AUTUMN 2018 | VOL. 106
MOCA 5 update Doctor Q is free to AMA Queensland Members
New Queensland Health Minister New Health Ombudsman
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Doctor Q Autumn
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Ups and downs are for your working week, not your super. While you’re looking after your patients, it’s good to know someone’s looking after you. Every day at QSuper we strive to deliver strong returns with less risk.
Welcome to the QSuper feeling. This information and all products are issued by the QSuper Board (ABN 32 125 059 006 AFSL 489650) as trustee for QSuper (ABN 60 905 115 063). You should consider whether QSuper is right for you, by reading the PDS available from our website at qsuper.qld.gov.au or call us on 1300 360 750. © 2018 QSuper Board
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CONTENTS
REPORTS
12
6
Editor’s desk
12
MOCA 5 negotiations progress
8
President’s report
14
10
CEO’s report
New Health Minister Steven Miles
26
Council of Doctors in Training update
40
AGM, election notice and nomination form
36
Member news
64
Foundation news
M O C A 5 U P D AT E
BUSINESS TOOLS
14
F E AT U R E S
CURRENT ISSUES
46
Stuff* happens
16
New Health Ombudsman
48
Service entities: tips and traps
18
50
Patient referral spotlight: MND and Me Foundation
The Prince Charles Hospital medical imaging report
22
51
Storing your money
Workplace Relations Potential Claims
52
When is it okay to breach patient confidentiality?
28
Improving the quality and appropriateness of health care
54
Doctors’ Health Fund records lowest average premium increase in 2018
30
Medical culture: what are you doing to change it?
31
MBS review
32
GPs on the front line to improve veteran health
N E W H E A LT H M I N I S T E R STEVEN MILES
PEOPLE & EVENTS 20
44
MEET THE SPEAKER: DR DAN DIAMOND
Meet our Workplace Relations Team
24
Resilience on the Run
29
Obituary: Dr John Waller AM
34
Events calendar
35
Online registration is here
38
LMA round up
42
Annual Conference New Orleans
44
Meet the Speaker: Dr Dan Diamond
45
Junior Doctor Conference 2018
LIFESTYLE 57
Enchanting and exciting Egypt
58
NOA Restaurant review
59
Ageing whites
60
Meeting Otzi, the ice man
62
All About You
63
Dendy Cinemas
66
InPrint: Sherris Medical: Microbiology, Seventh Edition
Doctor Q Autumn
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Editor’s Desk Welcome to our jam-packed Autumn edition! If you would like to contact us in regards to Doctor Q, please email me at editor@amaq.com.au.
APOLOGY
Our sincere apologies to Dr Susan O’Dwyer, Chair, Queensland Medical Board of Australia and Practitioner Member from Queensland, Medical Board of Australia for omitting her correct title. Dr O’Dwyer is a medical practitioner and is currently the Executive Director, Medical Services at Metro South Health.
OBITUARIES
The following AMA Queensland members have recently passed away. Our sincere condolences to their families. Dr Ronald Neil BROWN General Practitioner Late of Keperra Member for 60 years
Dr Douglas John CHAPMAN General Practitioner Late of Buderim Member for 68 years
Dr John Lewis FOTHERGILL General Practitioner Late of Ashmore Member for 57 years
Dr John Powell WALLER AM Medical administration specialist Late of Hendra AMA Queensland Past President 1989-90 Member for 61 years
Dr Leslie Strafford STARK General Practitioner Late of Surfers Paradise Member for 66 years
AU S T R A L I A DAY H O N O U R S
Congratulations to the following members recognised at the recent Australia Day awards.
Dr Peggy BROWN AO Dr Brown was named an Officer the in the General Division for distinguished service to medical administration in the area of mental health through leadership roles at the state and national level, to the discipline of psychiatry, to education and to health care standards. Member for 35 years Dr David William GREEN OAM Dr Green received a Medical in the General Division for service 6 Doctor Q Autumn
to emergency medicine, and to professional organisations. Member for four years Dr Barry Peter HICKEY OAM Dr Hickey received a Medical in the General Division for service to thoracic medicine. Member for 54 years Dr Sharon KELLY PSM Dr Kelly received a Public Service Medal for outstanding public service to the health sector in Queensland.
BOARD OF DIRECTORS Dr Bill Boyd President Dr Jim Finn Vice President Dr Shaun Rudd Chair of Board and Council
Dr Dilip Dhupelia Member Appointed Director
Dr Bav Manoharan Member Appointed Director
Dr Peter Isdale AM Skilled Director
Dr Mellissa Naidoo Member Appointed Director
Ben Hancock Skilled Director
COUNCIL Dr Kimberley Bondeson Greater Brisbane Area
Dr Katherine Gridley Greater Brisbane Area
Dr Paul Bryan General Practitioner Craft Group
Dr John Hall Downs and West Area
Dr Matthew Cheng Doctors in Training Craft Group Dr Michael Cleary Greater Brisbane Area
Clare Mahon Medical Student Observer Dr Bav Manoharan Greater Brisbane Area Dr John F. Murray Specialist Craft Group
Associate Professor Geoffrey Hawson Retired Doctors Craft Group
Dr Alex Ritchie Specialist Craft Group
Dr Wayne Herdy North Coast Area
Dr Michael Clements North Area
Dr Scott Horsburgh General Practitioner Craft Group
Dr Sarah Coll Specialist Craft Group
Dr Viney Joshi International Medical Graduate Craft Group
Haydn Dodds Medical Student Craft Group Dr Dilip Dhupelia Part-time Medical Practitioner Craft Group
Dr Sam Kim Greater Brisbane Area Professor Steve Kisely Greater Brisbane Area
Dr Siva Senthuran Full-time Salaried Medical Practitioner Craft Group Dr David Shepherd Far North Area Dr Stephen Withers Gold Coast Area Dr Nicholas Yim General Practitioner Craft Group Dr Chris Zappala Immediate Past President
AMA QUEENSLAND S E C R E TA R I AT Jane Schmitt Chief Executive Officer
Filomena Ferlan General Manager Corporate Services
Holly Bretherton General Manager - Member Relations and Communications
Editor: Michelle Ford Russ
Doctor Q is published by AMA Queensland
Graphic Designer: Aleisha Coffey
Phone:
Journalist: Chiara Lèsevre Advertising: Louise Glynn
(07) 3872 2222
Address: PO Box 123, Red Hill QLD 4059 Email:
amaq@amaq.com.au
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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.
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President’s report DR BILL BOYD
In another life, I did my time as med super in Weipa. In addition to the designated role, I was also the private GP, the Government Medical Officer, the Commonwealth Medical Officer and the local vet. I could write a book on my experiences but I report on this last attribute advisedly. As the only port of call for pet owners, I ministered life and death to a number of animals who required all manner of healthcare. One prominent lady brought me a Siamese cat suffering, in her mind, from constipation. Life, and death, in a remote setting, in hard country, was almost matter of fact. On my arrival there was a motorcyclist with a fractured skull. Next day a 16 year-old, Indigenous lady with a syphilitic, 28-week intra-uterine death. Next day, Easter Monday, a miner hanged himself in the washrooms. I was informed that, as Government Medical Officer, it was my responsibility to do the post mortem. Little did the (wonderful) police officer know that, in another life yet again, I had done about 150 teaching post mortems. When I performed before him a full Rokitansky autopsia cadaverum in about 45 minutes, he was speechless. Rural and remote medicine is at once terrifying and yet fulfilling. I was, on face value, an inadequate GP but my advanced obstetrics and gynaecology training at least taught me to recognise what I didn’t know and how to get the answers.
I was parachuted by Queensland Health into Weipa as an International Medical Graduate (IMG). Little has changed since that time and Queensland Health still relies on staffing the bush, anywhere north of Redcliffe, with junior doctors and IMGs. Worldwide, it is human nature to be metro-centric and Queensland Health is no different. A bum-on-a-seat mentality prevails and as long as there is not a political imperative, that town is off the radar screen. Our recent Rural, Regional and Remote Workforce Survey showed most doctors working in these areas reckon it takes six to 12 months to fill new vacancies. AMA Queensland remains committed to our Five Point Plan for Better Health put forward at last year’s state election. The plan includes policies to make the healthcare system fairer for patients and medical professionals in our regional areas. Queensland needs to take effective action to tackle the shortage of doctors that is affecting these areas. Too few medical graduates are choosing to practice outside the south-east. In remote areas of Queensland, doctors treat twice as many patients as their colleagues in the cities. The AMA proposes initiatives in education and training, rural generalist pathways, support for the families of doctors who decide to relocate, and new financial incentives to encourage more young doctors to work in the bush. Other points in the election platform involved extending funding for programs to improve the health of our doctors. Life is not always easy for a single doctor in a small town, away from friends and family, and in the case of IMGs, away from their own country too. Our Resilience on the Run program has Queensland Health funding to go out to interns all over the state and I hope this program helps some of our young isolated doctors in the bush. We’d love to see this program reach more established doctors in the future.
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When vision loss affects her daily life, it’s time to refer to Vision Australia. The allied health team at Vision Australia complement the work of eye care professionals. Our vision loss experts help patients use their remaining vision to get the most out of life. Your patients can also get help to access NDIS and My Aged Care funding. When to refer • Upon diagnosis of a permanent, non-correctable or progressive eye condition • Vision loss starts to impact everyday activities • Glasses no longer correct vision. To refer online or download free vision loss resources go to visionaustralia.org/AMA or call 1300 84 74 66 Gold Coast | Brisbane | Maroochydore | Townsville | Cairns
Sarah, Vision Australia client
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CEO’s report
JANE SCHMITT
M O C A 5 N E G O T I AT I O N S OFF THE STARTING BLOCKS AMA Queensland, in partnership with our affiliate union partner ASMOFQ, has commenced negotiations with Queensland Health to bring about the next Medical Officers’ Certified Agreement 5 (MOCA 5) for junior and senior public hospital doctors. We will be negotiating on your behalf for a MOCA 5 agreement that provides: a five per cent salary increase per year for the three years of the agreement; increased professional development leave and allowances; indexing allowances which haven’t previously been indexed; and travel provisions to support doctors working in regional public hospitals. You can read the full log of claims on p12. More than ever, it is important that we have critical mass to support negotiations. Ensure your AMA Queensland membership is renewed so we can continue to negotiate on your behalf. Ring (07) 3872 2222 and renew your membership today. The more member power we have behind us, the more effective we can be in advocating for you. We look forward to delivering a strong agreement that recognises the important work that our public hospital doctors provide to the state. We will keep members informed of progress with the negotiations, as they get underway. 10 Doctor Q Autumn
NEW MEMBER BENEFITS As a member, you have access to an expanding range of services and benefits. Whether you are setting up a medical practice, you are interested in securing a home loan or you wish to book an upcoming trip, our corporate partners are there to provide you with significant savings. This year, we have exciting new Emirates flight discounts offering up to 8 per cent off the best fares of the day to 145 countries across six continents. The discount code and details are available for members upon payment of their 2018 renewal. Don’t forget, you can also access discounted Virgin Lounge and QANTAS Club membership, and up to 10 per cent off a new vehicle purchases. In 2018, you will also be introduced to the membership rewards program, which will provide discounts on member fees and many other benefits, and we are currently working on new partnerships to further expand our offerings for you. Please take a moment to find out more about how you can get the best value out of your membership. You can find the full range of 2018 member benefits available to you on the AMA Queensland website – Member Benefits page.
2018 AMA QUEENSLAND ELECTIONS Nominations will open at 5pm on 26 March for the positions of President, Vice President, and Council members. More information about the new positions and requirements for being a councillor will be provided via email and on the AMA Queensland website once nominations open. Please find information about our Annual General Meeting and nomination forms on p38. The election results will be announced at our AGM on Thursday 17 May 2018.
A M O M E N T T O PA U S E We are trying something a little different with our Doctor Q covers this year. We will be featuring covers that inspire you to take a moment in your busy day to relax and have a few minutes of peace and tranquility. This edition’s cover image is taken at Coolangatta by ALT Images. If you have a photo that you would like our editorial team to consider, please let us know at editor@amaq.com.au.
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“Only collectively can Queensland doctors continue to improve the their wages and conditions of employment. So to make your voice heard - renew or join AMA Queensland and our partner union ASMOFQ” Dr jim finn
MOCA 5
negotiations progress On 20 February, The Australian Salaried Medical Officers’ Federation Queensland (ASMOFQ) and AMA Queensland bargaining team met with Queensland Health and the junior and senior doctor hospitals’ representatives to progress the Medical Officers’ Certified Agreement 5 (MOCA 5) on behalf of doctors within Queensland public hospitals. The AMA Queensland/ASMOFQ team is taking a proactive approach to these negotiations and meetings so far have clearly set the framework for how key negotiation issues and themes will be taken forward.
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AMA Queensland requested that existing terms and conditions from MOCA 4 be preserved and rolled over into MOCA 5. Queensland Health agreed to this claim. The team is negotiating for a MOCA 5 agreement that provides: a five per cent salary increase per year for the three years of the agreement; increased professional development leave (PDL) and allowances; indexing allowances which haven’t previously been indexed; and
travel provisions to support doctors working in regional public hospitals. Resident Medical Officers (RMOs) Dr Chris Maguire, Chair of AMA Queensland Council of Doctors in Training covered the Resident Medical Officer (RMO) claims, in particular: increase in the Vocational Training Subsidy to $6,000; increase in the Professional Development Allowance to $4,000; increase in the PDL to four weeks and a separate clause that PDL will
Moca 5 - laying the foundation for cultural change “Today, junior doctors have been given a guarantee that their voice and their concerns will form a central part of the new MOCA 5 negotiations. It’s an encouraging first step, but there’s a lot left to do.” Dr Chris Maguire During the final months of 2017, we visited 12 hospitals across Queensland and conducted meetings to consult with regional, senior and junior medical officers in preparation of the log. AMA Queensland also hosted webinars for junior and senior doctors in December. Along the way, more than 50 junior and senior public hospital doctors responded to our call to become MOCA 5 local representatives.
not be used as a replacement for examination leave; and meal breaks and rest pauses. Senior Medical Officers (SMOs) The most important claims put forward in the log of claims for Senior Medical Officers (SMOs) include: indexation and back payment of Motor Vehicle Allowance, Professional Development Allowance and Inaccessibility Allowance increased annually in line with pay increases, with increases back paid since introduction of allowances;
MOCA 5 - Membership matters Ensure your membership is up-to-date. Having a strong and united medical workforce behind the MOCA 5 negotiation team ensures your voice is heard at the negotiating table. Keeping your AMA Queensland and/or ASMOFQ membership current ensures the department knows the medical officers’ log of claims is backed by 100 per cent of the workforce. Renew now and encourage colleagues to join and you will also receive a referral discount of 25 per cent off next year’s membership. Contact details: P: (07) 3872 2222 W: www.amaq.com.au E: moca5@amaq.com.au
ASMOFQ and AMA Queensland will undertake regular bargaining meetings with the hospitals’ representatives and representatives from Queensland Health. Our team will continue their visits to Queensland hospitals throughout the bargaining period.
on call rates equally divided based on full-time equivalent within the department within SMOs scope of clinical practice; minimum of 10 per cent clinical support time per SMO, with higher amounts payable where the SMO can demonstrate they require additional time due to increased non-clinical duties (e.g. clinical leadership positions, supervisors of training etc.) We are also asking for a statement confirming that CST is protected time and should not be used to deal with staffing shortfalls or fatigue mitigation strategy; and
270 per cent payment for SMOs who are identified as being fatigued but “subject to the Medical Superintendent or delegate making an assessment of the organisation’s ability to reasonably defer or delegate the medical officers’ work” the SMO is required to perform work. “Ordinary work” – Fatigue leave applies when recalled, on-call and identify as fatigued. Reference to patient safety regarding fatigue reporting.
Doctor Q Autumn 13
MEET QUEENSLAND’S N E W H E A LT H M I N I S T E R
Steven Miles What are yo u r p r io r ities in this term o f g over n men t? I’m looking forward to building on the excellent work achieved by the Palaszczuk Government in Health last term. Our Specialist Outpatient Strategy will be extended by $154 million to ensure patients will continue to have access to safe, quality health care when and where they need it. We will continue to fund additional specialist appointments to deal with increasing demand – which is rising by over 10 per cent a year. We are investing in more appointments so Queenslanders get the right care at the right time.
W h a t is your b a ckground and h o w will t h is h elp you drive the h ea l t h p o r t f o lio ? Prior to entering parliament in 2015, I worked as a senior campaigner for Together and United Voice, and co-founded national parent advocacy organisation The Parenthood before running my own communications business. I’ve just spent three very busy years in the environment portfolio where one of my priorities was driving action on climate change. Health is a priority for the Palaszczuk Government. And I am committed to making sure our health service cares for Queenslanders no matter who they are, what they do or what part of the state they live in. Because everyone will need the health system at some point in their lives. And it is our wonderful health professionals that shape that experience. I want to be a champion for them. Making sure they have what they need to provide the best possible care for Queenslanders.
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We are delivering new hospitals in Roma, Kingaroy and Blackall and rolling out big redevelopments of the Logan, Caboolture and Ipswich hospitals. Of course, the quality of our health care is a reflection of the quality of our amazing staff, which is why we’ve committed to employ 3,500 additional nurses and midwives to care for our growing population. However, I also want to empower our health professionals to provide the very best care to Queenslanders. Our healthcare system does an excellent job of caring for people when they are sick but I think there is more work to do in helping people stay healthy.
I n our Five Point Plan for Better Health , we c alled f o r c h an g es to manda to r y rep o r tin g law s , favouring a WA mo d el. Wh at wi ll be yo u r ap p ro ac h to th is i ssue at Co u n c il o f Au s tr alian Governmen ts ( COAG ) ? I appreciated the opportunity to meet with the AMA Queensland soon after becoming Health Minister to discuss a range of issues facing doctors. As I explained at that meeting, Queensland did not participate in the COAG Health Council discussions about mandatory reporting in November 2017, as the government was in caretaker mode at that time.
In Queensland’s absence, the COAG Health Council agreed to progress this issue by focusing on supporting the mental health of practitioners while also protecting patients. I strongly support an approach that protects patients while also giving practitioners the support they need. I am keenly aware of the need to reach agreement on this issue as soon as possible. I will continue working with my counterparts in other states, territories and the Commonwealth to reach agreement on a nationally consistent solution.
You recently appointed a new Health Ombudsman. AM A Queensland and others have been highly critical of the per formance of the OHO, which led to a parliamentar y enquir y in 2016. Although that enquir y b eg an th e ref o r m p ro c e s s , i n s o me res p ec ts it d id n’ t go fa r en o u g h . Ho w are yo u g oi ng to b e mo n ito r in g th at t he new Omb u d s man imp roves i s s ue s s u c h as c o n s tan t b u d g e t over r u n s , in ves tig atio ns t a k i ng lo n g er th an th eir leg is l a t e d timeframes and the high number o f vex atio u s c o mp laint s ? There is no doubt the OHO can be improved, from both the patient and clinician perspective. I will work with the new Ombudsman to ensure complaints are investigated thoroughly and efficiently and investigations are conducted in a timely manner so that the health sector is transparent, accountable and fair.
Th e Medical Workforce Plan releas ed d u r in g th e las t t e r m d id n o t c o n tain mu c h of s u b s tan c e f o r j u n io r doc t or s . In p ar t tw o o f th e AM A Qu een s lan d ’s Health Vision , w e ad vo c ated f or a maj o r ref o r m to th e w ay Qu een s lan d tr ain s j u n i or d o c to r s in th e f o r m o f t he Qu een s lan d Med ic al Ed uc a t i on Tr ain in g In s titu te ( QME T I ) . W i l l
yo u co n sider t his duri ng your t i m e as Healt h Mini ste r? We’re committed to providing a strong framework for junior doctors as part of securing Queensland’s current and future medical workforce. The Palaszczuk Government acknowledges the serious issues of junior doctors’ health and wellbeing raised in the AMA Queensland survey and we’ll work collaboratively with your organisation to ensure all employees, including junior doctors, are provided with safe and supportive work environments. Last year we provided funding to implement a number of initiatives that provide support to our medical workforce. This includes the Resilience on the Run program available to every intern. The partnership between the Queensland Government and AMA Queensland to deliver the successful Resilience on the Run program has been paying remarkable dividends for junior doctors. Queensland Health is also developing a comprehensive careers website and is working closely with junior doctors to make sure information on the website in meaningful, accessible and informs their career choices. Over the past two years we have delivered resilience training to 142 junior doctors through the Learn to Lead junior doctors leadership development program, with a further 140 junior doctors in 2018 expected to take part.
W h a t is t h e t imef rame for ro l l i n g out t h e p rogram to se n i o r m edica l o f fi ce rs? Supporting the wellbeing of Queensland’s medical practitioner workforce is a high priority for the Palaszczuk Government. We are investing in targeted initiatives for junior doctors, doctors in training and senior clinicians to be rolled out in stages from 2017 to 2019. We’re mindful that any decisions made about support programs for senior medical doctors must consider the different stressors and challenges that doctors face at different stages of their careers.
AM A Queen s lan d c o n d u c ted a sur vey o f its memb er s in rural and reg io n al Qu een s lan d , whi ch hig h lig h ted s o me s tro n g conce rns aro u n d rec r u itmen t, and retention of medical staff in these areas. What will you do as Health Minister to improve this situation? What travel subsidies can Queensland Health provide for health workers to be able to re turn to b as e? The Rural Generalist Program recognises the value in improving access to local health care. We are now evaluating a skills development program that will support and train Rural Generalists in priority skill areas including mental health, addiction medicine and Indigenous health without requiring a full advanced skills training year. We announced the Rural Doctors Upskilling Program to support the development and maintenance of a flexible and skilled GP and rural generalist workforce to meet the medical service needs of regional, rural and remote Queensland. This was part of the Medical Practitioner Workforce Plan for Queensland. Five Hospital and Health Services (Darling Downs, Central Queensland, Cairns, Mackay and Townsville) received funding for a total of 15 rural doctors to undertake upskilling in anaesthetics, obstetrics and emergency medicine under round one of the Rural Doctors Upskilling Program. Round two of the program will open in mid-2018.
I n our Five Point Plan for Better Health , we f o c u s ed o n c are at the end o f live. We’ ve s p o ken about do in g a j o in t c amp aig n to raise aw aren es s ab o u t th e i mpor tanc e o f ad van c e c are pl anni ng . Th e c amp aig n w o u ld aim to e d u c ate th e p u b lic o n the be nef its o f p lan n in g en d of l ife care an d en c o u r ag e G P s to star t th e c o n ver s atio n s w ith their pat ien ts . Wh at o th er
CEO Jane Schmitt with the new Health Minister Hon Steven Miles at the Muscle up for MND Challenge
meas u res w ill yo u b e t a k i ng to in c reas e th e take u p of Ad van c ed Health Direc t i ves ? The Care at the End of Life campaign was launched in October 2017 to increase public awareness around advance care planning. Reluctance to talk about and plan for death is one of the most significant obstacles to improving quality of dying, and Queensland Health’s campaign has been developed to address this by encouraging people to start the conversation. In 2015, we also launched the state-wide strategy for end of life care. The strategy aims to increase community knowledge and awareness and ensure people with life-limiting illnesses and their families and the health professionals who care for them have the knowledge and skills they need. Queensland Health has engaged with GPs to support the promotion of the strategy and the public awareness campaign. I’m keen to talk more with AMA Queensland about how we can expand on these initiatives, and work with other stakeholders to progress this agenda.
Doctor Q Autumn 15
New Health Ombudsman appointed AMA Queensland was pleased to see the appointment of Rachel Hunter, a senior public servant and recently resigned chair of Children’s Health Queensland Hospital and Health Service, as Queensland’s new Health Ombudsman. Members will be aware of AMA Queensland’s strong criticism of the Office of the Health Ombudsman (OHO) to date, particularly the length of time taken to assess complaints. Our advocacy to improve the performance of the OHO began in 2016 when we released a discussion paper highlighting our concerns with the office, culminating in a parliamentary inquiry which produced a number of recommendations for improvement. The new Health Ombudsman was appointed following the dismissal of former Health Ombudsman Leon Atkinson-MacEwan, allegedly as a result of action he took after he was provided with information last year about a former anaesthetic technician.
We will keep members informed on the subsequent appointment to the role.
like to see the state’s new Health Ombudsman increase the speed at which medical complaints are investigated and reform the organisation to ensure it functions as effectively as possible. More than half of its investigations into practitioners take more than 12 months to complete. Complainants deserve swifter answers. These long drawn-out assessments also place a huge strain on medical professionals, whose careers and personal lives can be badly affected by such long delays. We believe these delays are partly due to underresourcing of the Office of the Health Ombudsman and will continue to press the State Government to increase funding of this key organisation. The Office of the Health Ombudsman comprises approximately 132 full-time equivalent employees and operated on an annual budget of $18.56 million in 2016-17.
‘ T H E O F F I C E O F T H E H E A LT H OMBUDSMAN’S VISION IS TO BE THE CORNERSTONE O F A T R A N S P A R E N T, ACCOUNTABLE AND FAIR S Y S T E M F O R E F F E C T I V E LY A N D E X P E D I T I O U S LY DEALING WITH COMPLAINTS A N D O T H E R M AT T E R S R E L AT E D T O T H E P R O V I S I O N O F H E A LT H C A R E I N Q U E E N S L A N D.
Although AMA Queensland has not always been pleased with the performance of the OHO, we are pleased the State Government has selected a candidate with significant experience of the health system. Ms Hunter has had a 34-year career in Queensland public service and her previous roles have included DirectorGeneral of the Justice and Attorney-General and Education, Training and the Arts. In addition to chairing the Children’s Health Queensland Hospital and Health Service, she is also Deputy Chancellor at Griffith University. She has a proven track record of leading reform in public service institutions. We have long been calling for reforms to overhaul the OHO’s current deficiencies and inefficiencies. We would
16 Doctor Q Autumn
At time of circulation, AMA Queensland has been advised that Rachel Hunter is no longer commencing in the role of Health Ombudsman.
As former AMA Queensland President Dr Chris Zappala told the Parliamentary inquiry into the performance of the OHO, Queensland doctors “give a repeated and very clear experience of being provided with only quite short time frames to give replies, despite the inordinate delays in the system overall—an overly persecutory system where the doctor is felt to be guilty rather than innocent until proven otherwise, frivolous claims are given credence when they should be dismissed early on at the filtering triage stage and, of course, inordinate delays overall.” AMA Queensland will meet with Ms Hunter at the earliest opportunity to discuss the range of reforms that need urgent attention to ensure that the OHO becomes an efficient, fair and streamlined complaints management system for both Queensland patients and doctors.
THE PRINCE CH ARLES HOSPITAL
Medical Imaging Report
In mid-2017, the Metro North Hospital and Health Service (MNHHS) Executive commissioned a report into the Medical Imaging Department at The Prince Charles Hospital (TPCH). MNHHS appointed two investigators with clinical experience from outside of Queensland to investigate a series of concerns that had been raised by staff working in TPCH Medical Imaging Department. The report was handed to MNHHS Executive in November 2017 with 92 recommendations considering infrastructure, technology, support staff, rosters and workplace culture. Within the report and recommendations, particular positions were identified that made it generally possible for anyone reading the report to identify the individuals attached to those positions. The report was made available to all TPCH employees when it was published on the organisation’s intranet. The report remained accessible on the intranet site for approximately six weeks. That report identified allegations against Australian Salaried Medical Officers’ Federation Queensland (ASMOFQ) members and other staff and made recommendations about those allegations. However, ASMOFQ has been advised that those allegations were not put to the affected staff members during the investigation and they did not have the opportunity to respond to the allegations prior to the reports release.
18 Doctor Q Autumn
In November 2017, ASMOFQ was alerted about the report’s publication and that some of the contents of the report raised concerns about the reliability of the report in total. Prior to Christmas, MNHHS undertook to ‘park’ the report pending submissions on the areas of concern raised by our members, but members of MNHHS Executive have continued to action aspects of the report, despite that commitment. ASMOFQ members have been adversely affected by MNHHS’s handling of the report and their unwavering intent to take action on the report despite the serious flaws in the data used in the report and our objections about the capacity of the investigators to make recommendations on matters that we say they do not have the requisite expertise to consider. Unfortunately, in late January 2018, someone leaked the report to the media. The way in which the media has treated the report and the questions they have raised has meant that external pressure has been applied for the report recommendations to be rolled out. MNHHS Executive have used the response to media reports to justify their continued attempts to urgently roll out the recommendations from the report.
ASMOFQ continues to fight to have the report stopped. We have sought an investigation into: the commissioning of the report; how the investigation was conducted; the quality and source of data on which the investigators made their recommendations; how the information about the recommendations was disseminated; and the actions taken against ASMOFQ members by MNHHS Executive. Of particular concern are allegations of bullying and harassment raised in the investigation process. ASMOFQ takes bullying and harassment matters most seriously but we contend that in this instance, the investigators were not sufficiently skilled to consider these and other industrial matters and that their recommendations on this point are unsound. However, MNHHS Executive have used the contents of the report and recommendations to threaten the employment of ASMOFQ members in circumstances that the information in the report remains untested. We continue to support our affected members through this complex and personally challenging process. ASMOFQ continues to meet with MNHHS and Queensland Health to resolve the concerns directly arising about and from the report. We are also supporting our affected members with the subsequent matters where MNHHS Executive has persisted in acting on the report despite our objections and where they have tried to adversely affect the employment of our members.
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www.ucmi.com.au Doctor Q Autumn 19
MEET OUR
Workplace Relations Team GEORGE SOTIRIS George Sotiris heads up the Workplace Relations Team for AMA Queensland as the Workplace Relations Manager and works closely with the team to achieve the best industrial and employment outcome for members. George has been with AMA Queensland for over nine years and has an extensive background and understanding of the health industry. George has a Bachelor of Business with a double major in Employment Relations and Human Resource Management. George also helps coach and mentor Griffith University students who are looking to excel their career in employment relations. On a day-to-day basis, he spends most of his time assisting members in general and specialist practice. Common support to these members include how to set up and close a private practice, managing the employment lifecycle, contractual support, and managing work health and safety. George also provides a range of educational training seminars throughout Queensland on a regular basis. He has a passion for assisting and supporting members with any employment or industrial query.
JAADEN CLARKE Jaaden Clarke is a Workplace Relations Advisor working predominantly with private practices. Jaaden is in the early stage of her career as she recently graduated from university with a Bachelor of Business in Human Resources Management. She began working for AMA Queensland in June 2017 and has been assisting mainly with member queries, particularly around award and legislation interpretation and employment contracts. 20 Doctor Q Autumn
JOHN COSGROVE John Cosgrove is a Senior Industrial Officer with AMA Queensland and is the Senior Industrial Advocate for the AMA Queensland’s union partner Australian Salaried Medical Officers’ Federation Queensland (ASMOFQ). Over the past 15 years, John has held senior positions in private, public and union organisations requiring him to develop, implement and manage strategic employee and industrial relations frameworks in highly unionised environments to achieve operational outcomes. During that time, John was responsible for successfully leading complex enterprise bargaining negotiations at local and national levels. Building and maintaining productive relationships with employees, senior management, union members, delegates and officials and other external stakeholders was crucial to this achievement and for the timely and successful execution of industrial strategies. John holds two Masters Degrees in Employee Relations and Human Resources and is studying a Degree of Laws.
MICHELLE COWAN Michelle Cowan is a Senior Industrial Officer working predominately with salaried medical officers. Michelle recently joined AMA Queensland from an Industrial Officer role with another member organisation, working in both the state and federal jurisdictions. Michelle’s early career was established in retail management roles for leading retailers, where she developed expertise in recruiting, training, developing and managing large workgroups in dynamic work environments. She returned to study law in 2010 and upon graduation, took an associate position in the Queensland Industrial Relations Commission and then moved into private legal practice, specialising in employment and workplace relations law. Michelle’s breadth of experience from all sides of employment disputes informs members about their employment rights and the practical options available to resolve workplace issues. Michelle has a particular interest and expertise in workplace bullying and harassment and has assisted a number of members to deal with workplace grievances on this topic.
MARK PAT T E L Mark Pattel is an Industrial Officer working predominately with salaried medical officers. Mark has been a member of the Workplace Relations Team for two and a half years. During this time, he has been directly involved with negotiation of Certified and Enterprise Agreements in both the state and federal jurisdictions, a variety of disputes within the Queensland Industrial Relations Commission and the Fair
Work Commission. Mark has a keen interest in providing members with interpretation of relevant legislation, contractual provisions and employment policies. Prior to joining AMA Queensland, Mark obtained a Bachelor of Business (Employment Relations and Human Resource Management), Bachelor of Laws (Class IIB Honours) and a Graduate Diploma in Legal Practice. Mark has worked with a number law firms and community legal centres.
Our Workplace Relations Team:
run training around the state twice a year; produce manuals; distribute a monthly award subscription service; and publish information updates.
T H E W O R K P L A C E R E L AT I O N S T E A M H AV E A R A N G E O F E X P E RT I S E A N D Q U A L I F I C AT I O N S T H AT B R I N G A W E L L - R O U N D E D A P P R O A C H T O R E S O LV I N G WORKPLACE ISSUES FOR OUR MEMBERS
The ASMOFQ Team also:
conduct negotiations for enterprise and certified agreements between our members Queensland Health or some private hospitals; appear in the Queensland Industrial Relations Commission and the Fair Work Commission to represent members for industrial disputes, wage claims, unfair dismissal claims; and assist members addressing disciplinary matters.
I H AV E A W O R K P L A C E R E L AT I O N S I S S U E . W H AT H A P P E N S W H E N I RING?
SALARIED MEDICAL OFFICERS If you’re a salaried medical officer, you will be referred to John, Michelle or Mark. You will need to send through your current employment contract and any relevant documents. Rosters, annual leave and other entitlements can usually be addressed at the time of your call. Otherwise, the team will review your information and the industrial documents that affect your employment and provide a response as soon as possible. If you need help lodging or responding to a workplace grievance, the team will speak with you about what has happened and then provide you with guidance so you can draft an initial response for them to review. For
serious matters or concerns that affect multiple members, one of the team may be able to visit your workplace to view and discuss your concerns. PRIVATE PRACTICE If you run a private practice, you will be referred to George or Jaaden. They will ask you for information about your matter and may require you to send through copies of documents so they can properly consider your matter and give advice. Due to the complexity of running a private practice, the team has a broad scope of practice that allows them to quickly identify the best solution for any employment, work health and safety, privacy or bullying matter. Support is most commonly provided on the phone and via email, however the team is regularly on the road and able to meet face-to-face to assist. If a matter extends outside the scope of the team, various AMA Queensland corporate partners can provide additional support.
lace Relations Team Please contact the Workp ) 3872 2211 for any assistance on (07 amaq.com.au or workplacerelations@ Doctor Q Autumn 21
A M A Q U E E N S L A N D W O R K P L A C E R E L AT I O N S
Potential Claims UNFAIR DISMISSAL
3478
unfair dismissal claims were lodged to the Fair Work Commission between January and March 2017. Only 34 were found to be fair.
ADVERSE ACTION
(GENERAL P ROTECTION S) Correct docu mentation during perform ance management processes is necessary to satisfy the dismissa l was on reasonable g rounds.
CONSTRUCTIVE DISMISSAL can result from: A reduction of hours; Change of duties; Failure to pay wages.
WORKERS COMPENSATION A recent case saw a QLD Registered Nurse be awarded almost 1.5 million in a negligence lawsuit against her employer. Damages were awarded due to psychiatric suffering due to workplace bullying, harassment and managerial mistreatment. Robinson V State of Queensland (2017) QSC 165.
CONTRACT F O H C A E BR
STOP BULLYING ORD
WORK, HEALTH & SAFETY CLAIM
have Ensure you written ve si comprehen rstand. at you unde contracts th a sland h ve AMA Queen t contract employmen ecific to the templates sp stry. health indu
Remember our Workplace Relations Team can conduct WH&S walk-throughs and training for you clinic.
ER
Employees can now lod ge for a stop bullying order by taking a quick eligibility test online. Whilst large monetary fines are not payable, emplo yers can be ordered to change roster s, the structure of the organisation and prevent particular employees from working together.
SEXUAL HARASSMENT
88%
of complaints to the Australian Human Rights Commission under the Sex Discrimination Act are related to sexual harassment in the workplace.
DEFAMATION Our recent social media webinar showed the importance of being aware of the implications social media can have on an organisation. Certain posts can cause defamatory risks for the business. Please ensure you take necessary steps to limit these risks. We also have a social media policy template available.
22 Doctor Q Autumn
PRI
BREA Y C A V
CH
tifiable ent (No d the m d n e m he stablis ivacy A The Pr ) Act 2017 e me (NDB) in s h Sche uary reache Data B e Data Breac nces 22 Febr s? e bl on Notifia a. This comm our obligati i y l a w r t o n Aus o you k 2018. D
Please contact the Workplace Relations Team for any assistance on (07) 3872 2211 or workplacerelations@amaq.com.au
UNIQUE OFFER TO AMA QUEENSLAND MEMBERS HWL Ebsworth is a full service commercial law firm providing expert legal services at competitive rates. Through our combination of legal specialists and industry experience, HWL Ebsworth is ideally placed to protect the interests of our clients while enabling them to achieve their commercial and operational objectives. HWL Ebsworth is currently ranked as the largest legal partnership in Australia according to the most recent partnership surveys published by The Australian and the Australian Financial Review. HWL Ebsworth is very pleased to have recently welcomed the team from TressCox Lawyers to the firm. This team offers clients more than 100 years’ experience representing medical practitioners in various areas of health and aged care law. The Health and Aged Care Services Team can help guide you through the increasingly complex operational, legislative and policy framework. We can provide you informed legal advice on litigious, disciplinary and commercial issues at all levels. With considered legal advice our team can assist you to operate a commercially viable business that complies with the health services industry’s unique and ever changing regulatory environment. As a member of AMA Queensland, this partnership provides you with legal assistance and support, both individually, for your business and your staff. HWL Ebsworth will provide AMA Queensland members with an initial consultation by phone or in person at no cost (up to 30 minutes). Take advantage of this benefit with advice from highly qualified lawyers on: ▪ ▪ ▪ ▪ ▪ ▪ ▪ ▪
Setting up your practice, including buying a business, business structuring, contracts and advice on restraint of trade clauses; Running your practice, including IR & Workplace Safety, employment, service, and locum contracts and corporate governance; Group practice issues and bringing in additional owners including partnership, shareholder and buy-sell agreements; Selling your practice including helping to get ready for sale, workout and earn-out arrangements; Resolution of disputes about restraints, contracts (including building contracts and shareholder agreements) and debt collection; Regulatory issues including investigations by the OHO, AHPRA and Medicare Australia; Your personal matters including buying, selling and leasing property; and Estate planning including creating and documenting strategies to transfer wealth from one generation to the next.
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WRAP UP FOR
Resilience on the Run 2017 The AMA Queensland Resilience on the Run program was delivered to over 633 interns state-wide in 2017. The program, funded by Queensland Health, is in its second year of rolling out to interns at hospitals across the state. Facilitated by resilience expert Dr Ira van der Steenstraten, the program focuses on the prevention of burnout and compassion fatigue amongst young doctors. The program makes attendees aware of their personal stressors, shows them how to deal with those stressors, which in turn, lowers the likelihood of their harmful consequences. Mindfulness techniques are demonstrated to help become more aware and to lower levels of stress.
Feedback from Sunshine Coast University Hospital attendees in 2017 included the realisation that difficult situations encountered are very commonly experienced by others. They also found it useful to find out where to get help, tools for conflict resolution, reminders for self-care and how to deal with stress. One attendee stated that, “we can’t choose our environment, but we can choose how we respond to it and how it affects us.” The program is delivered as a two-part workshop with each session 1.5 hours in length, and topics include:
SESSIONS FOR 2018 ARE BOOKING FAST
24 Doctor Q Autumn
an introduction to mindfulness and how it can improve well-being and resilience for doctors in training;
developing mindful communication techniques for more effective engagement with others; strategies for dealing with burnout and compassion fatigue; skills for managing challenging scenarios in the workplace e.g. caring for the dying patient or dealing with adverse feedback from a supervisor; and practical tips on getting help.
We are looking forward to rolling out Resilience on the Run in 2018. For all Resilience on the Run enquiries, contact the Business Support Team at AMA Queensland on (07) 3872 2222 or email resilience@amaq.com.au
A SUMMARY OF A P R I L A N D M AY SESSIONS
APRIL HOSPITAL
DATE
TIME
GROUP/ SESSION
ROOM
Townsville Hospital
Wednesday 4 April
12.30pm - 2pm
Session 1
Robert Douglas Auditorium
Royal Brisbane and Women’s Hospital
Thursday 5 April
12noon - 1.30pm
Group A, Session 2
Seminar Room Education Centre
Redcliffe Hospital
Tuesday 17 April
12noon - 1.30pm
Session 1
Lecture Room 4, Education Centre
Townsville Hospital
Wednesday 18 April
12.30pm - 2pm
Session 2
Robert Douglas Auditorium
Cairns Hospital
Thursday 19 April
12noon - 1.30pm
Session 1
Auditorium Room, A Block, Level 2, Southern End
Redlands Hospital
Tuesday 24 April
12noon - 1.30pm
Session 1
Canaipa Ward Tutorial Room
Cairns Hospital
Thursday 26 April
12noon - 1.30pm
Session 2
Auditorium Room, A Block, Level 2, Southern End
Logan Hospital
Friday 27 April
12noon - 1.30pm
Group A, Session 1
Auditorium
MAY HOSPITAL
DATE
TIME
GROUP/ SESSION
ROOM
Redlands Hospital
Tuesday 1 May
12noon - 1.30pm
Session 2
Canaipa Ward Tutorial Room
The Prince Charles Hospital
Wednesday 2 May
1pm - 2.30pm
Session 1
Room 4, Education Centre
Mater Hospital
Thursday 3 May
12.30pm - 2pm
Session 1
Mater Medical Study Space, Level 4 Duncombe Building
Logan Hospital
Friday 4 May
12noon - 1.30pm
Group A, Session 2
Auditorium
Redcliffe Hospital
Tuesday 8 May
12noon - 1.30pm
Session 2
Lecture Rooms 4, Education Centre
The Prince Charles Hospital
Wednesday 9 May
1pm - 2.30pm
Session 2
Room 4, Education Centre Doctor Q Autumn 25
AMA QUEENSLAND
Council of Doctors in Training update This year is critical. It is the year we negotiate the industrial future of the profession. While in the coming months, negotiations on the Medical Officers’ Certified Agreement 5 (MOCA 5) begin for all doctors, it is the most junior members of the profession that have the most to gain from this process. I was contacted recently by a university friend of mine who wanted to make me aware of another completed suicide by one of our own. A young surgical Principal House Officer (PHO) in northern Queensland. Tragically, over the past few years, we have become habitualised to this terrible loss of life, one that we now know permeates our entire profession. This most recent loss highlights again the need for radical change. Change that must include an unflinching focus on understanding the driving forces that push our colleagues to suicide, and a ceaseless effort toward addressing them. It is an effort that must take multiple forms: it must be personal, it must be professional, and it must be industrial, and it cannot be focused on the victim. This year the Council of Doctors in Training (CDT) will once more take on this task and we need your help to do it.
DR CHRIS MAGUIRE
Junior House Officer, Logan Hospital; and Chair, AMA Queensland Council of Doctors in Training
Alone, an industrial agreement cannot solve this crisis, but it can facilitate an environment that allows it to be solved. We need leave that is respected, pay that is appropriate, safe facilities, and access to professional assistance when required that is on time and yes, sometimes, even within working hours. The MOCA 5 negotiations have the capacity to set the stage for lasting change – if we work hard for it. However, in very real terms, the Australian Salaried Medical Officers’ Federation Queensland (ASMOFQ) and AMA Queensland cannot do it without your help. We don’t have all the answers, no one does, but we know there are people in our profession who have some of them - please come to us and offer that knowledge. The power of our arguments during the industrial negotiations are directly proportional to the number of members that we speak for – please join this movement and lend us that power. Our council’s capacity to see the state of the system and address the concerns of our members is limited by adequate representation – join us to lift this fog, and you will always be welcome. As a profession and as a community, we are up to the task of creating a better system. It is now our responsibility, each in our own way, to play a part in that.
26 Doctor Q Autumn
GREATER SPRINGFIELD SPECIALIST & OFFICE SUITES Mater applauds Springfield City Group for the establishment of the specialist suites adjacent to Mater Private Hospital Springfield. The hospital is looking forward to productive conversation and partnerships with doctors who move into this facility. Justin Greenwell Director, Mater Private Hospital Springfield
Artist Impression
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With areas from 34m2 to whole floors of 474m2 over five levels (above ground floor retail and car parking), don’t miss this unique opportunity to grow your patient base in the heart of South East Queensland’s growth corridor. To register your interest visit gssuites.com.au or contact Uma Ranchigoda on 0412 470 882
www.gssuites.com.au
Improving the quality and appropriateness of health care
Dr David Rosengren, Chair of the Queensland Clinical Senate The recent release of data on variation in healthcare across Australia gives clinicians an invaluable opportunity. The data in the Second Australian Atlas of Healthcare Variation shows large variations in care for some common treatments and potentially preventable hospitalisations for a number of chronic conditions. The information is crucial for understanding how our healthcare system is providing care. It doesn’t tell us what is good or bad variation (warranted or unwarranted) – it just tells us how much variation there is and where it is. We need to look at the data, analyse it, discuss it, decide if the variation is valid, based on the patient’s choices or circumstances, or whether the variation is an indication of challenges or problems in our system. We then have the invaluable opportunity to make change where change will mean our patients are receiving better and more appropriate care.
At the Queensland Clinical Senate’s December 2017 meeting, Dare to Compare, we used the data to start a discussion about what it means in Queensland and how we should use it. Our focus was on potentially preventable hospitalisations for diabetes complications, chronic obstructive pulmonary disease (COPD), heart failure, kidney and urinary tract infections (UTIs). In Queensland, variation was greatest for diabetes complications with an almost 12-fold difference in the age standardised hospitalisation rate for the highest compared to the lowest rate region. For COPD there was a 10-fold difference; heart failure an over four-fold difference; and UTIs an almost three-fold difference. I sensed a level of engagement and interest at the meeting that suggests clinicians and system leaders appreciate the importance of the topic. Not just because it’s measured both at a Commonwealth and state level or because it’s a key performance indicator for Queensland hospital and health services, but ultimately because it relates to value and patient outcomes. Certainly, there was agreement by meeting delegates that variation in care is more likely to be seen in our Aboriginal
28 Doctor Q Autumn
and Torres Strait Islander communities, rural and remote regions and areas of social and economic disadvantage. We cannot put everyone into the same basket when it comes to understanding the data and making change. What we can do, however, is share the data – make it available to our clinical colleagues across the entire health system – and then work together across tertiary, primary, government, non-government and community organisations to understand the problem at a local and state level to decide where to focus our efforts for improved patient care. It is vital that senior clinicians engage in and influence these discussions. I am certain that over the next five to 10 years, this concept of variation as it relates to value and outcome, will underpin a large amount of our policy work and I am delighted that from a Queensland perspective we have taken a proactive stance in that conversation. To read the meeting report and full list of recommendations visit: https://clinicalexcellence.qld.gov.au/ priority-areas/clinician-engagement/ queensland-clinical-senate/meetings
OBITUARY
Dr John Powell Waller AM R F D E D M B B S F R A C G P F R A C M A FA M A
AMA Queensland Past President 1989-90 5 September 1933 - 4 February 2018 John Powell Waller was born in Warwick to Cyril and Anne Waller. As his father was a magistrate, his early years were spent in various postings around country Queensland including Julia Creek and Pomona. Expected always to achieve, he didn’t disappoint, he worked hard at Nudgee where he was Dux of the college but boarding school was tough. Dr Waller was awarded a State Government Fellowship to study medicine at the University of Queensland. This was a great achievement as few were issued and it meant he was paid a small stipend while studying. In return, he was bonded to the government for several years after graduation. Dr Waller was the student union President and in a copy of the Semper Floreat, the UQ newsletter, the headline reads “Waller in a landslide”. It was also at this time that his sporting prowess shined and he was awarded a full blue for athletics. He was the 1953 Australian Universities 100-yard champion which he ran in 10 seconds flat. After residency at the Brisbane General, Dr Waller followed his parents up to Thursday Island. There, amidst a powerful cultural and medical experience, he met a glamorous nurse from Sydney Hospital and married her on the island 59 years ago. Next was a posting in Dalby where Dr Waller had fond memories of having to keep the stove on to cut through the bitter cold. He operated with a book on one side and a telephone to Brisbane on the other. He was really ahead of his time with the use of telehealth! After a stint back in Brisbane, at the Chest Hospital, he returned to Dalby to the Patrick Street surgery where Dr Humphrey Cramond was his general practice mentor. He worked all hours and he felt that many of his patients really needed more than his support for their physical symptoms. He wanted to further develop his understanding of mental health so he took a position at Wolston Park Hospital. Dr Waller realised at this time that his real love was supporting patients through service development and support for younger doctors. He studied hard to become a Fellow of the Royal College of Medical Administrators and became the Deputy Medical Director of the Princess Margaret Children’s Hospital in Perth. He was then recruited back to the position of Medical Superintendent at the new Mater Adult Public Hospital.
He was the best Grandpa and when he retired from the Mater in 1997, part-time practice as a GP and as a surveyor for the Australian College of Healthcare Standards, it allowed him more time with his family, including many happy stints at the Ascot State School tuckshop. He could sleep anywhere, perhaps another boarding school or doctor life gift but never for very long. He was famous in our family for quietly slipping away and finding a floor to sleep on. The family were sent a lovely card which said “John Waller will live forever in the hearts of thousands of medicos he has grown and inspired”. Phillipa Keogh
His dedication to service in the community led him to take up several roles including President of the Queensland branch of the Australian Medical Association from 1989-90 while also reaching the rank of Lieutenant Colonel in the Army Reserve.
Doctor Q Autumn 29
DR MARGARET K AY
Medical culture: what are you doing to change it?
At the end of last year, the National Forum on Reducing Risk of Suicide in the Medical Profession released its final report. The forum, held in Sydney just prior to the biannual Australasian Doctors’ Health Conference, was an important opportunity for key stakeholders, including medical practitioners and representatives of medical professional organisations, to focus on this serious issue. The purpose was to determine a whole-of-profession response. Medical Director, Queensland Doctors’ Health Programme
For well over a century, we have continued to document the higher rate of suicide in physicians. Suicide rates in female physicians match those of male physicians. These quantitative studies have been useful and associations with co-morbidity have been documented. Importantly, both mental health and/or physical health issues increase the risk. However there have been few qualitative studies done to explore these issues so as to provide the insights we need to reduce our risk through meaningful interventions. The paucity of such studies may reflect our cultural silence around this topic. When there is a lack of robust research, it is important that we challenge expert opinion founded on assumptions, including assumptions justified by known associations where no causation has been proven. It is fifteen years since Center et al published the Consensus Statement on Confronting Depression and Suicide in Physicians in The Journal of the American Medical Association (JAMA). This paper highlighted barriers to health access including discrimination and stigma related to mental health issues and subsequent career progress and regulatory concerns. These finding resonate strongly with the forum’s report. The forum provided our profession with a unique opportunity to publicly acknowledge the issue of physician suicide. This is always a vital first step towards a solution. Prior to this forum, there were similar local events including Queensland Forum. Our conversations in these public spaces have been enabled by the many families and friends of doctors who have died
30 Doctor Q Autumn
from suicide. Through social media and open discussion, our profession has been given a precious opportunity (indeed it is our duty) to find a way forward. The key messages of the report are culture and compassion. Culture was certainly a key issue highlighted in the beyondblue report released nearly five years ago. However, when we talk about our medical culture, it appears we have mastered the technique of appropriately changing the tone of our voice, and drawing on all our cultural strengths, as we deliver the requisite acknowledgement of concern in a manner that smacks of quiet resignation. Similarly, while compassion was the key message of the Francis Report (UK) investigating the quality of care in the Mid-Staffordshire Trust, we continue to struggle to integrate this into our health care delivery, our learning, our teaching and our practice as a whole. The Forum Report is presented as a call to action. In the opening pages, Doctors’ Health Services Pty Ltd identify five actions that they intend to deliver with the doctors’ health services such as the Queensland Doctors’ Health Programme across Australia. As we all settle into 2018, this report asks each of us to reflect on what steps we can take – as individuals and as members of professional organisations. As students, doctors in training and senior doctors – whatever our role - we are the change in our medical culture. Demonstrating personal compassion in our work. Compassion to our patients, our health team and our colleagues, including those we supervise enhances the quality of care we deliver. All medical organisations are challenged to read this report and consider what five actions they will commit to. If each organisation publicly declares five actions for 2018, and reflects on our progress early in 2019, we can make a real difference - together. This is pragmatic action designed to effect cultural change: change we so clearly need as we continue to suffer devastating loss already in 2018.
MBS REVIEW
Medicare Update The AMA advocated tirelessly to end the Medicare rebate freeze, resulting in the announcement by the Government in the last Federal Budget that the freeze on patient rebates was to be progressively lifted.
The second component of the rebate issue relates to the ongoing MBS Review – a body of work that seems to have been around for ever, but is really only in its infancy in terms of implementation of changes to items.
The freeze was lifted on bulk billing incentives for GP consultations on 1 July 2017. Re-indexation will commence for GP consultations and other specialist consultations on 1 July 2018, for procedures from 1 July 2019, and targeted diagnostic imaging services from 1 July 2020. The lifting of the freeze on Medicare rebates will cost the Government around $1 billion.
The AMA committed to support in principle the ongoing operation of the MBS Review Taskforce, including a transparent, consultative clinician-led approach to high-value care and ‘futureproofing’ the system. We have also been responsible for regularly bringing together the Colleges, Associations and Societies (CAS) to be updated by the MBS Review Chair on the progress of the work of the Clinical Committees.
Of course we would have liked to have seen it lifted all at once. The freeze, introduced by the previous Labor Government and continuing through the Abbott and Turnbull Governments was a harmful policy. But the gradual thaw is good news for our patients, GPs and other Specialists alike. It will be lifted earlier than planned, and one of the major contributors to out of pocket costs to patients will finally, albeit modestly, be indexed going forward. The lifting of the freeze was prominent in the national media, but it is in reality but one component of our ongoing advocacy on appropriate funding for medical practitioners. We’ve also been successful in:
reversing proposed cuts to bulk billing incentives for diagnostic imaging and pathology services;
scrapping proposed changes to the Medicare Safety Net that would have penalised vulnerable patients;
delaying the introduction of the Health Care Homes trial to allow fine-tuning of the details;
moving to an opt-out approach for participation in the My Health Record; and
recognising the importance of diagnostic imaging to clinical decision-making.
The AMA is continuing to work with members to identify areas to improve the review process and recommendations. We continue to press the Government to ensure that reviews remain more than just a cost-cutting exercise, or a mechanism to meddle with the scope of clinical decision making. This work is supported through engaging with our wider membership via an AMA Working Group, as well as our Medical Practice Committee. I am reassured by the calibre of the feedback and advice we receive from our wider membership on medical policy – the feedback is constructive, insightful and always aims to improve patient care. Be assured the feedback makes its way directly into our day to day advocacy efforts. Indeed, as a result of member feedback, the AMA has responded to every MBS Review consultation round in 2017, supplemented by my direct representations to the Health Minister, the Department of Health, and to Professor Bruce Robinson, the Chair of MBS Review Taskforce. It is fair to say the AMA feels the MBS Review process still needs improvement in a number of areas. Our direct intervention in the Anaesthetic committee has seen Minister Hunt order a re-boot.
DR MICHAEL GANNON AMA President
That is why we have also called for early engagement of the relevant CAS on each of the Clinical Committees to ensure future recommendations are practical and consistent. We have called for complete transparency, starting with how Clinical Committee members are selected and details of the Committees’ scope of work. Finally, the AMA has strongly recommended the Clinical Committees engage early with other Department areas including the Medicare Compliance and Professional Services Review to ensure that any changes to the schedule are practical for clinicians and do not result in sub-optimal care for patients. We all know a poorly worded MBS item can set up a practitioner to fail, especially when advice mechanisms can be difficult, or indecisive. Ultimately, what we do not want to see is a confusing MBS schedule, nor do we want to be limited in our clinical decision making. We want – and indeed we need - better targeted, increased investment in a modern MBS Schedule. I can assure you that we will continue to advocate on these issues and seek more cohesive government policy in areas such as: sensible compliance, further targeted investment in areas of need, and for the improvements to private health insurance policies, so as to limit the impact of out of pocket costs for patients. The AMA continues to have wins on behalf of doctors and their patients. Our work is informed through your representatives at state and federal level. We will continue our endeavours at Council and secretariat level in the months ahead. Doctor Q Autumn 31
GPs on the front line to improve veteran health A significant stumbling block for Defence Force personnel transitioning into civilian life can be their first contact with the healthcare system. Having a GP they trust can make all the difference to their ongoing health. RSL Queensland General Manager Scott Denner said many veterans were reluctant to admit to health problems. “Military personnel have a strong ethos of service, which can result in them overlooking their health issues in order to complete the task at hand,” Mr Denner said. “When they have discharged, they may not visit a GP until a health issue becomes very serious. It’s important that GPs treating veterans are aware and alert to any underlying health issues that may be due to their service or a response to enduring pain or illness.” Mr Denner said building trust was critical to the relationship between veterans and their GPs. “Veterans may not have had experience with the civilian healthcare system, so building trust with a GP is even more crucial to their ongoing health and wellbeing,” Mr Denner said. “They need to know that their GP is aware of the physical and mental impact military service may have, and is willing to give them the time and space to open up when they feel ready.” All ex-service personnel who have at least one day of continuous full-time service – including reservists and national servicemen – are entitled to treatment for a range of mental health conditions. They may also be entitled to claim treatment for other health issues directly related to their service. Data from the Department of Veterans’ 32 Doctor Q Autumn
Affairs (DVA) show the physical conditions veterans are most likely to suffer from include orthopaedic issues, hearing and skin conditions. “However, these health conditions must be able to be linked to their military service for them to get assistance through DVA,” Mr Denner said. He said navigating the claims process could be tricky but RSL Queensland’s trained advocates were available to help veterans get any assistance they were entitled to. “Our Veteran Services Officers work closely with veterans to identify the conditions they are able to claim, and then to support them through the claims process,” Mr Denner said. “All veterans need to do is contact our Veteran Services team.” Mr Denner said RSL Queensland also offered a comprehensive range of services that GPs could refer veterans to, including health and wellbeing programs, rehabilitation services, and help with transition including employment assistance. “Programs like the RSL RAEMUS off-road racing program or the RSL Queensland Surfing Initiative help veterans connect with others while staying healthy and active,” Mr Denner said. “Through Mates4Mates, we can also link ex-service personnel with physical rehabilitation and psychological services that are specifically tailored to their needs.” For more information on RSL Queensland’s many programs and services, visit www.rslqld.org. To contact RSL Queensland’s Veteran Services team, call (07) 3634 9444 or email vs@rslqld.org.
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Events Calendar
THRIVE IN YOUR JUNIOR DOCTOR YEARS Date: Thursday 22 March Location: Royal International Convention Centre, Brisbane Showgrounds FREE FOR AMA MEMBERS With the spotlight firmly on the importance of junior doctor mental health, our panel of senior and junior doctors will discuss a range of topics crucial in keeping yourself healthy, happy and motivated during your junior doctor years.
ESSENTIAL C O N S I D E R AT I O N S FOR STARTING A G R O U P P R I VAT E PRACTICE Date: Wednesday 18 April Location: Hunstanton Verandah, AMA Queensland Are you considering the transition to private practice or have you recently started your own practice? Join our panel of industry experts and corporate partners for valuable insight into the essential components of setting up and running your private practice.
FIFTH ANNUAL JUNIOR DOCTOR CONFERENCE Date: Saturday 23 June - Sunday 24 June Location: Hilton Brisbane AMA Queensland’s fifth annual Junior Doctor Conference boasts a slew of local, national and international speakers who will inspire and educate our junior doctors on everything from global health to ground-breaking medical research, medical leadership, mental health and career development. Day two of the conference will feature emergency clinical skills competition Simulympics 2.
More 2018 Events
Visit www.amaq.com.au for more information or to register for our upcoming events.
34 Doctor Q Autumn
May - June Workplace Relations Training Series One
23 - 29 September Annual AMA Queensland Conference - New Orleans
23 August Women in Medicine Breakfast
12 October Dinner for the Profession
7 - 8 September Private Practice and Medico-Legal Conference
November - December Workplace Relations Training Series Two 6 December Minister’s Breakfast Cairns
Online registration is here Coming along to an AMA Queensland event is now even easier with online registration up and running. We’ll take you through it step by step, so you can register directly in your own time.
STEP 2
STEP 5
Register myself
Select your itinerary (not required for some events)
STEP 1
STEP 3
Log in to AMA Queensland’s online event registration
Select your registration option
For event and conference programs, your itinerary selection may include optional workshops and/or breakout sessions. Select your program items, then proceed to checkout.
An item must be selected to proceed.
STEP 6
AMA members log in with the same username and password you enter to log into the AMA member website. In most cases, your username starts with Q for Queensland members and it is followed by six digits. E.g. Q252708. Some usernames are six digits only. If you’ve forgotten your username or password, no problem. Just select ‘forgot my password or my username’ and your details will be emailed to you. AMA Queensland student members just need to enter their university email address when requesting your username or password.
To commence your registration, click the purple ‘register myself’ button.
Proceed to checkout
STEP 4 Questions All questions are related to your event registration and include in person versus webinar attendance, dietary requirements and additional social functions inclusive of your registration fee. To proceed, you must click on the purple ‘update responses’ button.
Ensure you double check the items in your shopping cart and make sure you have registered for the correct event and the total amount is what you expected. Proceed to ‘submit order’. For paying delegates, complete your payment details and ‘submit order’. In the case of free member events, directly ‘submit order’ after checking your registration details.
If you’ve only just signed up, you’ll need to allow 24 hours to be recognised in the system. If you are a non-member, your username will be your preferred email address. If you have attended previous AMA Queensland events, you will already have a username. Click on ‘forgot my password’ to receive a link to create a new password. New non-members are required to ‘create a new account’, the link is found under the sign in button.
YOUR INVOICE FOR TAX PURPOSES An automated tax invoice will be emailed to your preferred email address. You can re-enter your preferred email address or an alternate address after submitting your order in the shopping cart.
EVENT DETAILS
PAYMENT OPTIONS
CONTACT
Basic event details will be displayed on your tax invoice. A formal event confirmation email will be issued prior to the event date.
Currently you can pay by Visa, MasterCard and AMEX online. Online registrations are available for free member events.
For troubleshooting or any enquiries, please contact the Events Team on (07) 3872 2222 or email registations@amaq.com.au
Doctor Q Autumn 35
Welcome to our new members OCTOBER Doctors in Training Dr Jonathan Hardy Dr Sarin Zillabathula Dr Ravanjit Singh Dr Dylan MacLeod Dr Sophie Boast Dr Alyssa Courtney Dr Michael McHutchison Dr Mark Dowling Dr Mary Ghazawy Dr Catherine Egan Dr Victoria Lee-Shrewsbury General Practitioners Dr Asoka Ranasinghe Dr Brendan Baragry Dr Lee Fan Sui Private Specialists Dr Darren Marchant Dr Gunasiri Mallikarachchi Salaried Medical Officers Dr Johanna Matthews Dr Bhavik Patel A/Prof Jasotha Sanmugarajah Part-time Practitioners Dr Jean Kelly Dr Edwin Ling Dr Andrea Stimming
36 Doctor Q Autumn
NOVEMBER Doctors in Training Dr Andrew Law Dr William Nicol Dr Caitlin Ross Dr Susan Dragone Dr Carolina Izquierdo Paez Dr Heidi Freeman Dr Gopi Ravindran Dr Samuel Bryson Dr Kristy Tybura Dr Erica Barton Dr Keith Potent Dr Fusun Baumann General Practitioners Dr James Doran Dr Saman Perera Dr Paul Colbrook Dr Catherine Crilly Dr Cassandra Henderson Private Specialists Dr Phoebe Hong Dr Andrew Small Salaried Medical Officers Dr James Cox Dr Alice Chang Dr Michelle Sumner Dr Dean Powell Dr Shailendhra Bethi Dr Katrina Hopcraft Dr Charles Horsfall Part-time Practitioners Dr Graeme Kay Dr Mohammed Eisa Dr Jeffrey Adams Dr Cassandra Faris
D E C EM B E R Doctors in Training Dr Jia Yi Anna Ne Dr Fabio Margiotta Dr Mohammadali Zad Dr Indervir Bharj Dr Alexander Norrie Dr Keil Auer Dr Karin Houriez Dr Henry Su Dr Anwar Bilal General Practitioners Dr Mobolaji Farotimi Dr Siew Hong Chai Dr Janus Van Heerden Dr Malcolm Gomez Private Specialists Dr Roderick Chua Dr Matthew Hope Salaried Medical Officers Dr Anne Miller Dr Eugene Wong Dr Dheeraj Shukla Dr Andrew Bai Dr Khurram Aftab Dr Allan Wesley Dr Shauna Taylor Dr Mahrokh Davarpanah Dr Cheriya Adbulla Dr Saliya Ovitgalage Part-time Practitioners Prof Ravi Thomas Dr Muriel Soden
For any membership enquiries, please contact the Membership Team on (07) 3872 2222 or email membership@amaq.com.au
Member benefits If you have some leave planned over Easter, let our member benefits help you out. Our corporate partners have these special offers to help you reach your destination, all because you’re a member of AMA Queensland. Whether you’re travelling for business or going on holiday, we’ll ensure you get there in style for less. Get your log in details ready and visit our website at www.amaq.com.au – Member Benefits page.
As a member of the AMA, you can benefit from great discounts and preferential treatment at Hertz, the world’s number one car rental company.
Enjoy the personalised services of AMA Queensland’s very own travel provider, AMA Travel Queensland (operated by Orbit World Travel) for your holiday or conference bookings.
R E N E WA L S W I N N E R S Thanks to all our members for renewing and supporting our crucial advocacy and dedicated workplace support services.
AMA members and their partners are entitled to great discounts on Qantas Club Membership.
AMA Members are entitled to significantly reduced joining and annual fees for the Virgin Lounge.
AMA members, and their travelling companions, can save on Emirates airfares in Economy Class and Business Class. 5% off Business Saver and Economy Saver fares across all Emirates destinations;* 8% off Business Flex/Flex Plus and Economy Flex/Flex Plus fares across all Emirates destinations;* 10% off Business Flex Plus fares on select flights.
Congratulations to the following members who won an early-bird prize: Dr Margaret Anderson won a trip to the Barossa Valley for two nights, which includes flights, accommodation, car hire, a Sunrise Barossa Balloon Adventure and dinner at the Appellation Restaurant. Dr Ajit Calais won a Lexus for the weekend and an exclusive Lexus gift hamper comprising a selection of Crabtree & Evelyn products, Veuve Clicquot and chocolates. These members won a $500 Coles-Myer voucher:
Dr Klaus Loibl Dr Mirza Beg
Dr John Cairns Dr Mitesh Gandhi
Contact membership@amaq.com.au for access details to these discounted flights. *Terms and conditions apply. Doctor Q Autumn 37
Local Medical Association round up Redcliffe District Local Medical Association (RDLMA)
Ipswich & West Moreton Medical Association (IWMMA)
Gold Coast Medical Association (GCMA)
Contact:
Contacts: Dr David Morgan, President; Dr Aletia Johnson, Meetings Convenor; Dr Thomas McEniery, Treasurer (07) 3281 1177 Phone:
Contact:
Dr Kimberley Bondeson, President Web: www.rdma.org.au (07) 3049 4444 Phone: Meetings: 28 March 24 April 30 May 26 June 25 July 28 August - AGM 12 September 30 October 7 December - end of year networking function
Sunshine Coast Local Medical Association (SCLMA) Contact: Jo Bourke, Secretariat Web: www.sclma.com.au Email: jobo@squirrel.com.au Phone: (07) 5479 3979
Bundaberg Local Medical Association (BLMA) Contact: Dr Daud Yunus Email: daud.yunus@gmail.com Phone: (07) 4152 2888
Mackay Local Medical Association (MLMA) Contact: Phone:
Brisbane Northside Local Medical Association (NLMA) Contact:
Dr Robert (Bob) Brown, President Web: www.northsidelma.com (07) 3121 4029 Phone: Meetings: 10 April 12 June 14 August 9 October 11 or 14 December
Toowoomba and Darling Downs Local Medical Association (TDDLMA) Contacts: Dr Mark Wyche, President; Dr Peter Schindler, Treasurer Web: www.tddlma.org.au Email: info@tddlma.org.au Phone: (07) 4633 1939 Wilsonton Medical Centre (Dr Peter Hopson)
Chantell Badenhorst, Secretariat Manager Web: www.gcma.org.au Email: info@gcma.org.au 0419 780 505 Phone:
Fraser Coast Local Medical Association (FCLMA) Contact: Dr Nicholas Yim, Secretary Email: drnnyim@gmail.com Phone: 0421 659 892
Cairns Local Medical Association (CLMA) Contact: Phone:
Dr Sharmila Biswas (07) 4036 4333
Central Queensland Local Medical Association (CQLMA) Contact: Phone:
Dr Michael Donohue 0419 715 658
Dr Bill Boyd 0419 676 660
CAN’T FIND YOUR LOCAL AREA? 38 Doctor Q Autumn
If your Local Medical Association does not appear or your details are incorrect, please email amaq@amaq.com.au.
women in medicine breakfast
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Thursday 23 august 2018
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7am - 9am
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to express your interest to attend, email registrations@amaq.com.au
Election Notice 2018 The Returning Officer invites nominations and will hold an election for the positions of President, Vice President and Council of The Queensland Branch of Australian Medical Association Limited.
ANNUAL GENERAL MEETING The Annual General Meeting of the Members of The Queensland Branch of Australian Medical Association Limited will be held at: Time:
6.30pm
Date:
Thursday 17 May 2018
Venue:
AMA Queensland 88 L’Estrange Terrace Kelvin Grove, Queensland
PRESIDENT AND VICE PRESIDENT 2018-2019 For election as President or Vice President of the The Queensland Branch of Australian Medical Association Limited, one representative for each position is required. A nominee can be an ordinary or honorary member; Any two (2) ordinary or honorary members may nominate the nominee.
Business The business of the Meeting will be: 1.
Candidates for President or Vice President may submit with their Nomination Form:
To receive and consider the accounts, balance sheets and reports of:
A short statement of no more than 250 words. Any words in excess will be discarded; and
(i)
The Board;
(ii)
Any committees instructed to report to the meeting; and
(iii) The Auditors. 2.
A passport-sized head and shoulder photograph; and A video statement of no more than three minutes. The candidates may elect to have their video statement filmed at AMA Queensland. Film in excess of three minutes will be discarded.
The declaration of the results from the election of: (i)
A brief CV of no more than 250 words. Any words in excess will be discarded; and
The President, Vice President and Council members.
3.
The appointment of the Auditors and approval of the remuneration (if any) to be paid to the Auditors;
4.
To deal with all business which any statute, the Constitution, or the By-laws requires.
Proxy Notice A member who is entitled to attend and register one vote at the Annual General Meeting is also entitled to appoint another member as a proxy to attend and vote in his or her place. Proxy forms can be downloaded from the AMA Queensland website (www. amaq.com.au/page/Election) or by phoning AMA Queensland on (07) 3872 2222 and must be received by 6.30pm 15 May 2018.
COUNCILLOR POSITIONS 2018-2020 Nominations must be in writing and signed by the nominee, and two (2) nominators. All persons must be financial members of the The Queensland Branch of Australian Medical Association Limited. Any two (2) ordinary or honorary members may nominate another member provided all members belong to and are registered in the same Geographical Area, Craft Group or other position.
Craft Group Representatives required:
Other Positions required: One (1) Doctors in Training Representative 2018-2020. One (1) Retired Doctors Representative 2018-2020.
Geographical Area Representatives required: Three (3) Greater Brisbane Area Representatives Postcodes 4000 - 4199, 4300 4349, 4500 - 4513, 4514 - 4549 inclusive. One (1) Gold Coast Area Representative Postcodes 4200 - 4299 inclusive. One (1) North Area Representative Postcodes 4799 - 4850 inclusive. One (1) North Coast Area Representative Postcodes 4500 - 4601, 4619 - 4675 inclusive.
Candidates for Council may submit with their Nomination Form: A short statement of no more than 250 words. Any words in excess will be discarded; and A brief CV of no more than 250 words. Any words in excess will be discarded; and A passport-sized head and shoulder photograph.
What is required of a Councillor? Availability to attend Council meetings, and relevant AMA Queensland events/functions such as the Dinner for the Profession; Actively contribute to setting policy for the Association; Actively support membership retention and growth strategies; Provide a written report (template provided) for council meetings; and Availability to attend and contribute to AMA Queensland Committees.
One (1) General Practitioner Craft Group Representative 2018-2020; One (1) Specialist Craft Group Representative 2018-2020.
Annual Report *The 2017 Annual Report will be available online from 20 April 2018 at www.amaq.com.au/page/About_Us/ Annual_Reports
If you need to make changes to your craft group, geographical area or other position in the register of members for the purpose of the election this must be done by 5pm Wednesday 11 April 2018. Return completed nomination forms by 5pm Friday 13 April 2018 to the Returning Officer. Further nomination forms can be obtained at www.amaq.com.au/page/Election
N O M I N AT I O N S C LO S E 5 P M F R I DAY 13 APRIL 2018 40 Doctor Q Autumn
THE QUEENSLAND BRANCH OF AUSTRALIAN MEDICAL ASSOCIATION LIMITED | ACN: 009 660 280 | ABN: 17 009 660 280
Nomination Form
N O M I N AT I O N S C LO S E 5 P M F R I DAY 13 APRIL 2018
Nomination forms are to be returned to the Returning Officer, Andrew Vivian, by fax, email or post by 5pm, Friday 13 April 2018.
Time Frames 11 April 2018, 5pm:
Final changes to register of members
Phone:
(07) 3232 2900
13 April 2018, 5pm:
Nominations close
Fax:
(07) 3891 9292
30 April 2018, 5pm:
Ballot opens
Email:
nominations@priestleyspfn.com.au
15 May 2018, 5pm:
Ballot closes
Post:
The Returning Officer, PO BOX 1770, COORPAROO DC QLD 4151
17 May 2018, 6.30pm:
Annual General Meeting
We nominate
(full name)
as a candidate for the position of Craft Group/Geographical Area/Other Position
(for councillor nomination only)
If nominating for President or Vice President, you can only nominate for one of these positions.
NOMINEE’S DE TAILS: I consent to this nomination. Full name:
Craft/Area/Other Position:
Date of birth:
Member number:
Telephone number:
Primary practice address: Residential address: Signature:
N O M I N AT O R ’ S D E TA I L S X 2 : Full name 1:
Full name 2:
Craft/Area/Other Position:
Craft/Area/Other Position:
Telephone number:
Telephone number:
Residential address:
Residential address:
Signature:
Signature:
Please Note If nominating for President or Vice President you can only nominate for one of these positions; If nominating as a representative for a Craft Group, Geographical Area or other position, your nominators must both be registered in the Craft Group, Geographical Area or other position for which you are nominating; and You cannot represent a category on Council at the same time as you are President, Vice President, Immediate Past President or Chair of Council. Access this nomination form and the position description for the role of President and Vice President at www.amaq.com.au/page/Election
Doctor Q Autumn 41
AMA QUEENSLAND’S ANNUAL CONFERENCE
Join us in New Orleans Perhaps Tennessee Williams said it best: “America has only three cities: New York, San Francisco, and New Orleans.” New Orleans is one of the world’s most fascinating cities, with a history as winding and arabesque as the stretch of the Mississippi River Delta upon which it sits.
New Orleans is the destination for the next AMA Queensland Annual Conference and will run from 23 – 29 September 2018. With the theme The Future of Health Care, the conference will feature a range of renowned presenters from the University of Queensland Ochsner Medical School, on the future of health care, including cutting-edge topics such as: wearable technology innovations in the hospital
setting; advances in 3D printing and how this technology is reshaping complex congenital heart surgeries; the future of Electronic Medical Records; training the physicians of the future (including a student’s experience); obesity - a global problem; the rise of robotics in medicine; exploring trends of consumerism in medicine; connected health: an emerging model of maternity care; and health and general practice as a good investment.
Confirmed speakers from the University of Queensland Ochsner Clincial School, New Orleans: Dr Richard Milani, Chief Clinical Transformation Officer,
42 Doctor Q Autumn
Ochsner Health Systems Associate Professor Rajiv Gala, Director, Department of Obstetrics and Gynecology Dr Jody Morris, Chair, Department of Obstetrics and Gynecology, Ochsner Clinic Foundation Dr Korak Sokar, Senior Neurologist, Ochsner Health System Dr Todd Burstain, Chief Medical Information Officer, Ochsner Health System Associate Professor Leo Seoane, Head of School, UQ Ochsner Clinical School Dr Dana Smetherman, Section Head of Breast Imaging, Ochsner Health System Dr Bill McDade, Board Member, American Medical Association Dr Gabriel Uwaifo, Senior Clinical Research Scientist and Endocrinologist, Ochsner Diabetes and Weight Management Clinical Research Institute.
Outside the conference sessions, there will be plenty of time to explore New Orleans and all it has to offer. Tours around the city will include New Orleans’ highlights such as the Garden District and its mansions and magnolias, a day trip to experience the marvels of Louisiana’s Bayou Country and the mystical swamplands, and optional ghost and cemetery tours or Mississippi River cruises.
PRE AND POST CONFERENCE TOURS Experience the best Cuba has to offer, visit The Deep South, taking in Memphis and Nashville, or cruise the magnificent Mississippi River on the American Queen Steamboat. Alternatively, Orbit World Travel can help craft your ideal tour option. Numbers are limited so be sure to book your pre and post Conference tours now.
Keen to book your pre and post conference tours? Contact Ros Bulat at World Orbit Travel Email: ros.bulat@worldtravel.com.au For any enquiries about the program: Contact Neil Mackintosh, AMA Queensland Conference Organiser Phone: (07) 3872 2267 Email: n.mackintosh@amaq.com.au Phone: (07) 5556 7267 or 1300 262 885
Doctor Q Autumn 43
MEET THE SPEAKER
Dr Dan Diamond
DR DAN DIAMOND
Founder and Director of the first stateaffiliated medical disaster response team; and doctors’ mental health advocate
After working in first response teams since founding the first state-affiliated medical response team in 1994, Dr Dan Diamond has seen humans in their rawest form. Dr Diamond has been one of the first on the ground after hurricanes in Mexico, Honduras and New Orleans; an earthquake in Haiti; and a typhoon in the Philippines. He served as Director of the Mass Casualty Triage Unit at the New Orleans Convention Center after Hurricane Katrina and Medical Director for Medical Teams International’s First Response Team in Haiti. He came back from the trenches of Katrina with a burning question: “How is it that some people become unstoppable?” He saw people who had lost their loved ones or been injured themselves, lost their homes and their belongings and found that people took very different approaches. From this, Dr Diamond discovered what drives motivation, increases engagement and empowers people from the inside out. He developed a passion for helping people under pressure. “I’m in the triage unit at the New Orleans Convention Centre, we’ve got six helicopters at a time landing around us, blowing everything around, there’s all this noise and chaos and in the midst of all that, I saw some people give away the last few items that they owned to someone else. It’s the worst situation, but I found people at their best,” said Dr Diamond. The American Academy of Family Physicians awarded Dr Diamond the degree of Fellow and he is Board Certified with the American Board of Family Physicians. He has been interviewed on CNN, Larry King Live and Anderson Cooper 360°.
44 Doctor Q Autumn
As an experienced family physician and an award-winning educator, Dr Diamond delivers practical information with creativity and skill. Participants experience learning through a variety of effective strategies that foster rapid mastery of new information. Well-known for creating an exciting learning environment, Dr Diamond engages the mind of the learner leaving participants with an experience and information they will never forget. After earning his medical degree from University of Washington, Dr Diamond completed his residency in family medicine in Milwaukee, Wisconsin. He is a member of the Editorial Board for the Primary Care Companion to the Journal of Clinical Psychiatry. Dr Diamond is also a Clinical Assistant Professor at the University of Washington School of Medicine. In 2010, the American Red Cross gave him the Real Hero award and he also received the Washington State Governor’s Award of Excellence for his work in Haiti. In 2014, Dr Diamond received the President’s Volunteer Service Award from President Obama and he also received the Quality of Care Lifetime Achievement Award, Healthcare Heroes.
REGISTER NOW FOR THE FIFTH ANNUAL JUNIOR DOCTOR CONFERENCE TO HEAR DR DIAMOND SPEAK
ABOVE AND
BEYOND AMA QUEENSLAND FIFTH ANNUAL JUNIOR DOCTOR CONFERENCE 2018
Day one Brigadier Michael Bond CSC Director, Department of Communities, Child Safety and Disability Services Queensland Brigadier Bond will share his top five leadership learnings from over 30 years of commanding soldiers
S AT SUN23 JU 24 NE HIL TON JUN BRI E SBA NE
Dr Geoffrey Toogood, Cardiologist; Founder of CrazySocksforDocs; and long-term mental health advocate for doctors and the community
Panel: Shining a light on the habits of medicine’s best leaders
Medical Officer, World Health Organisation Solving obesity: the crucial role of millennial doctors
Dr Michael Bonning, General Practitioner and Head of Expedition Medicine, Inspired Adventures; Senior Medical Officer, Royal Australian Navy; Board Member, AMA NSW
Dr Dan Diamond MD
Dr Amandeep Hansra, Chief Executive Officer, Telstra Readycare
Dr Alessandro Demaio
Founder and Director of the CMRT and doctors’ mental health advocate Lessons learned in resilience following disaster response
Dr Kate Kearney, Advanced Cardiology Trainee, St Vincent’s Hospital Dr Amanda Smith, General Practitioner and co-owner/operator of Queensland Raceways, Willowbank
Panel on junior doctor mental health/mandatory reporting: challenges and solutions
Career building in regional and remote Queensland
Dr Dan Diamond MD, Founder and Director of the CMRT and doctors’ mental health advocate
Join our panel for a discussion on pathways available and typical experiences of ‘being out bush.’
Members of AMA Queensland’s Council of Doctors in Training
Dr Drew McMenamin
Dr John Reilly, Chief Mental Health Alcohol and Other Drugs Officer, Clinical Excellence Division, Department of Health Dr Alessandro Demaio, Medical Officer, World Health Organisation
Managing Radiologist, Noosa Radiology; and Senior Lecturer, Lightbox Radiology Education Chest x-ray interpretation of airways, lungs and pleura
MEMBERS CAN REGISTER NOW AND SAVE WITH GREAT EARLY- BIRD RATES WHICH CLOSE 20 APRIL. DON’T KNOW YOUR ROSTER? REGISTER NOW AND A FULL REFUND IS AVAILABLE IF YOUR ROSTER CHANGES.
Day two Hon Steven Miles Minister for Health and Ambulance Services Following the annual address, the Health Minister will showcase the Queensland Health research recipients
Clinical Skills Development Services presents Simulympics 2 Following on from a successful first CSDS simulated exercise at JDC 2017, the CSDS team is back with a new emergency challenge.
Dr Michael Wagels Plastic and Reconstructive Surgeon, Princess Alexandra Hospital Clinical translation of 3D printing technology
Professor Stephen O’Leary Department of Surgery (Otolaryngology), Royal Victoria Eye and Ear Hospital, East Melbourne Virtual reality in medicine
Christine Brill Careers Adviser, Australian Medical Association Why your resume is the most important document you can create
Dean Clifford Business and Marketing Officer, Ken Mills Toyota and Brand Ambassador, Toyota Above and beyond; my story and insight into great patient care Doctor Q Autumn 45
Stuff* happens
Running a modern medical practice exposes the practice owners to complex and varied risks. While clinical risks are front of mind – it’s the business risks which are often forgotten, at least until something goes wrong. Even when covered by insurance, it’s important to have a plan B, or as those in risk management say, a disaster recovery plan or business continuity plan, particularly around patient continuity of care. One of our clients recently opened the front reception doors on a Monday morning to find themselves knee-deep in sewerage. Overnight, there was a blockage in the main building sewer line and with the practice being on the ground floor, gravity did its thing and the closest place for the sewerage to overflow was out of their toilets. In the last few years, some of the more mundane events within practices has included:
A hand therapy practice whose washing machine pipe burst and due to inadequate drainage, the practice, plus the medical practice downstairs, suffered both water
46 Doctor Q Autumn
damage to their rooms, plus the resultant lost revenue due to closure. Again, the client opened the doors in the morning to discover the damage as they had put the machine on automatic cycle overnight and then left for the evening. A driver crashed into the power line across from a GP clinic and the electricity wasn’t restored for several days. While there was no physical damage to the premises, the lack of ‘public utilities’ meant the practice had to close until power was returned. The specialist practice who lost all internet services when the local exchange burnt down. With no plan B in place, the practice ground to a halt without access to their electronic medical records.
While the risk of your rooms burning to the ground is relatively low, its often major weather events such as cyclones in north Queensland or floods in Brisbane or the above short-term practice closures that occur which may range from a few days to a few weeks or more.
In each of the above events, the practices suffered lost revenue and additional costs – which were covered by their business interruption insurance cover (commonly found within a business package insurance policy). In the lost electricity and internet services cases – they was no actual physical loss to the business, but the resultant lost revenue was covered under the extensions for ‘loss of public utilities’ and ‘unspecified suppliers’. Going back to the burst pipe client above, the practice was closed for around five days. The insurer (Chubb Insurance) settled the claim quickly. They paid for the clean-up and loss of damaged stock and contents. They settled the lost revenue claim by paying a daily rate for lost revenue based on the last three months of accounts. Over the course of the next 12 months, the client was hit with lost revenue legal letters from the medical practice downstairs, as well as from the landlord for damage to the building and common areas. The client’s public liability cover paid both these demands (which totalled over $60,000), as this policy covers ‘civil liability for third party property damage’.
S O W H AT ’ S Y O U R P L A N B Whether from a fire, water damage, storm, lost electricity or other stuff happens event - which closes your rooms – what would be your plan B? We have clients who are highly reliant on their rooms such as:
the single-site GP clinic; or the radiology/pathology practice reliant on specialist equipment as well as the rooms which would take months to repair or replace. These practices may also require a specialised ‘equipment breakdown’ insurance policy.
We also have clients such as the physician who consults from multiple practices paying sessional fees and isn’t overly reliant on any one location. E.g. they believe they could move patients from Monday’s rooms to Tuesdays – although if all rooms are within a major weather event, they may find this plan B to not be as bulletproof as they imagined. Some questions to ask yourself when thinking about a plan B:
How reliant are we on our rooms and our equipment? Could we quickly and easily move patients to another location and is this feasible if the other location is already at maximum capacity? How would we deal with a broader event such as a natural disaster? Who are our key suppliers – what if they suffer an event and can’t provide us services or products? If we didn’t have access to our electronic medical records, how
would we advise patients and manage rescheduling and resultant medico-legal risks? If we suffered a total loss, would we close down and wait for the rebuild, or look to move to temporary rooms as soon as possible? This question alone makes a big difference to how your business interruption insurance should be structured. Do we have the right insurances in place to protect the lost revenue and additional costs incurred following a disaster?
CHRIS MARIANI Medical & General Risk Solutions
P: 0419 017 011 E: chris@mgrs.com.au Authorised Representative No.434578
Disclaimer: Medical and General Risk Solutions is a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, Australian Financial Services Licence No 240549, ABN 15 003 886 687. Authorised Representative No 436893. The information provided in this article is of a general nature and does not take into account your objectives, financial situation or needs. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.
This article provides some general information and points to consider when thinking about a plan B. We encourage you to do your own research on disaster recovery plans and business continuity plans. This article does not consider the impacts from loss of key people and your practice may be more reliant on people than rooms or equipment. As part of your plan B, you should be sitting with your insurance broker to discuss what insurances are appropriate for your circumstances including business interruption cover. Please contact us for a discussions and review of insurance needs. *We don’t really mean ‘stuff’, we mean the stuff you find on the Bristol Stool Scale
Doctor Q Autumn 47
Service entities TIPS AND TRAPS When doctors establish their own practice, start taking rooms, employing staff and purchasing equipment, they essentially create a new business. From a tax and structuring perspective, there are two businesses operating - the individual medical practice of the doctor and the new service business. The service entity employs all staff associated with the practice, provides all administrative materials such as stationery, postage and telephones, operating premises and perhaps the equipment used by the practice. The service entity then charges a fee to the doctor for the supply of these services. The use of this structure is extremely common within the medical profession and the Australian Tax Office (ATO) has accepted the use of service entity arrangements. However, where there is an overcharging of service fees or a service fee is charged at noncommercial levels to the doctor/s, it can be seen as tax avoidance and attract substantial penalties. In determining the appropriateness of a service fee, ask yourself, “If I did not control the service entity to which I am paying the service fee, would the level of the payment differ?” That is, would I pay an external provider the same amount that I currently pay my own service entity? If the answer is no and you would in fact be paying less, it is possible you are overpaying your service fee. The ATO are placing greater scrutiny on this area. There have been a few cases in recent years, where the service entity arrangement has not been upheld by the courts and some taxes such as payroll
48 Doctor Q Autumn
tax have been made to be payable by these entities. However, if the service fee entity and its service fee arrangement is set up correctly and is appropriately documented, neither the relevant contract provisions nor employment agency contract provisions should apply. Therefore, payroll tax and employee entitlement provisions (such as leave and superannuation) would not be payable in these circumstances. The key components of these arrangements are as follows:
It is not the medical professional providing any services to the service entity, but rather the service entity is providing premises and administrative support to the doctor, which allow them to operate their business from the premises in exchange for a mutually agreed fee. The patients under this model are patients of the individual doctors and not the service entity. A correctly worded service fee agreement – beware of any back of the envelope-type contracts as they may not stand up in court. Use of advertising – ideally practice advertising should focus on the practice’s clients which would be medical practitioners who wish to use the premises, rather than patients. Also, the doctors should not be identified as ‘our staff’.
These factors must exist in order for an arrangement to be considered a correctly administered service entity arrangement.
ANGELA JEFFREY
Business Advisory Director, William Buck Accountants P: (07) 3229 5100 E: angela.jeffrey@ williambuck.com
1 . D O I N E E D T O O P E N A S E PA R AT E BANK ACCOUNT TO RECEIVE THE PAT I E N T F E E S O F T H E I N D I V U D U A L DOCTORS? This is not a mandatory requirement, provided you can track and record each medical practitioner’s patient fees for each payment period and are able to use these numbers to calculate a service fee. We advise clients to maintain a patient fee liability account on the balance sheet for each doctor utilising the practices services, to track this income, their service fee and the net payment owing to them. Where this process is followed, a separate bank account is not required.
2. DO I NEED A WRITTEN SERVICE AGREEMENT BETWEEN EACH INDIVIDUAL MEDICAL PRACTITIONER AND THE SERVICE ENTITY? SHOULD THIS CONTRACT B E A L E G A L C O N T R A C T P R E PA R E D BY A SOLICITOR?
3.THE PRACTICE’S AGREEMENTS FA L L U N D E R T H E E M P L O Y E E AND CONTRACTOR PROVISIONS, W H AT D O E S T H I S M E A N F O R M Y PRACTICE? If this does occur, then this may be very costly to your practice. This will mean that the practice must pay superannuation, leave entitlements and potentially payroll tax if you exceed the $1,100,000 taxable wages threshold. It never hurts to seek a second opinion. As an AMA Queensland member, William Buck provides you with a complimentary consultation to review your financial affairs and ensure you are compliant with tax legislation. This second opinion is at no risk to you and will give you peace of mind that you are doing the right thing and can stay off the ATO radar. Disclaimer: The contents of this article are in the nature of general comments only, and are not to be used, relied or acted upon with seeking further professional advice. William Buck accepts no liability for errors or omissions, or for any loss or damage suffered as a result of any person acting without such advice. Liability limited by a scheme approved under Professional Standards Legislation.
The answer to both of these questions is absolutely yes! This is the only way that you, as the owner of the practice, can be sure that you fall within the service fee arrangement guidelines and can gain some reassurance that the doctors utilising your services will not be classified as employees or contractors
Doctor Q Autumn 49
PAT I E N T R E F E R R A L S P O T L I G H T
Motor Neurone Disease 2 The MND and Me Foundation aims to provide and facilitate the right solutions at the right time throughout the cycle of pre-diagnosis, diagnosis, living with Motor Neurone Disease (MND) and following a loved ones’ passing. Doctors could further assist their MND patients by referring them to the foundation for assistance. Having a disease-specific support system available can make a huge difference to providing peace of mind and increasing the quality of life for someone living with MND.
3
1
Many people newly diagnosed with MND struggle to know what that next step is post-diagnosis. Accessing appropriate support mechanisms and services can often be difficult and confusing due to the varied options associated with location, age, stage of the disease and financial resources. The MND and Me Foundation aims to ensure Queenslanders with motor neurone disease (MND) have timely access to much needed equipment, information, emotional support and care services:
1. Dr Shuyan Ngo: Scott Sullivan Memorial Research Fellowship aims to: Develop a translational research program that bridges the clinical and basic sciences, to decipher the mechanisms by which altered metabolic balance contributes to disease pathology. 2. Woodruff Laboratory members 2017 L-R Samantha Levin, Trent Woodruff, John Lee and Angela Hanton: 2017 Fat Rabbit Research Grant focuses on: The role of the immune system in driving the progression of motor neuron disease (MND): Discovery of new therapeutics 3. Sarah Durand and Julia Spotswood, MND Care Coordinators.
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service coordination – ensuring no one faces MND alone; research funding – providing grants and funding towards a cure; supply of equipment (short/ medium term) – filling the access gap between prescription and delivery; tailored support groups – developing a community support network for metropolitan and regional Queenslanders;
access to health professionals – demonstrating individual solutions for individual needs; information services – keeping the community connected via support, care, awareness and research updates;
home improvement and care grants – improving quality of life; and
carer services – facilitating mental health and wellbeing for adults and children.
The MND and Me Foundation focuses on four key areas: care, research, awareness and community engagement. The Foundation is a philanthropic organisation, funded by community donations, corporate sponsorship and non-government grants. A big fundraising event for the MND and Me Foundation is the Scott Sullivan Memorial Gala. This event is designed to honour Scott Sullivan’s legacy and raises vital funding via ticket sales, main auction, silent auction and raffle tickets. Visit www.mndandme.com.au for more information.
Storing your money WHERE IS YOUR MONEY KEPT? Deciding where to keep your money can be a daunting process. With so many options out there, should you go for a term deposits or a high interest savings account? High interest savings accounts and term deposits are two of the main places to store your money, but which option is best? A high interest savings account is a bank account designed to help your savings grow faster. Generally, it offers a higher interest rate compared to other transaction accounts. A term deposit is a savings product where your money is invested for a fixed term at a fixed interest rate. Choosing between these two alternatives will largely depend on your circumstances and your cash flow needs.
THE TERM AND THE FEES For high interest savings accounts, you can keep your money in there for as long as you like. While many high interest savings accounts don’t have fees, some banks do charge for set-up, monthly ongoing or annual fees. When it comes to term deposits, you’ll need to decide on the length of investment time. This can be anywhere from one month to five years. A shortterm deposit is one that is 12 months or less. A long-term deposit is anything longer than one year. There are generally no fees attached unless you decide to withdraw any funds before the term is finished.
T H E I N T E R E S T R AT E
ACCESSING YOUR MONEY
Generally, the interest rates offered on a high interest savings account is a standard variable rate, so your rate is not fixed and can move with the market. On the plus side, the interest rate is competitive and usually higher than that offered by a traditional transaction account—helping you build your savings faster.
Your high interest savings account is open and accessible to you at all times. This means you can withdraw your money if and when you need it. But remember, the amount of interest you earn is dependent on the amount of money in there. Plus, many accounts offer bonus interest rates if you don’t withdraw so it’s wise to keep that in mind.
Some high interest savings accounts pay a bonus rate above the standard variable rate if you deposit a certain amount each month and/or not make any withdrawals. Not meeting the behaviour could result in just the standard variable rate being paid.
With term deposits, you cannot access your money at all until the term is up. If you do decide to break your term deposit early, this is where penalties will arise.
With term deposits, your interest rate is locked. So even if the market dips, your rate remains the same and you have certainty around how much you will receive at the maturity of your term deposit. Generally speaking the longer the term, the higher the interest rate you will receive.
SHEHAN RAJAKUMAR BOQ Specialist
www.boqspecialist.com.au
ADDITIONAL DEPOSITS Because your high interest savings account is open and accessible, you can add to your savings at any time. The more money in the account, the more interest you earn, so it’s beneficial to keep adding to it. Also, some accounts will require a certain amount to be deposited each month in order to qualify for a bonus interest rate so you will really see your savings grow. For term deposits, you cannot make any additional deposits. The only way to add money is to wait for the term to mature and then deposit your additional savings into a new term deposit. The credit provider is BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 Australian credit licence no. 244616 (“BOQ Specialist”). Terms and conditions, fees and charges and lending and eligibility criteria apply. The information contained in this article is general in nature and has been provided in good faith, without taking into account your personal circumstances. While all reasonable care has been taken to ensure that the information is accurate and opinions fair and reasonable, no warranties in this regard are provided. BOQ Specialist is not offering financial, tax or legal advice. We recommend that you obtain independent financial and tax advice before making any decisions.
Doctor Q Autumn 51
When is it okay to breach patient confidentiality? behind her and realised Mr Jackson was now standing directly behind her. The receptionist was alone in the practice except for the doctor. Although she was uncomfortable with Mr Jackson’s request, she was reluctant to ask him to return to the waiting room.
NERISSA FERRIE
Medico-legal Adviser, MDA National Doctors approach the doctor–patient relationship with diligence, and are usually reluctant to breach patient confidentiality. Situations can arise where doctors feel ethically and morally bound to release patient information to protect the welfare of others, as detailed in the case below. A patient booked a follow-up appointment with Dr Johns, a part-time GP working in a small rural practice. The patient, Peter Jackson, was returning for the results of a CT scan. When Mr Jackson arrived for the last appointment of the day, he was told Dr Johns was running behind time. Mr Jackson wasn’t happy about the delay, but said he would rather wait than reschedule as he needed to see the doctor that day. After ten minutes, Mr Jackson advised the junior receptionist that he had been out of town for a while and wanted to check his details were up-to-date. The receptionist, feeling slightly intimidated by the patient, agreed to check his details and opened the patient database. She was surprised when she heard a noise
52 Doctor Q Autumn
Keen to get the patient away from her desk, the receptionist typed in ‘Jackson’ into the computer. A list of patient names appeared on the screen and the patient pointed to an entry for Peter Jackson, saying, “That’s me”. The receptionist brought up the record – but before she realised it couldn’t be correct because the date of birth only made him 12 years of age, the patient grabbed a post-it note and wrote down the address on the screen. Mr Jackson smiled at the receptionist and said, “I don’t need that appointment after all – but my ex might need a doctor now that I have her address”. The receptionist called for Dr Johns who came out of his consulting room immediately. The receptionist was distraught, realising she had inadvertently disclosed the current address of Mr Jackson’s ex-wife and son. Dr Johns had not initially recognised Mr Jackson, but was familiar with the family and aware of
a long history of domestic violence which had resulted in the patient being jailed for three years. Even though Dr Johns had only seen Mr Jackson once, there was still a doctor– patient relationship to consider, so he turned his mind to the issue of privacy and patient confidentiality. He was aware that confidentiality can be breached under certain circumstances and he formed the view that Mrs Jackson and her son were at serious risk. Dr Johns called both the local police and Mrs Jackson to warn them of the breach and the potential danger to the family and he provided the police with Mr Jackson’s current address. Mrs Jackson was picking her son up from after-school sports when she received the call from Dr Johns and she drove straight to the local police station. Mr Jackson was arrested outside the family home and was returned to jail for breaching his bail conditions. Mrs Jackson was grateful to Dr Johns for raising the alarm, but was equally concerned about her son’s personal details being released by the practice. The practice responded with an unreserved apology, and Mrs Jackson moved to another town for her own safety.
Disclaimer: 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.
Doctor Q Autumn 53
PETER ARONEY
Doctors’ Health Fund records lowest average premium increase in 2018
CEO, Doctors’ Health Fund
Doctors’ Health Fund has recorded the lowest average premium increase across all health funds, and the sixth consecutive year of below industry average increases.
P: 1800 226 126
On 25 January, Minister for Health Greg Hunt released the table of average premium increases by health funds1, which becomes effective from 1 April 2018. Our track record of premium increases, as shown below, has been below the industry average and our major competitors, for the past six years, since becoming part of the Avant Mutual Group. In addition, Doctors’ Health Fund has recorded the lowest average premium increase in three out of the past four years.
E: doctorshealthfund. com.au
7% References 1. http://www.health.gov.au/ internet/main/publishing.n sfContent/0B815BFEB8EDE CA7CA257BF000195929/$ File/Table%20of%202018% 20Individual%20Insurer%20 Premium%20Increases%20 -%20for%20website.pdf 2.
AMA, AMA Private Health Insurance Report Card, Pg. 9, 01 April 2017 https://ama.com.au/amaprivate-health-insurancereport-card-2017
6%
6.20%
6.18%
5.60%
5.59%
5%
4.84% 3.95%
4% 3% 2% 1% 0%
2013 Industry
2014
2015
Doctors’ Health Fund
2016 Medibank
2017 Bupa
2018 HCF
Whilst affordability is a key concern for the health insurance industry, we at Doctors’ Health Fund strongly believe comprehensive and transparent policy coverage should never be compromised. We have always believed in providing quality products and services, and funding only for treatments with proven efficacy. We believe that our unique Top Cover, which pays medical benefits up to the AMA list of medical services and fees, sets the benchmark for the industry and proves that quality can be delivered at sustainable prices. We do not believe in so-called ‘junk policies’, which are characterised by a very limited number of services covered. We are owned by doctors and understand that doctors and their practice staff bear the brunt of consumer confusion and frustration when the unexpected occurs. Our below industry average pricing has been achieved whilst Doctors’ Health Fund continues to outperform the biggest, open funds in terms of the percentage of medical services being provided with no-gap2. In the almost six years since the union with Avant, Doctors’ Health Fund has more than doubled its size and now insures almost 37,000 lives, which eclipses the industry’s relatively flat growth, and shows that more and more doctors are making the switch. 54 Doctor Q Autumn
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MBAQ
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The MBAQ has established a Medical Almoners Group comprised of medical practitioners who are prepared to visit colleagues who are patients in hospitals or nursing homes at their request to see if they can be of any help. They will not provide treatment and there is no charge. It gives the opportunity for those who have the time to help less fortunate colleagues. If you would like to arrange a visit from a medical colleague, or, would like to volunteer to visit a medical colleague, please contact MBAQ Coordinator on ph: (07) 3872 2222 or e: mbaq@amaq.com.au or visit: www.MBAQ.org.au
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Enchanting and exciting Egypt
Ros at AMA Travel Queensland is happy to tell you that Egypt is her favourite travel memory! For centuries, the iconic sights of Egypt have held visitors under their magic. From the pyramids of Giza to the pharaoh’s tombs, Egypt is a veritable melting pot of ancient history, with a cultural history so different to our own. Exploring the country, the rich history and beautiful monuments are sure to amaze you.
LUXOR
You can tour many of the tombs in the Valley of Kings and Valley of Queens, with walls and ceilings covered in paintings and hieroglyphics, and see the Colossi of Memnon. The Colossi are two somewhat worse-for-wear seated statues, sitting 18 metres high. They are all that remain of the funerary temple of Amenhotep III, constructed on the Nile’s flood plain. The temple of Queen Hatshepsut is in much better condition, since it’s further away from the river. Carved into the mountain that borders the Valley of the Kings, many of her statues and pillars still stand intact. The Luxor Temple is a strikingly graceful monument in the heart of a modern town.
ASWAN
Aswan is one of Egypt’s most tranquil and attractive towns and is about 200km south of Luxor. Aswan snakes through large granite outcrops in and around the Nile. These protrusions made navigation on the river difficult, but also made Aswan a strategic gateway to the trading routes of the south. Moreover, they made the city a fortress against invasion from the south. Backed by orange-hued dunes, this is the perfect place to stop and unwind for a few days.
THE MUSEUM OF ANTIQUITIES
MEMPHIS
Built before Egypt became independent, the museum is home to many magnificent treasures from the days of the pharaohs. Additionally, there are artefacts from the period after Alexander the Great brought Egypt into his empire. This move started a lineage of Ptolemaic kings and queens, including Egyptian Queen Cleopatra VII. However, the ornate death mask of Tutankhamun is certainly the most famous relic in the museum.
Memphis is south of the Nile River Delta, on the west bank and about 24km south of modern Cairo. Home of the Pyramids of Giza and the Sphinx, Memphis covers many other ancient ruins as well. The Sphinx and the three great pyramids are without a doubt the most well recognised Egyptian attractions. The ancient ruins of the Memphis area were collectively designated as a United Nations Educational, Scientific and Cultural Organisation (UNESCO) World Heritage site in 1979.
T H E T E M P L E S O F R A M S E S A N D H AT H O R
The Temple of Ramses II and the Temple of Hathor stand next to each other in Abu Simbel. Cut into the rocks lining this part of the Nile, they are 40km north of the border with Sudan. Inside you’ll find large statues and rooms covered in stone carvings showing Ramses defeating and imprisoning his enemies. Ramses built these temples as a reminder to those living further south of Egypt’s power. The building of the Aswan high dam and the subsequent filling of Lake Nasser threatened to submerge the temples. Therefore, starting in 1964, they were moved 65m higher and 200m back from where the river had been. The cut marks from the stone saws are still evident, but it was certainly a remarkable achievement.
For more information call or email Ros at AMA Travel Queensland. P: 1300 262 885 F: (07) 5556 7200 E: travel@amaq.com.au www.orbitworldtravel.com.au
RESTAURANT REVIEW:
NOA
DR SARAH COLL,
When you travel to Cairns, you tend to settle in the city or the beaches. Can I suggest that it is well worth catching an Uber to the suburb of Edge Hill to soak up a village atmosphere, the jewel in the crown being NOA restaurant? The maitre’d remembers who you are and reserves your favourite table, without asking. Agatha, the regular morning waiter, beams graciously while taking your umpteenth coffee order and no one complains about your bike pants as you are close to the red arrow, which is a haunt for fitness freaks who run up and down its steep incline all day, sweating in
The food is innovative, the brainchild of the head chef who developed the tapas plate to a more Australian size, and between 4pm and 6pm the food and drinks are discounted (a locals secret). The potted bread arrives in a clay flowerpot, with blackened salt and gently flavoured butter - a new flavour every time I go. For breakfast, I have the avocado toast, which comes with fresh greens, in the form of shaved cucumber to make it extra healthy.
Orthopaedic Surgeon, AIR Medicine and Specialist Craft Group Representative, AMA Queensland Council owners support local artists with live entertainment Thursday, Friday and Sunday - lilting melodies from young talent. The cocktail specials are always tempting and the milkshakes are spectacular. For dinner, our family had hot and spicy chicken wings, massive potato wedges, beef carpaccio, potted bread (yes, I love it) with caper butter and to finish, a barely sweet hazelnut chocolate torte. Service was quick, friendly and delivered with a charming French accent. If you come to Cairns just to try this restaurant, it will be worth the trip!
‘THE POTTED BREAD ARRIVES I N A C L A Y F L O W E R P O T. . . A NEW FL AVOUR EVERY TIME.’ NOA is promoting its dinner offerings, which is a good idea in summer when the heat of the day has settled. The
NOA A: 1 Pyne Street, Edge Hill P: (07) 4032 3117
58 Doctor Q Autumn
RED DRINKERS NEED TO READ THIS:
Ageing Whites I’ve been a card-carrying member of the aged white cult my entire career. There’s not many of us but we’re there, lurking amongst the shadows at auctions snapping up aged rieslings and semillons well below what they’re worth or fumbling around in quit barrels at independent wine shops or bottloes attached to country pubs. What on Earth drives us? I can’t speak for my brothers and sisters in this bizarre cult except to tell my own story which thankfully started early in my career as a wine merchant in the United Kingdom. On this occasion, I was in Bordeaux for Vin Expo ’93, at the time the world’s biggest gathering of wine producers showing their wares to would be buyers. On the second night, my desperate posse descended on a restaurant at 10pm and I was sent away to the wine shop to find something “interesting, white, not too expensive but make sure it’s the best thing since…” Yeah, okay, we’ve all had that brief before!
and said, “he says it started raining in this vineyard on October 8 that year but fortunately they had harvested two days prior, not precisely when they wanted to, but they knew it was going to be a wet year and there would be problems - this should be fine”.
Without hesitation, I purchased all three bottles and took the first one back to the table. This was amazing, still showing some grassiness but the palate was full of honey, lime and lemon zest with a clean, long finish… 29 years old? In there, I found a Just amazing. I have since ‘WITHOUT remarkable looking white H E S I T A T I O N , I been a lover of well-aged wine, a 1964 Bordeaux whites and have only Blanc, light gold in colour P U R C H A S E D A L L been able to replicate T H R E E B O T T L E S ’ similar experiences in with level into the neck. When I worked it back to Australia through riesling Aussie dollars it seemed like a bargain and semillon… I say to red-only but I wanted to be sure. The merchant drinkers, wake up and taste these rolled his eyes and said “follow me”. wines! They really are red-drinker whites, full of body and complexity We walked a little way down an and unlike pinot noir, much less alley way and found an old man, expensive a journey. well dressed in a crumpled, off white linen jacket and pants. The merchant Drop me a line, I have several to showed him the bottle and for a recommend for ageing and there’s moment he reflected on the label, associate membership to the cult on mumbled a paragraph and handed it offer… phil.manser@winedirect.com.au back. The merchant then turned to me or 1800 649 463.
PHIL MANSER Wine Direct
P: 1800 649 463 E: phil.manser@ winedirect.com.au Doctor Q Autumn 59
Meeting Otzi, the ice man I studied archaeology a few years ago. It had always been an interest but the catalyst for doing a degree was that I really loved travel. The Pyramids, Chichen Itza and Machu Picchu are all extraordinary but with some archaeological insights, they are even more remarkable. Recently I headed off to the South Tyrol region of Italy to see Otzi the Ice Man. I emailed the South Tyrol Museum in advance and mentioned that despite being a doctor by trade, archaeology was my biggest fascination and also that I wrote for Doctor Q. Otzi would be a fascinating story. In typical Italian fashion the red carpet of hospitality was rolled out quicker than a Roman legion could launch a raid on the Gauls. The head curator Paula took my two medical mates, Pete and Doogs, and me on a personalised tour of Otzi and his belongings. She gave us the definitive account of his discovery in 1991, his demise 5,300 years ago and all the treasure trove of belongings that he had on him at his time of death. My mate Doogs lived out his dream by being granted a press photography pass and armed with his monstrous lens proceeded to snap off the definitive photographic record of the best of Otzi. Despite lying silent for 5,300 years frozen in the Italian Alps, Otzi, has spoken volumes in the last 26 years since his rediscovery. He was a man of the Copper Age, which just predated the Bronze Age. He had a remarkable collection of tools on him when he died. He had a dozen arrows, some of which were flint tipped and a magnificent bow made of yew wood. Yew wood was still being utilised when the pommy archers belted the French at Agincourt 4,700 years later. He possessed a perfectly crafted copper axe that actualised experiments have proven could fell enemies as well as trees. His flint dagger was immaculately worked. A fungus found with him has been shown to have anti-bacterial, haemostatic and anti-inflammatory properties. He had needle and string, butchering tools, a net and kindling, all in a backpack. He had obviously been in the Copper Age scouts, because Otzi was certainly living the scouting creed of ‘be prepared’.
60 Doctor Q Autumn
Being Italian, fashion was close to his heart. An eight panel goat hide shirt was complemented by deer skin pants which allowed a greater degree of flexibility for the working Copper Age man about town. The softest chamois hide was used for his loin cloth. Comfort was essential for even a Copper Age man’s crotch. Bear fur fashioned his hat and it also was used for his shoes’ soles, with deer fur making up their sides. Grass could be stuffed into a compartment within his shoes for extra insulation. After all he lived in the alpine regions. A thatched grass rain coat and hat were also part of his mobile wardrobe. He had a Copper Age esky with him full of grains, goat meat and solid fat. After our definitive tour with Paula we then had the pleasure of speaking to the deputy director, Dr Katharina Hersel. Her husband accepts that although she is happily married, she also has a deep love for another 5,300 year old man. She unveiled many of the medical perspectives of Otzi. Modern postmortem examination revealed many fascinating facts. He was 46 years old and grey, 1.6m tall and weighed 50kg. He most likely had brown eyes and I am sure, plenty of flirtatious Italian charm. The constant mountaineering that was essential to his everyday lifestyle forged muscular limbs. Several tattoos adorned his body but remarkably these were not purely decorative.
D R M AT T Y O U N G I N V E N T S A D O C T O R Q M E D I A PA S S TO GET BACKSTAGE ACCESS TO OTZI THE ICE MAN IN SOUTH TYROL.
Charcoal had been rubbed into cuts on his skin to form the tattoos. Most of these consisted of small sets of lines placed over what acupuncturists would consider vital points of energy flow. The medical connotations of this are staggering for 5,300 years ago. Perhaps the most fascinating aspect of Otzi was not his life but his death. X-rays and CT scans showed that he had a flint arrow head in his left scapula (but no penetration of his chest cavity) and an occipital haemorrhage. He had a stomach full of fat and goat meat. He had just eaten his final meal when he was murdered. Pollens in his stomach revealed that he had been at 1,000 meters altitude a day before his death but he had been at 3,000 meters when he died. He had obviously been on the run, chased over his beloved mountains. He had a healing laceration on his right hand that had severed tendons and also cut his metacarpals about 36 hours prior to his demise. It was a defensive injury. The archaeology team at South Tyrol put all this together by proposing Otzi
had been attacked 36 hours before his death at a low lying village, sustaining his laceration. He fled to the mountains that he knew and loved but as he rested for his meal, he was ambushed and felled by an arrow, shot from about 30m that injured him but was not fatal. As he writhed in pain he was set upon and was clubbed in the back of his head. Unconscious, he died of exposure in the icy conditions of the Italian Alps. His murderer’s motive is a Copper Age mystery.
D R M AT T Y O U N G General Practitioner, Inala Medical Centre
Otzi then lay almost perfectly preserved for the eons. While so much has been revealed about his life and the lives of his Copper Age friends, I was left to ponder what went on in his mind and heart. I wondered about his beliefs and what he thought about as he was on his fugitive’s run. What inspired him? What motivated him? What made him laugh and cry? What family did he have? So as I left the South Tyrol Museum, I reflected on the passionate enthusiasm that Paula and Katharina brought to their professions and, I must admit, I was phenomenally happy to have studied medicine and archaeology and to have met Otzi so intimately.
Photographs courtesy of Dr Mark McDougall
Doctor Q Autumn 61
All about you THE GOOD PLACE
#CRAZYSOCKS 4DOCS Grab your wacky socks on 1 June to raise awareness for doctors’ health. It’s not a day to raise funds, but to remember the many health professionals who have died by suicide or in the line of duty; raise awareness of physical and mental health issues among health professionals; and reshape the culture of the health care industry with hope and humanity, so that health care workers are given the space to care for each other.
When Eleanor Shellstrop finds herself in the afterlife, she’s both relieved and surprised that she’s made it into the Good Place. But it doesn’t take long for Eleanor to realize she’s there by mistake. She hides in plain sight from the Good Place’s architect Michael and his all-knowing assistant Janet. Her seemingly perfect neighbors Tahani and Jianyu and open-hearted soul mate Chidi help her realise that it’s never too late. With the help of her new friends - and a few enemies - Eleanor becomes determined to shed her old way of life in hopes of discovering a new one in the afterlife. Two seasons are on Netflix now.
ELON MUSK Ashlee Vance South African born Elon Musk is the renowned entrepreneur and innovator behind PayPal, SpaceX, Tesla, and SolarCity. Musk wants to save our planet; he wants to send citizens into space, to form a colony on Mars; he wants to make money while doing these things; and he wants us all to know about it. He is the real-life inspiration for the Iron Man series of films starring Robert Downey Junior.
HIKING Get out and see our beautiful country on foot, whether it be a few hours’ walk in nearby bushland or the 655km Australian Alps Walking Track. Prepare like a cub scout, pick a route that matches your ability and enjoy all the fresh air, scenery, vegetation and wildlife you can set your eyes on. Visit www.trailhiking.com.au to pick a route, with options for time, length, style, duration and grade.
62 Doctor Q Autumn
UPCOMING FILMS*
LA BOHEME 31 March, 1pm | 1 April, 12.50pm MET Opera
12 April 22 March Mary Magdalene Isle of Dogs Peter Rabbit 19 April The Divine Order The Guernsey 29 March Literary and Potato Peel Pie The Death of Society Stalin
The world’s most popular opera returns in Franco Zeffirelli’s classic production starring a cast of young stars, including Sonya Yoncheva as the fragile Mimì and Michael Fabiano as the poet Rodolfo. Marco Armiliato conducts.
A Wrinkle in Time 26 April Avengers Infinity 5 April War Walking Out Last Flag Flying Art on Screen: Unsane Hitler v Picasso
14 April, 1pm | 15 April, 1pm National Theatre Live
*Please note upcoming films are subject to change
WIN
movie tickets for two! Name:
Telephone:
JULIUS CAESAR
Caesar returns in triumph to Rome and the people pour out of their homes to celebrate. Alarmed by the autocrat’s popularity, the educated élite conspire to bring him down. After his assassination, civil war erupts on the streets of the capital. Nicholas Hytner’s production will thrust the audience into the street party that greets Caesar’s return, the congress that witnesses his murder, the rally that assembles for his funeral and the chaos that explodes in its wake.
SEMIRAMIDE 28 April, 1pm | 29 April, 12.55pm MET Opera This masterpiece of dazzling vocal fireworks makes a rare Met appearance—its first in nearly 25 years— with Maurizio Benini on the podium. The all-star bel canto cast features Angela Meade in the title role of the murderous Queen of Babylon, who squares off in breathtaking duets with Arsace, a trouser role sung by Elizabeth DeShong. Javier Camarena, Ildar Abdrazakov, and Ryan Speedo Green complete the stellar cast.
C AT O N A H O T T I N R O O F 5 May, 1pm | 6 May, 1pm National Theatre Live
Member no:
Fill out the form and fax it to (07) 3856 4727 or email competitions@amaq.com.au. Entries close 1 April Portside Wharf, Remora Road, Hamilton P: (07) 3137 6000 www.dendy.com.au
Tennessee Williams’ twentieth century masterpiece Cat on a Hot Tin Roof played a strictly limited season in London’s West End in 2017. Following his smash hit production of A Streetcar Named Desire, Benedict Andrews’ ‘thrilling revival’ (New York Times) stars Sienna Miller alongside Jack O’Connell and Colm Meaney. On a steamy night in Mississippi, a Southern family gather at their cotton plantation to celebrate Big Daddy’s birthday. The scorching heat is almost as oppressive as the lies they tell. Brick and Maggie dance round the secrets and sexual tensions that threaten to destroy their marriage. With the future of the family at stake, which version of the truth is real – and which will win out?
Doctor Q Autumn 63
Have a Di Bella coffee and support the AMA Queensland Foundation The AMA Queensland Foundation is pleased to announce a partnership with Australia’s leading specialty coffee roaster, Di Bella Coffee. Founded by Brisbane’s iconic coffee personality Phil Di Bella in 2002, Di Bella Coffee has grown to become Australia’s leading specialty coffee roaster. The brand’s strong social responsibility roots are evident in the Crop to Cup program, under which the company collaborates directly with farmers to support ethical and sustainable practices. These close relationships provide access to the world’s finest coffees and help to achieve the ultimate coffee experience for its customers. Closer to home, Di Bella Coffee strives to support the local community.
The AMA Queensland Foundation and Di Bella Coffee decided to collaborate and offer AMA Queensland members a delicious way to support the AMA Queensland Foundation through their coffee purchases: 10 per cent of the value of every coffee purchase at dibellacoffee.com will be donated to the AMA Queensland Foundation. This will surely bring a sweet taste to any coffee you buy. To celebrate the new year, Di Bella Coffee has released a 2018 Reserve Limited Edition. This coffee provides an insight into where the company wants to direct its efforts to be relevant in the Australian coffee market in the future. The 2018 blend is, in every sense, the best annual reserve the brand has ever created. We hope you will enjoy!
Buy coffee at
www.dibellacoffee.com and check out with code
AMAQ18
to donate 10 per cent of your purchase to the AMA Queensland Foundation.
64 Doctor Q Autumn
Doctor Q Autumn 65
INPRINT
Sherris Medical Microbiology, Seventh Edition
by Kenneth J. Ryan, Nafees Ahmad, J. Andrew Alspaugh, W. Lawrence Drew, Michael Lagunoff, Paul Pottinger, L. Barth Reller, Megan E. Reller, Charles R. Sterling, Scott Weissman
The most dynamic, comprehensive, and student-friendly text on the nature of microorganisms and the fascinating processes they employ in producing infections disease. For more than a quarter of a century, no other text has explained the link between microbiology and human disease states better than Sherris Medical Microbiology. Through a vibrant, engaging approach, this classic gives readers a solid grasp of the significance of etiologic agents, the pathogenic processes, epidemiology, and the basis of therapy for infectious diseases. Courtesy of our friends at McGraw-Hill Education, we have one copy of Sherris Medical Microbiology to give away.
Win this book Fill out this form and email to competitions@amaq.com.au Name:
Telephone:
Member no:
Entries close 1 April 2018
BOOK WINNER Dr Tim Croft won a copy of Fizpathrick’s Color Atlas and Synopsis of Clinical Dermatology, eighth edition, thanks to McGraw-Hill Education.
Don’t forget to enter in this Doctor Q edition to win.
DENDY WINNERS Dr R Boyle Dr Nigel Dore Dr Kevin Lee See Dr Noel Saines
66 Doctor Q Autumn
Dr Julia McLeod Dr Marj Busby Dr Barry Hickey
Dr Chris Que Hee Dr David Wood Dr Alison McColl
SIMPLICITY
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BRISBANE CLINIC - Leanne Winter P: 07 3270 4551 or 07 3270 4555 E: administrator@brisbaneclinic.com.au
Doctor Q Autumn 67 DoctorQ March 2015 13
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