctors. We will have a breakout room focusing on building and supporting private practice. You will have the chance to hear from practice owners, GPs, specialists and industry leaders about the best ways to ensure the sustainability of your practice including financial strategies, technology, innovation, retention, workforce and environmental issues and solutions while improving healthcare quality and patient safety.

The activity will be refined and reshaped to best match delegates’ needs, so register early so your interests can be considered.

DATE LOCATION

Monday 7 April - Sunday 13 April 2025 Hobart, Tasmania

REGISTER NOW ama.com.au/qld/events/TransTasman2025

FOR REGISTRATIONS: ORBIT WORLD TRAVEL P 1300 262 885 E amaq@orbittravel.au

President report As the year draws to a close, it is time to reflect on the many achievements AMA Queensland has won for our state’s patients and medical profession. As the only organisation representing all specialties across all career stages, from student to senior active doctor, AMA Queensland covers the gamut of public health issues and concerns for the profession.

Whether this is a call for better access to palliative care in our regions or practical solutions to ambulance ramping and elective surgery wait lists, we work closely with all political parties and all levels of government in the best interests of patients, the community at large and the profession.

This has been a very big year, culminating in the change of government in the October state election, a change in Queensland Health leadership and the resignation of the Chief Health Officer. Health was a major focus during the campaign, and we rated both major parties’ promises against our Election Priorities. The parties were neck and neck with only a couple of minor areas of difference.

Read more Perhaps our biggest win has been the confirmation from the new state government that general practice will be exempt from the new interpretation of tax law that followed a tribunal ruling in New South Wales in 2021.

Queensland has led the nation and we hope this will be the trigger for change for the other states as part of tax harmonisation.

We have already met with Treasurer David Janetzki and Queensland Revenue Office Commissioner Simon McKee and advocated for the exemption to extend to all medical practices. We have also made it clear the exemption will only succeed if it is not tied to bulk billing.

Read more We have also had a meeting with new Health Minister Tim Nicholls and the new Director-General of Queensland Health Dr David Rosengren. Minister Nicholls stressed that his sole focus is on delivering the LNP’s election commitments, including increasing the health workforce by 34,200 staff by 2032, stopping the growth in elective surgery wait lists within the next 12 months, and a 30 per cent drop in ambulance ramping by 2028.

We will continue to advocate for reforms and initiatives that will improve ramping, elective surgery access and staffing – the things our members tell us they want.

This will necessitate making Queensland the most attractive destination for doctors, nurses and allied health professionals from around Australia and the world.

Dr Nick Yim President

We secured a change of heart from the new government on cancelling the pill testing service at Schoolies this year. Pill testing is not just about checking what is in the substances, it is about education and early intervention for young people who are already contemplating taking an illicit substance. While the government has not yet committed to continuing this program beyond this year, we will continue to advocate for its retention, and the retention of drug diversion and alcohol treatment reforms.

Read more Our Resident Hospital Health Check of more than 800 junior doctors at hospitals across the state has again found that about one-third of junior doctors report feeling unsafe at work, and about one-half are worried that they are so fatigued from long hours that they will make a clinical mistake. We will keep working with Queensland Health and the government to fix these issues.

Read more The new government has also pledged to rename the existing satellite hospitals to avoid confusing patients about the services available. We have been calling for a public education campaign about where to seek treatment – when to see your GP, when to attend an urgent care clinic, satellite hospital or nurse-led walk-in clinic, and when to present to the emergency department.

Read more Next year will see a federal election that will likely be fought on health issues. We saw the abortion debate weaponised during both the Queensland and United States elections and hope we do not see the same in the federal campaign. With our interstate and federal colleagues, we will continue to advocate for a fairer split of Commonwealth-state funding for public hospitals and reform of Medicare to make it fit-for-purpose in the modern age.

Thank you for your continuing membership of AMA Queensland. We could not do this without you.

Read more

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ScoreCard

Supporting Queensland doctors, Creating better health

2024 Q3

16.5M Audience

MEDIA

152 New Members 54.23k Website

79

page

views

01 jul - 30 sep

AMA Queensland

395 Mentions 126 Inquiries

1,678 Member engagements

13.5k followers Social media

Ministerial, government and key stakeholder meetings

14 Submissions 39 Advocacy

Policy

2,225

member engagements

Industrial

relations

81 New employment contracts

895 member engagements

Events

Workplace

relations

2 In person 2 online 323 Total Attendees

CEO report It feels like a cliché to say that every year goes by faster with more work to do, but that has certainly been the experience at AMA Queensland in 2024.

Dr Brett Dale

Chief Executive Officer

We have had many powerful wins on behalf of patients and members, all of which were hard-fought. The new year brings new challenges – working with a new state government, a federal election by May, and a state budget in June. This Doctor Q lays out our achievements and plans for you, our members. Thank you for being part of AMA Queensland.

State election The election was held on 26 October, resulting in a change of government for the first time since 2015.

AMA Queensland Past President Dr Christian Rowan (2013-14) is now Leader of the House. The new government has set itself an impressive list of tasks for its first 100 days in office. We will hold them to account.

Read more on page 18.

2024 Achievements The first sitting week of the Queensland parliament this year brought a commitment to an independent review of sexual assault policies and processes in our public hospitals. The final sitting day saw the introduction of legislation to exempt GPs from payroll tax.

Read a list of our achievements from page 24.

Resident Hospital Health Check Our ninth annual Resident Hospital Health Check has found that junior doctors continue to be overworked and fatigued. We will be taking these results to each hospital.

We thank the hospitals that facilitated AMA Queensland and ASMOFQ visits to promote our survey – their commitment to transparency is critical to improving our public hospitals for workforce and patients.

You can read more on page 40.

Senior Active Doctors AMA Queensland Councillor and Vice President of Australian Senior Active Doctors Association (ASADA) A/Prof Geoff Hawson has an update on advocacy for doctors over 70, including representations to Ahpra on proposed mandatory health checks.

Read more on page 20.

Women in Medicine We held two Women in Medicine Breakfasts this year, most recently in Brisbane in November.

See the photos from page 12.

Workplace Relations This year has seen a raft of legislative changes that affect private medical practices – from Right to Disconnect laws to casual employees. More changes come into effect on 1 January about sexual harassment. Our Workplace Relations Team has put together some helpful guides.

Read more on page 32.

Member profile Throughout the year, we have profiled members at all career stages and in all specialties through our Meet a Member social media posts. Our final post of the year is a very impressive individual – Associate Professor Richard Lewandowski. Richard is a specialist plastic and reconstructive surgeon who specialises in repairing facial deformities in children and adults. His charity, Operation Smile Australia, has clocked up 25 years of not only performing surgery in developing countries but training the medical workforce in those countries.

Read more on page 42.

2025 It has been a big year, but there is even more to come in 2025. For the first time, we are running two Annual Conferences – a family-friendly domestic conference in Tasmania in the first week of the Easter school holidays, and our international conference in Vancouver, Canada, in September.

It has been an honour and a privilege to serve as your CEO during 2024, the 130th anniversary of AMA Queensland. I look forward to working on your behalf in 2025.

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AMA Queensland in the media Schoolies a chance for drug intervention Before the October state election, the LNP proposed to repeal Queensland’s drug diversion laws, including cancelling the pill testing trial at Schoolies in November.

This went against the advice of medical, health, legal and law enforcement experts and sparked intense media interest.

AMA Queensland President Dr Nick Yim did more than 35 interviews, reaching a potential audience of more than seven million people. His advocacy eventually saw the LNP decide to go ahead with pill testing at Schoolies – a win for patient safety and our health care system.

“We know that drug use is not good, we shouldn’t be doing it, but we know that it does happen within our community,” Dr Yim told Sunrise.

“The initial statistics already show that people who do present to a pill testing centre, 16 per cent actually dispose of those pills after getting it tested and 25 per cent actually on-refer to another healthcare professional to discuss health, drug use, alcohol use and also any other health issues they may have.”

The fixed pill testing sites are also finding that legal drugs being purchased online due to cost of living pressures are not always what people thought they were buying.

“It’s not just your stereotypical illicit drugs, your amphetamines, dexamphetamines that are being tested.

We’re actually seeing weight loss drugs, antidepressants And that’s a result of, unfortunately, the cost of living where people cannot afford medications from our regular pharmacies. They are relying on the internet,” Dr Yim told ABC Radio Brisbane.

“We know a lot of our healthcare is about prevention, and what we’re hearing from overseas is that there is a rise of synthetic narcotics, which are very strong, higher strength than morphine, and that can lead to unintended overdoses and hospitalisations, adding pressure to the healthcare system.”

Unfortunately, the LNP remains publicly committed to ending pill testing services in the state – both the permanent and future Schoolies pop-up sites.

AMA Queensland will continue to work with them to ensure public health and safety and minimise preventable pressure on our EDs.

Pill testing on Sunrise Pill testing decision needs further consideration

Payroll tax decision a win for patients After three years of fierce advocacy from AMA Queensland, the LNP made a pre-election commitment to exempt GPs from payroll tax if they win government.

Less than a fortnight after the LNP commitment, the Labor government also made the same commitment, ensuring the new tax would not be imposed no matter who won the 26 October state election.

AMA Queensland Immediate Past President Dr Maria Boulton welcomed the news in the media, acknowledging it will reduce costs and improve access to primary care for patients throughout the state.

Within seven days of being sworn into office, the new LNP Queensland Government began the legislative process of exempting GPs.

“We know that it will make a difference for people who are having issues accessing their GP,” Dr Boulton said.

“Medicare rebates are woeful. We know that they have not kept up with the cost of providing services, and we’re looking on the federal government to increase them. But certainly this will make a huge difference, particularly in Queensland where the payroll tax rate is not insignificant.”

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Doctor Q | Summer

The decision gives both GPs and patients certainty. AMA Queensland continues to call for an exemption for all private medical practices.com.au/qld/news/Concernsremain-around-physician-assistant-proposal Payroll tax doorstop Payroll tax move welcome

RHHC reveals junior doctors are concerned for their safety AMA Queensland’s ninth annual Resident Hospital Health Check released on Friday 15 November revealed that almost one in three junior doctors in Queensland hospitals feel unsafe in their workplaces.

Committee of Doctors in Training (CDT) Chair Dr Elise Witter spoke to the ABC about her personal experience working in Queensland hospitals - specifically, how she felt safer working in a prison than in a Queensland hospital emergency department.

“Working in the ED, I’ve had things thrown at me, patients punch holes in the walls, I’ve been slapped by a patient.

It’s not unusual for these events to happen at work.

Obviously, that’s the more extreme end. There’s also verbal abuse from patients and other factors as well,” Dr Witter said.

While there are systems in place to deal with inadequate workplace conditions, junior doctors do not feel they are sufficient.

“We very rarely have structured debriefing available to people who experience incidents like this. And there’s variable support or follow-up available,” she said.

Get involved Get involved

“In terms of prevention, again, there’s variable strategies in place for prevention. There certainly needs to be more done in terms of security and building environments with things like CCTV and exit doors so that people can be safer at work.”

Other issues reported include burnout, lack of resourcing, fatigue-associated error and bullying.

AMA Queensland will meet with every Hospital and Health Service in the report to outline the results and offer practical actions to address issues.

Junior hospital doctors concerned for their safety Australian Medical Association Queensland survey finds junior doctors feel unsafe and fatigued at work

If you’d like to put your hand up to speak to media on particular current issues, please call our Media Team on 07 3872 2222.

If you’d like to be a part of any upcoming social media campaigns, or would like us to highlight your workplace or practice, please call the Social Media Team on 07 3872 2222.

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Nicole White, Isobel Walker and Kathryn Heyworth

Vicki Yeung, Erin Kim, Shaelene Hancock and Cara Lynch

Speaker Dr Mellissa Naidoo making an entrance on the pink carpet

AMA Queensland Councillor Dr Erica Gannon, Chief Medical Officer Dr Catherine McDougall and AMA Queensland President Dr Nick Yim

Drs Helena Franco, Michelle White and Catherine Burns

Speaker Dr Marlene Pearce

Drs Fiona Raciti, Alison Green, Erica Gannon, Maria Boulton, Catherine McDougall, Eleanor Chew, Jillann Farmer and Katie Panaretto

Keynote speaker and AMA Queensland Vice President Dr Emilia Dauway

Kirsty Broun, Eugenie MacMillan and Clare Denver

Women in Medicine Queensland’s illustrious women in medicine came together for our annual Brisbane breakfast to hear more about inspiring change. We hope their stories have motivated and inspired you. It was wonderful to watch everyone networking, catching up and making new connections.

Our speakers for the morning included:

Keynote speaker - AMA Queensland Vice President Dr Emilia Dauway

Event MC and AMA Queensland Board Chair Dr Eleanor Chew OAM

Panel host - AMA Queensland Immediate Past President Dr Maria Boulton

Panellists:

Queensland Health Chief Medical Officer A/Prof Catherine McDougall

Specialist Medical Administrator Dr Mellissa Naidoo

AMA Queensland Councillor Dr Katie Panaretto

Locum Emergency GP and A Better Culture CEO Dr Jillann Farmer

Executive Director of Medical Services, Sunshine

Coast Hospital and Health Service Dr Marlene Pearce

Speaker, post-event session -

Directors Australia CEO Kerryn Newton

With your help purchasing flowers and raffle tickets, we raised $7,841 for Restore more!

We would like to acknowledge the support of our generous sponsors: Cutcher & Neale Accounting and Financial Services Cutcher & Neale Residential and Commercial Finance Doctors’ Health Doctors’ Health in Queensland Hillhouse Legal Partners MDA National Avant

Healthscope Summer | Doctor Q

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Drs Alan Wallace, Brett Dale, Chris Cuneen OAM with Gary Smith AM on the panel for AI brainstorming.

Drs Sybill Kellner and Eleanor Chew OAM

Dr Linda McQueen, Rob Parker and Dr Kathryn Harger

Dr Eleanor Chew OAM, Prof Chris Perry OAM, Mrs Faedra Kalligerou, and A/Prof David Colquhoun

Dr Jim Kyranis and Irene Kyranis

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Doctor Q | Summer

Past President Prof Chris Perry OAM, President Dr Nick Yim and CEO Dr Brett Dale

Annual International Conference Dinner at the Divani Palace Acropolis Hotel

From discussing robotic surgery to spectacular sunsets, this year's AMA Queensland Annual Conference in Athens was a huge success.

From the welcome function overlooking the Acropolis on Sunday night to the Soapbox session on Friday, delegates were informed, entertained and energised.

Standouts included: he role of AI in healthcare: pivotal role in T diagnosis, remote monitoring, advanced diagnostics and robotic surgery, how the Queensland government is using AI and how doctors can use AI in their practice. Presented by Drs Brett Dale, Chris Cunneen OAM, Alan Wallace and Gary Smith AM. ustralian and Greek healthcare issues: A collaboration with AMA Queensland members and the Athens Alzheimer Association discussing healthcare issues, the Mediterranean diet, CVD prevention, the nutrition link to Alzheimer's and health systems in both countries and how they are working to fix challenges. Presented by Drs Eleanor Chew OAM and Fedra Kalligerou, A/Prof David Colquhoun and Prof Chris Perry.

Drs James and Janeane McKeon

Accreditation: improving healthcare quality and patient safety through accreditation and consumer feedback. Presented by Adj A/Prof Tina Janamian and Gary Smith AM from AGPAL and practice owner and manager Madeline Jammal, the AAPM representative on the RACGP Expert Committee – Standards for General Practice.

Breast preservation: a modern approach to breast cancer and patient treatment. Presented by AMA Queensland Vice President and breast cancer surgeon Dr Emilia Dauway.

Busy conference sessions

Senior doctors: research into the importance of advocating for supportive policies and resources for senior practitioners with practical implications for healthcare systems and policy makers. Presented by researcher Rakiza Hussein. edicinal benefits of wine since ancient Greece: M a fun session to end the week with the history of Greece’s ancient wine culture and its modern rebirth through its exciting indigenous grape varieties.

Presented by Dr Roslyn Seeney.

Cultural dinner experience: with traditional Greek cuisine, dancers and music – a night we will never forget created by Orbit World Travel Thank you to everyone who joined us and thank you to our sponsors: Cutcher & Neale Accounting and Financial Services, Hillhouse Legal Partners, Orbit World Travel (AU) and AMA Queensland.

Guests enjoyed some wonderful entertainment with Greek dancers and plate smashing

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Member Networking Brisbane Brisbane members and guests joined us at AMA Queensland offices for drinks, platters and a discussion about local issues.

Dr Eleanor Chew OAM, Erin O’Donnell, A/Prof Geoff Hawson and Dr Andrew Cronin

Members and guests joined us at Hunstanton to catch up, enjoy a drink and hear a policy update from AMA Queensland Vice President Dr Emilia Dauway. Craig Hong from Hillhouse Legal Partners gave us the latest legal news, while Phil Manser from Wine Direct showcased premium wines.

Thank you to our sponsors for the event:

Hillhouse Legal Partners Wine Direct Drs Ben van Haeringen and Michael Wyld

Drs John Whitchurch, Robert Taylor and Graham McNally

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Vice President Dr Emilia Dauway and Hillhouse Legal Partner Craig Hong

Drs Mia Crous, Tereza Stillerova, Edward Benson and Jasraaj Singh

Drs Kim Hansen and Dr Sanjeev Naidu Celebrating Crazy Socks 4 Docs Day

Dr Nick Yim (right) congratulates 50 year members Drs Michael Williams and Ross Phillipson

Dr Nick Yim (right) congratulates 40 year members Drs Ross Stinton, Christopher Cunneen OAM, Terence (Terry) Coyne OAM, John Buckley and Michael Kennedy

Dr Nick Yim (left) congratulates 30 year members Drs Meg Cairns and Janet Draper

Dr Nick Yim (left) congratulates 20 year members Drs David King, Sarah Coll, Su Mien Yeoh and Siaw Kang (Chris) Ho

Dr Nick Yim (left) congratulates 45 year member Dr Thomas McEniery

Dr Nick Yim (right) congratulates 35 year members A/Profs Geoff Hawson and Simon Bowler and AMA Queensland Past President Dr Shaun Rudd

Dr Nick Yim (left) congratulates 25 year members Drs Jim Griffin, Sybil Kellner, Abbas Hussein and Petar Vujovic

Membership milestones celebrated Every year AMA Queensland recognises dedicated doctors who have been members for decades with a special breakfast and certificate to mark their years of service.

It was an honour to host long-term AMA Queensland members and their families and friends at a special Membership Milestone Breakfast in Brisbane on 15 November.

This event celebrates doctors who have combined their care for the community with their passion for advocacy by joining and remaining as members of AMA Queensland for decades.

It was particularly special to acknowledge two members who have been with AMA Queensland for 50 years.

AMA Queensland is a member association.

Our members are, and will always be, our most precious resource. We thank all of you for your support.

40 year members Drs Chris Cuneen OAM and Dr Terry Coyne OAM

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2025 and a new state government A tumultuous state election campaign came to end on 26 October, resulting in defeat for Labor and the first LNP state government since 2015.

As predicted, health was a major campaign issue and AMA Queensland kept the pressure on both major parties with the release of both the Surgical Wait List Roundtable Action Plan and the Election Priorities document, which outlined 17 key areas for the healthcare system.

Both parties made publicly identifiable commitments in 13 of the priority areas, and in the final week of the campaign, we released our Election Scorecard, rating the promises made by both the Labor government and LNP opposition.

The parties were neck and neck, with both parties committing to major growth in the healthcare workforce, exempting GPs from the new interpretation of payroll tax, and no changes to existing termination of pregnancy laws.

The new government has set out an ambitious agenda for its first 100 days in office. Depending on whether the count started on the day after the election or when the full Cabinet was sworn in, the 100-day mark will fall between 4 and 9 February 2025.

Legislation enshrining the payroll tax exemption was introduced into parliament on the last sitting day of the year, along with an administrative arrangement ensuring the exemption applied immediately while the Bill makes its way through the parliamentary process.

This is a great victory for AMA Queensland.

Importantly, the change to Queensland law rules out tying the exemption to bulk billing rates, as some other jurisdictions have attempted. It also specifically includes GP Registrars – something that only AMA Queensland recognised as an issue and called for action on.

We are optimistic that the Queensland law change will take effect in other states under tax harmonisation arrangements.

Controversially, new Premier David Crisafulli dropped bombshell legislation banning any discussion of termination of pregnancy laws during this parliamentary term.

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Doctor Q | Summer

The LNP promised to increase the Queensland healthcare workforce by 32,400 by 2032. However, we are disappointed and shocked that in the final sitting week of parliament for 2024, Health Minister Tim Nicholls confirmed that the Workforce Attraction Incentive scheme would be scrapped, with no alternative proposed to recruit and retain regional healthcare workers.

AMA Queensland has called for this scheme to be expanded, not axed.

If the scheme has not worked as intended, the government should consult with medical bodies on how it can be fixed.

Workforce is the number one issue facing our health system and the new government has pledged to find 32,400 new health workers by 2032. We cannot do that without incentives.

AMA Queensland was disappointed by the LNP pledge to cancel pill testing at Schoolies Week on the Gold Coast.

That decision was reversed, but for 2024 only with the government vowing to undo drug law reforms introduced in 2023.

New Health Minister Tim Nicholls has announced that contracts for the two fixed pill testing sites is unlikely to be renewed in 2025, and it is likely the drug diversion program for people caught with small amounts of illicit substances for personal use will be rescinded.

More than 7,000 people were diverted away from the legal system and into healthcare in this scheme’s first year, freeing up courts and law enforcement for more serious offences.

AMA Queensland will advocate for pill testing and the diversion scheme to remain.

More than 1,000 young people visited the testing site at Schoolies and while only 27 presented substances for testing, it was an opportunity for them and their friends to talk to a healthcare worker about the potential harms of drug and alcohol use.

We look forward to working with the new government and opposition in 2025 for the best interests of our community.

Fluoride decision abandons vulnerable Queenslanders One in 10 Queenslanders do not have enough functional teeth to chew food. Adding fluoride - a naturally occurring mineral - to water supplies has been proven for 70 years to be safe and effective in preventing dental decay.

The decision by six Cairns councillors to vote against reintroducing fluoride to the local water supply goes against decades of scientific evidence and abandons vulnerable people who cannot afford dental care or healthy food.

“AMA Queensland thanks Councillors Anna Middleton, Trevor Tim and Rob Pyne for their passionate advocacy for this incredibly safe, proven health measure,” AMA Queensland President Dr Nick Yim said.

“Fluoride is a naturally occurring mineral that is found in all natural water supplies at some concentration. The benefits of adding it to water supplies at about 1 part per million – between 0.6-0.8 mg/litre - have been proven since the 1940s.

“Fluoride helps prevent tooth decay, particularly in children’s teeth as they are forming. It helps reduce dental decay in adults.

“Since 2012, when the state government handed responsibility – including financial responsibility – to local councils for fluoridating water supplies, we have seen fluoridation coverage fall from 90 per cent of Queenslanders to just 70 per cent – the lowest in Australia.

“One in 10 Queenslanders do not have enough teeth to chew food.

“This is another case of regional inequity. The 11 council regions in Southeast Queensland have fluoridated water through SEQwater, but regional and remote council areas have stopped fluoridation, mostly as a cost measure.

“It is disappointing to continue to see a healthcare divide between the city and regional areas.

“It is important for elected leaders to make decisions based on scientific evidence and from medical and dental experts.

“The state government should assist councils with the costs of fluoridating their water supplies as a simple preventative health measure.”

AMA Queensland and the Australian Dental Association Queensland have written a joint letter to the relevant Ministers and all councils in Queensland, raising concerns about the increasing prevalence and severity of oral disease, particularly among children.

Read the correspondence

Summer | Doctor Q

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Health checks for late career doctors

The evidence for MBA health checks for late career doctors is lacking and raises concerns about ageist policy.

The Medical Board has proposed a change to the registration standard for doctors aged over 70 with mandatory three-yearly ‘health checks’ up to age 80, then annually. Although described as ‘general health checks’, the assessments go beyond a general check, are extensive, and include health and lifestyle questions and formal cognitive assessment.

Read more While the MBA has stated health checks are between the doctor and their medical practitioner, the regulator has asked what role they should play in the checks, whether information should be shared with the Board and implied that other health professionals may be involved in assessing. Without privacy and confidentiality provisions in record keeping and access within practices, there is potential for misuse and leakage of assessment results.

In the case of a complaint, will doctors be required to provide their health check information as evidence of their level of competency, or an assessing doctor be asked to release information?

Cognitive testing is highly problematic The suggested cognitive screening tests are diagnostic tests in individuals considered to have mild cognitive impairment (MCI). Their use as large scale screening tests in low prevalence MCI groups lacks support and positive and negative predictive values are unknown. The increase in false positives will incorrectly diagnose MCI, with a number of doctors having their registrations impacted, being subjected to further assessment and experiencing personal and professional stress.

Mandatory testing is likely to exacerbate underperformance, particularly when the testing is seen as punitive and used to establish baselines against which future performance is to be measured, as in the MBA recommendation. Distinguishing between underperformance due to impairment and underperformance due to aged-based stereotype threat (ABST) is problematic.

Unsubstantiated complaints (notifications) are not evidence of impairment The MBA argument is concerning as it rests on notifications to Ahpra. Notifications remain unsubstantiated until assessed and, if necessary, further investigated. A complaint in itself is not evidence of impairment, nor any other behaviour or condition and it is misleading to imply levels of impairment from

20 Doctor Q | Summer

complaints ‘data’. Unsubstantiated complaints data are often published without caveat, regardless of the level of veracity, and regardless of the outcome of the complaint.

For 2023, only 5.7 per cent of all registered doctors in Australia had a complaint made against them and the majority were discontinued (70-85 per cent, depending on source). In 2023, an estimated 90 doctors over 70 had notifications with Aphra leading to regulatory action, representing 1.29 per cent of all doctors over 70 registered in Australia (6,975). None had their registration cancelled or suspended.

A 2022 Senate inquiry into notifications management by Ahpra reveals the potentially devastating impact: “The impact the notifications process has on the health and wellbeing of practitioners is disproportionate to the risk to public safety.” The RACGP has documented the effect of complaints and protracted Ahpra processes on doctors, their practices, and their wellbeing, including suicide.

Errors and biases in portrayal of late career doctors A detailed analysis undertaken by ASADA reveals a concerning range of errors and biases in the MBA document. Notifications data has been reported in a way that exaggerates the issue, misleads the profession and the public, and undermines confidence in late career doctors. Selective reporting and use of references paints a biased picture upon which the profession and the community have been asked to form an opinion.

Read more The analysis identifies inconsistencies in the numbers for categorised notifications between the MBA document and the Ahpra Annual Report Tables; biased presentation of data in regard to numbers of notifications and rates; reporting of relative rates without reference to absolute numbers or frequencies; and a failure to distinguish between the number of notifications and the number of doctors with a notification.

A further concern is the misrepresentation of findings from several references. For example, four of the references that are used to show ‘impairment’ in older doctors actually report an increased notification risk for IMGs. This important fact has been omitted. References used to argue cognitive decline with age lack recency, reliability, and support from contemporary research on ageing.

The use of relative ratios without absolute numbers The MBA argument relies on the use of relative incidence (risk) ratios to describe differences between younger and older doctors. As doctors are aware, relative risk is known to statistically inflate the prevalence of issues, particularly when applied to small numbers. The MBA has emphasised the Thomas et al. report that doctors over 65 are 15.54 times more likely to receive a physical illness/cognitive decline complaint. When viewed in the light of absolute numbers this ratio is misleading.

A/Prof Geoff Hawson AMA Queensland Senior Doctor Representative and Australian Senior Active Doctors Association Inc Vice President

For doctors over 65, 4.5 per cent or 72 of the complaints were categorised as physical illness/cognitive decline.

An estimated 0.98 per cent of doctors in the study received this notification. Not reported is how many led to regulatory action. For doctors aged 36-60 years, 0.4 per cent or 45 of the complaints were for this category.

In absolute terms, there were 1.6 times the number of doctors in the older group with a physical illness/cognitive decline notification, but no information regarding veracity or outcome.

Not reported in the MBA document is the notifications categorised as mental illness and substance misuse.

These comprised 3.4 per cent of the complaints for doctors aged 36-60 with an estimated 383 doctors receiving a complaint versus 1.5 per cent for doctors aged over 65 with an estimated 24 doctors receiving a complaint. In absolute terms, there were 16 times the number of doctors in the younger group with a notification for mental illness and substance misuse.

Given the much larger number of doctors aged 36-60 who had mental illness and substance misuse notifications, and if public safety is the primary concern of the regulator, why not introduce mandatory drug testing for younger doctors? Or psychiatric assessments for this group?

Not reported is that 86.8 per cent of doctors aged over 65 did not receive a notification during the target period compared with 84.2 per cent of doctors aged 36-60 years and that only 8.5 per cent of notifications for all doctors led to regulatory action.

Conclusion A very small percentage of late career doctors are subject to complaints (notifications) leading to regulatory action. Mandatory imposition of health and cognitive assessments for all late career doctors is unwarranted, disproportionate and ageist, and likely to cause stress and test underperformance. Cognitive tests lack norms for doctors, with questions about appropriate cut off scores. Highly experienced senior doctors will leave the profession, exacerbating current and projected medical workforce shortage. Mechanisms already exist to identify impaired practice in doctors of all ages. Current GP health checks in the context of a trusted relationship take into consideration far more nuanced information and a sensitive approach to health issues.

Summer | Doctor Q

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Ahpra agrees to leave fee relief Following a year-long campaign by AMA Victoria, Ahpra has agreed to a 30 per cent rebate on annual registration fees for practitioners who take parental leave comes into effect on 1 July 2025.

The rebate applies to all forms of protected leave, including disability and carers’ leave.

AMA Victoria President Dr Jill Tomlinson gathered almost 3,800 signatures on a petition that stated: “Ahpra must operate a fair and equitable fee setting policy to enable a flexible and responsive health workforce.

Failing to provide reduced fees for practitioners on parental leave shows that Ahpra doesn’t ‘walk the walk’ when it comes to principles of equity.”

Previously, Ahpra and the Medical Board did not offer reduced registration fees during periods of extended or parental leave. There is no reduction in registration fees for practitioners who work part-time, or for those who are on reduced incomes or under significant financial hardship.

“This is not simply unjust (because only those who can afford to pay will stay registered, while others drop out), but inefficient. A practitioner who is not seeing patients poses a much lower risk and consequently much lower costs to regulate,” Dr Tomlinson said.

Ahpra does provide “non-practising registration” for practitioners on extended leave, but Dr Tomlinson argued this is not fit-for-purpose for those on parental leave, due to a restrictive and complex re-registration process.

“Non-practising registration removes practitioners’ ability to engage in any work activities — such as locum shifts or ‘keeping in touch’ days. It also burdens practitioners with significant re-registration delays of weeks to months,” she said.

On the news today that Ahpra agreed to the rebate, Dr Tomlinson responded: “I welcome Ahpra’s efforts to introduce equity for practitioners on parental leave and with legally protected attributes including parental or carer responsibilities, and disability.

22 Doctor Q | Summer

“It’s notable that the review Ahpra has conducted does not consider the principles of equity more broadly, and is limited only to legally protected attributes. Consideration of practitioner income levels would deliver a more equitable approach, and a more fulsome achievement in embedding the principles of equity and providing for a flexible workforce. Such an approach is used widely within medicolegal indemnity, although income is not the only measure considered by those organisations in premium determination; risk is also relevant. I am hopeful that Ahpra’s next project will address these broader considerations.

“A retrospective rebate in the registration period after leave is not the most desirable long-term approach to fee relief but it appears that this approach is being used because Ahpra currently doesn’t have the capability to offer a pro rata approach. I welcome Ahpra’s acknowledgement that a pro rata approach “may improve the practitioner experience with fees”. The quantum of 30 per cent is proportionately low where the bar is a period of leave of at least 50 per cent, but could be 100 per cent, of the duration of the prior registration year.”

Dr Tomlinson called for: the 30 per cent retrospective rebate to only be an interim measure while Ahpra undertakes further work to embed the principles of equity in its fee setting arrangments Ahpra to commit to implementing pro rata fees once it develops the capability Ahpra to commit to developing the capability and providing an implementation timeline Ahpra to document clear guidelines for staff and practitioners of the intended and appropriate purposes of non-practising registration, as non-practising registration is not fit for purpose as an option for registration during parental leave.

Doctors and their role in tackling family violence As always, there is a great deal happening in health regulation, through reform and growth. We have over 922,000 registered health practitioners in Australia, of which approximately 22 per cent are in Queensland.

Currently, Ahpra and National Boards and other health practitioner regulators are shining the light on family violence. Together, we have issued a joint statement reminding practitioners of the critical contribution they can make in Australia’s response to tackling family violence.

The statement recognises the role of regulators in the collective effort to end family violence by supporting victim-survivors, setting clear expectations of health practitioners, taking regulatory action as appropriate and condemning all forms of family violence.

Health practitioners are often the first point of contact for victim-survivors, so play an essential role in the early detection, support, referral, and delivery of specialised treatment to those experiencing family violence.

It’s a timely message following the 16 Days of Activism against Gender-Based Violence Against Women annual international campaign, which ran from 25 November, the International Day for the Elimination of Violence Against Women, and ended on 10 December, Human Rights Day. Each year, Queensland recognises 16 Days of Activism Campaign to send a clear message that gendered violence will not be tolerated, and that our community will strive for promotion and protection of women’s rights, interests and wellbeing.

It draws inspiration from the global movement for 16 days of activism to drive a change in culture, behaviour and attitudes that lead to violence against women and their children. While government leadership is critical, ending family violence is everybody’s business.

Queensland Medical Board of Australia chair Dr Philip G Richardson reflects that health practitioners’ own conduct, as well as that of their colleagues, must reflect the trust and confidence the public places in them for safe healthcare.

“As regulators, we work to ensure health practitioners are safe, ethical, and professional for the protection of the public. We respond in a trauma-informed way. This means minimising the risk of adding to victim-survivors’ trauma or exposing them to further risk of harm,” Dr Richardson said.

Perpetrating family violence is a departure from the standards of behaviour expected of health practitioners.

They may face regulatory action including suspension, cancellation, the imposition of conditions, or refusal of registration.

The joint position statement on family violence by regulators of health practitioners can be viewed here.

Support is available if you or someone you know is experiencing family and domestic violence.

A comprehensive list of Queensland help and support options is available via here. If you or someone you know is in immediate danger, call 000.

AMA Queensland welcomes the unprecedented statement from the nation’s health practitioner regulators condemning family and domestic violence and acknowledging the essential role doctors and other healthcare workers play in tackling this scourge.

“Family violence is unacceptable in all forms,” AMA Queensland President Dr Nick Yim said.

“GPs can be the first to identify the signs of an abusive or coercive relationship.

“The family doctor’s relationship of trust with their patients lets them support victim-survivors, encourage them to seek help from specialised services, and refer them to mental health support.

“This is a major social issue and we acknowledge the important work of the former state government in criminalising coercive control behaviours and sexual offences like stealthing.

“We support the regulators’ commitment to ensuring that health practitioners who perpetrate family violence face serious consequences, including having their registration cancelled or suspended.

“AMA Queensland’s charitable arm, AMA Queensland Foundation, is partnering with family and domestic violence support services this year.

“Through the ongoing support of generous donors, a Charity Gala in August and its Christmas Appeal, the Foundation has raised $140,000 so far.

“We must tackle this scourge on our society and change behaviours.”

The AMA Queensland Foundation’s Christmas Appeal is raising money for family violence support services.

Donate now

Summer | Doctor Q 23

Snapshot of 2024 achievements Here is a snapshot of our achievements we’ve secured for AMA Queensland members during 2024.

Payroll tax

Hospitals

Mental health and wellbeing

Queensland is the only state or territory to have achieved an exemption for GPs from payroll tax. The legislative process began in November. We hope this will be the trigger for tax harmonisation across Australia. We will continue to advocate for the exemption for all medical practices.

Implementation of AMA Queensland Ramping Roundtable Action Plan recommendations including patient flow and discharge initiatives, virtual ED, rapid access services, extended hours for medical imaging and allied health, electronic rostering and transit lounges.

Qld Health staff wellbeing laws to make HHSs and their boards responsible for promoting a culture and implementing measures to support the health, safety and wellbeing of staff.

Workforce

Patient Care Facilitators to ensure patients discharged from hospital see their GP within seven days to improve outcomes and prevent readmission.

Surgical Wait List Roundtable Action Plan to address inequitable access to elective surgery for regional patients.

Workforce Attraction Incentive Scheme for interstate and international doctors to relocate to Queensland ($10K-$70K each; $40M expansion). $40,000 General Practice Trainee Grant Program (2 years; $24M).

Grants for 50 GPs to upskill in obstetrics and anaesthetics ($5.25M).

International Medical Graduates Technology QScript look-up exemptions for patients in hospital and other settings, including in RACFs. Digital Passports for all Queensland Health staff and internal locums for key specialties and regions. This must now be implemented as a priority and locum opportunities extended to all Queensland Health staff.

Vaccinations Free Meningococcal B and RSV vaccines and ongoing funding for influenza vaccinations.

We are working to convince the new state government to renew the free influenza vaccine program for 2025.

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Independent review into sexual assault policies and procedures at public hospitals.

International Medical Graduate (IMG) recommendations submitted to the Queensland Government to improve supports for this valuable medical cohort. The recommendations are also being considered for progression

by AMA’s IMG Working Group (WG).

The AMA Queensland IMG WG prompted the formation of the federal AMA IMG WG. The WG will recommend actions the AMA can take to advocate for pathways to support work participation and career progression and provide advice on how to ensure membership of the AMA is relevant to IMGs.

Aged and end-of-life care

First Nations health

Increase to the palliative care eligibility access period for all services from three months to 12 months and improving access to the Medical Aids Subsidy Scheme (MASS); continued funding for the Specialist Palliative Care in Aged Care (SPACE) program; and $18M for voluntary assisted dying services.

First Nations funding for AMA Queensland health partners including the Institute for Urban Indigenous Health and the Queensland Aboriginal and Islander Health Council.

Fought for your safety Conducted the ninth Resident Hospital Health Check, evaluating employment conditions and wellbeing among doctors in training across Queensland.

LGBTQIASB+ Health Tobacco/vaping Introduction of amendments to Queensland legislation to restrict the availability and sale of vaping products.

Sustainability AMA Queensland-Queensland Health Sustainability Summit to promote adoption of climate actions, including emission reporting and targets and a sustainability champions program within all HHSs. Active Travel Position Statement to improve public health and reduce emissions.

Drug laws Drug law reform to implement a three-tier drug diversion program for limited quantities of illicit drugs and pharmaceuticals, ensuring a health rather than criminal justice approach.

Sustainable Events Guide to help shape our efforts to mitigate the impact of AMA Queensland’s activities on the climate and carbon emissions.

Funding of $6.8M in the State Budget for gender affirming care that is tailored and more accessible for this community.

Hospital Infection Controls The former CHO committed to visiting Queensland Health facilities to discuss current arrangements with staff. Unfortunately, he did not finish these consultations or inform us of their outcomes before announcing his resignation.

Federal AMA will take up this work with the new CHO.

Summer | Doctor Q 25

Federal AMA achievements

Food labelling

MBS

Ethics

Key changes to the Health Star Rating (HSR) system in Australia have been announced.

In May the AMA welcomed the new Health Insurance Legislation Amendment Bill (Assignment of Medicare Benefits) Bill 2024 — a key step towards fixing out-of-date assignment of benefit rules under the Health Insurance Act. The Bill was passed in July.

In February the AMA made a submission to Treasury calling for a ban on the use of genetic testing in life insurance underwriting, with AMA President Professor Steve Robson appearing at a press conference with Senator David Pocock and Mr Kylea Tink to advocate further for a ban.

Professor Robson later spoke about the need for ban at a Senate inquiry hearing. In September Assistant Treasurer Stephen Jones announced a total ban on genetic discrimination in life insurance.

GP chronic disease management items In September the AMA succeeded in having reforms to GP chronic disease management items delayed allowing time for further discussions about funding for the items. The AMA remains strongly committed to the reforms being introduced in 2025.

Submissions and position statements This year AMA Federal lodged more than 44 submissions to parliamentary inquiries and consultations from departments and regulators on key issues that impact our members; and published six position statements, with work underway to update several others.

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The AMA had called for changes to the Act to bring it in line with modern practices, including removing statutory requirements for patients to have to sign paper-based forms when assigning their Medicare benefit. We continue to work with the Department of Health and Aged Care to design more relevant rules that will do away with the requirements for paper-based forms and provide much greater flexibility in how assignment of benefit can be demonstrated.

Advocacy in action AMA Federal had more than 400 meetings with politicians, political staffers, government departments and stakeholders and wrote 2360 pieces of correspondence.

Video telehealth items In June the AMA welcomed the release of a new report that drops an earlier interim recommendation to remove video telehealth items for initial consultations with non-GP specialists. We provided a strong initial submission to the consultation opposing this recommendation and met several times with the department.

We issued more than 80 media releases attracting extensive media coverage on our advocacy asks.

Supporting Queensland doctors, creating better health.

RENEW FOR Medicines and Medicare

Private health

60-day dispensing

In late 2023, the AMA hosted a workshop on the private health system with key stakeholders including ministerial advisers and senior departmental staff in attendance. One of the key outcomes was the need for a detailed exploration of sustainability issues in the private hospital sector. This year the government conducted a financial viability health check of private hospitals which the AMA President participated in through the CEO’s forum. Almost 2000 AMA members contributed to this work through our member survey.

In March AMA Federal welcomed the second stage of the 60-day dispensing. The introduction of 60-day dispensing followed a concerted campaign by the AMA to introduce the PBAC-recommended change. The second stage means doctors are now able to write 60-day prescriptions for close to 100 additional medicines for health conditions like diabetes, epilepsy, breast cancer and menopause.

Sildenafil 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.

IV fluid shortages 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.

2025

Protheses list Years of AMA advocacy on prostheses list reforms resulted in the win to retain general use items.

Medicover scheme AMA intervention saw HCF fix a problem which had prevented surgical assistants with limited or provisional Ahpra registration from accessing HCF’s medicover scheme.

Nib known gap The introduction of 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.

Summer | Doctor Q 27

A medical practitioner could experience adversity at any stage in life...

MBAQ Can Help FINANCIAL ASSISTANCE FOR DOCTORS

(07) 3872 2222

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mbaq@amaq.com.au

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www.mbaq.org.au

Managing and responding to violence in the medical workplace It is a sad reality for many frontline doctors that they may become a victim of violence and aggression at any moment.

We often care for patients and their families at stressful and traumatic points in their lives. Feelings of frustration, confusion and anger are understandably common lifeand-death situations.

However, when this frustration leads to violence and aggression, it places patients, healthcare workers and non-clinical staff lives at risk.

We are seeing cases of violence becoming more prevalent in public hospitals, as widespread ambulance ramping, bed block and delays caused by the logjam crisis deepen.

Responding to the rising threats of violence against doctors, we have developed a new position statement — Managing and responding to violence in the medical workplace.

While the AMA has an existing suite of position statements relating to safe work environments, this is the first position statement to offer a comprehensive approach to violence in the medical workplace, particularly public hospitals.

The World Health Organization estimates up to 38 per cent of medical professionals will suffer from physical violence at some point in their careers.

And Safe Work Australia regards healthcare as an industry with an elevated risk of workplace violence, with some estimates predicting that up to 95 per cent of Australian healthcare professionals have experienced the effects of physical violence and/or verbal abuse.

Doctors and healthcare staff who fall victim to workplace violence not only risk serious physical injury, but also profound psychological impacts such as anxiety and decreased job satisfaction. It is also proven to have negative impacts on patient outcomes.

It is in absolutely everyone’s best interest to eliminate violence in medical workplaces.

This is why the AMA is going on the front foot, taking a leadership role in addressing this crisis.

Our latest position statement offers practical measures hospitals and other medical workplaces can implement to reduce the risk of violence. Some measures will be obvious and familiar to you — things like educational material to be shown to patients, informing them of notolerance policies, and making physical adjustments to include unimpeded exit points and video surveillance.

But, crucially, the position statement advocates for a shift in culture and management processes to reduce the risk of violence in the workplace.

Our position statement endorses recent changes to state legislation in South Australia and Queensland that place the responsibility of staff psychosocial wellbeing onto the boards of hospitals, and we encourage this change across all jurisdictions.

While everyone has a role to play in ensuring safety, this change is important because it encourages a top-down, systems-based approach guided by those in medical leadership positions.

The position statement also stresses the importance of post-incident support — both immediately and longer term — and the benefits of risk audits to assess the level of risk in your workplace and the appropriateness of mitigation measures.

Violence in medical workplaces remains under-reported and poorly studied, in part due to perceptions that violence is an inherent part of the job. Violence is absolutely unacceptable, and everyone deserves to be safe at work. A change of mindset is needed, whereby a culture and system of reporting, monitoring and evaluation of incidents is embedded.

Don’t get me wrong, governments have a huge role to play here too, and our position statement calls on governments to invest in continuous monitoring and evaluation mechanisms to enable medical workplaces to report incidents with confidence.

There are major benefits in deidentified data being made available to state and federal authorities, encouraging collaboration on research relating to violence in medical workplaces and pursuing evidence-based solutions.

We call for all state and territory government to place greater protections on all medical professionals.

While our latest position statement is primarily focused on hospital settings, the principles are also applicable to other medical workplaces, such as private practices, general practice clinics and other community settings.

It is our hope this position statement can spark longoverdue, serious discussions about violence in medical workplaces. I encourage you all to read the document and consider how you can help be part of the solution.

Read the position statement

Summer | Doctor Q 29

Dr Danielle McMullen AMA Federal President

Scope of practice review – the Good, the Bad and the Ugly After a year of discussion papers and countless workshops and meetings, the final report of the Scope of Practice Review was finally released in early November.

The 194-page report contains 18 recommendations ranging from sensible, small reforms through to others I would politely refer to as ‘questionable’.

Federal Council meeting. We also discussed the review regularly with the GP colleges and other groups to ensure alignment in our positions.

Titled Unleashing the Potential of our Health Workforce, one of our major frustrations with this review from the start has been its title, and the assumption that all regulation is bad — that ‘leashes’ are just turf protection, rather than patient protection.

In discussions with the federal government and the Department of Health and Aged Care, we have explained the risks with many of these recommendations, such as fragmented care. Sometimes I feel like a broken record in these meetings explaining that we need to invest in and support general practice, not eternally fund programs that only circumvent general practice, inevitably cost more, and are less efficient. We will continue to press this message.

Above all, there has been failure to answer the question of who should hold the leash.

We firmly believe that decisions about scope of practice and workforce should be made by independent, expert bodies, with robust processes — not politicians with kneejerk reactions.

The AMA recognised the potential threats to patient care posed by the review and was strongly engaged in the review through three public submissions and a confidential submission to the draft final report.

We also provided a detailed literature review on the international evidence on non-medical prescribing. This showed autonomous prescribing is not as prevalent or successful as other stakeholders would have you believe.

We met with the lead reviewer, Professor Mark Cormack on many occasions, including inviting him to an AMA

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I won’t detail all 18 recommendations, but I want to highlight a few that we are particularly concerned about and will continue to advocate against.

Recommendation 3 is to amend the Health Practitioner National Law to grant health ministers the power to give Ahpra and National Boards even greater policy direction on registration and accreditation functions.

We strongly oppose this on the principle that the regulation of health professionals exists to protect the community and ensure the highest standards of care for patients, and this is not something that politicians should be meddling in.

As we repeatedly highlighted in our submission, Australia has processes for reforms to scope of practice that are independent and consultative. The problem is these are regularly overridden by state and territory health ministers.

This leads to the absurd situation where scope of practice is now determined by political promises during election campaigns rather than independent bodies with expertise in relevant skills and standards.

Recommendation 6 is to introduce activity-based regulation of scope of practice. This recommendation demonstrates the review’s continued failure to understand that scope of practice is dynamic and contextual — a qualification is not the sole determinant of scope.

The determination of scope of practice should remain with the relevant National Boards. Proposals to expand scope should continue to proceed through the consultation process they currently undertake, with regulation impact statements conducted.

We continue to be very supportive of enhancing collaborative multidisciplinary care and ensuring all health professionals can work to their full breadth of scope in primary care, but this requires better funding models and improvements to the many reforms currently underway in general practice, such as MyMedicare. We need strong clinical governance to ensure that full scope is safe scope, and that we are truly working together.

This recommendation is frustrating because our health system already has the Medical Services Advisory Committee (MSAC), which can consider the value of this recommendation. The same goes for recommendation 11 to introduce bundled payments for maternity care.

MSAC is an independent, expert body that appraises proposals for public funding for new medical services and provides advice to government based on an assessment of its comparative safety, clinical effectiveness and cost-effectiveness. We need to support and use the mechanisms that exist — not reinvent the wheel.

It’s not entirely bad news — there are a couple of recommendations that we do like in the review, such as recommendation 7, the harmonisation of existing legislation and regulation, and recommendation 9, the establishment of an Independent Mechanism to provide evidence-based advice and recommendations on workforce models and scope of practice, provided it includes economic assessment.

It is important to note this is just a review. The government is yet to announce any actions in response to the report, and we are working to ensure any actions do not further fragment care or undermine our GPs. All our public submissions are available on the AMA website including our response to the final report.

Recommendation 12 is to introduce direct referrals from non-medical health professionals to non-GP specialists.

We never understood where the suggestions in this list came from (for example, osteopaths referring to orthopaedic surgeons), but the AMA was not consulted.

As I highlighted directly to the reviewer, there have been many instances where an allied health professional has referred a patient to me with the expectation that I would then refer on to a non-GP specialist, only for the issue to be one I can easily manage as a GP. The issue is that our allied health colleagues do not understand the scope of a GP. This recommendation risks both the MBS budget and creating backlogs to non-GP specialists through unnecessary referrals.

Read the report

Summer | Doctor Q

31

Criminalising wage theft The Fair Work Legislation Amendment (Closing Loopholes) Act 2023 comes into force on 1 January 2025, introducing criminal penalties for wage theft.

Employers proven to have intentionally underpaid or withheld employee wages and entitlements may face up to 10 years in prison and fines reaching $1.5 million for individuals or $7.8 million for corporations. This represents a significant shift in wage theft enforcement from civil to criminal penalties, creating a strong deterrent and aligning federal policies with existing state laws in Queensland.

Wage theft is already a criminal offence in Victoria. This legislation unifies the rest of Australia.

The legislation specifically targets deliberate underpayment. Isolated or unintentional errors, if quickly corrected, will not typically be prosecuted as wage theft. The legislation differentiates between inadvertent payroll errors (considered unintentional underpayments) and wage theft, which requires clear evidence that the employer acted with intent to shortchange employees.

Practices can become unstuck if they suspect there may be a mistake with payroll but do not follow up or seek a second opinion, or if an employee comes to them with concerns about their payslip and no action is taken.

Negligent actions in these circumstances can lead to wage theft accusations or back payments to staff with additional hefty fines. Small businesses that proactively comply with the upcoming Voluntary Small Business Wage Compliance Code may avoid prosecution and can seek cooperation agreements with the Fair Work Ombudsmen by self-reporting any violations.

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Further information relating to the Voluntary Small Business Wage Compliance Code will be in subsequent Workplace Relations News and Practice Manager Affiliate News articles.

Practice owners, managers and payroll services need to be aware of the appropriate and relevant penalties applicable to their practice staff in accordance with their relevant Award. This includes understanding when overtime, penalty rates or allowances should be paid. The low-risk operating position is to keep in mind that employees should remain better off overall in any arrangement or agreement made between the employee and the practice. This will help reduce the chances of underpayments occurring.

Enhanced investigative powers for the Fair Work Ombudsman, including collaboration with law enforcement, are also part of the Act to bolster enforcement capabilities and deter non-compliance across industries.

This reform, part of the Australian government’s broader efforts to improve job security and employee protections, underscores a zero-tolerance approach to wage theft which aims to bolster employees’ rights and deter intentional exploitation in the workplace. In relation to employers not complying with workplace laws, Maurice Blackburn employment lawyer Patrick Turner told ABC News: “It just reflects the need to treat wage theft just as seriously as we currently treat theft by employees, and there needs to be criminal penalties for people who deliberately underpay their staff.”

State and Territory health departments have faced hefty bills over the past year. NSW Health and the ACT Government have reached settlements of $230 million and $31.5 million respectively, while the Federal Court has found a Victorian Health Service took a ‘highly irresponsible attitude’ towards its obligations regarding the payment of unrostered overtime to junior doctors by ‘expressly and brazenly’ instructing trainees to perform unpaid overtime.

Lawyers acting on behalf of thousands of junior doctors warn that other Victorian public health services may face millions of dollars in fines.

Gordon Legal and Hayden Stephens and Associates, the law firms representing ASMOF and junior doctors in the unpaid overtime cases, say: “once the penalties are assessed for the thousands of junior doctors across the state, penalties may run into tens of millions of dollars.”

Australian Salaried Medical Officers’ Federation v Peninsula Health (No 3) [2024] FCA 1255 (31 October 2024) ASMOF & Anor v Peninsula Health VID115/2021 These cases are a demonstration of what is happening in the public hospital space. For private practice queries, contact AMA Queensland’s Workplace Relations Team.

The WR Team has essential expertise in helping private practice prevent and understand wage-related incidences occurring. Please contact us on 07 3872 2264 or email us at workplacerelations@amaq.com.au

The AMA Queensland Workplace Relations Team offers three levels of support: Workplace Relations Support

offers general support and advice regarding questions related to Modern Awards, rates of pay and legislation.

This service is included free as part of your AMA Queensland membership.

Workplace Relations Toolkit

provides you with a 12-month subscription to up-to-date, relevant and practical support templates, handbooks, policies and procedures relating to all your employment matters. All the accessible resources and templates have been created by our Workplace Relations specialists with a focus on the medical industry.

Workplace Relations Tailored Services

is a comprehensive, tailored services on a fee-for-service basis in line with the level of risk identified or the complexity of the project required.

For further information regarding any of the above, the Workplace Relations Team can be contacted on 07 3872 2264 or through email support at workplacerelations@amaq.com.au

Summer | Doctor Q 33

Key changes every employer should know A raft of changes to state workplace health and safety laws came into effect throughout 2024.

The Work Health and Safety and Other Legislation Amendment Act 2024 (WHSOLA Act) implements legislative change from the 2022 review of Queensland’s Work Health and Safety Act 2011 and the national 2018 review of the model work health and safety (WHS) laws.

The WHSOLA Act strengthens worker protection and representation, as well as encourages the take up of health and safety representatives (HSR) in the workplace.

Let’s look at the changes that have commenced throughout 2024 that may impact your practice: 28 March 2024: Insurance contracts and arrangements Ban on using insurance arrangements to avoid paying work health and safety penalties.

Prohibition on entering into, providing or benefiting from an insurance contract or arrangement that purports to cover monetary penalties under the Acts.

Private practice owners encouraged to proactively review and revise insurance arrangements.

20 May 2024: Worker representation and consultation A health and safety representative (HSR) can be represented or assisted by a relevant registered union or another entity authorised that is not an excluded entity.

20 May 2024: Entry permit holders An entry permit holder (EPH) can enter a workplace to give notice of entry. A notice is no longer invalid because of a minor administrative error such as spelling mistake.

An EPH who has given notice of entry for a suspected contravention is not required to give additional notice if they have not left the premises to review workplace documents or consult workers.

An EPH can enter a workplace to inquire into suspected contraventions of the WHS Act or Electrical Safety Act 2002 (Qld) and remain during working hours to achieve the purpose of entry.

It is not reasonable for a person conducting a business or undertaking (PCBU) to request the EPH to comply with WHS requirements if it would unduly hinder or delay the EPH exercising a right of entry.

34 Doctor Q | Summer

Information obtained by an EPH when inquiring into a suspected contravention may be used to disclose if a person reasonably believes it is necessary to lessen or prevent a serious threat to public health or safety.

20 May 2024: Health and safety representatives The powers and functions of health and safety representatives (HSRs) are amended to enable an HSR to request assistance from a suitable entity for the HSR. 29 July 2024: Health and safety representatives A PCBU (Person conducting a business or undertaking) must consult with representatives of the workers if requested by one or more workers. The consultation must be conducted at a time and place at the place of work agreed to by both parties.

A PCBU must share relevant information with workers when carrying out consultation, but this does not include providing representatives with access to identifying personal or medical information about workers (unless given consent to do so by the worker) or provide confidential commercial information.

Changes to the election of HSRs and establishing working groups and health and safety committees.

In the event a HSR has been appointed, amendment to clarify the right of HSRs in relation to training provider, remuneration and timing of training.

Amendments to clarify the powers of HSRs. Amendments to provisional improvement notices (PINs):

29 July 2024: Issue and dispute resolution process Pathways for issue and dispute resolution split into two pathways: 1. Matters where an inspector is required to make a decision before it can be referred to the Queensland Industrial Relations Commission (QIRC) - matters relating to work group determinations and variations and the constitution of health and safety committees.

2. Matters where parties can request an inspector to be appointed to assist with resolution of the issue and then refer the matter to the QIRC, or go directly to the QIRC for matters such as: HSR access to information or copies of notices access to a workplace by a person assisting an HSR HSR training HSR issuing a cease work direction 28 September 2024: Further insurance contracts and arrangements All persons must not: enter into an arrangement that purports to cover penalties provide an arrangement that purports to cover penalties take the benefit of an arrangement that covers penalties.

Source: WH&S Act Review Comms Kit

compliance with a PIN is reduced to 4 days timeframe from requesting review of PIN is reduced to three days HSRs may change the day by which a contravention is to be complied with in agreement with the PCBU or the person to whom the notice was issued.

For further information regarding any of the above, the Workplace Relations Team can be contacted on 07 3872 2264 or through email support at workplacerelations@amaq.com.au

Summer | Doctor Q 35

Annual Wellness Day On Saturday 5 October, Doctors’ Health in Queensland (DHQ) held the fourth Annual Wellness Day on the Brisbane River.

Naomi Iten

Program Manager, Doctors’ Health in Queensland

This day coincided with the 2024 Queensland Mental Health Week and focused on the theme of ‘Connect for mental health’, emphasising the proactive measures we can adopt to nurture and support positive mental health and wellbeing for ourselves and our communities.

Boarding at South Bank cultural precinct, our guests enjoyed a Mirimar boat cruise along the Brisbane River, through Southbank and the city, under the Story Bridge and all the way down to Bulimba point, watching the incoming sunset with refreshments and canapes.

Mental Health Week provides an opportunity for all Queenslanders to consider and connect with the people and communities they rely on to help them be mentally healthy, through a range of events and activities.

Wesley Taylor Art Studios joined the celebration and gave a step-by-step paint tutorial of the Story Bridge while we cruised underneath the iconic structure itself. It was wonderful seeing colleagues and new friends alike connecting, discussing art and taking some time to reflect on their personal wellbeing moments.

This year the theme focused on four areas: 1.

Connect with self: Take care of yourself, do something you enjoy, make healthy choices and seek help when needed.

2.

Connect with community: Create supportive and inclusive environments, look after one another and connect with culture. Show kindness and initiate connection with those who are struggling.

3.

Connect with others: Foster relationships with loved ones, friends, family and mob. Spend time with others and make meaningful connections.

4.

Connect with nature: Take a break from technology, spend time outdoors, embrace mindfulness and take care of the world around you.

With these four areas in mind, DHQ celebrated Mental Health Week with a Paint & Connect Sunset Cruise along the Brisbane River and invited doctors of all stages who have an interest in doctors’ health and wellbeing.

36 Doctor Q | Summer

The paintings were all beautifully unique in their own way and we hope they are a reminder of a great afternoon centered around wellbeing and one of Brisbane’s most memorable landmarks. Thanks to everyone who joined this wonderful afternoon and hope to see you again next year!

A huge thanks to our amazing sponsors MIPS and RACGP for making this event possible. qldmentalhealthweek.org.au/ Doctors’ Health in Queensland (DHQ) provide an independent, confidential, colleague to colleague support service for Queensland doctors and medical students.

Call their 24/7 helpline on 07 3833 4352

Committee of General Practice update

Dr Lee Jones

Chair, Committee of General Practice

I have been a GP for nearly a decade, primarily working in the regions. Like many of my fellow rural GPs, I have grown increasingly concerned about the future of general practice and what the many changes mean for primary care, and more importantly, patient health.

Specifically, we have discussed AMA Queensland Councillor and North Queensland rural GP Dr Lisa Fraser’s Disaster Emergency Kit for general practitioners.

This kit is a work in progress made possible following Dr Fraser’s successful application for funds from the AMA Queensland Foundation GPTQ Bursary.

It will come as no surprise that workforce has been our biggest challenge this year. As 2024 comes to an end, it’s fantastic to reflect on what AMA Queensland has achieved for our GP workforce. However, our work is certainly not over yet.

The emergency kit would ensure all GPs in disaster areas are primed and ready when a disaster strikes.

The CGP wrapped up their final meeting of the year in late October, and we look forward to continuing the fight for GPs and patient safety well into 2025.

Payroll tax exemption It is with pleasure that I can begin this update with one of the largest recent wins for general practice – an exemption for all Queensland GPs from payroll tax.

The new government has kept its election promise to exempt GPs from payroll tax, with Treasurer David Janetzki confirming in early November that he has instructed Treasury to begin the process.

Following three years of fierce advocacy from AMA Queensland, both major political parties committed to the exemption, with Premier Crisafulli pledging to begin the legal process in his first week.

This move will give GPs and patients certainty.

Cyclone Jasper had a significant impact in Cairns where Lisa and I work. Many areas of Queensland, but particularly the North, experience cyclones, heavy rain and subsequent power outages during most summers that create challenges in continuation of healthcare.

We need the government to invest in measures to help clinics everywhere in Australia prepare for worst-case scenarios.

Being without power and with limited access to mobile phone service can be lonely and isolating.

Combined with prolonged delays in being able to provide GP services, our doctors need extra resources and support under such extreme, yet not uncommon conditions.

Dr Fraser plans to review existing resources, complete small qualitative surveys and compile feedback from GPs at other national emergency events.

CGP supports this endeavour and will continue working with Dr Fraser to support rural GPs to support patients during times of trauma and disaster.

However, non-GP private specialists remained concerned.

They are still not eligible for the amnesty and have no certainty that they will not be hit with crippling retrospective bills out of the blue.

Access to primary care

AMA Queensland continues to call for all private medical practices to be exempt from this new interpretation of the tax.

The latest ABS patient experience data shows cost and workforce are the main culprits, with nearly 9 per cent of patients reporting cost as a reason for delaying or not seeing a GP when needed, up from 7 per cent in 2022-23.

Disaster emergency kit With storm and fire season arriving rapidly, disaster preparedness has naturally been another recent topic of discussion for the CGP.

Communities across Queensland continue to struggle to access primary and preventive healthcare.

While the data does show progress in some areas, too many of our communities are being left behind.

We have seen recent investment into primary care including incentives to boost our general practice workforce, but more needs to be done.

We will continue working until everyone across the state can get the care they need.

CGP next meets in mid-February 2025.

Summer | Doctor Q 37

Research round up Research Review Australia has more than 50,000 health professional subscribers across Australia. It provides clinical research updates and webinars that qualify for CPD points.

The updates cover more than 50 clinical areas and feature 10 papers from global journals with commentary by a local expert on the impact to everyday practice.

Sign up for Australian health professionals at no cost is available at researchreview.com.au

How successful can we be at reversing type 2 diabetes in the real world?

General Practice Research Review Issue 116 Reviewer: Professor Gerard Gill

Uterus transplant in women with absolute uterine factor infertility Obstetrics & Gynaecology Research Review Issue 13 Reviewer: Associate Professor Mark Erian, Senior Consultant Obstetrician and Gynaecologist, Brisbane This paper reports on a case series of 20 women (median age 30 years) with uterine-factor infertility and at least one functioning ovary who underwent a uterus transplant at a US tertiary care centre between 2016-19.

Allografts were carried out with transplants from 18 living and two deceased donors, and recipients were administered immunosuppression until the transplanted uterus was removed after one or two live births, or graft failure. A total of 14 recipients (70 per cent) underwent a successful allograft, and all of these women gave birth to one or more live infants. No congenital malformations were observed in any of the 16 live-born infants. Grade three complications occurred in four of the 18 living donors.

“Uterus transplant is a concept that captured the imagination of many gynaecologists for decades.

When the patient has uterine factor infertility and at least one functioning ovary, and the recipient is aged around 30 years, uterus transplant is technically feasible.

The surgeon is trained to perform this unique operation, as was shown in this large US centre. The results were rather encouraging, with a high percentage (70 per cent) of recipients having successful allografts and live births afterwards, without any known congenital foetal malformations.” e Obstetrics & Gynaecology Research Review Issue 13

Current and back issues of Research Reviews can be found at researchreview.com.au. Australian health professionals researchreview.com.au can sign in and download copies.

38 Doctor Q | Summer

This study investigated outcomes of patients with type 2 diabetes enrolled in the NHS Type 2 Diabetes Path to Remission program. The 12-month behavioural intervention is designed to support weight loss and incorporates an initial three-month period of total diet replacement. Mean weight loss over 12 months in these participants was 9.4kg (8.3 per cent). In a subgroup of 710 (42 per cent) participants who had two HbA1c measurements recorded, 190 (27 per cent) had disease remission.

“Should one of our goals in type 2 diabetes mellitus be to induce remission? This real-world trial from the British NHS suggests it can be done by dietary modification but the number achieving remission is less than that seen in the British general practice trial of weight loss.

“Having seen a number of Indigenous patients achieve remission using the newer diabetic agents, I suspect most patients will require these agents to achieve the necessary weight loss to achieve remission. What remains uncertain is how much of the macro and microvascular risk of diabetes remains. While waiting for the evidence on these topics we should encourage all newly diagnosed diabetic patients to try and lose some weight.”c General Practice Research Review Issue 116

Committee of Doctors in Training update It’s been a busy few weeks for the CDT! We launched the results of our Resident Hospital Health Check in November, with significant interest from the media and from Hospital and Health Services (HHSs) around Queensland.

While some health services had seen improvement, close to a third of doctors in training continued to report feeling unsafe at work, and almost half reported burnout and fearing making a fatigue-related error at work.

We’ve been calling for evidence-based improvements in occupational violence prevention strategies, fatigue management, improved rostering and enhanced recruitment and retention of the workforce to manage workload. We will work with HHSs and government to target problem areas into the new year.

We would love to hear what you think about how your hospital went and how we can use this data to enhance our advocacy priorities. A massive thank you to everyone who participated in the survey, which is invaluable in shaping our priority areas for the year.

We are also hoping to launch our Rural Hospital Accommodation Survey soon. We want to know what the state of rural and remote accommodation is across Queensland, what features are valued and particularly what improvements can be made. Keep an eye out for this in your email soon!

Dr Elise Witter

Chair, Committee of Doctors in Training

With MOCA 7 bargaining coming up in 2025, it’s an important time to identify any areas that need to be included in our agreement and to flag these for escalation – our Industrial Relations Special Interest Group would love to hear from you if you have any ideas to share.

Finally, the federal AMA Council of Doctors in Training recently met in Canberra. Other states and territory chairs were impressed with our Resident Hospital Health Check completion rates (a 15 per cent increase on last year) and our Ward Call Position Statement which is in the final stages of approval. Thanks again to everyone who contributed to our Ward Call Survey earlier in the year to make this possible – the results have been presented at the BMJ International Forum of Healthcare Quality and Safety and we hope this will inspire further research into this important area!

Wishing everyone a Merry Christmas and a Happy New Year!

Summer | Doctor Q 39

Annual comparison: state-wide Leave and professional development In 2024, 42% of respondents had applied for professional development leave (PDL), a continued decrease from 47% and 56% in 2023 and 2022 respectively.

Among those who applied, 89% had their PDL approved, representing a steady increase from 86% and 82% in 2023 and 2022 respectively.

Further, 43% and 22% respectively were satisfied their clinical rotation preferences had been accommodated, and with opportunities to be involved in research and auditing (down from the 61% and 36% in 2023, but similar to 43% and 30% respectively in 2022).

Hours of work and overtime 84% of respondents reported being fully paid for claimed overtime, which was lower than in 2023 (89%) but similar to 2022 (85%).

Resident Hospital Health Check 2024 In 2024, ASMOFQ (Australian Salaried Medical Officers’ Federation Queensland), in collaboration with AMA Queensland and its Committee of Doctors in Training, surveyed Resident Medical Officers (RMOs) throughout Queensland, including Interns, Junior House Officers, Senior House Officers and those on Continued Residency.

The survey evaluated their experiences of employment in Queensland and subsequently compared hospitals across the state. A total of 831 junior doctors completed the survey. This was the ninth consecutive year for the survey, which was designed to be similar to previous years to allow comparison across time.

40 Doctor Q | Summer

Further, 19% reported that they had been advised not to claim overtime payment (similar to previous years) and 17% believed doing so may negatively affect their assessment (down from 39% in 2023).

Wellbeing and workplace culture Importantly, 29% of respondents reported feeling their safety had been compromised at work (similar to the 33% and 28% in 2023 and 2022 respectively) and 46% reported that they had been concerned about making a clinical error due to fatigue caused by their hours worked (a continued decrease from 53% and 58% in 2023 and 2022).

Less than a third of respondents (31%) were satisfied with the hospital facilities (down from 47% and 42% in 2023 and 2022) and the quality of the formal teaching and training (37%, down from 48% in 2023 but similar to 2022).

Bullying, discrimination and harassment Significantly, over one-third (35%) experienced and/or witnessed bullying/discrimination/ harassment (similar to the 39% in 2023 but down from the almost half (48%) in 2022).

A quarter (26%, compared with 25% and 26% in 2023 and 2022) said they reported the incident and 81% were concerned there may be negative consequences personally for reporting an incident (up from 74% and 75% in 2023 and 2022).

Before relying on the information contained in the survey results provided, users should carefully evaluate its accuracy, currency, completeness and relevance for their purposes, personal objectives and career goals, and should make their own enquiries, including consulting with the relevant hospital and staff. All analyses and reporting of results were undertaken by an independent statistician with a background in medical research.

Top 6 priorities in Queensland The following are the top six aspects which the most respondents identified in their top three for importance when applying for a job.

43%

were satisfied clinical rotation preferences were taken into consideration

1.

Clinical rotation

84%

preferences

got

This was rated important by 72% of respondents.

In contrast, 43% were satisfied clinical rotation preferences were taken into consideration (down from 61% in 2023 and similar to the 43% satisfied in 2022).

paid for claimed overtime

FULLY

This was rated important by 51% of respondents.

16% of respondents worked 76 hours per fortnight

5.

Working a 76 hour fortnight This was rated important by 22% of respondents. Only 16% of respondents worked 76 hours per fortnight on average over the month preceding survey completion.

Being appropriately paid for unrostered overtime worked This was rated important by 53% of respondents. 84% of respondents reported being fully paid for claimed overtime (which was lower than in 2023 (89%) but similar to 2022 (85%); however, only 54% claimed all their overtime and 37% claimed some of the hours worked.

4.

3.

Annual leave process and allocations

2.

Residency education programs

37%

satisfied with formal teaching and training

12%

did not have adequate breaks between shifts.

This was rated important by 27% of respondents.

37% were satisfied with the formal teaching and training (down from 48% in 2023 but similar to 2022).

6.

Not working fatigued This was rated important by 21% of respondents.

46%

reported that they had been concerned about making a clinical error due to fatigue caused by their hours worked (a decrease from 53% and 58% in 2023 and 2022).

Further information If you would like to discuss any aspect of the 2024 Resident Hospital Health Check survey in detail, please email membership@amaq.com.au.

ASMOFQ also provides confidential, assured industrial relations advice to members on employment terms and conditions, or any industrial matter that may be causing you concern. Contact the team on 07 3872 2222 or email asmofqld@asmof.org.au. Not a member of ASMOFQ and AMA Queensland? You can join at ama.com.au/join-the-ama to receive support and guidance on employment matters in addition to a range of professional development programs, services and benefits to support your career in medicine.

Summer | Doctor Q

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Meet a member

A/Prof Richard Lewandowski

I’ll probably never give up teaching.

What I love about it is some of the people that I teach as medical students then reappear as trainees in plastic surgery. So I’ve obviously made it sound really interesting.

It’s that joy of seeing people actually appreciating the teaching and then getting more absorbed in the specialty.

If you’re ever lucky enough to meet specialist plastic and reconstructive surgeon and founder of Operation Smile Australia, Associate Professor Richard Lewandowski, you’re guaranteed to leave the room grinning from ear to ear. Predominantly because of his work providing facial surgery to repair deformities in children and adults, but also thanks to his infectious joy and passion for helping others.

His career aspirations began with an interest in both science and architecture.

Unable to decide, he figured a surgeon was the best of both worlds – humorously calling himself a “surgical architect”.

“Plastic surgery is largely about rebuilding, redesigning and reshaping,” A/Prof Lewandowski said.

“The word plastic just means to remould or reshape. So there’s that architectural bit that says – if you had to do something in medicine, repairing or reconstructing is probably the thing I wanted to do.”

His interest in cleft and craniomaxillofacial surgery led him to founding Operation Smile in Australia.

“I landed up in Virginia in the US to do my craniofacial subspecialist training and one of my bosses, Bill McGee, had started Operation Smile,” he said.

“It was still a little bit fledgling in those days, and we used to look at some of the complex cases out there and try to bring them to the US for what would be exorbitant sums of money.

“So he and I decided that maybe this was something we could do from Australia. We planned to do all the complex stuff here while the US got more under-resourced countries to do things like assemble cleft lip and palate operations.

“It was about trying to meet a need that would otherwise be difficult to achieve.”

This year marks its 25th anniversary as a registered charity in Australia – run by and reliant entirely on its more than 200 volunteers.

“We’ve got programs in the Philippines, in Vietnam. We’re going back to India to see how we can re-establish some more complex work over there... We also bring some of the specialists from those countries to Australia for further training. So it’s multifaceted and pretty busy,” he said.

“Our aim is to teach rather than purely do. Because if we teach the locals and we help with limited amount of resources, we can teach and assist them in building their capacity.”

Like many doctors, A/Prof Lewandowski’s work extends far beyond his day job.

Although he suggested his workload was gradually slowing down, his schedule says otherwise.

Between travelling to North Queensland for surgery work, to Vietnam for Operation Smile and writing court reports for various patient injuries, he also runs the Craniofacial Clinic at Brisbane’s Mater Hospital and teaches medical students through the University of Queensland.

“I’ll probably never give up teaching,” he said.

“What I love about it is some of the people that I teach as medical students then reappear as trainees in plastic surgery. So I’ve obviously made it sound really interesting.

“It’s that joy of seeing people actually appreciating the teaching and then getting more absorbed in the specialty.”

His teaching methodology prioritises a balance of medical theory and practice with the history of the craft embedded.

“A major thing I want them to understand is that plastic surgery isn’t something new. If you look at the history, we’ve been reconstructing noses for millennia,” he said.

“Even if they don’t end up becoming a surgeon, I love the idea that if they go into general practice, they have a really good understanding of what’s available out there rather than this misconception that something’s untreatable.

“My practice is more reconstructive than cosmetic, but sometimes there’s a large overlap. You can’t reconstruct something that looks horrible.

“There is this kind of myth that there are two types of plastic surgery, one that deals with appearance and one that deals with function. But in reality, the two go hand in hand.”

Consistent throughout all of his roles is his sturdy, professional philosophy – treating communities that otherwise wouldn’t get the help they need and deserve.

A/Prof Lewandowski joined AMA Queensland 42 years ago as a “no-brainer”.

“Back when I was a medical student, the AMA was really one of the only voices of the medical profession.

“Even more so when I set up specialist practice, because they helped us enormously with things like practice management and HR issues.

“I’ve sort of wound my practice down, but AMA Queensland is still involved in support in so many other ways, including industrial issues and workforce planning, which is critical as you get to the end of your career.”

Summer | Doctor Q 43

The foundation of Queensland medicine As AMA Queensland celebrates its 130th anniversary, medical practice in Queensland, as it exists today, celebrates 200 years and began in the Moreton Bay Settlement on 14 September 1824.

On that day, His Majesty’s Colonial Brig, Amity, moored off Red Cliff Point, the Redcliffe of today. In the preceding weeks, the Governor of New South Wales, Sir Thomas Brisbane, had that made the decision to establish an open-air convict settlement and military garrison in Moreton Bay; and had appointed the former Royal Navy officer, John Oxley, as leader of the expedition.

Sir Thomas directed Oxley to make the decision concerning the site of the new northern settlement.

Oxley examined several islands in Moreton Bay, including St Helena Island, as a possible site for the settlement.

Whilst Oxley was in the southern waters of Moreton Bay, a shore party had found freshwater in what was later named Humpybong Creek. On his return, Oxley made the decision to establish the settlement just north of Red Cliff Point. Having left the foundation group of men (soldiers, convicts and a surgeon-storekeeper), women and children at Red Cliff, Oxley returned to Sydney on the Amity, several weeks later.

The settlement party consisted of 15 soldiers, 10 soldiers’ wives and nine children, 29 convicts and one civilian. The civilian was the surgeon-storekeeper, Mr Walter Scott.

The Commandant of the Settlement, Lieutenant Henry Miller of the 40th Regiment of Foot, was a career infantry soldier and veteran of both the Peninsular War (1809-1814) and the Battle of Waterloo (1815). The convicts were chosen as skilled tradesmen. At least 15 of them volunteered for service in the new outpost .

The Indigenous forebears of the Redcliffe Peninsula had lived in this bountiful region for at least three millennia prior to the European Settlement. The land and sea were bountiful, and it is estimated that food gathering required no more than two hours hunting or gathering each day.

Indigenous men and women practised a rich culture with sophisticated lore and law in all matters of social order, ceremony and healthcare. In particular, they practised a sophisticated system of both symptomatic treatment and preventive medicine.

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Emeritus Professor John Pearn AO AM Paediatrician, Queensland Children’s Hospital

The convicts and soldiers built the huts of the settlement, which were widely dispersed over a range of more than 300 metres. Attempts, ultimately unsuccessful, were made to plant the ‘hundred acres of maize’ which Governor Brisbane had directed. Timber-cutting and thatch-collecting parties also ranged widely.

Mr Walter Scott, appointed primarily as the storekeeper but, in Alan Cunningham’s words ‘also to act in the capacity of a surgeon’ served throughout the seven months that the settlement was based at Red Cliff; and continued to serve when the settlement was moved to the north banks of the Brisbane River, near the site of today’s Victoria bridge.

The heat and humidity of the region, and a torrid summer, caused distress and debilitation. Fevers developed, thought by subsequent historians to be malaria. Sandfly infestation and subsequent fevers overtook many in the settlement. Ultimately, the water supply in what came to be called Humpybong Creek, proved to be inadequate for the settlement and became polluted. More than half of the convicts became ill and were unable to work. This delayed the construction of huts and attempts at agriculture.

Within 10 weeks of landing, three infants were born in the settlement, the infants of soldiers’ wives.

The privations of disease, although extremely debilitating, seemed initially to have been well-managed. Subsequently, epidemics of trachoma and fever occurred in summer throughout the convict period from 1824 to 1842. Only one death occurred at Red Cliff, that of Private Felix (or Phelim) O’Neil. Later, at the transferred penal settlement on the Brisbane River, one in 10 of the convicts died there, 220 deaths in all, of which 208 had succumbed before the end of 1832.

The Commissariat Stores as it stands today

There is no record of any hospital hut at Red Cliff, and is probable the sick and injured were nursed in their own beds — initially in their tents, and later in the huts built to house the soldiers and their families and the convicts. The eye disease, trachoma, was particularly severe. Walter Scott’s surviving records described ‘the exposure and privation’ to which he had been subject at Red Cliff, and the severe ‘infliction of loss of sight to a considerable extent’ from which he himself had suffered in his later life.

for the first 11 months of his life at Moreton Bay, as the surgeon. His health and eyesight were affected; but he took with him on his return to Sydney an insight and experience which was to modify his public life in the years to come. He became a pastoralist and magistrate in the Hunter Valley until his final return to London in early 1854. Tragically, he died from acute cholera during the devastating epidemic which swept the East End of

From the medical point of view, the first year (1825-1826) of the settlement at what was to become Brisbane Town, was grim. Health problems encountered at Redcliffe, rather than decreasing, became worse and were to intensify over the next five years. Medical supplies continued to be sparse or non-existent.

The Bicentenary

The late Professor Douglas Gordon wrote: The unfortunate convicts had their diet of salt junk and flour in a country devoid of fruit, with little hope of growing fresh green vegetables except in the cooler months of the year and with very little in the way of livestock.… grain was brought in over the years 1825 and 1826 to augment what little was grown locally, but of course, with a meagre supply of greens, cases of scurvy were occurring.

As Walter Scott’s duties consisted of those of combined surgeon and storekeeper — the latter traditionally responsible for the holding, issuing and rationing of food — his lot must have been particularly difficult. As the surgeon, Mr Scott also had to attend the results of flogging of recalcitrant prisoners. In March 1826, for example, the second Commandant, Captain Peter Bishop, had ordered 60 lashes from one John Wilcockson ‘for insolence and sending an impertinent message to the Commandant’.

Scott witnessed the building of the new Commissariat Store on the high ground above what is now North Quay.

That building took the form of a low barn, and besides being Scott’s quarters, also comprised a corn store and a meat house. It is probable that sick and injured convicts and soldiers continued to be nursed in their own quarters at that time. Scott did not remain to see the first hospital finally completed at the Moreton Bay Settlement.

Captain Patrick Logan, the third Commandant, wrote that by 1 October 1826 the hospital was almost completed — ‘one half of the [hospital] building, containing quarters for the surgeon, a ward, 40 feet by 20 feet, is now roofed in and will be fit for occupation in five or six weeks’ time; the building is of brick on a stone foundation’.

Walter Scott continued to serve ‘in the capacity of a surgeon’ until 7 September 1825, when Dr Henry Cowper arrived as the first formally-appointed doctor in the settlement. As was also relieved as the settlement’s storekeeper in October 1826 and returned to Sydney on the Amity. On the boat with him were 20 convicts returning to Sydney, 14 of them had come north with him as volunteer convicts, on the same brig, two years before.

Scott had received just over £90 for his service of over two years in what was to become the City of Brisbane — acting as both the Commissariat Storekeeper and,

In September 2024, three historical societies joined together to host a major Bicentenary Conference to commemorate the foundation of what became the colony (1859) and later the State (1901) of Queensland. The three societies were the Royal Historical Society of Queensland, History Redcliffe and the Bribie Island Historical Society.

This important Bicentenary commemoration was a celebration not only of the foundation of medicine in the northern State, and also that of the military, agriculture and accountancy in what was to become (1901) the State of Queensland.

The foundation of medicine was a particular theme at the Bicentenary Conference. This was made possible by the generosity and support of both AMA Queensland and the AMA Queensland Foundation; and of several medical families of Queensland. The history of the foundation of medicine was also supported by medical colleagues of the Redcliffe and District Medical Association.

Scholarly papers were presented highlighting details of Indigenous healthcare as this was practised prior to September 1824; and the account of Walter Scott’s life as a surgeon-storekeeper at Red Cliff and Brisbane, and his later life as a pastoralist and magistrate in New South Wales.

Because of the support of AMA Queensland, it was possible to commission and strike a commemorative medallion – The Foundation of Queensland Medicine.

A medallion with accompanying certificate was presented to each of the 240 registrants at the Bicentenary Conference. In addition, because of the philanthropy and generosity of three medical families in Queensland — the Efstathis family, the Allan family and the Pearn family — a second commemorative medal, the Foundation of the Settlement, was also commissioned and struck, and presented to registrants at the Bicentenary Conference. These two commemorative medallions will endure, long after oral history and other records of the bicentenary have faded.

Summer | Doctor Q 45

2025 events calendar

March

Medical Careers Expo Saturday 9 March Voco Hotel, Brisbane Trans-Tasman Conference/ Private Practice Conference Monday 10 March – Monday 7 April Hobart, Tasmania

July

Women in Medicine Breakfast

Thursday 17 July Townsville Private Practice Seminar Series Friday 18 July Townsville Member Networking Event Friday 18 July Townsville

Visit the AMA Queensland website for more information about our events: ama.com.au/qld/events

October

Women in Medicine Breakfast Thursday 31 October Brisbane

November

May

Member Networking Event Friday 16 May Hervey Bay Junior Doctor Conference Saturday 17 - Sunday 18 May Fraser Coast AGM and Dinner for the Profession Friday 30 May Brisbane

August

Senior Doctors Conference Saturday 9 August Brisbane

Member Networking Event Thursday 20 November Brisbane Intern Workshop Thursday 20 November Brisbane Intern Workshop Gold Coast Townsville Private Practice Seminar Friday 28 November Gold Coast Member Networking Event Friday 28 November Gold Coast

September June

Private Practice Seminar Series Brisbane 46 Doctor Q | Summer

Annual Conference International Sunday 19 – Saturday 25 September Vancouver, Canada

December

Intern Workshop Townsville

AMA QUEENSLAND ANNUAL CONFERENCE

AMA QUEENSLAND

Where will your career pathway take you?

Vancouver Saturday 8 March 2025 Voco Hotel, Brisbane 50+ exhibitors

C A NADA

21 TO 27 SEPTEMBER 2025

Tasmania 7 TO 13 APRIL 2025

TR ANS -TA SMAN CONFE RE NCE

C P D AC C R E D ITE D | P R I VATE P R AC TI C E S TR E A M | FA M I LY F R I E N D LY

Vancouver C AN ADA

21 TO 27 S E PTE M B E R 2025 F O R M O R E I N F O R M AT I O N E M A I L r e g i s t r a t i o n s @a m a q .co m . a u

AMA.COM.AU/QLD

AMA QUEENSLAND 2025 ANNUAL CONFERENCE

New year, new tax-saving goals!

Let’s make maximising your tax savings one of your New Year’s resolutions.

More money to spend on the important things We are committed to helping you legitimately minimise your tax. By optimising tax deductions, you can retain more of your hard-earned money to spend on the things that really matter to you.

With the extra savings on tax you could:

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Improve your cash flow

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Achieve your financial goals sooner

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It’s never too late to start saving on tax. We can help you identify where you can save and turn it into financial growth.

SYDNEY | BRISBANE | NEWCASTLE

1800 988 522 | medical@cutcher.com.au | cutcher.com.au

Contact us today and start the year with a tax strategy in place.

Nicole Brown

Partner, Cutcher & Neale Specialist Medical Services

Minimise your tax to maximise your wealth Whether you’re an employee doctor or running your own practice, these simple strategies can help you minimise your tax.

1. Use salary packaging to increase the amount that hits your bank account Salary packaging can help you save money. You can package up to $9,010 of your salary tax-free, allowing you to receive more each payrun into your bank account.

Queensland Health also allows employees to salary package other options, like a car , to reduce your tax bill.

If you’re a Queensland Health employee and haven’t yet explored salary packaging, we can help you set it up to maximise your earnings.

2. Maximise superannuation contributions Did you know you can contribute concessional superannuation contributions up to $30,000 annually?

This includes contributions made by your employer.

Let’s say your taxable income is $200,000:

employer contributes $25,500 balance available to contribute from personal cashflow is $4,500

tax saving $2,115 in personal tax return;

15 per cent tax paid in superannuation fund (overall saving of 32 per cent) Earnings within super are also taxed at a maximum of 15 per cent; the compounding effect of contributing more sooner can have a profound impact at age 65.

3. Turn study expenses into tax deductions If you’re pursuing a master’s degree or further study (post undergraduate) related to your medical specialty, even if it’s funded via HELP Loans, those costs may be taxdeductible.

4. Utilise negative gearing on investment properties If you own an investment property, negative gearing can assist in reducing your tax liability. Negative gearing occurs when the costs of owning a rental property exceed the income, creating a loss. This loss can be used to offset

other forms of income, lowering your taxable income.

Obtaining a quantity surveyor’s capital works report can be beneficial as it helps you maximise depreciation deductions.

You may be eligible to apply to your employer to withhold less tax throughout the year on your frequent wage payments.

5. Claim your income protection deductions annually Income protection insurance is essential for safeguarding your income in the event of illness or injury and the premiums for this insurance are tax-deductible. Be sure to claim these deductions annually.

6. Keep track of receipts for better record keeping We can’t claim a tax deduction without a receipt! Good record-keeping is key to maximising your tax deductions and paying less tax.

For all medical professionals in private practice, it’s essential you utilise accounting software to streamline the deductions at year end and for quarterly activity statements.

By taking responsibility for your financial affairs, you can effectively minimise your tax liability while setting yourself up for long-term financial success.

We care about legitimately minimising your tax. We want you to have more funds available for wealth creation and accumulation. Do you need guidance on maximising your tax savings? Speak to one of our advisors today at 1800 988 522 or medical@cutcher.com.au.

The information in this publication contains general advice only. It has been prepared without taking your personal objectives, financial situation or needs into account. You should consider whether the information contained within this publication is appropriate for you. Where we refer to a financial product you should obtain the relevant Product Disclosure Statement or offer document and consider it before making any decision about whether to acquire the product.

Summer | Doctor Q 49

Nerissa Ferrie MDA National

Total and permanent disability Doctors often feel conflicted when patients seek written confirmation of total and permanent disability (TPD). What should you consider before completing a TPD form?

Things to think about

Jim makes an appointment to see you. You inherited him from a colleague who recently retired, and you’ve only seen him once or twice.

Is there objective evidence of a permanent disability?

Jim is 45 years old, with a history of chronic back pain. He hasn’t returned to his construction job since he accepted a workers’ compensation settlement two months prior.

He comes in today asking you to complete a TPD form.

You eventually sign the form, after pressure from the patient’s lawyers. Jim hasn’t been in since, so you’re surprised when he presents a year later, with a stack of paperwork in hand.

“I blew my TPD payout on jet-skis and holidays, and now I need to return to work. Can you give me a certificate to say I’m completely fit to work in the construction industry? My back feels much better now.”

You offer to examine him, while noting it will be difficult to provide a clearance so soon after signing a TPD form.

Jim snatches up the paperwork and leaves the consultation, yelling expletives.

What is TPD? Definitions can vary according to the terms of the policy. A patient may be eligible for a TPD payment when they lose the ability to work in their own profession. More commonly, eligibility is triggered if a patient can never return to any occupation reasonably suited to their education, training or experience.

This is a fairly high threshold, and you must read the wording carefully before you sign a TPD form, in accordance with 10.9.1 of the Medical Board’s Good Medical Practice: A Code of Conduct for Doctors in Australia.

How old is the patient, and when did they become disabled?

Is the patient compliant with treatment recommendations?

Has the patient reached maximum medical improvement?

Factor in any comorbidities, psycho-social influences, education and work history.

Should I sign the form?

Medico-legally, you should exercise your best clinical judgement based on information available to you at the time, and document this clearly in the notes.

Consider a referral to an occupational physician if necessary, and don’t allow anyone to pressure you into completing the form if you don’t feel it is appropriate to do so.

If you support the patient’s TPD claim, you can complete the form as requested. Consider advising the patient that if they opt to rejoin the workforce without any identifiable improvement to their disability (i.e. new treatment or surgical intervention), it may be difficult for you to provide a certificate of fitness.

If in doubt, contact our Medico-legal Advisory Services team for advice.

The case study is fictitious. Any resemblance to real persons, living or dead is purely coincidental.

This article is provided by MDA National.

They recommend that you contact your indemnity provider if you need specific advice in relation to your insurance policy or medico-legal matters. Members can contact MDA National for specific advice on freecall 1800 011 255 or use the ‘contact us’ form at mdanational.com.au.

Summer | Doctor Q

51

Still rocking old insurance?

If you haven’t reviewed your insurance in a while, you may be underinsured or overpaying. We can make sure your policies are working for you, not against you.

Our General Insurance Services provide comprehensive insurance solutions for health professionals, including liability insurance, property insurance, cyber insurance, business insurance, and professional indemnity insurance.

Insurance doesn’t have to be complicated.

We understand the technical language, legal terms, fine print and how insurance changes over time, so that you don’t have to.

Our advisors can help you:

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Identify the specific coverage you require

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Ensure your coverage features are right

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Find the most cost-effective policies

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Handle paperwork and streamline the process

Speak to one of our insurance advisors today and get the best out of your insurance.

Protect yourself with confidence.

SYDNEY | BRISBANE | NEWCASTLE

1800 988 522 | generalinsurance@cutcher.com.au | cutcher.com.au The information in this publication contains general advice only. It has been prepared without taking your personal objectives, financial situation or needs into account.

You should consider whether the information contained within this publication is appropriate for you. Where we refer to a financial product you should obtain the relevant Product Disclosure Statement or offer document and consider it before making any decision about whether to acquire the product.

Cutcher & Neale General Insurance is a Corporate Authorised Representative (No: 1260321) of McLardy McShane Partners Pty Ltd AFSL No: 232987 ABN: 14 064 465 309

Andrew Harrison

Medical Insurance Adviser, Cutcher & Neale General Insurance

The importance of retroactive dates in indemnity insurance Picture this: you’ve spent years building a thriving practice, helping patients every day. Then, years after providing care to a patient, you receive notice of a claim alleging negligence. The treatment in question happened long ago and, without the right protection in place, that one claim could jeopardise everything you’ve worked so hard for.

This is where Professional Indemnity Insurance comes in.

Professional Indemnity Insurance is vital for medical professionals who provide expert advice and services, protecting them against claims of negligence or breach of duty. Understanding how retroactive dates impact your coverage is crucial, as they determine whether past services are covered.

What is a retroactive date?

Professional indemnity policies typically include a retroactive date, which dictates how far back in time the policy will cover claims for professional services. Any breach of professional duty occurring after the retroactive date will be covered, but breaches occurring before this date will not. Understanding and maintaining the correct retroactive date is vital to ensuring comprehensive coverage.

There are three common types of retroactive dates, and each has different implications for coverage:

Policy inception This type of retroactive date only covers claims for professional services provided after the start of the insurance policy. It is most common when a medical professional takes out professional indemnity insurance for the first time. If the insured provided medical advice or treatment before the inception of the policy, those services will not be covered if a claim is made in the future.

Specific date With this retroactive date, the policy covers claims for breaches of professional duty that occurred on or after a specified date. For example, if a policy runs from 1 July 2023 to 30 June 2024 with a retroactive date of 1 July 2018, only claims related to services provided on or after 1 July 2018 will be covered. Any breaches that occurred before this date will not be insured. This is common for doctors who established their practice or took out their first policy on that specified retroactive date.

Unlimited retroactive date This is the most comprehensive option. The policy will respond to claims made during the policy period, regardless of when the breach of duty occurred. An unlimited retroactive date offers peace of mind, as it ensures coverage for any past services, even if those services were provided long before the policy began.

The importance of maintaining continuity Continuity of coverage is crucial. If a policy lapses or if the retroactive date changes when switching insurers, there could be gaps in coverage. It’s essential to confirm that any replacement policy carries the same retroactive date as the previous one. Medical professionals should also avoid gaps between the expiry of one policy and the inception of another.

Ensuring the right type of retroactive date and maintaining continuous coverage will help protect against the financial and reputational risks associated with claims of professional negligence.

Do you need advice? Get in touch with us today at imedinsurance@cutcher.com.au or 1800 988 522.

The information in this publication contains general advice only. It has been prepared without taking your personal objectives, financial situation or needs into account. You should consider whether the information contained within this publication is appropriate for you. Where we refer to a financial product you should obtain the relevant Product Disclosure Statement or offer document and consider it before making any decision about whether to acquire the product.

Summer | Doctor Q 53

Are you giving your kids a leg up on the property ladder?

While you have your child’s best interest at heart, we have yours. Helping your child buy their first home is a generous and exciting milestone, but it’s important to understand all the implications.

Our team specialises in tailored solutions for parents who want to provide financial support responsibly—whether through gifting, loan structures, or co-ownership options.

Book your

Our advisors can provide tailored guidance on:

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Flexible loan terms Using home equity instead of cash

complimentary appointment with our finance experts today.

Minimising guarantor risks

Make homeownership a reality for them – contact us to explore your options.

SYDNEY | BRISBANE | NEWCASTLE

1800 988 522 | finance@cutcher.com.au | cutcher.com.au The information in this publication contains general advice only. It has been prepared without taking your personal objectives, financial situation or needs into account.

You should consider whether the information contained within this publication is appropriate for you. Where we refer to a financial product you should obtain the relevant Product Disclosure Statement or offer document and consider it before making any decision about whether to acquire the product.

Cutcher & Neale Finance Pty Limited ACN 137 924 755 Australian Credit Licence 381084.

Dean Menzies

Partner, Cutcher & Neale Residential & Commercial Finance

Gifting money for a first home purchase In today’s housing market with skyrocketing property prices, many young people are turning to their parents for financial assistance in purchasing their first home.

Interestingly, parents are quickly becoming one of the country’s biggest lenders, often referred to as the ‘Bank of Mum and Dad’. While helping your children buy their first home is a milestone many parents dream of, it’s important to carefully consider the risks and benefits.

Providing family support When helping your child buy their first home, family support can play a crucial role in getting them on the property ladder. However, gifting a large sum of money, while generous, can come with significant risks for both you and your child. As parents, it’s essential to consider how such a financial gift might impact your long-term financial security, particularly your retirement plans. Additionally, there can be legal complications or unintended tax consequences for your child if the gift isn’t properly documented. Before proceeding, it’s vital to understand the legal, financial and emotional implications to ensure both parties are protected.

Do understand tax implications You should consider the implications for any means-tested government benefits (e.g. age pension) that you or your child might be entitled to in the future.

Do prioritise your financial security Make sure you’re not compromising your own retirement savings by gifting a large sum.

Do consider tax-free savings opportunities In some cases, you may be able to reduce tax by giving money in a way that takes advantage of tax-free allowances or through superannuation to reduce your tax liabilities or improve estate planning.

Do communicate the gift clearly to all involved parties Lenders often require a formal letter stating the money is a gift and not a loan. Make sure you provide the necessary documentation to avoid delays in the mortgage approval process.

Don’t forget about Centrelink implications For those receiving Centrelink benefits, gifting large sums of money can impact your entitlements. Make sure to check this so as not to affect your benefits.

Don’t co-sign or take out loans on behalf of your children Co-signing on a mortgage or borrowing against your own assets may seem helpful, but it puts your own financial security at risk. If your child defaults, you could be left responsible for the debt.

Don’t ignore the potential impact on your child’s future tax obligations If the property appreciates in value and your child sells it, capital gains tax could apply depending on their residence status and property use.

Helping your child purchase their first home is a generous and rewarding gesture, and with careful planning, you can ensure it benefits both your family’s financial future and your child’s long-term success.

Are you looking for further advice? Get in touch with us today on 1800 988 522 or finance@cutcher.com.au The information in this publication contains general advice only.

It has been prepared without taking your personal objectives, financial situation or needs into account. You should consider whether the information contained within this publication is appropriate for you.

Where we refer to a financial product you should obtain the relevant Product Disclosure Statement or offer document and consider it before making any decision about whether to acquire the product.

Cutcher & Neale Finance Pty Limited ACN 137 924 755 Australian Credit Licence 381084

Summer | Doctor Q 55

Are you on top of your practice’s privacy law obligations?

Privacy law is constantly evolving and it is crucial for all staff to understand their legal obligations to ensure personal and sensitive information is appropriately collected, used and stored to protect their medical practice from reputational damage and costly penalties.

In this article, we cover privacy requirements, breach protocols, safe data collection and storage and key privacy legal tips to help you navigate this complex area.

What information is regulated?

In Australia, any data that is ‘personal information’ falls within the scope of the national privacy law framework.

Personal information is defined as ‘information or an opinion about an identified individual, or an individual who is reasonably identifiable.’ This can include a person’s: name phone numbers driver licence details health information and religious beliefs.

Sensitive information, including medical information, is subject to stricter requirements than other personal information and greater care must be taken with this information.

The Privacy Act 1988 (Cth) sets out requirements surrounding personal information and sensitive information. All medical businesses must be compliant with this law.

What is a privacy policy?

All medical businesses and entities classified as an Australia Privacy Principle Entity (APP Entities) are required by law to have a privacy policy. This policy must be freely available, most commonly on a website, and must be tailored to reflect the operations and practices of the business.

A privacy policy informs third parties of: what personal information you collect how that information is held what you use that information for whether you will disclose personal information to any overseas recipients and other required matters.

56 Doctor Q | Summer

Craig Hong

Director hillhouse.com.au

Collection and storage of personal information The Privacy Act includes a number of requirements around the collection and storage of personal and sensitive information. Unless an exemption applies, APP Entities should only collect personal and sensitive information with consent and only if collection of that information is reasonably necessary for or directly related to its functions or activities.

AAP Entities must take reasonable steps to ensure the personal information (including sensitive information) they hold is protected from misuse, interference, loss, unauthorised access, modification and disclosure.

Good data hygiene and regularly updated policies and procedures around collecting and storing personal information are necessary to ensure compliance.

An APP Entity is required to destroy or de-identify information when it holds personal information about an individual and the business no longer needs the information for any purpose for which the information may be used or disclosed by the business under the Privacy Act the information is not contained in a Commonwealth record and the business is not required by or under an Australian law, or a court/tribunal order, to retain the information.

What do you do if there is a data breach?

APP Entities must notify the Office of the Australian Information Commissioner (OAIC) if they have reasonable grounds to suspect that an eligible data breach has taken place. An eligible data breach is where there is unauthorised access to, disclosure of, or loss of personal information held by an APP Entity and such access, disclosure, or loss is likely to result in serious harm to individuals the information relates to.

In July-December 2023, more than 20 per cent of data breach notifications were made by health service providers, more than double every other sector (Australian Government, 2024). It is vital for health and medical practices to have a carefully considered procedure in place for dealing with a data breach before it happens.

A report to the OAIC does not need to be made if the entity takes action which reasonably prevents serious harm. This can include informing any persons affected of the scope of the breach and what actions they should take to protect themselves. However, a decision not to report a data breach on this basis must be made carefully.

In the event of a data breach, the business must as soon as practicable provide a statement to the Privacy Commissioner sharing: the identity and contact details of the business a description of the eligible data breach that the business has reasonable grounds to believe has happened the particular information concerned recommendations about the steps that individuals should take in response to the eligible data breach that the business has reasonable grounds to believe has happened and any other required information.

As a special benefit to AMA Queensland members, we offer a no-obligation 30 minute virtual consultation regarding privacy policies issues in your practice.

Data Breach Statement Businesses need to take reasonable steps to provide the information in the Data Breach Statement as soon as practicable after it is prepared: to either all individuals whose personal information was the subject of the data breach to either all individuals who are at risk from the eligible data breach or if neither option above is practicable, by publishing a copy of the statement on its website and taking reasonable steps to publicise the contents of the statement.

Next steps Ensuring you are compliant with privacy laws is a proactive and crucial step in safeguarding your business.

The Australian Government has recently introduced privacy reforms, to be implemented in tranches, focusing on enhancing the protection of personal information and establishing new privacy-related offences. It is important these be considered in addition to the current privacy compliance obligations.

We encourage you to seek professional legal advice around your practice’s needs with regards to privacy.

Hillhouse Legal Partners has extensive industry knowledge and expertise in the medical sector working with clients on these issues.

To discuss your practice’s privacy requirements, please contact Craig Hong, Director, Hillhouse Legal Partners on 07 3220 1144 or email craig@hillhouse.com.au.

Retirement isn’t a passive event.

It’s an active choice.

Taking control of your retirement planning means making intentional choices about your future. With a well-crafted retirement plan, you can actively decide how you want to spend your time, manage your resources, and maintain the lifestyle you deserve.

The power of starting early The earlier you start, the more you can grow your wealth, leverage compounding benefits, and set yourself up for a comfortable future. Starting now allows you to build a retirement where you have the time, freedom, and confidence to pursue your personal interests.

It’s simpler than you think We know retirement planning can seem complex—balancing today’s expenses with tomorrow’s needs. But it’s easier than you might expect, and our team is here to guide you each step of the way.

Our advisors can help you:

     

Set retirement income goals Estimate expenses Develop wealth creation strategies Maximise your superannuation contributions Implement tax-efficient strategies for retirement savings Continuously review and improve your plan

Start your journey today.

Take the first step toward a secure and exciting retirement.

Connect with our advisors to create a tailored plan that grows with you.

SYDNEY | BRISBANE | NEWCASTLE

1800 988 522 | financialplanning@cutcher.com.au | cutcher.com.au The information in this publication contains general advice only. It has been prepared without taking your personal objectives, financial situation or needs into account.

You should consider whether the information contained within this publication is appropriate for you. Where we refer to a financial product you should obtain the relevant Product Disclosure Statement or offer document and consider it before making any decision about whether to acquire the product.

Cutcher & Neale Investment Services is a Corporate Authorised Representative (No: 260696) of Cutcher & Neale Financial Services Pty Ltd AFSL No: 433814 ABN: 22 160 682 879

Wade Johnson

Partner, Cutcher & Neale Wealth Management

WEALTH MANAGEMENT

Time is money: why early retirement planning matters Retirement is a major life transition, and the earlier you start planning, the better prepared you’ll be for a smooth, comfortable post-work life. Early planning allows you to take advantage of compounding investments, build a strong financial foundation, and set clear goals for the lifestyle you want in retirement.

When should you start planning?

The best time to start planning for retirement is as soon as you begin earning an income. The earlier you establish your goals and put a plan in place, the better positioned you’ll be to achieve the retirement lifestyle you desire.

The primary advantage of starting your retirement planning early is the ability to benefit from the power of compounding. When you invest or save over a long period, your money grows not just based on your initial contributions but also on the returns those contributions generate. The longer your investment horizon, the more time compounding has to work its magic.

Starting early also allows you to adopt a more balanced approach to saving and investing. You can contribute smaller amounts consistently over time, rather than feeling the pressure to save large sums closer to retirement. This is often less stressful and more sustainable, enabling you to manage current financial responsibilities, like paying off a mortgage or supporting children, while still building your retirement nest egg.

For many Australians, superannuation is a critical source of retirement income. The earlier you start contributing to your super, the more money you will have when you retire. Voluntary contributions can help boost your super balance and offer tax advantages, particularly for higherincome earners.

Maximising your concessional and non-concessional contribution caps each year is a valuable strategy to grow your super. The current concessional cap is $30,000 annually, while the non-concessional cap is $120,000.

The importance of a financial plan Creating a solid financial plan is essential for long-term security and peace of mind. A well-thought-out plan not only helps you grow your wealth through investments but also ensures you’re prepared for any future expenses, such as healthcare or aged care, without compromising your current lifestyle.

By starting early and budgeting for the life you want in retirement, you can enjoy your golden years free from financial stress, knowing you’ve taken the right steps to secure your future.

Our expert advisors are here to help you build a financial roadmap that ensures a secure, fulfilling retirement.

Get in touch with us on 1800 988 522 or at cnis@cutcher.com.au.

How much will you need?

One of the questions we get asked the most is ‘how much will I need?’. The answer will depend on a variety of factors, such as the lifestyle you envision and any changes in your spending habits during retirement.

For example, you may expect lower expenses once you have paid off your mortgage or reduced work-related costs, but you may also want to travel more frequently or take up new hobbies.

The information in this publication contains general advice only. It has been prepared without taking your personal objectives, financial situation or needs into account. You should consider whether the information contained within this publication is appropriate for you. Where we refer to a financial product you should obtain the relevant Product Disclosure Statement or offer document and consider it before making any decision about whether to acquire the product.

Cutcher & Neale Financial Services Pty Ltd AFSL No. 433814

Summer | Doctor Q 59

Want better value health cover?

We’re with you.

Join on any combined hospital and extras or extras only cover by 24 January*.

To claim for essentials like dental and optical straight away.

Dr Alice Rudd Member since 2006

Compare your cover today 1800 226 126 doctorshealthfund.com.au *New Doctors’ Health Fund members only. Must join by 24 January 2025. Offer & policy terms and conditions apply, visit doctorshealthfund.com.au/quickjoin for more details.

IMPORTANT: Private health insurance products are issued by The Doctors’ Health Fund Pty Limited ABN 68 001 417 527, a member of the Avant Mutual Group. Cover is subject to the terms and conditions (including waiting periods, limitations and exclusions) of the individual policy, available at www.doctorshealthfund.com.au/our-cover. MJN-1762 10/24 (ID-407)

1800 226 126 doctorshealthfund.com.au

Get to know Doctors’ Health Fund in under three minutes Part of a member-owned organisation and one of the fastest growing health funds, Doctors’ Health Fund continues to play an important role in protecting the health needs of the Australian medical community.

Choice, clinical independence, personalised service and health cover that provides true value at a competitive price, continue to be Doctors’ Health Fund’s priority. Their rich history and deep roots in the Australian medical community uniquely positions them as the trusted health fund for doctors at all stages of life.

Founded and owned by doctors Founded by the NSW Branch Council of the AMA in 1977 and first known as the AMA Health Fund, the health fund was created to ensure doctors and their colleague patients were adequately compensated for medical fees.

To this day, Doctors’ Health Fund continues to offer the best medical gap cover in Australia: benefits up to the AMA Fees List on Top Cover Gold hospital cover, protecting doctors as both patients and practitioners.

Members before profit As part of Avant, a member-owned organisation, Doctors’ Health Fund is owned by doctors and any profits are reinvested to benefit their members and the community.

Because of this, their goal isn’t to maximise profits for public shareholders but to keep premiums affordable and improve services for their members.

They’re also part of Members Health, a peak industry body for an alliance of health funds that are not-for-profit or part of a member-owned group, regional or community based, strengthening their focus on putting members first.

A focus on value Members of Doctors’ Health Fund get value through industry leading gap cover, competitively-priced Gold hospital cover and generous extras benefits and limits:

Doctors’ Health Fund covers more medical services with no gap than any other health fund, with 93 per cent of medical services covered compared to an industry average of 88.3 per cent*

Prime Choice Gold hospital cover provides

comprehensive protection at a price that’s comparable with and, in some cases, cheaper than the big health funds**

No-gap general dental checkups once a year for

Starter Extras, twice a year for Essential Extras and unlimited for Total Extras.

Plus, unlike some other health funds, Doctors’ Health Fund has no preferred provider networks for extras, so members choose the provider that’s right for them.

Local service team who understand doctors The Doctors’ Health Fund service team truly understands the unique demands on your time. They answer calls quickly, most in under 30 seconds, and with a 95 per cent member satisfaction rating, their knowledgeable and helpful team is perfectly equipped with all the answers to really care and support both members and providers with any enquiry.

Visit their website or call 1800 226 126 to see how your cover compares and what else Doctors’ Health Fund can offer you. *Private Health Insurance Ombudsman, State of the health funds report 2023, Ombudsman’s website **Comparing Doctors’ Health Fund and the big health funds (BUPA, HCF, NIB, HBF & Medibank) only and is based on Gold hospital cover for one person – or a single policy – with a $750 excess, full or interim Medicare eligibility and doesn’t include the Australian Government rebate on private health insurance.

We have compared open, retail hospital policies and have excluded closed and corporate policies. Prices were sourced from privatehealth.gov.au on 1 April 2024 and are subject to change. Prices don’t include extras cover. It’s important to always consider your own circumstances when comparing health insurance policies as there’s a lot of factors that make up the final premium amount. ^New Doctors Health Fund members only. Must join by 24 January 2025. Offer & Policy terms and conditions apply, see doctorshealthfund.com.au/quickjoin for more details.

Private health insurance products are issued by The Doctors’ Health Fund Pty Limited, ABN 68 001 417 527 (Doctors’ Health Fund), a member of the Avant Mutual Group. Cover is subject to the terms and conditions (including waiting periods, limitations and exclusions) of the individual policy, available at doctorshealthfund.com.au/our-cover.

Doctors’ Health Fund is the only health fund made for doctors, their families, and the medical community. Ready to switch to better value health cover? Join now on any combined hospital and extras policy or extras only cover, and we’ll waive the two-month waits on extras.^ You’ll be able to claim for health and wellness essentials like dental, optical and physiotherapy straight away.

All about you

Watch

Read

Slow Horses

Leave the Girls Behind

by Jacqueline Bublitz Nineteen years ago, Ruth-Ann Baker’s childhood friend was murdered by convicted killer Ethan Oswald. Haunted by what happened, Ruth has long been convinced Oswald had other victims. But no one has ever believed her.

After dropping out of college and failing to prove her serial killer theory, Ruth is bartending when she hears that another young girl has gone missing from her home town. With Oswald now deceased, she begins to suspect he had an accomplice. A partner in crime who is still active today.

Crossing the globe from New York to New Zealand, Ruth unlocks parts of herself that she hasn’t dared to revisit, bringing her perilously close to three different women. The deeper she delves, the more she can’t shake the feeling that one of them knows the truth. About her childhood friend. About the missing girl. And, perhaps most dangerously of all, about Ruth herself...

The acclaimed author of the ‘tour de force’ (The New York Times Book Review) Before You Knew My Name returns with another taut suspense thriller, overlaid with a moving exploration of the ways in which violent crime ricochets through the lives of those left behind.

WIN

Surrounded by losers, misfits and boozers Hanging by your fingernails You made one mistake, you got burned at the stake You’re finished, you’re foolish, you failed Mick Jagger wrote the theme song for this British spy thriller television series based on the Slough House series of novels by Mick Herron. Slough House is an administrative purgatory for MI5 service rejects who have seriously failed a task but not been sacked. Those consigned there are known as “slow horses”, a play on “Slough House”.

If you ever had a small crush on Gary Oldman, particularly after he played Harry Potter’s rockstar godfather Sirius Black, you may be cured of that after seeing Dracula himself playing Jackson Lamb, the head of Slough House. He’s slovenly, flatulent, rude and a terrible boss who expects his slow horses to quit out of boredom or frustration.

Life in Slough House is defined by drudgery, yet the slow horses somehow get involved in investigating schemes that endanger Britain. Check it out on Paramount Plus.

this book: Leave the Girls Behind Entries close 30 January 2025 Fill out the online form

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Discounts on workwear If you need some new workwear in 2025 – scrubs, suits or footwear – get a better price with your Blue Light Card through AMA Queensland.

You’ll find discounts on NNT Uniforms, Ergonx work boots, Peter Jackson, Crocs, New Balance, Vivobarefoot, Clarks and The Iconic.

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62 Doctor Q | Summer

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Dendy Cinemas tickets Entries close 30 January 2025

Andrew Lloyd Webber’s Love Never Dies Starts 1 February Love Never Dies continues the story of The Phantom of the Opera. Featuring one of Andrew Lloyd Webber’s finest musical scores performed by a 21-piece orchestra, a stunning cast of 36 including Ben Lewis and Anna O’Byrne, more than 300 incredible costumes and a magnificent set illuminated by over 5,000 dazzling light bulbs. The year is 1907. It is 10 years after his disappearance from the Paris Opera House and the Phantom has escaped to a new life in New York where he lives among the screaming joy rides and freak-shows of Coney Island. In this new electrically-charged world, he has finally found a place for his music to soar. All that is missing is his love - Christine Daaé.

Aida: Live in HD 2024-25 Metropolitan Opera | Starts 8 February

American soprano Angel Blue headlines as the Ethiopian princess torn between love and country in a new production of Verdi’s Aida by Michael Mayer that brings audiences inside the towering pyramids and gilded tombs of ancient Egypt with intricate projections and dazzling animations. Romanian-Hungarian mezzo-soprano Judit Kutasi also stars as Aida’s rival, Amneris, alongside Polish tenor Piotr Beczała as the soldier Radamès—completing opera’s greatest love triangle. Met Music Director Yannick Nézet-Séguin takes the podium.

Macbeth

Starts 7 February David Tennant (Doctor Who, Broadchurch) and Cush Jumbo (The Good Wife, Criminal Record) lead a stellar cast in an ‘enthralling’ new production of Shakespeare’s Macbeth, filmed live at the Donmar Warehouse in London, especially for the big screen. Unsettling intimacy and brutal action combine at breakneck speed as Max Webster (Life of Pi, Henry V) directs this tragic tale of love, murder, and nature’s power of renewal. With staging ‘full of wolfish imagination and alarming surprise’, the immersive 5.1 cinema surround sound places the audience inside the minds of the Macbeths, asking are we ever really responsible for our actions?

Dawn of Impressionism: Paris 1874 Exhibition on Screen | Starts 22 March

The Impressionists are the most popular group in art history – millions flock every year to marvel at their masterpieces. But, to begin with, they were scorned, penniless outsiders. 1874 was the year that changed everything; the first Impressionists, “hungry for independence”, broke the mould by holding their own exhibition outside official channels.

Impressionism was born and the art world was changed forever.

What led to that first groundbreaking show 150 years ago? Who were the maverick personalities that wielded their brushes in such a radical and provocative way? The spectacular Musée d’Orsay exhibition brings fresh eyes to this extraordinary tale of passion and rebellion. The story is told not by historians and curators but in the words of those who witnessed the dawn of Impressionism: the artists, press and people of Paris, 1874. Made in close collaboration with the Musee d’Orsay and National Gallery of Art, Washington D.C. Summer | Doctor Q 63

The stars that align It is a frequent topic of conversation whenever doctors meet, especially when older ones meet the younger ones. I love asking young doctors and medical students what motivated each of them to pursue the life of the doctor? What were the influences? What were the triggers? What was the attraction?

The usual responses percolate through the conversation.

The passion for altruism, the powerful subliminal forces of family dynasties (think ENT and ophthalmology), the fascination with the complexities of the human body or the intellectual curiosity. Maybe even job security. Disease is right there beside death and taxes as the great constants in life. Interestingly and refreshingly, I have never heard anyone talk about the money.

For me it was a bit simpler. It was all down to Hawkeye.

That smooth-talking, quick-witted charmer, cutting and suturing, drinking and flirting his way through the Korean war as the star of M*A*S*H. I loved his compassion and altruistic fervour. I loved that he always knew what to do and more importantly always did the right thing.

As a shy young fella, I was envious of the twinkle in his eye and the ease with which he charmed every nurse south of the 38th parallel. He was confident and always quick with the one liners. Hawkeye and his mates at the 4077th M*A*S*H certainly made a massive impact on me as I was pondering my future career and filling in my university enrolments. I loved the adventures and the incredible variety of problems that he confronted, expertly. I admired his tenacity and his staunch commitment to help his patients. I found his forthright loyalty to his friends something to copy and implement in my own life.

There were other fictional doctors. I loved ER too. I used to love the adrenaline rush of their work in Cook County Hospital’s Emergency Room. Carter was the medical student I always wanted to be. Smart, sharp and always knowing the answers on ward rounds. In reality I was the very opposite. I always fantasised about confidently ordering a ‘chem 7, CBC and cross table ‘C’ spine, chest and pelvis and then paging Benton’ just like Carter did each Thursday night.

These days the grim truth is that reality TV shows are cheaper to produce and so the great series like MASH and ER seem to have become extinct. I liked RPA and I still watch 24 hours in Emergency. I know some doctors hate watching medical shows. They writhe with frustration with the inaccuracies and I suppose they reckon they need a break from it all when they are relaxing at home.

But for me there is a bit of freedom in knowing that all the patients, with their mysterious symptoms, complex problems and demanding dispositions are not my problem and not my responsibility. I find that liberating. And when I get sick of it I can turn the TV off. What a treat it would to be able to do that to a waiting room full of coughs, gripes and complaints.

64 Doctor Q | Summer

Dr Matt Young

General Practitioner, Inala Medical Centre

It is funny how life pans out. For the last almost 20 years I have worked in Inala. I moved there with my great mate, Stevo, whom I met when I was working at the Army hospital at Enoggera. We wore Hawaiian shirts at least once each week and by a phenomenal coincidence the post code of Inala is 4077, just like the numerical signature of M*A*S*H. We didn’t ever quite get around to establishing a still in the staff room to make martinis but we certainly had plenty of laughs and continue to do so.

Disappointingly, we never hired anyone quite as idiotic as Frank Burns, or anyone as glamorous as Margaret ‘Hot Lips’ Houlihan, but we have had some great colleagues and friends on staff.

Sometimes working in general practice feels like a war zone but at least no one is shooting at us. So, 40 years down the track, I thank Dr Benjamin Franklin Pierce - or Hawkeye to his mates. I still love watching MASH reruns and my kids have become addicted too. All these years down the track, I still love wearing Hawaiian shirts to work, I still aspire to be half as noble as Hawkeye and he still makes me laugh.

Phil Manser

Wine Direct 1800 649 463 phil.manser@winedirect.com.au

How much wine?

We often get asked some variation of ‘how many glasses in a bottle of wine?’ And our response is always: ‘Do you want the short answer, or the long answer?’ Short answer? Five. The long answer: it depends.

How many millilitres is a glass of wine?

First of all, let’s talk about units of alcohol versus serving sizes. This is the scientific bit behind the question of how many glasses are in a bottle of wine.

A unit of alcohol, according to the Australian Government Department of Health and Aged Care, is 10g of pure alcohol, which is the amount of alcohol the average adult can process in an hour. ‘Processing’ means that within an hour there should be little to no alcohol left in the blood of an adult (this isn’t a hard and fast rule because it can vary from person to person).

Of course, when you’re drinking wine, you’re not drinking pure alcohol, so the number of standard units of alcohol in a glass of wine will depend on the percentage of alcohol in the wine itself.

So, for example, for a wine that has an alcohol by volume (ABV) of 13.5 per cent, a single unit of alcohol is 93.75ml.

If your wine has a higher ABV, a single unit will be smaller than that. If the wine is lower in alcohol, you’ll get more in your glass before you hit that single unit threshold.

The short answer above (five glasses of wine in a bottle) is based on five pours of 150ml, but it’s important to remember that this measure of a standard glass isn’t the same as a standard unit of alcohol.

What size is a glass of wine?

As we mentioned above, a standard pour at a bar or restaurant is usually 150ml, but some will serve glasses that are 125ml, and some will offer a large glass option, which is 250ml.

When you’re at home, free-pouring wine, you could be serving much more than this. Which means you might only get three, or fewer, glasses from a bottle of wine.

The size of your pour might also be influenced by the size of your glass. If you’re pouring into a smaller glass, you’re likely to pour a smaller serve.

It doesn’t make a lot of sense to pour drinks that are 93.75ml though, so a standard pour is usually 150ml (although this also can vary depending on the place doing the pouring).

Summer | Doctor Q 65

Discover Canada There’s so much more to Canada than maple syrup and skiing! As the world’s second-largest country, it offers a wealth of experiences for travellers. With towering peaks, crystal clear lakes, bustling cities and famously friendly locals, Canada is a destination that promises something for everyone.

Breathtaking natural beauty

History and culture Canada’s history is as rich and diverse as its landscape.

Once a battleground between French and British forces, it remains part of the Commonwealth, as we do in Australia, while retaining strong French influences.

Today, it’s proudly bilingual, blending ‘Bonjour’ and ‘Hello’ in everyday life.

One of the most iconic wonders of Canada is the Canadian Rockies. This majestic mountain range, formed over 70 million years ago by tectonic plate collisions, is a spectacle of rugged peaks, glacier-fed lakes and abundant wildlife, including grizzly bears, elk and caribou. A UNESCO World Heritage site, it’s a year-round playground for nature lovers.

Dig deeper into its heritage, and you’ll uncover the stories of the First Nations, Inuit and Métis peoples.

Their unique cultures, languages and traditions enrich the country’s multicultural fabric, offering visitors a meaningful connection to its roots.

Did you know British Columbia alone has more forested land than the size of Germany and France combined?

With so much space to explore, it’s the perfect place to reconnect with nature.

AMA Queensland invites you to Vancouver for its Annual International Conference in September 2025.

With mild temperatures ranging from 12°C to 19°C, it’s the perfect time to visit.

Adventure for everyone Canada’s diverse landscapes make it a haven for adventure enthusiasts. Whether it’s skiing in renowned resorts like Whistler and Lake Louise, hiking scenic trails or kayaking on glacial lakes, there’s an activity for every season.

Prefer to relax? Climb aboard a glass-domed train and let the stunning views come to you. From snow-capped peaks to roaming wildlife, your eyes will be treated to their own unforgettable adventure.

Wild wildlife With vast wilderness. unspoiled habitats and low human population, Canada is a sanctuary for wildlife. Spot killer whales off the coast, observe polar bears in the Arctic tundra or catch a glimpse of moose and grizzlies in their natural habitats.

Home to more than 200 species of mammals, 462 bird species and an array of marine life, Canada is an animal lover’s paradise!

Your invitation to explore Canada

Vancouver is the gateway to several national parks, including the famed Stanley Park. As Vancouver’s first and largest urban park, it’s a magnificent green oasis amidst the city. From cultural landmarks and beautiful beaches to wildlife and dining, Stanley Park is a hub for sporting events, weddings, and film production.

Exclusive pre- and post-conference travel options Orbit World Travel has curated spectacular packages to make the most of your Canadian journey, with exclusive bonus inclusions: uxury Alaska Cruise: Explore the breathtaking L Alaskan coastline aboard Regent Seven Seas Cruises, with up to USD$1,200 onboard spending included. layoquot Wilderness Lodge: Indulge in a luxurious C retreat on Vancouver Island, with a CAD$500 credit towards heli-tours. ocky Mountains Explorer Tour: Join a dedicated R AMA Queensland group tour, complete with Fairmont resort stays. ocky Mountaineer Rail: Experience the iconic rail R journey through the stunning Banff, Lake Louse and Jasper landscapes.

Earlybird perks Register early to enjoy additional inclusions valued at over $1,200! This is your chance to combine professional development with the adventure of a lifetime.

Canada awaits, let Ros and Karen from Orbit World Travel take you there.

Ros Chillingworth

Orbit World Travel 1300 262 885 amaq@orbittravel.au

Summer | Doctor Q 67

2024 Christmas Appeal

Christmas

Raising funds for family violence support services

is not always easy

Donate now

Support the AMA Queensland Foundation Christmas Appeal This Christmas, as we celebrate the season of giving, let’s come together to bring hope and safety to families affected by domestic violence. For many, the holiday season isn’t filled with joy or warmth but rather the burden of fear and uncertainty. The demand for safe spaces and support is more crucial than ever, and with your help, we can help provide comfort, shelter, and vital resources to those in need.

We are asking for your continued support for the 2024 AMA Queensland Foundation Christmas Appeal, which will raise money for family violence support services to continue their work.

With your help,

we can help provide comfort, shelter, and vital resources to those in need.

amaqfoundation.com.au 07 3872 2222 amaqfoundation@amaq.com.au

Family violence support services Domestic and family violence involves abusive and violent behaviour towards a partner, former partner or family member.

It extends beyond physical violence, and can involve actions that control, humiliate or scare the other person or people in the household.

National statistics can help us understand the gravity of the situation, but alarmingly, many victims of domestic and family violence will never report their experience.

With many incidents going unreported, domestic and family violence may be much worse than we think.

Your kind donation will give hope to families that 2025 might be safer and less stressful.

Thank you for your consideration and for your financial support!

Yours Sincerely,

Dr Dilip Dhupelia AMA Queensland Foundation Chair

For more information about the AMA Queensland Foundation or to make a donation 68 Doctor Q | Summer visit amaqfoundation.com.au or call the Foundation office on 07 3872 2222.

It’s been a big year for the AMA Queensland Foundation Medical Student Scholarships opening January Medical Students Scholarship applications will open in mid-January. Scholarships of $10,000, paid in two $5,000 instalments will be awarded to up to three medical students experiencing financial hardship to support them to continue their studies.

Fundraising for this initiative is through the generosity of our donors during our End of Financial Year tax appeal.

Congratulations to this year’s recipients Goachagorn Darathai, Wylie Leeson and Taylor Edgley, chosen from a record 84 applicants.

We know the costs of living and study are hitting medical students harder than ever, and we are grateful to be able to help even a handful of individuals.

Sponsor one Student program In 2024, the AMA Queensland Foundation was able to support an additional student applicant via the Sponsor one Student (SoS) Program. This initiative enables an organisation to fundraise in partnership with the Foundation to provide a much-needed $10,000 medical student scholarship.

Congratulations to Anna Duan who received a scholarship thanks to the generosity of Indian Medical Association of Queensland (IMAQ) members.

Along with EOFY fundraising, we envisage SoS partnerships to be a crucial way we can support more Queensland medical students experiencing hardship.

If you are interested in supporting SoS in 2025, please reach out to us by phone 07 3872 2222 or email amaqfoundation@amaq.com.au.

GPTQ Training and Research Bursaries opening March Applications for General Practice and Training Queensland (GPTQ) Training and Research Bursaries will open on 1 March 2025 and close 1 May 2025. Up to three GP Registrars will receive bursaries of $20,000 in 2025 to undertake training initiatives or research relevant to general practice.

2024 recipients

Professor Ewen McPhee for exploration in Artificial Intelligence (AI) as a tool for doctors.

Dr Lisa Fraser for further training to improve

reproductive and sexual health outcomes in rural and remote areas and expand on the Doctors Bag for use in rural disaster management.

Dr Rowan Gibbs to advance medical expertise and operate outreach clinics in remote communities in Queensland.

Dr Naomi Penna to support research into postpartum support for mothers in rural and remote North Queensland.

Causes supported in 2024 The AMA Queensland Foundation also provided:

$10,000 contribution to University of Queensland

Centre of Clinical Research (UQCCR) fundraising for a Digital qPCR apparatus for gene detection to help improve outcomes for prostate cancer patients.

$20,000 to support newly bereaved parents through the Ladybird Care Peer Mentoring program. Funds provide training, matching and supervision for 25 peer mentors to offer empathetic support and companionship at a crucial time of need.

Give regularly to help us do more It’s not just at Christmas that your donation makes a difference. Consider a regular and ongoing contribution to the AMA Queensland Foundation to help fund the causes that matter to you. Our Regular Giving Program is the lifeblood of our Foundation, helping us plan well and commit confidently to important projects that fall through the gaps of existing funding.

Donate today

Thank you for your support.

Summer | Doctor Q 69

InPrint Current Medical Diagnosis and Treatment 2025 The #1 annual guide in adult internal medicine.Each year CURRENT Medical Diagnosis and Treatment (CMDT) undergoes extensive revision to deliver new clinical developments in every field of adult internal medicine-making it the most popular annual textbook of its kind.

For more than six decades, CMDT has been disseminating authoritative information that students, residents, and clinicians need to build their medical knowledge, expertise, and confidence. Written by top experts in their fields, chapters are formatted so you can find the most relevant diagnostic tools for day-to-day practice.

Win this book: 30 January

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this book: Current Medical Diagnosis and Treatment 2025 Fill out the online form. Entries close 30 January

InPrint book winner

Winners Dr Nigel Dore Dr Ruth Susnja Dr Anne Kynaston Dr Chris Cunneen OAM Dr Barbara Woodhouse

Dr Nigel Dore won a copy of The Foundation and Art of Robotic Surgery, thanks to our friends at McGraw-Hill Education.

Novel winner

Dr Kerinya Pillai has won a copy of The Chilling

by Riley James, thanks to Allen and Unwin Publishing.

Refer 1 member 25% discount*

Want a discount on your membership rate for 1 year?*

Refer 2 members 50% discount*

Refer a member today.

Refer 3 members 75% discount*

Read more *T&C apply

70 Doctor Q | Summer

Refer 4 members 1 year complimentary*

AMA Queensland is now part of something bigger at Officeworks.

Officeworks has partnered with AMA Queensland to provide you with the best products, services and solutions to help make bigger things happen for your business.

Register now for a 30 Day Business Account at officeworks.com.au/ ama-queensland

Who needs complicated CPD in their lives?

Ahpra medical registration renewals may now be closed, but with CPD Home’s special 2 for 1 offer, now is the perfect time to switch! Make the smart move for a seamless, easy, uncomplicated CPD solution that saves you time and money.

Secure your CPD home for the next two years at an unbeatable price If you haven't yet chosen your 2024 CPD home, that's OK — our 2024/2025 offer is still open!

But if you’ve already joined another CPD home provider for 2024, why not get ahead of the game and take advantage of our exclusive 2025/2026 2-for-1 offer? Subscribe today, and your CPD Home subscription will be covered until December 2026 at no extra cost. That’s right, pay for one year and get 2025 and 2026 included! *

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What we offer A comprehensive program to suit every career stage and scope of practice Access the broadest range of CPD activities tailored to you Enjoy seamless tracking and personalised support

We understand that as a doctor, your time is precious. You’re constantly helping others, and the last thing you need is to deal with overly complicated CPD compliance requirements. That’s why we’re here – to simplify the process, so you can spend more time doing what you do best.

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2024

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For CPD tracking anytime, anywhere, the CPD Home ad-free app gives our Subscribers access to all the most important CPD Home features right at their fingertips. Just another reason to join CPD Home - we make CPD simple.

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