Doctor Q Winter 2022

W I N T E R 20 2 2

Meet your new President Dr Maria Boulton

How should the state health budget be spent?

The UTI pharmacy disaster

Contents Features

Reports 5

Editor’s desk

6

16

How should the state health budget be spent?

Final President’s report

The UTI pharmacy disaster

8

18

President and CEO report

New AMA Queensland President

9

20

AMA Queensland scorecard

10

AMA in the media

31

Committee of General Practice update

39

Committee of Doctors in Training update

68

AMA Queensland Foundation update

People & Events

Business 50

What’s driving the South East Queensland property market?

52

Owning your own medical practice premises

54

The value in having a treating GP

56

Underinsured and overexposed

58

Getting your practice ready for expansion

14 AMA QUEENSL AND FOUNDATION CHARIT Y E V ENT

40

12

Medical Careers Expo

14

AMA Queensland Foundation Charity Event

23

2022-23 AMA Queensland Board

24

2022-23 AMA Queensland Council

27

VAD to begin 2023

40

Meet a member: Dr Honor Magon

28

Parental leave – what an employer should know

45

Local Medical Associations

33

Term wrap-up

60

The changing face of travel

46

Events calendar

34

MOCA 6 negotiations underway

62

All about you

49

Obituary: Emeritus Prof Mary Deirdre Mahoney AO

35

Registrations and notifications affect every doctor

63

Dendy cinemas

37

Foundation helps students with life-changing scholarships

64

Dr Matt Young: the perks of saying g’day

42

Leading a change in healthcare

65

Wine: The real cost of a vineyard

43

Death Café

66

Restaurant review: Manly Boathouse

44

Research round up

70

InPrint: Williams Hematology

Current Issues

MEET A MEMBER: DR HONOR MAGON

Lifestyle

12 MEDIC AL C AREER S E XPO

WINTER | DOCTOR Q

3

What’s happening on Queensland Doctors’ Community?

Our online community is a central point for member interaction and continues to be a great place to get the latest information from Queensland Health, the Department of Health, the Chief Health Officer and more. There’s also discussion on:

the North Queensland Pharmacy Trial (please see more information on p18)

AMA Queensland Board and Council elections

#crazysocks4docs

Senior Doctor Conference

J O I N T H E C O N V E R S AT I O N community.amaq.com.au

ADVERTISE WITH AMA QUEENSLAND

2022 deadlines for Doctor Q: Spring edition – 28 July Summer edition – 27 October

FIND OUT MORE

qld.ama.com.au/about-us/advertising-and-sponsorship CONTACT US: advertising@amaq.com.au or (07) 3872 2222

Editor’s Desk

Board of Directors Dr Maria Boulton President Dr Nicholas Yim Vice President, Chair of Council

Dr Eleanor Chew OAM Chair of Board, Member Elected Director

A/Prof Geoff Hawson Member Elected Director

Dr Sarah Coll Member Elected Director

Dr Peter Isdale AM Skills Based Director

Council Dr Hash Abdeen Doctors in Training Representative Dr Antony Attokaran Specialist Representative Dr Sanjeev Bandi Capricornia Area Representative Dr Kimberley Bondeson Greater Brisbane Area Representative Dr Andrew Cronin Part-Time Medical Practitioner Representative Dr Emilia Dauway International Medical Graduate Representative Dr Stephanie Dawson-Smith Greater Brisbane Area Representative

Dr Siyaguna Ekanayake (Dilum) Greater Brisbane Area Representative Dr Erica Gannon Specialist Representative A/Prof Geoffrey Hawson Senior Doctors Representative Dr Lee Jones General Practice Representative A/Prof Alka Kothari Greater Brisbane Area Representative Dr Robert Nayer Committee of Doctors in Training Chair A/Prof Cornelius (Kees) Nydam North Coast Area Representative

Dr Rachael O’Rourke Greater Brisbane Area Representative Prof Chris Perry OAM Immediate Past President Dr Fiona Raciti General Practitioner Representative Dr Siva Senthuran Full-time Salaried Medical Practitioner Craft Group Dr David Shepherd Far North Area Representative Shiven Singh Medical Student Representative Dr Ben Wakefield Downs and West Area Representative

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

Katherine Gonzalez-Cork General Manager – Member Services and Strategic Partnerships

Bronwyn Fardon General Manager – Marketing, Communications and Media

Hands up if you’ve had COVID? We’ve now moved from lockdowns and masks (but still in medical settings!) to been there, done that, thank God I was vaccinated.

Immediate Past President Prof Chris Perry boasted that all he had was a ‘moist left nostril for about half an hour’ and I can only hope that any of our members who get it or have had it, are just as lucky!

In this edition, we introduce the people who represent you at AMA Queensland – our President, Board and Council (p20-25). We’ve also got the results of our survey into the urinary tract infection pharmacy pilot and the proposed trial in North Queensland (p18-19) as well as our budget submission (p16-17).

Keep warm and safe this winter.

Michelle

Acronyms If there’s one thing all doctors can agree on, it’s surely a love of acronyms. We’ve decided to concede defeat on the acronyms, and we are now referring to a general practitioner as a GP and the Australian Health Practitioner Regulation Agency as Ahpra. Yes, I know it should be capitals but we have to do it the way they do it. For a full list of the acronyms you might come across in any AMA Queensland publications, please visit qld.ama.com.au/acronyms.

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

Editor: Michelle Ford Russ Print Post Approved PP100007532

Follow Us

Phone: Address: Email: Website:

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

Queensland Doctors’ Community

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.

Dr Philip Alan HILFORD GP Late of Kippa-Ring Member for 40 years

Dr Charles Terence RUSSELL GP Late of Macgregor Member for 13 years

Dr Bruce KYNASTON Radiation Oncologist Late of Ascot Member for 65 years

Dr William Ernest Martin RENTON-POWER Surgeon Late of Rockhampton Member for 57 years

Dr Eugene George GALEA Cardiologist Late of Indooroopilly Member for 58 years Dr Barbara Elizabeth CRAIG GP Late of Ashmore Member for 49 years

Assoc Prof William Barry WOOD OAM GP Late of Kenmore Member for 58 years

WINTER | DOCTOR Q

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Final President’s report “May you live in interesting times” is apparently not a true Chinese curse.

The real Chinese curse is much more earthy – “Better to be a dog in times of tranquillity than a human in times of chaos” – Feng Menglong (1627).

I have not been fortunate enough to be a dog over the last two to three years, although others may beg to differ.

Dr Dilip Dhupelia was President when I slipped into the Vice President role without an election and then was unopposed when, after 12 months, the Presidency was on offer. I was attracted to AMA Queensland because it was a better vehicle to push my passion project of establishing a First Nations Hospital network as per Canada and Alaska. This project was initiated by Dr Noel Hayman, Queensland’s first Indigenous doctor and Director of the Inala Aboriginal Community Health Centre. The idea of this network is to engage Indigenous Australians in the health system and to bypass the unconscious bias in otherwise very well-meaning people within our public hospital system. This bias results in low levels of participation by Aboriginal and Torres Strait Islander people in advanced therapies (especially for surgical treatments) of cancer, renal transplantation, ENT diseases, orthopaedic injuries, joint repairs, and surprisingly even cataract surgery, despite all the well-meaning ophthalmologists visiting Aboriginal communities around Australia. Aboriginal peoples’ access to cataract surgery is a third that of a white person with similar sight issues. ‘Discharge against medical advice’ is many times higher for Aboriginal and Torres Strait Islander people than other Australians.

I have always worked two days a week in public hospitals (four half days) and three days privately. The AMA Queensland Presidency certainly cuts into private practice time.

Fortunately, I am past paying for school fees and a mortgage.

The learning curve for AMA Queensland Vice Presidency and Presidency was steep. Dilip was a terrific mentor.

My apprenticeship was conversion therapy versus gender dysmorphia counselling. Then Voluntary Assisted Dying (VAD) was heating up. Dilip suggested I start up and Chair the AMA Queensland’s VAD, Aged Care and Palliative Care Committee. It was an interesting time that conflicted my enclosed Catholic world-view with trying to discern the difference between 100mg shot of Morphine from a glass of Pentobarb – there isn’t any really.

The VAD, Aged Care and Palliative Care Committee members were very insightful but so was going to Local Medical Association (LMA) meetings and discussing the issues with medical colleagues as widely as COVID permitted. There were well-balanced points of view and discussions everywhere, including not only doctors but also archbishops, moderators, priests, owners of not-for-profit aged care facilities and hospitals, and Buddhist palliative care people. That has been a two-year journey and it is still incomplete.

I have been nominated by the Board to represent AMA Queensland in Queensland Health’s VAD Implementation Committee. There are numerous issues such as the experience required to be an adequately trained VAD doctor; the tyranny of distance and telehealth illegalities; dealing with people in their last couple of months of debility;

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PRO F C H R IS PE R RY OA M Immediate Past President

incontinence and death. There is also the protection of conscientious objecting healthcare workers including doctors, nurses and hospital and aged care administrators.

There will need to be respect, patience and give-and-take on all sides. VAD legislation is like the arguments for and against a Bill of Rights – how do you define it and how do you address the exceptions? VAD laws are now defined. The laws have been passed. It is going to happen. If done properly it will be open and transparent and nothing much hopefully will change. Doctors have always relieved suffering from the time of the battlefields of ancient Greece and before. It now, if done with respect, will no longer be done quietly and no longer at some professional and criminal risk to the caring doctor, while hopefully protecting the non-consenting 98 per cent from over-eager relatives and facilities wanting to free up a bed.

I have purposely not started this essay with COVID. We are all sick of it, but it has dominated my Presidency for the last two years. The very real fear that Queensland would go down the paths of Venice, New York and then India has passed hopefully but variants may still emerge. The Herculean feat of humanity finding a dozen great vaccines in under a year is inspiring and the emerging anti-virals are a game changer. Our public support of Dr Jeannette Young was the correct call which was controversial at the time.

No doctor should have their lives threatened by doing their jobs. Jeannette was surrounded by four machine gunbearing police in flak jackets for a while. The threats to her and her family were real. The AMA’s public support for her was the right call even though it meant, appropriately, being on the same podium as a politician. I did get a criticism for that from some of the doctors who I really do respect, but I don’t resile from the position that we took.

COVID meant a lot of interviews, many requiring getting up at 4am, especially to talk to Karl Stefanovic on the Today program. I was accused of having a Karl bromance, but alas it was not to be. The journalists would come to my house and set up the cameras to show my front lawn which was laid during the early and complete COVID shut down in 2020 and has obviously been well watered since. Our media team has been terrific. Even if the journalists had my mobile number and called me directly, I would always refer them and their questions back to the team and sometimes to our CEO, Dr Brett Dale, and our policy people, to get the questions and have the appropriate information and responses to those questions. Not always would Karl ask questions from the script, and not always would I follow the scripted answers from the media team, mostly because I could not remember all the answers and their dot points.

There is a reason that actors take hours to learn a script and need a few takes to get it right. Having three to four interviews on radio and television a day was not unusual any day of the week, including weekends.

IT WA S A HIG H LIG HT TO RECOG NISE OU R 50 Y E A R M E M BE R S AT TH E MEM BER MILESTONES E V E NT

I could go on about the many things AMA Queensland do.

The workloads over the eight to 10 portfolios of the AMA Secretariat and its 26 people are phenomenal.

The output of media, policy, membership, doctor health, industrial relations and written and electronic publications

by AMA Queensland is immense. I enjoy going into the AMA Queensland office. I enjoy banter with people who are intelligent and motivated and the staff working in the AMA Queensland secretariat are that. The secretariat care about doctors. They care about the health of the Queensland community.

I have always felt supported by Dilip, Michael Cleary, Brett Dale and his terrific AMA Queensland team – too numerous to mention individually here. I have had great support from the Board and especially from the Chair, Dr Eleanor Chew, and of course Council who decide policy and the various members of sub-committees of finance, governance, risk assessment etc. The three fellow South Queensland AMA Queensland Board doctors, Bav Manoharan as Vice President, Maria Boulton and Nick Yim, have been very supportive for ideas, policy and media appearances etc.

I want to thank Bav in particular for his support as Vice President during my tenure as President. His insights and strategic input have been invaluable. Nick has been elected unopposed as Vice President and Maria has been elected as President. Both are eminently qualified and prepared and I look forward to cheering from the sidelines.

DAILY M E DIA INTE RV IE WS

To the members of AMA Queensland, thank you very much for your support. To the medical non-members, you really must become a member to protect yourself, the profession, and the wider community. Unvetted and under-educated medical advice from task-substitution is a massive risk to patient safety. Our national health budget, as a percentage of gross domestic product, is vastly inadequate. The Medicare rebates and insurance payments in Australia are completely inadequate, at about a third of what they started at in 1984. Our public hospitals mostly perform extremely well, largely due to the quality of evidencebased care and the culture of hard work and diligence that permeates Australia’s medical profession.

Our primary care sector is probably the worst of all worlds, especially for rural and outer metropolitan areas.

I don’t know how GPs in these areas cope with patient disloyalty and disengagement/fragmentation from chronic underfunding leading to the need for rapid fire medicine.

The subsequent inability of towns that demand their GPs bulk-bill to replace their disaffected doctors when they naturally are forced to leave is a problem that is blamed on the doctors. We get the government we deserve and, at the time of writing, neither side had shown any understanding of health issues in the federal election campaign. That is the conversation for the next few years, I’m afraid.

SPE A KING AT DINNER FOR THE PROFESSION

WINTER | DOCTOR Q

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President and CEO report PRO F C H R IS PE R RY OA M Immediate Past President

This is the last report from this double act. A new President, Dr Maria Boulton, has been elected and you will be hearing from her in Doctor Q for the next year. We would like to thank Dr Bav Manoharan for his sterling efforts over the past two years – as Vice President, as a Board Director, and as the Executive General Manager for some months in 2020. We also welcome our new Vice President, Dr Nick Yim. Maria was announced as President at the AGM on 27 May 2022. Her experiences of growing up in war-torn El Salvador and returning to her home country as a medical student have helped shape her career as a GP and an advocate for the profession. You can read more about her on pages 20-21.

DR BR E T T DA L E Chief Executive Officer

#StopNQPharmacyTrial AMA Queensland members and other doctors responded strongly to our survey about the North Queensland pharmacy trial and the urinary tract infection (UTI) trial it is purportedly based on.

More than 1,300 doctors responded, reporting at least 240 patients who needed further attention after taking part in the UTI trial. The most common issue was misdiagnosed sexually transmitted infections, but there were also six cases where a pregnancy diagnosis was missed and women in their first trimester were sold unsafe antibiotics. A potentially life-threatening ectopic pregnancy was misdiagnosed as an uncomplicated UTI.

The State Budget to be handed down in June was an opportunity for the government to take immediate and dramatic action to address the pressures, shortages, gaps and inequities in our health system.

At least nine patients ended up in hospital with sepsis or kidney and bladder infections due to ineffective or delayed treatment, and six cancerous or pre-cancerous conditions were missed.

COVID-19 has forced the reshaping and reprioritising of health services, leading to even longer elective surgery waits.

Doctors had no way to report adverse outcomes to the Queensland University of Technology (QUT) ethics coordinators who were overseeing the UTI pilot. The only option was to report the individual pharmacist to the Office of the Health Ombudsman – in effect, blaming the pharmacist for the scheme’s failing without being able to alert the scheme’s designers to risks to patient safety.

At the time of writing, the State Government had yet to release the QUT evaluation report of the UTI trial.

However, a leaked version given to The Australian newspaper revealed about 270 cases of complications and a worryingly low follow-up rate - less than 40 per cent of the women who took part.

We have the support of many pharmacist colleagues in this fight. Like us, they value the need for all medical and health professionals to practise within their scope. Encouraging pharmacists to become de facto GPs and diagnose and treat a range of potentially serious health conditions – including prescribing and dispensing a range of medicines despite a lack of training – is a risk to public health.

You can read more about our campaign on pages 18-19.

8

State Budget

DOCTOR Q | WINTER

AMA Queensland has persistently advocated for action on these issues for years. Queensland’s health system was stretched beyond its limits before COVID-19. Workforce shortages were already deepening and staff were fatigued.

AMA Queensland called for five priority actions in the Budget – you can read about them on pages 16-17.

Floods The AMA Queensland Foundation has been active in supporting members, other doctors and the community as the recovery from the South East Queensland floods continues. You can read more about the Foundation’s work on pages 68-69, and see photos from the Foundation’s charity event on pages 14-15.

Member profile Dr Honor Magon has been involved with AMA Queensland since her medical student days. Now she’s off to California after being awarded a Fulbright Scholarship to Stanford University. Read more on pages 40-41.

ScoreCard 2022 Q1

MEDIA

15.8M Audience

2,744 Member engagements

136

01 Jan - 31 MAR

AMA Queensland

318 Mentions 138 Inquiries

282 New Members

Ministerial, government and key stakeholder meetings

Policy

3 Submissions 39 Advocacy

Industrial

relations

1,905 member engagements

3 Matters 12 Appearances

before the Commission

49 New employment contracts

248 member engagements 1 In person 1 online 237 Total Attendees

Workplace

relations

Events WINTER | DOCTOR Q

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Get involved If you’d like to put your hand up to speak to media on particular current issues, please call Bronwyn Fardon or Maria Hawthorne on (07) 3872 2222.

If you’d like to be a part of any upcoming social media campaigns, or would like us to highlight your workplace or practice, please call Michelle Ford Russ on (07) 3872 2222.

Free flu jabs took GPs by surprise The Queensland Government’s decision to become the first jurisdiction to make flu jabs free to everyone was welcome but came without consultation with GPs, leading to confusion and frustration for patients and practices.

New AMA Queensland President Dr Maria Boulton told ABC Radio that 30,000 more people came forward to get an influenza vaccination in the week following the announcement of free flu jabs, which was a great achievement but not without difficulty.

“This is not the first time that we’ve heard about a big announcement through the media without having the details to back it up,” Dr Boulton said.

“We support making flu vaccines more accessible. However, we didn’t have any details, so we weren’t able to tell our patients what vaccines were the free ones, for example.

“To their credit, Queensland Health have worked really hard since then to make sure that we iron out all those details.”

GPs had already done more than three million flu vaccines by the end of May, Dr Boulton said. qld.ama.com.au/news/ABCBrisbaneTranscript

Survey finds hundreds of UTI complications An AMA Queensland survey of doctors across the state revealed at least 240 cases of patients needing further treatment after being treated by a pharmacist as part of the urinary tract infection (UTI) prescribing trial.

AMA Queensland in the media AMA Queensland uses our powerful media profile to influence government and lead the conversation on key issues for the medical profession in the state. Here are key media stories we achieved in the last quarter.

The confidential survey of 1,300 doctors mirrored a leaked report of the official trial evaluation reported in The Australian, which showed that 270 women who took part in the trial needed extra care.

The Queensland Government is yet to release the official trial evaluation carried out by the Queensland University of Technology, but The Australian reported that a leaked copy of the QUT report found that 3,000 participants could not be contacted afterwards, with only a 35.7 per cent follow-up rate.

“In the absence of credible information about outcomes from the UTI pilot, we asked doctors to share their patients’ stories. The results are alarming,” AMA Queensland President Professor Chris Perry said in May. Six pregnant women were prescribed unsafe antibiotics, while at least nine patients were admitted to hospital with sepsis or kidney and bladder infections. medicalrepublic.com.au/hundreds-misdiagnosedin-qld-pharmacy-bungle-ama/68696

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DOCTOR Q | WINTER

Ambulance ramping needs solutions

Health system inquiry slammed as a farce

Ambulance ramping became a national issue earlier this year, and in May the AMA released a Ramping Report Card which showed that Queensland is consistently failing to meet its own targets for transferring patients from ambulances and into emergency departments (EDs).

In April, the Queensland Government released an inquiry into the state’s health system, which made 44 recommendations for improvements. But only four of the recommendations were for state government action, with the remainder being actions for the federal government.

Queensland has a target of getting 90 per cent of patients off an ambulance stretcher into ED within 30 minutes, but only managed 65.2 per cent of the time in the last financial year.

Released just weeks before the 21 May federal election, the report echoed the AMA’s call for the Commonwealth to lift its share of public hospital funding by five per cent.

It also called for the Commonwealth to pay its ‘fair share’ of emergency department (ED) costs, reimburse the costs of aged care and disability patients who stay long-term in hospitals and comprehensively reform Medicare Benefits Schedule (MBS) rebates.

Documents obtained under to Right to Information by Nine News revealed that health officials discussed changing the methodology so that the time was measured from when the patient was seen by a triage nurse, not from when the ambulance arrived at the ED. The government quickly moved to rule out the change.

But ramping continued to dominate headlines, as the Omicron outbreak led to thousands of doctors, paramedics and other healthcare workers infected or furloughed as close contacts and hundreds of COVID patients in hospital.

The then AMA Queensland President Professor Chris Perry said the hospital overcrowding was a product of chronic underfunding rather than the pandemic.

“There’s nine per cent of gross domestic product being spent on health and it’s been like that for 40 years,” Prof Perry told ABC News.

“We’re very disappointed with the health policies of both major parties. Both sides of the house in both levels of parliament in Australia have been shooting the messenger: it is all doctors’ fault, somebody else’s fault, it is never them.” abc.net.au/news/2022-05-18/qld-coronaviruscovid19-hospitals-strained-influenzaseason/101076770

The only recommendations for Queensland Health included reviewing hospital discharge policies, providing a progress update to earlier recommendations, and “exploring options” to invest in early intervention programs to prevent chronic conditions.

The then AMA Queensland President Professor Chris Perry said the report “smacks of blame shifting”.

“It helps a federal Labor campaign when what we really need are state and federal governments to collaborate on solutions, instead of ducking and weaving to point the finger at each other,” Prof Perry told News Corp.

“The Queensland state government has not provided an adequate response to our Ramping Roundtable Action Plan that has clear and realistic steps to address hospital bed block and ambulance ramping.” heraldsun.com.au/news/queensland/stategovernment-accused-of-blame-shifting-ashealth-inquiry-findings-released/news-story/ b19dac45b7d6aba5da6244925d92014f WINTER | DOCTOR Q

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DR GU Y L A M PE FROM TH E ROYA L COLLEG E OF PATHOLOGIS T S OF AUS TR A L A SIA, DR JOSH UA FL AV E LL FROM TH E ROYA L AUS TR A LIA N A N D N E W Z E A L A N D COLLEG E OF P S YCHIATRIS T S A N D DR ROBE RT N AY E R, CH AIR, A M A QU E E NSL A N D COM MIT TE E OF DOC TOR S IN TR AINING IN A PA N E L DISCUSSION.

Medical Careers Expo AMA Queensland’s first ever Medical Careers Expo attracted more than 200 medical students, junior doctors, senior doctors, GPs and specialists in March.

They had the chance to speak with colleges and employers from all over the state, including: LE A NG TA NG WITH MICH E LLE H E RDY FROM JA M E S COOK U NI V E R SIT Y

Royal Australian College of General Practitioners Australian College of Rural and Remote Medicine The Royal Australian and New Zealand College of Psychiatrists Royal College of Pathologists of Australasia Defence Force Recruiting Uniting Care – St Stephen’s Hospital St Vincent’s Hospital Toowoomba Mater Fraser Coast Regional Council UQ Regional Training Hubs For Health James Cook University Doctors Health Queensland

NOTE -TA KING AT TH E PA N E L DISCUSSIONS

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DOCTOR Q | WINTER

Hospital Health Services Rockhampton.

DR S LIA M SCOT T, SA SH A SE LI, SUSIE LE E A N D H A N XIAO

R A SH A A LYA SSE N

DR KE E S N Y DA M SPE A KING ON BE H A LF OF TH E U NI V E R SIT Y OF QU E E NSL A N D ( UQ ) REGION A L TR AINING H U BS

( L- R ) DR RYAN FR A ZER FROM MATER, DONNA TURNER FROM JAMES COOK UNIVERSIT Y, DR REBECC A LYON FROM UQRTH – UQ REGIONAL TR AINING HUBS, K ATRINA RYAN FROM UNITING C ARE – ST STEPHEN’S HOSPITAL AND SUZIE BYRNES FROM ST VINCENT’S HOSPITAL TOOWOOMBA.

RE ECE RE E D, JE SSIN A CH E N E Y A N D NIL A L HIL A L

DRS L AUREN GOMES AND SREEKRUTHI BACHU

WINTER | DOCTOR Q

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DR KE V IN T WOM E Y, LIDIA Z A Z Z E R A, DR K ATH RY N PE RRY A N D PAU L DORE

ISA AC O’DE M P SE Y, N E V E O’DE M P SE Y, DR DAV ID CRONIN, IN DIA N N A WORT A N D DR TIM O’DOW D

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A M A QU E E NSL A N D V ICE PRE SIDE NT DR NICK YIM, LOU COLE S, DR OTILIE TORK, A N N E DH U PE LIA A N D A M A QU E E NSL A N D FOU N DATION CH AIR DR DILIP DH U PE LIA

G A RY VOSS, DR E LE A NOR CH E W, DR DE B H A M BLE TON A N D OU TGOING A M A QU E E NSL A N D FOU N DATION DIREC TOR DR S TE V E H A M BLE TON

DR SA R ATH BODA PATI, DR SA JITH K A RU N A SE N A, BE N SMIT S, DR A SH V INI A BE YSE KE R A, DR E MILY SH AO, DR H A SH A BDE E N, DR N ATA SH A A BE YSE KE R A, CH RIS PIGGOT T- MCKE LL A R, BR A DLE Y LUSCOM BE, HOLLY P OW E LL A N D DR A LE X SCH LIM M E R

Foundation Charity Event

M A RIO PE N NISI, BE N RYA N, SA FFI RYA N A N D A M A QU E E NSL A N D BOA RD DIREC TOR DR PE TE R ISDA LE

The AMA Queensland Foundation Charity Event was a huge success this year. It was great for members, charities, and corporate partners to come together to celebrate the incredible work of the Foundation. Thanks to the generous donations from everyone at the event where a total of $11,893 was raised for Youngcare to support their At Home Care and Home Support Grants.

The night started in the viewing room where guests mingled with one another while observing the outstanding array of auction items and raffle prizes. Drinks and delicious canapés were served as the string quartet played and guests looked out over the Brisbane River and took in the city views.

A M A QU E E NSL A N D IM M E DIATE PA S T PRE SIDE NT PROF CH RIS PE RRY, FOU N DATION SCHOL A R SHIP HOLDE R S ISA AC O’DE M P SE Y A N D HIRU NI GU N A SE K A R A A N D FOU N DATION CH AIR DR DILIP DH U PE LIA

Guests were then escorted into the dining room where mains and dessert were served. An entertaining Welcome to Country was performed by Shannon Ruska which was followed by inspiring presentations and speeches from our Foundation Chair Dr Dilip Dhupelia, Youngcare Board Director Jamie Shine, Chair of the AMA Queensland Board Dr Eleanor Chew OAM, and 2021 Foundation Medical Student Scholarship recipient Isaac O’Dempsey. The MC for the night, Juiced TV Founder Pip Forbes, ensured the night ran smoothly. We look forward to seeing you at future Foundation events.

WINTER | DOCTOR Q

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How should the state health budget be spent?

AMA Queensland advocates for the immediate delivery of the following five priority actions in the 2022-23 Queensland State Budget.

Fill fundamental gaps in mental health ($700 million) AMA Queensland calls on the Queensland Government to urgently invest $700 million to:

Implement the Ramping Roundtable Action Plan (>$1.2 billion) In December 2021, AMA Queensland presented the Queensland Government with a comprehensive action plan to improve patient flow and address bed block in public hospitals – the Ramping Roundtable Action Plan.

The action plan was devised by a group of dedicated doctors, including specialist consultants, general physicians, doctors in training and government representatives.

Over eight months, this group diligently assessed the latest data on patient numbers and ramping from Queensland hospitals and the Queensland Ambulance Service (QAS).

Informed by this alarming data and the collective expertise of the roundtable, the action plan outlines five practical and realistic strategies to improve patient flow, patient safety and patient access.

1. Ongoing investment in 1,500 more beds 2. Fully operational acute hospitals functioning seven days a week with extended hours 3. Hospitals operating at 90 per cent occupancy

16

increase the number of beds available for patients presenting to emergency departments (EDs) with mental health conditions, including dedicated beds for adolescent patients review mental health funding models, focusing on how GPs are subsidised to support mental health and increasing funding for community mental health services extend activity-based funding to community ambulatory mental health services to increase their efficiency (by motivating a higher proportion of time to be spent on consumer-related activities) and reduce incentives for local hospital networks to prioritise hospital-based care provide alternatives to EDs for people seeking mental health care, for example peer- and clinicianled after-hours services and mobile crisis services support additional mental health training and professional development for GPs improve the competency of mainstream health services in mental health care by providing additional support for GPs increase the number of psychologists, psychiatrists and mental health nurses particularly in regional communities improve the use of technology in assessments, referrals, treatments and supports, and increase the range of treatments and supports available increase perinatal mental health services to ensure a secure attachment between parent and baby in the early stages of life

4. HHSs analyse hospital patient flow and report against specific measures

adopt innovative workforce solutions to increase and maintain staffing levels, including the proposed step down solutions for retiring doctors previously submitted by AMA Queensland to the Minister for Health and Ambulance Services

5. Support alternative models of accessing hospital care other than through emergency department presentation

amend workers’ compensation schemes to fund clinical treatment for mental health related workers’ compensation claims, regardless of liability, until the injured worker returns to work or up to a period of six months following lodgement of the claim, which is estimated to cost around 0.6 per cent of total annual premium revenue received by insurers.

DOCTOR Q | WINTER

Address unmet need in palliative care ($120.35 million) While the Queensland Government’s $171 million Palliative Care Reform Program through to 2025-26 is laudable, it falls well short of the comprehensive investment needed to meet the demands of Queensland’s increasing and ageing population.

In the interim, AMA Queensland calls for: Palliative home care packaging ($117 million), including: last days packages ($70 million) palliative Care Community Packages ($42 million) MASS Statewide palliative care patient equipment and syringe driver program ($5 million) Seed funding for new initiatives to improve access to quality palliative care and support for Queenslanders from diagnosis to bereavement ($3.35 million) AMA Queensland also calls on the Queensland Government to change the time period for which patients can access palliative care to ensure consistency with Section 10 of the Voluntary Assisted Dying Act 2021, i.e. palliative care should be available to patients for 12 months rather than the current three-month constraint. This timeframe for palliative care would conform with the overwhelming preference of AMA Queensland members, 98 per cent of whom feel palliative care should be offered at the same time as, or prior to, assessment for VAD.

Fix digital healthcare technologies ($313 million conditional upon, and guided by, independent review) AMA Queensland acknowledges the temporary cessation of digital health progress due to COVID 19.

Now, however, it is imperative that the Department of Health recommits to, rolls out and improves technologies that support continuity of care.

Optimisation of digital technologies can improve patient safety, boost productivity and provide rich clinical and administrative data to inform decisionmaking. It can also ensure the efficient use of medical professionals’ time.

However, end-users continue to raise persistent issues with ieMR, Communicare and QScript that compromise patient safety and increase administrative burdens for staff. Therefore, it is essential that robust, transparent and independent external review guides investment in IT systems.

Such review should focus on patient safety, productivity and privacy, and ensure the yield from IT investments exceeds other potential interventions or investments that would improve patient outcomes.

AMA Queensland calls for:

Make medical workplaces safe and healthy ($1.67 million) While AMA Queensland applauds Queensland Health’s investment in Wellbeing at Work and in local programs in individual hospitals, the current state of workplace morale warrants: the extension of Wellbeing at Work to PGY2-5 doctors ($1.67 million).

past reviews of ieMR and Communicare to be published (cost neutral) technical issues delaying the expansion of ieMR to be addressed (previous analysis indicates a required investment of $313 million, however spending should be conditional upon, and guided by, a robust and transparent external review) clear and consistent messaging for doctors about QScript to be developed and communicated (cost neutral) regulations governing the use of QScript to be reviewed and amended to ensure QScript can deliver its potential in minimising intentional and unintentional harms from monitored medicines (cost neutral).

The physical safety of medical practitioners also warrants attention, including: adequate PPE, including fit testing for all doctors appropriate travel and fatigue management policies, especially for doctors in training required to travel between placements.

WINTER | DOCTOR Q

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The UTI Pharmacy disaster

Areas impacted by NQ Pharmacy Pilot

Since June 2020, Queensland Health has been running the Urinary Tract Infection Pharmacy Pilot – Queensland (UTI Pilot) allowing pharmacists across Queensland to provide treatment to women with a suspected UTI.

Recently, the Queensland Government has hailed the ‘success’ of the UTI Pilot as the basis for an expanded trial to occur in North Queensland allowing pharmacists to autonomously prescribe for 23 conditions from June 2022 – the North Queensland Pharmacy Scope of Practice Pilot (NQ Pharmacy Pilot).

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The Queensland University of Technology (QUT) managed the UTI Pilot’s implementation and evaluation and provided a research study to Queensland Health.

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However, this information is not publicly available.

bladder pain syndrome

In the absence of any available data, reporting or evaluation of the UTI Pilot, AMA Queensland invited doctors across the state to report on their experiences with patients treated under the pilot.

The survey ran from 18 to 28 March 2022 and also sought doctors’ views on the expanded NQ Pharmacy Pilot.

More than 1,300 responses were received with an alarming 240 patient complications reported because of the UTI Pilot.

One in five GPs who responded to the survey had seen a patient with complications after visiting a pharmacist with a suspected UTI. The most shocking reports were that many patients had been misdiagnosed and did not have a UTI at all, but often a: sexually transmitted infection (chlamydia, herpes and gonorrhoea) pelvic inflammatory disease pregnancy (on at least six occasions, including one ectopic pregnancy) cancerous conditions

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Other misdiagnosed conditions treated as a UTI included:

DOCTOR Q | WINTER

renal colic ruptured ovarian cyst pyelonephritis interstitial cystitis.

After misdiagnoses, inappropriate or ineffective antibiotic use was the next most commonly occurring complication. Of the 240 incidents reported through the survey, approximately 30 per cent related to antibiotics.

Specifically, comments related to: the UTI-causing bacteria being resistant to the prescribed antibiotic repeated courses of the same antibiotic being prescribed patients being prescribed an antibiotic to which they were allergic.

Through the survey, doctors reported eight cases where misdiagnosis or ineffective treatment resulted in hospitalisation of patients suffering urosepsis or pyelonephritis.

A common theme among doctors’ comments, especially relating to misdiagnosis of STIs, was patients’ reluctance to provide full and frank information to a pharmacist in the presence of other customers or to discuss sexual history over the counter. Non-disclosure of sensitive or embarrassing information due to a lack of privacy may have contributed to misdiagnoses.

Key risks of the proposed pilot in North Queensland

96% concerned about patient safety

87% believe it will fragment healthcare

Expanding on disaster All pharmacy-trained doctors who responded to the survey said the proposed 120 hours of online training for pharmacists taking part in the NQ Pharmacy Pilot was not enough.

Fewer than two per cent of all respondents believed the training required for pharmacists to participate in the NQ Pharmacy Pilot (120 hours of online training) was adequate for pharmacists to safely diagnose and treat patients for the 23 conditions covered in the NQ Pharmacy Pilot.

It has been suggested the NQ Pharmacy Pilot will address workforce shortages in the region but 50 per cent of GPs said the pilot would deter them from working in North Queensland.

Doctors held concerns over patient safety relating to the NQ Pharmacy Pilot, with 96 per cent of respondents highlighting this as a key risk of the pilot.

Commentary often reflected doctors’ concerns about risk of ‘misdiagnosis and missed diagnosis’. This included myriad other issues canvassed by doctors during a consultation beyond the specific trigger for the appointment.

Examples included opportunities to conduct routine or overdue screening, monitoring and management of other conditions, and checking in with patients about their mental health.

A high proportion of doctors (87 per cent) perceived risks associated with the fragmentation of healthcare.

Respondents’ reflections on this issue frequently highlight concerns about a pharmacist autonomously altering treatment without the doctor’s knowledge or consent, and without adequate record keeping of that decision.

Inadequate or incomplete medical records, and absence of patient monitoring or follow up were significant concerns.

85% worried about over prescribing

The survey showed the UTI Pilot has failed. Women did not receive the care they needed and an alarming number became more ill due to their participation in the trial.

The Queensland Government has been careless with patient health in this UTI pilot and failed to protect our community and investigate the health outcomes.

There is no thorough analysis, scientific evaluation or genuine stakeholder engagement or feedback.

We hold grave concerns the Queensland Government is now looking to expand this trial in North Queensland and wants to include more health conditions. The results of this survey are unfortunately just the tip of the iceberg.

Delivering high quality healthcare is not without challenge and must embrace a commitment to continuous improvement. However, the UTI trial and proposed expansion in North Queensland are not improvements, but are an erosion of healthcare standards and patient outcomes. They undermine the collaborative strength, standards and expertise our current team-based healthcare system thrives on.

The survey report is a compelling read for anyone who cares about the health of Queenslanders.

Read the AMA Queensland survey report: If you haven’t already then we urge you to take action! We have template letters and guides on how to raise this issue with your local and federal Member of Parliament. qld.ama.com.au/Stop-NQ-Pharmacy-Trial WINTER | DOCTOR Q

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Stop, collaborate and listen

Dr Maria Boulton, AMA Queensland President As a GP and small business owner, Dr Maria Boulton spends a lot of time listening and collaborating. As AMA Queensland President, she plans to apply those skills over the next year to ensure the best outcomes for patients, doctors and the health system.

“Our health system is really operating on the goodwill and altruism of the doctors and healthcare workers in it. Without that, it would have failed a long time ago,” Dr Boulton, the ninth woman to hold the role of AMA Queensland in the association’s 128-year history, tells Doctor Q. “Our doctors and healthcare workers are amazing.

Their skills and experience are second to none. We want to be able to continue to provide these services, but without change, patient care will suffer as systems collapse.

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DOCTOR Q | WINTER

“We need to fight for sustainability. While the past two years have been very much about the pandemic, COVID has just further exposed the precarious state of our healthcare system.

“Our hospitals are over capacity and primary care is woefully underfunded. Overworked, burnt out doctors in training are no longer receiving as many meaningful educational opportunities or training. Medicare rebates have not kept up with the cost of providing the healthcare that GPs and other private specialists deliver every day.

“I am determined to ensure that the AMA Queensland Council and Board continue to have strong cross representation of all specialties that we work for all doctors, but most importantly that we work for the community and patients.

“It was eye-opening. I had the opportunity to see diseases that you don’t see in Australia. The health system is very different – it’s very much user-pays and not everyone has access to the healthcare that everyone should have access to,” she says.

“As we move forward, we must fight for sustainability and safety for the system, for our patients, and for our workforce.

“So people present very late, very sick, and in a lot of need, and the hospitals aren’t resourced in the same way that they are in other countries.”

Dr Boulton credits Immediate Past President, Professor Chris Perry, an ENT specialist working in public and private practice, for setting the example of leading for all doctors.

Sadly, Uncle Migue, the paediatrician, died of COVID in Spain at the start of the pandemic before any vaccines were available.

“I’ve been lucky to have worked very closely with Chris.

He’s been a champion for general practice,” she says.

A third uncle, Uncle Ronald, graduated first in his class in medical school but died in a car accident before he could practise as a doctor.

“I’d like to follow that example of being a President who works for all our members, regardless of where they work, what specialty they’re in, what stage of their training they’re in, whether they’re an intern or an active senior doctor, a private specialist, a GP specialist, a hospital specialist or a doctor in training.

“I want to ensure that AMA Queensland serves all our membership and that we are open to listening to all of our members’ issues and concerns and any advocacy issues that they think should be brought to light.

“Our membership is quite varied and it’s important that we support all areas of medicine, because we’re in this together. We all just want the best for our patients in the end, and it’s that collaboration that ensures our patients get the best care.”

“I never met him, but I heard so many good things about him.

He had been very active as a student and he used to help out in public clinics in the regions in El Salvador,” she says.

“I was greatly inspired by my uncles. I’m one of those weird people that whenever I used to go to a hospital as a child, I used to get goosebumps out of excitement in seeing all the action.”

Dr Boulton chose general practice while living and working in Mackay. Spending days working with a local GP who also worked in the hospital emergency department, she saw how he provided care to multiple generations of families and the variety in healthcare workers his day.

Our doctors and are amazing. Their skills and experience are second to none. We want to be able to continue to provide these services, but without change, patient care will suffer as systems collapse.

Dr Boulton came to Australia from El Salvador with her family when she was 13.

The civil war that had broken out almost a decade earlier was reaching its bloody peak. A child waiting in line to go to school was kidnapped, an English language academy owned by her mother was bombed. It was no longer safe.

Accepted by Sweden, Canada and Australia, the family – including a grandmother and uncle – opted for warm weather and arrived in Brisbane in 1990. It was not what they expected.

“For the first few months, I kept looking outside to see any kangaroos or koalas,” Dr Boulton says.

“I guess the shock for me was more the freedom – the fact that you could walk outside without fear of getting mugged or shot, the fact that you could catch public transport. In El Salvador, girls weren’t encouraged to study. When I came to Australia, I found out very quickly that girls were encouraged to achieve and do something with their schooling, which was really amazing for us.”

Medicine was a natural fit for the niece of three doctors, and while studying at the University of Queensland, she was able to work with two of her uncles – one a paediatrician, the other a gynaecologist – during UQ overseas rotations in El Salvador.

“I saw the excellent work he did and all the good he did.

And I really love people, I like knowing what happens to them, and general practice just suited what I wanted to do and where I wanted to work,” she says.

“It has a bit of everything. I love suturing, so you can do skin cancer excisions. You can look after kids, and I love caring for kids. I love caring for pregnant women, and general practice is all of that and more.”

She comes from a family of ‘doers’. Her grandmother used to drive from village to village in El Salvador, delivering blankets. Her mother, a teacher, organised her school and scout group to put together and deliver food and water parcels following a devastating earthquake.

“When I started in general practice, I realised we were getting to a point where the quality healthcare that we were providing was being put at risk by the lack of funding and resources,” she says.

She and her business partner, Dr Fiona Raciti, were encouraged by Dr Mellissa Naidoo to join the AMA Queensland Council, just as they were starting to build up their practice.

“We said, ‘we’ve got a new practice, we’re really busy’, and Mellissa said ‘busy people manage the best, you’ll be fine’. So there wasn’t a choice to say no,” Dr Boulton says.

“I’ve belonged to many other organisations, but I find that AMA Queensland is extremely supportive. I’ve found an organisation full of doers, and it’s a very good fit for me.”

WINTER | DOCTOR Q

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AMA Queensland Board MEMBER ELECTED DIRECTOR DR SARAH COLL MBBS FRACS FAOA

Specialty: Orthopaedic Surgeon

PRESIDENT DR MARIA BOULTON MBBS FRACGP GAICD

CHAIR OF BOARD, MEMBER ELECTED DIRECTOR DR ELEANOR CHEW OAM

Specialty: GP

MBBS FRACGP MMed(GP) FAICD

“Opening Family Doctors Plus increased my awareness of the challenges faced by my GP and non-GP specialist colleagues, motivating me to become involved in creating positive change.

Primarily, these challenges revolve around providing quality, evidence-based healthcare in the face of dwindling funding and inadequate MBS rebates.”

Specialty: GP

“As a Fellow of the Australian Institute of Company Directors, I have a clear understanding of my responsibilities as director and chair, and will work to ensure that the AMA Queensland Board exercises its responsibilities and fiduciary duty to support the association in serving its members. In my various roles representing the profession, I have gained valuable insights into the many challenges facing the medical profession, providing a sound basis for me to support council to formulate policy and provide direction for the advancement of critical issues affecting Queensland doctors.”

VICE PRESIDENT AND CHAIR OF COUNCIL DR NICK YIM BPharm MBBS FRACGP

Specialty: GP

“The last couple of years, the COVID-19 pandemic has brought challenges to our community and the medical profession. All doctors from medical students, doctors in training, GPs and public/ private specialists are paramount to ensure that we maintain the health of our community.

“We require active and purposeful interaction between the medical profession and all levels of government. We require long term planning and not band aid solutions. Similarly, we require clear and concise messaging to our community.”

SKILLED DIRECTOR DR PETER ISDALE PhD Hon DSc FQA MAICD

Specialty: Governance and advisory

“Good governance and wellconceived strategy are cornerstones of excellence in member-focused organisations.

I intend that my contribution to the AMA Queensland members’ benefit will be through support for the Board and management in applying effective, well-tried principles and practice in wise governance.”

“I am keen to represent regional doctors, and those who work too hard to represent themselves.

I would like to see doctors advocate for their own quality of life and set an example of healthy living. I am interested in the role doctors have to play in advocating for change in nutrition and activity practices across their communities.”

BOARD: MEMBER ELECTED DIRECTOR COUNCIL: SENIOR DOCTORS REPRESENTATIVE ASSOC PROF GEOFFREY HAWSON FRACP FAChPM FRCPA

Specialty: Clinical Haematology, Medical Oncology, Palliative Care

“I am passionate about ensuring senior medical professionals can continue to contribute to their communities and their profession as they transition to retirement.

Senior active and retired doctors are an underutilised asset in advancing the health of the Australian community. It is imperative that a lifetime of training does not go to waste. I hope to be able to lobby on behalf of our senior members.

If a retired judge can run a royal commission, why are we considered past our prime just because we hang up our shingle? Many doctors view their profession as a calling which doesn’t cease when practice reduces, employment ends, or full registration demands cannot be met. We deserve the option of an encore career. As a board member I wish to assist AMA Queensland represent its members and ensure their wishes are incorporated in our strategic direction.”

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AMA Queensland Council SPECIALIST REPRESENTATIVE DR ANTONY ATTOK ARAN MBBS FRACP FCICM

Specialty: Intensivist and General Physician “I am excited to be part of the AMA Queensland Council and look forward to lobbying for policies for betterment of the medical fraternity.”

DOCTORS IN TRAINING REPRESENTATIVE DR HASHIM ABDEEN

CAPRICORNIA AREA REPRESENTATIVE DR SANJEEV BANDI

B Biomedicine M BBS

MBBS FRCSI FRACS

Specialty: Rheumatology Advanced Trainee “I am passionate about advocating for a positive training environment that both supports and protects high quality education and training whilst concurrently promoting the wellbeing of doctors and medical students. I appreciate the ever-growing need of the medical profession to take leadership in the Australian healthcare system: to actively represent ourselves as doctors in concert with passionately advocating for our patients.

As the Doctor in Training Representative on AMA Queensland’s Council, I hope to empower my fellow DIT colleagues to become involved in AMA Queensland and take charge of our futures.”

Specialty: Urologist “I am looking forward to representing the regional doctors from the Capricornia Area, and those of us who work hard in these trying times to balance work and family commitments.

I would like to see doctors be more proactive in influencing their own quality of life and set an example for healthy living.

I am keen to be a role model to influence a change in the nutrition and activity practices across the wider community.”

PART-TIME MEDICAL PRACTITIONER REPRESENTATIVE DR ANDREW CRONIN MBBS BEng(Hons) MMgtSt MPH&TM GCertAeromedRet GCertHltSci FRACGP FARGP AFRACMA MRAeS GAICD

Specialty: Retrieval Physician and Senior Medical Officer “I represent those medical practitioners who hold part-time and casual positions - providing essential increases in workforce capacity if and when required.

It is not always possible to work in a full-time capacity for many reasons. I aim to support these options for part-time AMA Queensland members.”

INTERNATIONAL MEDICAL GRADUATE REPRESENTATIVE DR EMILIA DAUWAY MD FACS FRACS

GREATER BRISBANE AREA REPRESENTATIVE DR KIMBERLEY BONDESON BSc (Hons) MBBS FRACGP DAME

Specialty: GP, Aviation Medicine, Coal Mine Medicals “My intention is to represent the views and voices of the doctors in the Greater Brisbane Area. This includes both public and private doctors, specialist and general practitioners, and doctors in training. I will ensure the concerns of our patients and the public are listened to carefully and advocate for those who do not have a voice.

Continuing ongoing monitoring of important local and national medical and political issues.”

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Specialty: Breast, General and Oncologic Surgeon “My goal as the IMG representative on the AMA Queensland Council is to represent all doctors’ professional and personal well-being, but especially IMGs. In addition to the sacrifices related to relocating themselves and families to a new country, IMGs have the added professional challenges of fulfilling the requirements for fellowship to their respective college with limited registration while providing the best care to their new regional community hospital. Highlighting these challenges, the AMA can provide support to enable IMGs to make the greatest impact on the healthcare needs of their region.

I look forward to representing our members in Queensland, especially those located in regional areas.”

GREATER BRISBANE AREA REPRESENTATIVE DR SIYAGUNA EK ANAYAKE (DILUM) MPH MBBS BSc (Biomed) Dip IT GAICD CHIA MAIDH MHL (pend)

Specialty: Doctor in Training “In joining the AMA Queensland Council, I aim to represent and promote the interests of doctors in training, employed/salaried doctors, especially those based in the Greater Brisbane Area, as their representative within the council.”

SPECIALIST REPRESENTATIVE DR ERICA GANNON B Pharmacy MBBS

Specialty: Emergency Physician “I believe the AMA is a powerful, important body and a community of members.

Championing leadership and advocacy for members, patients and the community in general is of paramount importance.

Representing members on council has provided me a platform to not only benefit others, but also allowed me the opportunity to help maintain and uphold the traditions and integrity of the medical profession in which we work. It has been a pleasure to see and be part of the tangible benefits of the governance transformation that has occurred at AMA Queensland since my involvement at council level.”

GREATER BRISBANE AREA REPRESENTATIVE ASSOC PROF ALK A KOTHARI MBBS MD FRANZCOG DDU Grad Cert EBP (Monash), PhD (Enrolled)

Specialty: Obstetrician and Gynaecologist “I am extremely impressed by the leadership demonstrated by AMA Queensland leaders and council and the excellent work done in health advocacy. As I am getting close to completing my PhD, I would like to contribute to the important areas of Maternity Services, extended scope of practice, medical training and ethical issues confronting the profession including voluntary assisted dying. These are all current priorities for AMA Queensland, where I can offer my expertise.”

GREATER BRISBANE AREA REPRESENTATIVE DR STEPHANIE DAWSONSMITH MBBS DCH FRACGP

Specialty: GP “AMA Queensland is a vital voice safeguarding the healthcare of Queenslanders and advocating for medical professionals. I will use my time on council to promote health policy that optimises patient care and supports doctors to provide exceptional healthcare for all Queenslanders.”

COMMITTEE OF DOCTORS IN TRAINING CHAIR DR ROBERT NAYER

GENERAL PRACTITIONER REPRESENTATIVE DR LEE JONES

GENERAL PRACTITIONER REPRESENTATIVE DR FIONA RACITI

MBBS

BSc (Biomed) MBBS FRACGP

MBBS (Honours) FRACGP DCH

Specialty: Emergency Medicine Registrar “There are many issues facing our medical system.

Doctors are overworked, and frequently undervalued in the workplace. This has a huge effect on medical training.

Many doctors in training (DIT) have insurmountable clinical pressures, receive precious little supervision or training throughout their average day, and suffer from burnout and other mental health problems as a result.

Many are languishing as PHOs. Responsible for keeping the hospitals running, but unable to progress their careers. My goal is to improve the DIT voice within AMA Queensland so we can better advocate for DITs across the state.”

Specialty: GP “I believe that AMA Queensland is an important advocacy group that will speak up for the doctors of Australia. My goal in joining the AMA Queensland Council is to stand up for the doctors of Queensland – advocating for improving our rebate conditions, improving the viability of GPowned businesses and increasing the status of general practice to the community and to inspire our junior doctors.”

Specialty: GP, business owner, company director “Empowering people to take charge of their own health and well-being is my driving ethos and I consider encouraging young doctors to actively participate in the ‘business’ of medicine equally important.

I’m proud to be part of a supported, committed and collegiate team which thrives in a workplace that actively focuses on providing continuity of care for all patients and all staff. I enjoy adding my voice to the advocacy of Australia’s general practitioners and helping to keep their interests in the public and government’s line of sight.”

GREATER BRISBANE AREA REPRESENTATIVE DR RACHAEL O’ROURKE MBBS FRANZCR CTCA

Specialty: Radiologist “I pledge to represent the needs of all doctors, but particularly the role and standing of doctors in our hospital health systems. These doctors are under increasing pressure by a bureaucratic healthcare system, determined to reduce the vital role of doctors in the delivery of healthcare. I believe that only medically trained doctors have the skills to make the important decisions regarding the management of our patients. Only doctors can determine the important diagnostic tests and treatments options necessary to obtain the best outcomes for our patients.

Only doctors can drive the vital relevant medical research and teaching that our public hospitals require. I will work diligently to achieve the best outcomes for all our members and our patients and resist efforts to diminish the role of doctors in healthcare delivery.”

FULL-TIME SALARIED MEDICAL PRACTITIONER REPRESENTATIVE DR SIVA SENTHURAN MBBS BSC FRCA FANZCA FCICM

Specialty: Anaesthesist “I believe that medical leadership and engagement between administrators and its front line clinicians needs to underpin any drive for efficiency in an era of increasing healthcare costs. Such engagement needs to be based on shared values transferred from websites where they are proclaimed into every organisational thought, word and deed.”

FAR NORTH AREA REPRESENTATIVE DR DAVID SHEPHERD

MEDICAL STUDENT REPRESENTATIVE SHIVEN SINGH

MBBS FRACS FAOrthA

“Australia’s medical students are the next generation of world leading doctors. My hope is to tackle issues medical students face throughout their pre-clinical and clinical years – highlighting the need of good mental, physical and spiritual health. By challenging these issues, I hope to unite our future workforce, to ensure our healthcare is as holistic and friendly to patients as possible.”

Specialty: Orthopaedic Surgeon “My intention on the AMA Queensland Council is to represent the views and needs of Far North Queensland doctors by acting as a conduit for communication between them and the AMA organisation.”

NORTH COAST AREA REPRESENTATIVE ASSOC PROF CORNELIUS (KEES) NYDAM MBBS FACEM FAChAM (RACP) AFRACMA MMEd MHM

IMMEDIATE PAST PRESIDENT PROF CHRIS PERRY OAM RFD ED MBBS DTM&H (Liverpool) FRACS)

Specialty: ENT Surgeon “I am now the immediate pastPresident of AMA Queensland.

After two full years of issues such as COVID, voluntary assisted dying and allied health extended scopes of practice (to questionable levels of competence), I have gone to AMA Queensland Council and will stay for a while to help promote AMA Queensland Foundation.

I will try to help doctors and the Queensland community as much as I can through AMA Queensland.

I’m available for advice and have many contacts within health and the Queensland Government.

I am happy to help in whatever way I can.”

Specialty: Addiction Medicine and Emergency Medicine Specialist “I live by Virchow’s mantra that medicine is a social science and politics is nothing else but medicine on a large scale. I see the AMA as the modern-day conveyor of that message. I have recent highlevel advocacy and policy developing experience as both a member of the RACP council (six years) and the RACP Chapter of Addiction Medicine Committee (six years). At present, I represent my medical colleagues in Wide Bay-HHS on the Queensland Health Clinical Senate. I am the North Coast Area representative on AMA Queensland Council (2000-present).”

DOWNS AND WEST AREA REPRESENTATIVE DR BEN WAKEFIELD FRACGP FARGP MBBS BSc/BEd

Specialty: Rural Generalist “I believe AMA Queensland is an important mouthpiece not only for doctors, but for our patients as well. My goal on the AMA Queensland Council is to represent the doctors of the Downs and Western Queensland - advocating for safe and sustainable working conditions.

I am a strong believer in rural generalism and am proud to work in an area of Queensland where this model of care is often celebrated as a positive example for others to follow.”

WINTER | DOCTOR Q

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FURTHER INFORMATION, 7)OR 4932 1211 M: 0417 608 386Private Hospital Hillcrest Rockhampton

PLEASE CONTACT:

T: (07) 4932 1211 M: 0417 608 386 bbard@ramsayhealth.com.au iona Hebbard, CEO, E: hebbard@ramsayhealth.com.au Hillcrest Rockhampton Private Hospital

: (07) 4932 1211 M: 0417 608 386

: hebbard@ramsayhealth.com.au

ramsaydocs.com.au msaydocs.com.au

VAD to begin 2023

Snapshot/key facts The Voluntary Assisted Dying Act 2021 was passed by the Queensland Parliament in September 2021 It comes into effect on 1 January 2023 To be eligible to access VAD, a patient must

Work is well underway at Queensland Health on the processes, governance arrangements and materials to support the voluntary assisted dying (VAD) scheme, which will be available to eligible Queenslanders from 1 January 2023. These include workstreams focusing on First Nations Queenslanders, statewide navigator services, ICT solutions, pharmacy services, clinical engagement and training, regional and remote access, and community and consumer engagement.

Queensland Health is developing detailed handbooks for release in the second half of 2022. Volume 1 will cover the regulatory framework and the VAD process, and Volume 2 will cover clinical practice.

Details about doctors’ eligibility, verification and training requirements to become an authorised VAD practitioner will be available soon. In the meantime, you can register your interest in the training by emailing VADImplementation@health.qld.gov.au with a brief outline of your qualifications.

Doctors do not have to participate in the VAD process, and can refuse to participate in all or any stages. However, doctors who conscientiously object have an obligation to provide the person with the details of another practitioner who they believe may be able to help, or refer the person to the VAD support service.

The process will involve three discrete requests from the patient, and three stages of assessment and review from medical practitioners. The patient can choose to self-administer the VAD substance or have an administering practitioner.

have an eligible condition (advanced, progressive condition and will cause death, death is expected within 12 months, and suffering is intolerable) be acting voluntarily and without coercion be over 18 fulfil residency and citizenship requirements have decision making capacity A person cannot request VAD in an advance health directive, and a substitute decision-maker cannot request it on behalf of another person.

What do I tell patients who ask to access VAD now?

It’s only available after 1 January 2023 Explore the person’s experience of distress or suffering and ask clarifying questions to understand its source Explore the person’s values and preferences for end-of-life care Identify how their needs can be addressed

Visit health.qld.gov.au/vad for detailed and up-to-date information about voluntary assisted dying.

WINTER | DOCTOR Q

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JA A DE N M O R R A L L Workplace Relations Manager

A N G E L A L E N TA K IS Workplace Relations Administrator

Parental leave – what an employer should know Parental leave is one of the 10 National Employment Standards (NES) all employees in Australia are entitled to. The NES prescribes a period of unpaid parental leave for those who are eligible and meet the criteria.

In conjunction with this, Services Australia offers a Paid Parental Leave scheme employees can apply for and receive during their time off if they are eligible.

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DOCTOR Q | WINTER

Employers should be aware of the entitlements and regulations around both these types of leaves to remain compliant with legislative requirements. For staff under the Health Professionals and Support Services Award 2020 and the Nurses Award 2020, there are no additional parental leave provisions in these Awards, and therefore, the NES applies.

Parental leave under the National Employment Standards The NES entitlement to unpaid parental leave and related entitlements applies to all employees in Australia and can be found in Part 2-2, Division 5, Section 70 of the Fair Work Act 2009. Employees must have completed at least 12 months of continuous service with the employer to be eligible. This includes casual employees if they have been employed on a regular and systematic basis for a sequence of periods over at least 12 months.

Unpaid parental leave applies to employees who have, or will have, responsibility for the care of a child. Parents are entitled to unpaid parental leave if the employee, the employee’s spouse, or the employee’s de facto partner gives birth or adopts a child under 16. Each eligible member of an employee couple can take a separate period of up to 12 months of unpaid parental leave. The combined leave cannot be for more than 24 months.

Return to work guarantee An employee is entitled to return to their pre-parental leave position or an available position for which they are qualified and suited that is nearest in status and pay to their pre-parental leave position, if their previous position no longer exists. Before hiring someone to perform the work of the employee on leave, the employer must notify any replacement employee that their engagement is temporary and that the employee on leave has a right to return to work when their unpaid parental leave ends.

Services Australia’s Paid Parental Leave scheme If your employee meets certain eligibility criteria, they may be entitled to government-funded paid parental leave as part of Services Australia’s Paid Parental Leave scheme. Employers have an important role in this scheme too. The scheme doesn’t change any of your employees’ existing leave entitlements, nor does it give them a new entitlement to leave.

The two types of payments available to families under the scheme include Parental Leave Pay and Dad and Partner Leave. Both these payments are taxable and paid at the rate of the national minimum wage.

It is the responsibility of the employee to apply for their parental leave pay through Services Australia. Once Services Australia has decided an employer must provide an employer’s parental leave pay, they will send you a letter to notify you. The employer’s responsibility is to give an acceptance notice within 14 days. Once this step has been completed, Services Australia will provide the paid parental leave funds to the employer to pass on to their staff. It then becomes the responsibility of the employer to provide it to the eligible employee.

Consequences for employers who fail to meet their obligations under the scheme may include financial infringements or penalties. Both Centrelink and the Fair Work Ombudsman have the power to investigate potential breaches of employer obligations and apply penalties.

In a recent case, the Fair Work Ombudsman secured a total of $69,552 worth of penalties in a case against a Melbourne health clinic that withheld government-funded parental leave payments from an employee. The employee had successfully applied for the Services Australia Paid Parental Leave scheme, and the government transferred the money to the Melbourne health clinic. Under the Paid Parental Leave Act, the clinic was required to transfer the funds to the employee in a series of instalments, however, breached the Act by transferring less than half the funds to the employee during her period of paid parental leave. The sole director and owner of the Melbourne health clinic transferred the employee’s money into their personal account and used it for their own purposes. This case outlines the seriousness of the unlawful misuse of government payments by an employer and highlights how important it is for an employer to be aware of their responsibilities.

Services Australia provides an employer toolkit guide for the Paid Parental Leave scheme that includes all the information and processes necessary for an employer to understand their responsibilities and rights under the scheme. You can find it by following this link: servicesaustralia.gov. au/paid-parental-leave-scheme-employertoolkit?context=23121

Workplace Relations Support can help members by providing information to any queries you have around different leave entitlements. You can contact us via phone (07) 3872 2222 and email support workplacerelations@amaq.com.au Workplace Relations Toolkit provides subscribers with practical guidance on topical issues which may arise due to cases like the one analysed in this article. These updates are provided in our Workplace Relations News (previously Award Subscription) which is part of the Workplace Relations Toolkit Subscription.

Workplace Relations Consultancy can work with our members to guide them through the processes associated with paid and unpaid parental leave, or assist with drafting any applicable written correspondence to an employee.

Please reach out to our Workplace Relations Team on (07) 3872 2222 or at workplacerelations@amaq.com.au to find out more about these services.

WINTER | DOCTOR Q

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Insurance policies available through MIGA are underwritten by Medical Insurance Australia Pty Ltd (AFSL 255906). Membership services are provided by Medical Defence Association of South Australia Ltd. Before you make any decisions about our policies, please read our Product Disclosure Statement and Policy Wording and consider if it is appropriate for you. Call MIGA for a copy or visit our website. 1 75,000 bonus Qantas Points offer only available to registered Australian medical practitioners who first insure with MIGA in a fully insured category, as a doctor in private practice, for cover commencing in the period between 30 June 2022 and 31 July 2022, and who pay in full by 31 July 2022 or enter into a direct debit arrangement with MIGA by 31 July 2022, and pay at least one instalment by 31 July 2022, who have not exercised their rights to cool off nor had their insurance cancelled by MIGA, as per the terms and conditions of the Policy. MIGA Terms and Conditions for bonus Qantas Points for Fully Insured are available at www.miga.com.au/qantas-bonus-tc-pp. 2 A business must be a Qantas Business Rewards Member and an individual must be a Qantas Frequent Flyer Member to earn Qantas Points with MIGA. Qantas Points are offered under the MIGA Terms and Conditions at www.miga.com.au/qantas-tc. Qantas Business Rewards Members and Qantas Frequent Flyer Members will earn 1 Qantas Point for every eligible $1 spent (GST exclusive) on payments to MIGA for Eligible Products. Eligible Products are Insurance For Doctors: Medical Indemnity Insurance Policy, Eligible Midwives in Private Practice: Professional Indemnity Insurance Policy, Healthcare Companies: Professional Indemnity Insurance Policy. Eligible spend with MIGA is calculated on the total of the base premium and membership fee (where applicable) and after any government rebate, subsidies and risk management discount, excluding charges such as GST, Stamp Duty and ROCS. Qantas Points will be credited to the relevant Qantas account after receipt of payment for an Eligible Product and in any event within 30 days of payment by You. Any claims in relation to Qantas Points under this offer must be made directly to MIGA by calling National Free Call 1800 777 156 or emailing clientservices@miga.com.au. © MIGA May 2022

Committee of General Practice update DR M A R I A BO U LTO N

The drop in temperature signals the start of the yearly influenza vaccination program in general practice. Many of our committee members have been busy encouraging the community to get an influenza vaccine and ensuring their patients are up-to-date with their COVID vaccines. More than 61 per cent of COVID vaccines and 67 per cent of flu vaccines thus far have been given in primary care. We are also caring for COVID patients with the assistance, when clinically indicated, of our colleagues in the COVID virtual care wards and hospitals.

We continue to advocate for issues affecting our members during the pandemic. We have been successful in pushing the PPE provision deadline from 31 March to later in the year. We thank the private pathology companies who set up COVID PCR priority testing for GP specialists and non-GP specialists, their staff and their families. This has been useful as our workforce has been affected by the current wave of COVID infections in Queensland.

I continue attending the regular state and federal health department meetings on the COVID response. These include weekly State Health Emergency Coordination Centre/ Primary Care Queensland meetings, COVID community care model working group (GP peaks and Queensland Health) meetings and the federal Department of Health-Primary Health Care COVID-19 Response teleconference meetings.

I also attend regular meetings with the Queensland GP Alliance (AMA Queensland, RACGP, ACCRM and RDAQ).

It has been a privilege to work with their representatives and collaborate on important issues affecting our community. Dr Dilip Dhupelia invited me to speak to the Queensland Rural Medical Leaders Network on issues related to the COVID pandemic. This was a great opportunity to learn more about the issues affecting our rural colleagues.

I was also invited by the Indian Medical Association of Queensland to be part of the panel discussion at their recent Domestic Family Violence in Medical Practice event.

AMA Queensland Councillor Dr Vikas Moudgil and AMA Queensland member Dr Alka Kothari gave insightful talks at the event. I continue attending urgent meetings between Queensland Health, AMA Queensland and the rest of the Queensland GP Alliance following the media announcement

GP, AMA Queensland President and Chair, Committee of General Practice

of the free flu vaccine initiative. It is important that all levels of Government consult GPs and GP peak bodies prior to announcing initiatives that affect general practice and our patients. There is a lot of anger and frustration at the stress that announcements without consultation or details cause to general practice and reception staff who have to field the increase in phone calls from patients. Consultation is essential to work out practical solutions for urban, rural and regional general practices and vulnerable populations prior to media announcements.

Many of our members have been active in the media advocating on issues such as the need for funding for general practice, ambulance ramping, extended scope and more. We welcome the launch of the AMA’s Modernise Medicare campaign calling on the major political parties to address the urgent need for reform and investment in general practice.

On behalf of the CGP, I would like to express our thanks to Prof Chris Perry for representing the interests of GP members during his tenure as AMA Queensland President.

A lot has been asked of GPs and their staff during the pandemic, yet the resources to undertake these tasks were not forthcoming. Prof Perry has actively listened to the issues affecting GP members and has provided us with endless support. He has represented GP members at stakeholder meetings and in the media. Our voice would not be as strong without his support and the support of our AMA Queensland CEO, leadership and the rest of the team.

A special thank you to the members of the CGP who devote their time representing their GP colleagues and community.

DR S M A RIA BOU LTON A N D FION A R ACITI WITH M E M BE R S OF TH E IN DIA N M E DIC A L A SSOCIATION OF QU E E NSL A N D

WINTER | DOCTOR Q

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P: (07) 3872 2222 E: bss@amaq.com.au 32

DOCTOR Q | WINTER

DR R I C H A R D K I DD GP, Past Nominee, Practice Group of General Practice on Federal Council and Past Chair, AMA Council of General Practice

Term wrap-up

It has been my absolute privilege to serve as the Nominee for the Practice Group of General Practice on Federal Council and the Chair of the AMA Council of General Practice over the last six years. During that time, AMA advocacy has very much focused on highlighting the enormous value of general practice and putting forward practical solutions to the challenges being faced by GPs around the country.

There have been some bruising fights with government along the way, as well as some notable wins. The work is never over and whoever takes my place will continue to face a challenging environment.

When I came to the position of Chair the Medicare Benefits Schedule Review (MBS Review) was underway; Medicare rebates were still frozen; the now defunct Health Care Homes trial was underway; difficult changes to the Practice Incentive Program (PIP) Digital Health Incentive were being implemented; and the AMA was calling for GP funding to better support quality care and the incorporation of non-dispensing pharmacists into general practice.

Over my time the AMA has successfully advocated for retention of key components of the PIP. These include the Indigenous health, teaching, GP procedural and the aged care access (ACAI) incentives, which government wanted to sacrifice to fund the Quality Improvement Incentive (QII). Not only did our advocacy see these incentives retained, but we also secured additional funding for the QII and more recently a doubling of the payments available under the ACAI. The most progressive step forward has without a doubt been the funding of telehealth (video and phone) services under the MBS. It is a shame it required a pandemic for government to realise the role that appropriate telehealth services contributes to timely and accessible patient care.

Continued AMA advocacy for the reduction in red tape contributed to the cessation of the Vocational Register and the introduction of streamlined access to Medicare for GPs via their registration status with Ahpra.

On the GP workforce front the AMA secured the expansion of prevocational training places in general practices with a focus on rural areas, and successfully lobbied for the introduction of the Rural Generalist Pathway. Funding for non-dispensing pharmacists is now accessible through the Workforce Incentive Program. We have also supported a return to college-led training arrangements and we continue to work to achieve more equitable conditions for the next generation of GPs, backed by improved support for supervisors.

COVID-19 threatened the viability of general practices around the country. In the first six months of the pandemic the AMA secured around $600 million in additional financial support for general practice that helped save many from financial extinction. We fought strongly for better access to PPE and a fair rebate for COVID-19 vaccination services. We secured a no-fault indemnity scheme and general practice can be very proud that it formed the backbone of the vaccine rollout.

The Council of General Practice has led the way in the quest for primary health reform and put words to the vision of many GPs around the country in our Delivering Better Care for Patients: The AMA 10-Year Framework for Primary Care Reform, while GP policy features strongly in the AMA’s broader Vision for Australia’s Health.

These strongly influenced the recommendations of the Primary Health Reform Steering Committee and our ideas were taken up in the government’s Primary Health Care 10 Year Plan. Unfortunately, the government is yet to fund this plan and the AMA will need to work hard to ensure it does not become another document that gathers dust on a shelf in the Department of Health.

Our Modernise Medicare campaign is designed to highlight the issues facing general practice and to keep the pressure on the major parties to do more to support general practice and build a health system that can meet our future needs.

While I will be taking a step back now, I know the AMA has the right policies in place to ensure patient-centred, collaborative and connected care and to guide a better future for GPs, general practice and the community we care for.

WINTER | DOCTOR Q

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MOCA 6 negotiations underway DR H AU TA N ASMOFQ President

ASMOFQ (Australian Salaried Medical Officers’ Federation Queensland) has had several Medical Officers’ Certified Agreement (MOCA) 6 negotiation meetings with Queensland Health.

We have a large and diverse negotiation team which includes senior doctors, junior doctors, rural and remote doctors and visiting medical officers.

The negotiations have focused on numerous issues including extended hours. Queensland Health proposed changes to MOCA Clause 11.4 (Extended Span of Ordinary Hours to Meet Clinical Need), that would give Hospital and Health Services (HHSs) the ability to force senior doctors to work extended hours shifts without their agreement (evening or weekend shifts outside the ordinary hours of 7.30am - 6pm, Monday to Friday).

ASMOFQ rejects this proposal as it would significantly reduce the employment conditions of our members.

Currently, under MOCA 5, any such roster change to include extended hours shifts must require the agreement of senior doctors. ASMOFQ fought hard for this protection in previous years during MOCA 4 and MOCA 5 negotiations.

ASMOFQ’s position is that the only meaningful way to address the unmanageable workloads and fatigue that doctors are enduring across the state is to simply employ more doctors.

Also discussed in negotiations were the critical issues facing our rural and remote doctors.

The current system is not working and is plagued by inadequate numbers of doctors, unmanageable workloads, widespread fatigue and burnout, low staff retention, poor attraction of trainees, and a heavy reliance on locums.

ASMOFQ considers the situation for rural and remote hospitals to be dire and unsustainable, and we are fighting for: alignment of Medical Superintendents with Private Practice (MSPP)/Medical Officers with Private Practice (MOPP) entitlements to that of senior medical officers (SMOs) (parity) 34

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indexing of inaccessibility allowances greater ability for part-time appointments recognition of Fellow of the Royal Australian College of General Practitioners (FRACGP) and Fellow of the Australian College of Rural and Remote Medicine (FACRRM) as specialties (and progression beyond L18)

J O H N C O SG ROV E ASMOFQ Chief Industrial Advocate 0417 972 038 asmofqld@asmof.org.au

specialist GPs receiving 50 per cent attraction and retention allowances consistent reimbursement of relocation costs, particularly for doctors in training accommodation that is provided to doctors be of a decent standard, and suitable for families

other measures such as multi-year contracts for doctors in training to incentivise careers in rural and remote medicine.

At this stage, MOCA 6 negotiations are scheduled to continue well into July 2022. There are still a significant number of topics to discuss, with junior doctor issues scheduled for June and senior doctor issues scheduled for July. MOCA 5 will continue to operate until a new agreement is formed.

ASMOFQ will continue to stand up for rural and remote doctors, who deserve recognition and respect for the invaluable service that they provide their patients and communities.

In addition to MOCA 6 negotiations, ASMOFQ is also currently engaged in negotiations with Mater with respect to the Enterprise Agreement for Senior Medical Officers.

appropriate supervision of and support for junior doctors working in rural and remote locations

If you would like more information regarding the MOCA 6 negotiations, please email us at asmofqld@asmof.org.au

Registrations and notifications affect every doctor

Registrations and notifications are products of the National Registration and Accreditation Scheme.

The scheme facilitates a single registration for health practitioners, based on uniform standards, recognised anywhere in Australia. It aims to ensure health practitioner registration is only available to people who are suitably trained and qualified to practise competently and ethically.

Unfortunately, the consultation process behind the bill was derisory and the AMA is now examining the bill’s extraordinarily complex series of amendments. Although many aspects of the reform agenda are welcomed, some changes could have potentially devastating impacts on doctors. The AMA will continue to oppose these alarming elements in the bill.

The legal framework for the scheme is set out in the National Law. The National Law also establishes regulators for each health profession, and is supported by Ahpra.

Of paramount concern is a potential lack of natural justice for doctors if they are the subject of a public statement from a regulator. A public statement can be made about a doctor if the regulator reasonably believes the person poses a serious risk to others and considers the public statement necessary to protect public health or safety.

In Queensland, Ahpra’s regulatory functions are shared with the Office of the Health Ombudsman (OHO). The OHO has primary responsibility for complaints, and broad powers to deal with health, conduct and performance issues of health practitioners.

Under current arrangements, media statements about a health practitioner are issued at the conclusion of a tribunal process. The bill proposes that a public statement could be issued prior to the completion of an action against a practitioner.

The scheme commenced in 2010 and has been subject to continual efforts to improve its operations. The most recent manifestation of this is the Health Practitioner Regulation National Law and Other Legislation Amendment Bill 2022.

A public statement about a doctor’s health, conduct or performance is a serious step. It implies guilt and could cause irreparable damage to a doctor’s reputation.

The reforms in the bill were jointly endorsed by Australia’s health ministers in February this year.

Queensland is the host jurisdiction for the National Law. This means after the bill is passed here, it will be adopted by other jurisdictions.

The bill was tabled in Parliament in mid-May 2022, and proceeds through the normal processes for Queensland legislation.

This involves the bill’s referral to the Health and Environment Committee for scrutiny. AMA President Dr Omar Khorshid and AMA Queensland President Dr Maria Boulton gave evidence to the committee in June, and its report is due on 1 July 2022. The legislation is then likely to be passed by the Queensland Parliament.

The AMA strongly contends that any public statement should be issued only after a health practitioner has been shown to have breached a code of conduct or been convicted of a relevant offence. Further, the requirements for a regulator to revoke a public statement if grounds no longer exist, or never existed, are manifestly inadequate to redress potential harms caused by a public statement.

There is no evidence that current arrangements are sufficiently flawed to warrant this dramatic step.

AMA Queensland will continue to oppose these changes, and keep members informed about changes to the scheme, how the changes are likely to operate in practice, and what doctors need to know.

WINTER | DOCTOR Q

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HIRU NI GU N A SE KE R A

LY DIA BU RNS

Foundation helps students with life-changing scholarships The AMA Queensland Foundation is committed to helping Queenslanders in need, whether it be by delivering vital health services outside those catered for by the public health system, raising money for an important cause, or supporting medical students fulfil lifelong dreams of becoming a doctor.

Since 2004, the Foundation has provided more than $475,000 in financial assistance to 28 medical students experiencing financial hardship in Queensland.

This year, the Foundation received more than 30 applications for the Medical Student Scholarships, making the decision a difficult one.

Two scholarships were awarded and announced at the AMA Queensland Foundation Charity Event in May. Hiruni Gunasekera, 21, is a second year medical student at Griffith University Gold Coast whose family lives in Brisbane.

During 2021, Hiruni experienced several challenges and disruptions to her home and social life including a shock breast cancer diagnosis for her mother.

“Following the diagnosis, I found myself travelling back to Brisbane as often as I could to help my Mum attend chemotherapy sessions, as well as assist in household work as my sisters attend school.

“These funds have made a world of difference to my family.

“My parents have supported me through university so far, but we’ve found our household income essentially slashed and halved.

“This opportunity has changed my life and has allowed me to pursue my studies and help relieve travel costs, enabling me to take care of my mum comfortably as well.”

The second scholarship winner, Lydia Burns, is a second year student at the University of Queensland. Lydia is the mother of four children and cannot afford to take time off from her studies.

“I come from a broken home in Toronto, Canada, and was raised for the most part by a single mother who struggled to look after her children on her own. Our family life was very unstable.

“I have always wanted to be a doctor, particularly a psychiatrist since being helped tremendously through life struggles by compassionate psychiatrists, and I hope to do the same for others.”

Lydia said her husband looks after their children – aged one month, three, seven and 10, so she can focus on her studies.

“The scholarship will help make ends meet and relieve some of the stress associated with taking care of a family while studying medicine full-time.”

“This entire situation impacted me profoundly and I found myself feeling overwhelmed with guilt and financial strain.”

We wish Hiruni and Lydia all the very best and look forward to an update on their studies later in the year.

With Hiruni’s time split between Brisbane and the Gold Coast, and the toll the diagnosis had taken on her family, she found it difficult to concentrate on her studies and even considered dropping out.

Applications for the AMA Queensland Foundation Medical Student Scholarships open in November of each year and close mid-February.

Hiruni managed to make it through the year and maintain good academic performance but recognised financial help would ease the pressures her family are still under.

You can support Medical Student Scholarships by making a tax deductible donation to AMA Queensland Foundation www.amaqfoundation.com.au.

WINTER | DOCTOR Q

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CONFERENCE SATURDAY 23 JULY WORKSHOP SUNDAY 24 JULY

THE CAIRNS INSTITUTE AT JCU ROYAL FLYING DOCTORS SERVICE

We’re looking forward to having an AMA Queensland Junior Doctors Conference this year in a new location, Cairns.

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CDT update

A force to change the future

DR R AC H E L E QU E S T E D Co-Deputy Chair, Committee of Doctors in Training (CDT)

To describe being the Co-Deputy Chair of the AMA Queensland Committee of Doctors in Training as a privilege feels like an understatement and a stereotype.

We know our current medical training environment is near, or maybe past, its breaking point. Time to learn, practise, teach and reflect have become luxuries; lost in the backlog of work that needs to be done. Despite this, there remains a strong and relentless ethos of hard work, study, teamwork and a dedication to patient care that is instilled in every doctor in training that I have worked with. Our vision statement is “AMA Queensland CDT be a useful, supportive, and integral part of the working lives of doctors in training, and ultimately, the health experience of Queenslanders”.

Chair Dr Robert Nayer’s goal this year is to take one small step on the journey to that reality.

This approach is reflected in our team.

The group is increasingly but not yet appropriately diverse. We have principal house officers from rural Queensland, metropolitan emergency trainees and every specialty in between.

We have a depth of age and work life experience – we are doctors in training and thus measure ourselves regularly by our postgraduate year factor.

The most incredible thing, however, is the collective drive to enact change – change that may not impact on us and our training but should improve the experience for those who follow. This single sentiment – change for the future – is what sets our committee apart from so much that I see elsewhere.

The year to date has been productive and busy, including some advocacy wins and a restructure of the way we approach our core business.

The leadership team held our first ever strategy day, combining techniques and knowledge from business and policy development with what we have learned from medical training.

Our aspirational visions and values and our determined mission statement exude enthusiasm and a desire to profoundly alter the path of future training doctors.

The AMA Queensland CDT structure consists of multiple groups, each with a dedicated area of concern and interest.

There are the hospital representatives whose role includes overseeing AMA Queensland member representation at all hospitals in which doctors in training work. Then there are our special interest groups – sustainability, industrial relations, education, wellbeing, rural and remote and digital health, each of which has a dedicated chair and deputy chair and a membership that is engaged and passionate about their chosen areas of expertise.

Our vision is that AMA Queensland CDT be a useful, supportive, and integral part of the working lives of doctors in training, and ultimately, the health experience of Queenslanders.

Our three main goals this year are to improve member engagement and communication, improve and continue advocacy for doctors in training – based on their reported concerns – and ensure a sustainable CDT model for the future. The first goal is necessary to achieve any others – AMA Queensland and the CDT need to become a relevant part of the conversation around what good medical training should look like and we can only do this if we are truly representative. More doctors in training present in rooms where decisions are made is the key to improving the future of medical training and, ultimately, healthcare in Australia.

Thank you to every one of you for what you do every day and please, if you are not a member already, check us out and consider joining.

WINTER | DOCTOR Q

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AMA Queensland helps by advocating for safe hours, more clinicians, getting help when needed, but I’m hearing from my colleagues that day to day, they also want faster access to data, the right data, and to access it easily.

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Meet a member

Dr Honor Magon Occupational Medicine Registrar, Metro South Health, Digital Health Clinical Consultant, Resile, Digital Health Special Interest Group Deputy Chair, Committee of Doctors in Training (CDT)

Registrar Dr Honor Magon is packing her bags for sunny California after being awarded a Fulbright Scholarship to Stanford University, funded by The Kinghorn Foundation.

Honor will study a Masters of Science in Clinical Informatics Management, which she describes as a mixture of a Masters of Business Administration, Public Health and information technology and analytics. While studying at Stanford, she looks to address three core questions.

1. How might we improve the digital ecosystem that surrounds our healthcare workers to reduce the administrative burden that is creating a key psychosocial hazard in the workplace?

2. How might we deliver timely and confidential support services to healthcare workers, particularly junior doctors using existing and emerging technology?

3. What needs to change in our governance structure within Australian hospitals and healthcare systems, to put in preventative health strategies to protect the health and wellbeing of our healthcare workers?

Honor has been involved with AMA Queensland since serving as a Medical Student Representative on Council in 2015. She has also been an active member of the Committee of Doctors in Training since graduating and was part of the team that created the first Junior Doctor Conference and Resident Hospital Health Check.

“I’ve been a part of AMA Queensland since 2015 as the medical student councillor, where I sat on state council to provide the voice of medical students. At that point in time, CDT was working on the very first hospital health check, and the very first iteration of Wellbeing at Work.

When asked why doctors’ health has always been a priority, Dr Magon said: “a clinician needs to be working at their best in order to provide the best care to our most vulnerable citizens. I’ve been a patient, and I’ve been the family of a patient. I want to know that I am being cared for by people who are working at their best, physically and psychologically.

“Through COVID, we saw that healthcare workers have already fragile workplaces. I also know through my occupational medicine training that there’s so much more work to go to reduce hazards and optimise safety in the workplace for doctors.

“AMA Queensland helps by advocating for safe hours, more clinicians, getting help when needed, but I’m hearing from my colleagues that, day to day, they also want faster access to data, the right data, and to access it easily.

“This practically allows them to do their jobs more efficiently, and allows them to get home on time - an element to improve wellbeing. Clinicians have a duty to help other clinicians, and I figure that this is my way of exploring another way to improve doctors’ health,” she said.

“Digital systems in healthcare are moving quickly, and there’s lots of different fields. Access to data is a big positive, but we face new challenges in ensuring security of such data, and getting the right data at the right time.

“In terms of impact on junior doctors, we will grow up in this space of needing to be quickly tech literate. It’s already growing with use of electronic medical records, where our junior doctors are the biggest users of the system. This is one application of a technology to do our job, and there’s so many more to come.

“This generation of doctors has an opportunity to be able to see our technologies mature, but with that will come a number of headaches when implementation doesn’t go to plan.

“There has always been a conversation about junior doctors, right from the very beginning of my involvement.

Since then, each of the aforementioned initiatives have blossomed into their own, highlighting the importance of the CDT’s role in doctors’ wellbeing.

“Where clinicians need to be is in the design, implementation and quality improvement space of our digital systems. This will help push forward the capabilities of our digital systems, with both patient users and clinician users considered at every step of the way.

“For me, I’ve been the membership and events representative, PA Hospital representative, and this year, the deputy chair of the digital health interest group. I always come back to CDT, as I find it’s always a similar group of people who want to do one thing – create change.”

“I’d specifically like to see a specialised group of clinicians in clinical informatics, ensuring there is always someone translating a technological change to a real world use case and application to the clinician. I’d also love to see more focus on intuitive user interfaces, and interoperable systems. Right data with the right clinician, for the right patient at the right time.”

It’s no surprise to AMA Queensland that Honor was destined for bigger things, and that doctors’ health has always been her passion.

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Leading a change in healthcare

My career as a clinician over the past 20-something years has been incredibly rewarding and still today, I share the same love of medicine and desire to achieve the very best outcomes for my patients.

Like most of us, I’ve had my challenges and certainly the past two years is front of mind when it comes to the most challenging. But in many ways, it’s also been rewarding.

It’s been rewarding to be part of Queensland’s incredible response to COVID-19.

It’s been rewarding to work alongside my clinical colleagues who’ve shown up and gotten on with the job regardless of their own fears and concerns.

And it’s been rewarding to be part of the changes that have allowed us to continue to deliver care in the face of a global pandemic.

While I definitely hit the ground running when I started as Chair of the Queensland Clinical Senate in the midst of the state’s first ‘planned’ COVID wave in January, I’m excited to have taken on the role as the reform agenda gets underway in Queensland Health.

We have seen through the recent disruptive period what can be done when we remove the clutter and just get on with it, and we now have the opportunity to build on this while also facing the future challenges on our healthcare system of population growth, increasing demand and workforce constraints.

Over the past three months, the senate has held a series of meetings under the banner of ‘Redesigning Healthcare’, giving our members – experienced and senior clinicians from around Queensland – the chance to look at healthcare differently

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DR TA N YA K E L LY Queensland Clinical Senate Chair and Senior Specialist Anaesthetist

to understand what opportunities exist to better serve our community and our healthcare workforce into the future.

Our first session in March recognised the importance of timely high availability care, when and where it is needed.

Care that wraps around the patient and their healthcare home. We have also recognised our agility and ability to adopt new models such as virtual care during the COVID-19 pandemic and want to harness that.

In our second session, facilitated by QUT Bridge Labs, we took a five-plus year view and thought radically about the journey through (not to and from) hospitals, to explore novel ways to access specialist and hospital care and transition home, in partnership with primary care and community teams, making use of current and future technology.

The third meeting in the series – our first in-person meeting since the beginning of the pandemic – looked at the fundamental changes that need to be made in the system to make sustainable change happen.

We will now bring it all together to provide good clinical advice to the system and reform agenda.

I know that many of us, as senior clinicians, feel very strongly about the need for reform and the need to leave a legacy of sustainable clinical services.

And I feel very privileged to be leading the senate in this change agenda to see high-quality healthcare delivered in a modern and agile way.

To find out more about Dr Tanya Kelly, her career as an anaesthetist and focus as Chair of the Queensland Clinical Senate, visit the Queensland Clinical Senate podcast page player.whooshkaa.com/ episode?id=931574.

Death Café I still vividly recall the first time I saw a dead person. I was 11 years old, and my grandfather had died after a prolonged illness. The family was invited to a ‘viewing’ at the funeral home. I recall feeling very afraid of seeing a dead body, with every ghost story that I had ever read coming back to haunt me. In my family, death was not something we spoke about, even in the presence of death. As a child, I intuitively obeyed the tacit rules of silence, asked no questions, said nothing, and processed the whole experience using only my own mind.

In some parts of the world, death remains a natural and ever-present part of life. People of all ages die at home, cared for by family. Bodies are prepared for burial or cremation by members of the community. Every culture has their own rituals for celebrating the life of the deceased and comforting the bereaved.

In our society, longevity is assumed, with death deferred by affluent living conditions and sophisticated medical care. Management of dying is commonly outsourced to hospitals, nursing homes and palliative care. Many people have never witnessed a death nor seen a corpse. Perceptions of death are unrealistically informed by movies and media. Like death itself, thinking and talking about death are deferred until we are confronted by mortality. Grief can then hit hard, confusingly combined with existential angst, for which we are often unprepared.

In 2004, not long after the death of his wife, Swiss sociologist Bernard Crettaz facilitated the first Café Mortel – an informal gathering with the goal of allowing people to talk openly about death and dying. The idea grew and spread across Europe. Inspired, Jon Underwood held the first Death Café at his home in London in 2011. Prior to his own death in 2017, Jon promoted Death Café as a social franchise, encouraging others to share the tradition (deathcafe.com). Death Cafés are now commonly held around the world.

Death Café is not a place, but an event.

People – often strangers – meet to discuss death and dying. The objective is ‘to increase awareness of death with a view to helping people make the most of their finite lives’. Death Café is NOT a bereavement support group and does NOT provide grief therapy – these are best managed by trained counsellors and in private. By design, there is no agenda, no set topics, no guest speaker, no formal teaching, and no outcomes - the conversation belongs to the group. Hosts organise the location and logistics, and a facilitator ensures the conversation takes place in a safe, respectful, and confidential manner.

As a facilitator, my experience is that every session has a life of its own, with different issues and topics arising based on the group’s shared reflections.

DR J E N N I F E R S C H A F E R Medical Director, Doctors’ Health in Queensland

24/7 Helpline 07 3833 4352 For doctors and medical students in Queensland

dhq.org.au Doctors’ Health in Queensland (DHQ) provides an independent, confidential, colleague to colleague support service for Queensland doctors and medical students.

While traditionally promoted to the general community, Death Café is just as relevant for special interest groups, including medical students and doctors.

If you would like to host a Death Café, please feel free to email Doctors’ Health in Queensland at md@dhq.org.au.

Death is not our enemy - suffering is.

In healthcare, we do not ‘save’ lives – we may prolong them, but everyone dies eventually. Conversations about the quality and quantity of life, as well as the timing and mechanisms of death are an integral component of care planning and will become even more important with the introduction of voluntary assisted dying. How can we encourage our communities to think and talk about death, with the clear understanding of death as the natural and inevitable end of every life?

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Research round up Research Review Australia has more than 50,000 health professional subscribers across Australia. It provides clinical research updates and webinars that qualify for CPD points. The updates cover more than 50 clinical areas and feature 10 papers from global journals with commentary by a local expert on the impact to everyday practice.

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

A double-blind, randomised, placebo-controlled trial involving high-risk non-hospitalised patients with COVID-19 evaluated the efficacy and safety of a three-day course of remdesivir. Eligible patients in this trial had at least one ongoing symptom within the previous seven days consistent with COVID-19 and had at least one risk factor for disease progression.

Early remdesivir to prevent progression to severe COVID-19 COVID 19 Research Review Issue 1 Reviewer: Professor Tania Sorrell

researchreview.com.au/au/Clinical-Area/InternalMedicine/Infectious-Diseases/COVID-19/COVID19-Research-Review,-Issue-1.aspx

Time to retire the concept of transient ischemic attack

that brain injury almost always occurs during these events. It is therefore time to retire the term TIA, and embrace the previously suggested term ‘acute ischaemic cerebrovascular syndrome’.

General Practice Research Review Issue 105 Reviewer: Professor Gerard Gill

“TIA may be anything but transient and should evoke a more intense response.

It is a marker for significant risk of further cerebral vessel disease and warrants intense intervention. This JAMA viewpoint argues for a change in approach and name.”

The utility of the diagnosis of transient ischaemic attack (TIA) has waned in conjunction with improvements in brain imaging and a better understanding of the natural history of acute cerebral ischaemia.

Although the current concept of TIA refers to an ischaemic episode in which symptoms are transient and not associated with brain injury, recent evidence suggests

researchreview.com.au/ au/Clinical-Area/GeneralMedicine/General-Practice/ General-Practice-ResearchReview,-Issue-105.aspx

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

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“Gottlieb et al found that a three-day course of remdesivir administered intravenously to unvaccinated, nonhospitalised patients with defined risk factors for COVID-19 progression was clinically beneficial and safe – reducing hospitalisation and mortality by 87 per cent when administered within seven days of symptom onset.

Although providing proof of concept in relation to early treatment, the need for intravenous administration of remdesivir is a significant disadvantage.”

DOCTOR Q | WINTER

Local Medical Associations

Contacts and meeting dates

Redcliffe District Medical Association (RDMA) Contact: Dr Kimberley Bondeson, President Web: redcliffedoctorsmedicalassociation.org Phone: (07) 3049 4444

Brisbane Local Medical Association (BLMA)

Gold Coast Medical Association (GCMA)

Contact: Dr Hasthika Ellepola, President Dr Felicity Jensen, Secretary

Contact: Professor Philip Morris

Email: hasthikaellepola@yahoo.com and Felicity.Jensen@health.qld.gov.au Web: www.brisbanelma.org Phone: (07) 3265 3111 Meetings: TBC June (BLMA and I-Med Radiology Educational Dinner meeting)

Central Queensland Local Medical Association (CQLMA) Contact: Dr Michael Donohue

Web: www.gcma.org.au Email: info@gcma.org.au Phone: 0419 780 505

Ipswich and West Moreton Medical Association (IWMMA) Contacts: Dr David Morgan, President Dr David Careless, Vice President Dr Thomas McEniery, Treasurer Phone: (07) 3281 1177

Phone: 0419 715 658

Mackay Local Medical Association (MLMA)

Email: mdonohue@yfp.com.au

Contact: Dr Bill Boyd

Fraser Coast Local Medical Association (FCLMA) Contact: Dr Rudi Prasad, President Dr David Goldsmith, Secretary Email: frasercoastlma@gmail.com Meetings: 21 June (Education Night) 19 July (Executive Meeting) 16 August (Education Night) 20 September (Executive Meeting) 18 October (Education Night) 22 November (AGM)

Phone: 0419 676 660 Email: boydgyn@bigpond.com

Email: RDMANews@gmail.com Meetings: 21 June 27 July 23 August (AGM) 28 September 25 October 18 November (Networking Meeting) Newsletter deadlines: 15th of each month

Sunshine Coast Local Medical Association (SCLMA) Contact: Jo Bourke, Secretariat Web: www.sclma.com.au Email: admin@sclma.com.au Phone: (07) 5479 3979 Meetings: 30 June 28 July 25 August 29 September 27 October 24 November

Toowoomba and Darling Downs Local Medical Association (TDDLMA) Contacts: Dr Sally Sojan, President Dr Peter Schindler, Treasurer Web: www.tddlma.org Email: info@tddlma.org Phone: (07) 4633 1939 Wilsonton Medical Centre (Dr Peter Hopson) Meetings: TBC October (AGM)

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Events calendar June/July

Annual Conference Date: Tuesday 28 June – Monday 4 July Location: Northern Territory Enjoy this year’s AMA Queensland Annual Conference with an all inclusive week in the Northern Territory.

Dinner for the Profession Date: Friday 15 July, 6.30pm Location: Waters Edge, Portside

July

Celebrate the incredible work of doctors throughout Queensland. The evening will include awards of distinction and the opportunity to network with friends.

Junior Doctor Conference Cairns Date: Saturday 23 July – Sunday 24 July Location: The Cairns Institute at James Cook University and Royal Flying Doctor Service Bringing JDC to North Queensland is integral in engaging with our rural, regional and remote junior and medical student members.

Senior Active Doctors Conference August

Date: Saturday 13 August – Sunday 14 August Location: The Komo, Redcliffe Hosted by the Australian Senior Active Doctors Association and AMA Queensland, the conference will discuss everything from global trends and models of senior doctor registration to college requirements.

September

Junior Doctor Conference – Gold Coast Date: September Location: Gold Coast Be engaged and inspired at AMA Queensland’s must-attend event for junior doctors and medical students on the Gold Coast.

Women in Medicine Breakfast – Brisbane October

Date: Friday 6 October, 7am Location: Emporium, South Brisbane Take the morning off and join us for a motivating and uplifting morning of support, networking and advice.

Ongoing events Workplace Relations Webinar Series Recruitment – Monday 25 July, 10am Fundamentals of Leadership – Monday 5 September Employment Status – Monday 28 November, 10am

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Private Practice Seminar Series Toowoomba – Saturday 20 August Gold Coast – Saturday 22 October Sunshine Coast – Saturday 5 November

DATE Friday 15 July 2022 TIME

DINNE R FOR T HE

PROFESSION CELEBRATING MEDICINE IN QUEENSLAND You are invited to celebrate the incredible work of doctors throughout Queensland.

BUY TICKETS TODAY qld.ama.com.au/events registrations@amaq.com.au (07) 3872 2222

6.30pm VENUE aters Edge – Portside W 39 Hercules St, Hamilton QLD 4007 COST Member – Table of 10: $1,300 Member – Individual Ticket: $145 Member – Doctors in Training (DiT): $99 Non-member – Individual Ticket: $180 Non-member – Table of 10: $1,740

Black tie gala event Three-course dinner Awards of distinction Network with friends old and new

SAVE THE DATE

5th Annual Southern Cross

and the Inaugural Southern Cross

Friday 16 - Sunday 18 September 2022 - Hilton Hotel Brisbane We are excited to announce the 5th Annual Southern Cross Travel Medicine Conference and the Inaugural Southern Cross Tropical Medicine Conference! Hear from local and international experts on travel medicine and tropical medicine, and participate in interactive workshops.

Travel Medicine

Travel vaccinations, malaria prophylaxis, disease outbreaks, practical workshops.

One Health Workshop Zoonotic diseases, and the impact of environment on emergence and transmission.

Tropical Medicine

Research

Neglected tropical diseases, malaria, clinical case studies.

Researchers and students will be invited to submit abstracts on tropical medicine and travel medicine.

Networking sessions for students and early career researchers.

www.sctravelmedconference.com

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ASADA and AMA Queensland

Senior Active Doctors Conference 13-14 AUGUST 2022

The Australian Senior Active Doctors Association and AMA Queensland are pleased to announce that the inaugural ASADA and AMA Queensland Senior Active Doctors Conference will take place in Redcliffe Queensland in August 2022. Redcliffe is located on Moreton Bay and is a 30-minute drive north of Brisbane Airport.

V E N U E:

Registration is available on the AMA Queensland website: qld.ama.com.au/events/senior-doctors-conference A detailed program will be made available closer to the conference.

The Komo 99 Marine Parade, Redcliffe Qld

Themes for discussion include: Global Trends and Models of Senior Doctor Registration, Medical Reserves, Encore Careers and Roles for Senior Doctors, Navigating the 2023 Registration Requirements, CPD, Recency of Practice, College Requirements, Maintaining Registration while Winding Down Practice, Emerging Issues for Senior Doctors, Progressing Senior Doctor Policy, Recent ASADA and AMA Queensland Initiatives.

REGISTER N OW:

Obituary

Emeritus Professor Dr Mary Deirdre Mahoney AO

MBBS RACGP Hon MD FRACGP GradDip ClinEd FAMA MRACMA FAIM 14 June 1940 – 15 September 2021 Member for 56 years

Emeritus Professor Dr Mary Mahoney received an Order of Australia medal for ‘service to medicine in the field of general practice, to tertiary education and university administration, and to the community through activities promoting the status of women and contributions to the early childhood education sector’.

Mary Deirdre Hirschfeld was born in Brisbane to Irish nurse Brigid Cooney and surgeon Konrad Hirschfeld. After attending All Hallows School, she won a Commonwealth Scholarship to the University of Queensland (UQ) to study medicine.

Dr Mahoney’s first job was at Royal Brisbane Hospital where she spent two years. She then began as a neonatal paediatric registrar at the Royal Children’s Hospital in 1966. She took a break from medical practice to give birth to her four children between 1966 and 1970. Wishing to work parttime, she found no openings available and sought to attend

a refresher course. Finding none existed she was told by Dr Peter Schmidt, of the Post Graduate Medical Education Committee (PGMEC), that if she found women keen to attend such a course, he would develop the curriculum for it. She attended the first refresher course for women held in 1970.

Her work as a medical practitioner and teacher influenced hundreds of students and medical graduates in the art of general practice. Her work also included research appointments with the Department of Child Health at UQ and involvement in research projects for the Royal Australian College of General Practitioners (RACGP), with whom she also held the role of State Director of the Training Program for 25 years.

Dr Mahoney joined the AMA shortly after graduation and served on the AMA Queensland Council for 10 years.

She contributed to multiple AMA committees, including Women and Medicine, Perinatal and Maternal Mortality, Membership, Community Health Centres, Medical Advisory and Fees Review. She chaired the Medical Manpower Committee for seven years. Her extensive contribution was recognised in 1985 when she was inducted into the AMA Roll of Fellows.

Throughout her career, Dr Mahoney has been widely recognised for her contributions to medicine, notably in 2006 when she was made Officer of the Order of Australia, and in 1994 when as part of a team she received a Research Award for Medical Education from the Australasian and New Zealand Association for Medical Education.

Dr Mahoney gave a lifetime of service to UQ. She served on the UQ Senate for 24 years and was twice elected as Deputy Chancellor, becoming the first woman to hold this office. In recognition of this service, UQ conferred on her an Honorary Doctorate of Medicine in 2005 followed by an Emeritus Professorship in 2014.

Dr Mahoney was state director of the RACGP training program for 25 years. She won the Rose-Hunt Award in 2001 and in 2005 she was the first woman to be made a Life Fellow of the RACGP. She was awarded an honorary doctorate of medicine by UQ in 2005.

Dr Mahoney is survived by her husband, Dr Patrick Mahoney, and their four children, Deirdre, Stephen, Rosie and Elizabeth and their grandchildren.

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What’s driving the South East Queensland property market?

According to data from CoreLogic, the average house price in Brisbane in January 2020 was $547,860. A year later, it was $583,902 in 2021. This year, it has shot up to $782,967 (as of January 2022). That’s a 40 per cent increase in just two years and has left a lot of buyers uncertain about what to do now.

Are interest rates driving South East Queensland property prices up?

Last year, interest rates were at all-time lows as the government provided banks with low-cost funding to help drive the economy. Since this funding ended we have already seen fixed rates increase by at least a full percentage point in some cases.

The RBA began increasing the cash rate in early May for the first time in 11 years, with more rate hikes ahead.

While interest rates will always be a factor and drive buyers to property, the reality is there’s a shortage of good properties for sale.

There has been some respite for buyers in recent months with realestate.com.au showing an increase in new listings, however, these are still down more than a quarter from pre-pandemic levels and that’s what’s really behind the steepest rise we’ve seen in a long time.

Separate to this, the cost of building a property has gone through the roof, as well as the timeframes to complete a new build, because the price of building materials has increased significantly. If you were planning to build a house from scratch, it becomes apparent that it’s quite expensive now, meaning that most people will be less inclined to build and more likely to favour buying something established.

As a result, it’s adding more fuel to the fire.

Now consider the impact of interstate migration, which is expected to continue, if not increase, now that borders have reopened.

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SI M O N M OO R E Finance Specialist credabl.com.au/amaq Live chat at credabl.com.au 1300 27 33 22 simon.moore@credabl.com.au

The ‘new normal’ house price Referring back to the current average house price of $782,967, people just aren’t used to seeing these prices in Brisbane. Often when I’m speaking to clients, they are turned off from buying a house because they think it’s too expensive. But this is where the market is now, which can be a big mindset shift. And sometimes, the longer you wait, the more you are pricing yourself out and missing opportunities.

Plus, there’s more competition – the latest trend of interstate buyers getting in on the South East Queensland (SEQ) market because property in Sydney and Melbourne is still too expensive, despite slowing down.

Market experts think this is just the start of the Brisbane market heating up. Other stand-out performers have been the Gold Coast and Sunshine Coast regions, which are now very attractive to anyone who wants to live next to the beach and work from home for a fraction of the price you would pay in Sydney.

What remains to be seen is if rising interest rates will be enough of a factor to slow down the market and put the brakes on rising house prices. From the level of buyer enquiry we have seen early in 2022, it looks like this is not going to be enough to deter home buyers or investors from the SEQ market. We may not see as steep an increase this year, but from all accounts, basic supply and demand is going to continue as the dominating force.

This article is a guide only and does not constitute any recommendation on behalf of Credabl Pty Ltd (ACN 615 968 100) or any of its related bodies corporate (Credabl). The information in this article is general in nature and we have not considered your personal objectives or financial circumstances or needs when preparing it. Before acting on this information you should consider if it is suitable for your personal circumstances. Credabl is not offering financial, tax or legal advice. You should obtain independent financial, tax and legal advice as appropriate.

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Owning your own medical practice premises

N I C O L E BROW N Partner, Cutcher & Neale Specialist Medical Services

Purchasing a medical practice premises is a significant investment into your financial future. Getting it right from the beginning can be crucial in not only limiting your risk but also reducing your future tax implications.

Which entity you purchase your medical practice premises in is pivotal and can be sometimes overlooked by medical professionals when considering how to purchase.

Just as important of course, once this is determined, is how to finance this investment and what key considerations need to be made when financing?

While there is no one-size-fits-all solution when it comes to purchasing your practice premises, there are many factors to consider when it comes to structuring and finance.

Structuring An individual (Medical Practitioner) Buying in an individual name can sound the most appealing, least expensive and least complex to set up, likely access to Capital Gains Tax (CGT) discounts and land tax threshold benefits. However, this may not necessarily be the case.

Buying in the medical practitioner’s name offers no asset protection. Despite holding insurances being a potential safeguard, medical practitioners should err on the side of caution when looking at holding assets in their own name.

Company A company can be a good vehicle for premises acquisition as access to the corporate tax rate of 30 per cent can aid debt reduction (less tax leakage). Furthermore, holding assets via a company can provide a layer of asset protection (when owned by a discretionary trust) not afforded if holding the premises in your personal name.

Companies have access to the land tax threshold and a 30 per cent tax rate. Unfortunately, companies do not 52

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have access to the 50 per cent CGT discount, however, may be eligible to access small medical practice CGT tax concessions (subject to eligibility criteria).

Discretionary trust Another option is a discretionary trust structure. Trusts generally offer an effective form of asset protection as beneficiaries generally do not have a defined interest in the assets, the trustee does.

Discretionary trusts also provide flexibility in the distribution of income.

Ordinarily a discretionary trust does not include land tax threshold as it is a ‘special trust’. This means additional land tax can be levied on a property held by a trust. An alternative option may be a unit trust. Unlike discretionary trusts, unit trusts are typically eligible for the land tax threshold.

A unit trust primarily differs to a discretionary trust as the beneficiaries and their interests are explicitly identified in the trust deed according to the proportion of ‘units’ they hold as a percentage of total issues units. This also creates a defined interest in trust and does not assist with asset protection.

A trust’s capital gain can be distributed to its beneficiaries who can access the 50 per cent capital gains tax discount.

Again, like companies if a trust can further satisfy the additional basic conditions, they may be eligible for small medical practice CGT concessions.

Self-managed super fund A self-managed super fund (SMSF) can be a tax-effective vehicle for acquiring your medical practice premises.

Under the right circumstances and executed correctly, this can be an efficient investment vehicle.

With a low tax rate of 15 per cent (when in accumulation phase), or tax free (when in pension phase) an SMSF certainly provides a concessional tax environment.

An SMSF can also access a one third or 33 per cent discount on any capital gain made on the sale of an asset held for at least 12 months.

However, as the rules and restrictions for purchasing property under the superannuation legislation are complex, caution must be exercised and advice obtained before buying your premises in an SMSF. It is important to select the appropriate structure for your specific circumstances as well as understanding the income tax consequences and ability to provide asset protection prior to making any significant investment decisions.

What about finance?

Making sure you can access the most appropriate finance for your new practice can be one of the biggest hurdles you will need to face.

The use of limited private fee income If you are considering commencement in private practice or private billings have only recently become your primary source of remuneration, a small number of banks can accept projected income or limited private fee income to provide adequate borrowing capacity.

A projection based on future billings and your experience in your field of specialisation can be acceptable to some lenders and if already in private practice, as little as one quarter of private patient income (net of service fees and expenses) can be annualised to maximise your ability to borrow.

Finance broker An experienced broker is a powerful resource when looking at purchasing your practice premises.

Brokers with medical specific funding expertise and established relationships with banks are an important piece of the puzzle. A good broker will understand the career and income progression of medical practitioners which can provide superior outcomes to using a broker or banker with limited medical funding experience Depending on the type of funding required, your broker should know the best banking teams to work with for your situation.

The best bank for a home loan is not necessarily the best bank for practice related funding.

Always ask an expert Your accountant should be your first point of contact and will have the best understanding of your financial position and what may be achievable.

Advice on appropriate entities to be established, debt structuring and analysis of future cashflow and taxation will be a small part of the guidance you will receive.

The transition to private practice and the potential finance requirements can initially appear a daunting process.

Seek out your accountant’s input and advice at the earliest possible time.

WINTER | DOCTOR Q

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The value in having a treating GP

All doctors should have their own treating GP – but according to the Doctors’ Health Advisory Service, more than 50 per cent of doctors don’t 1.

But where’s the harm? Surely a script or two can’t hurt?

We take a look at two different scenarios.

The GP registrar You are enjoying a long-awaited family BBQ after the end of lockdown, and everyone is enjoying the beautiful spring weather. You are feeling relaxed and not thinking about work when your younger sister comes over.

“Can I ask a really big favour?”

Your heart sinks because you know she is going to ask you for a script. She says she has run out of panadeine and she has a terrible headache. She is due to work that night, and she doesn’t want to call in sick. You write the script and tell her this is the last time.

You forget all about it, until two months later when you receive a letter from Ahpra asking for a medical report and medical records for one of your patients. The patient, a nurse with a different surname to you (your sister), is being investigated by the Nursing and Midwifery Board for concerns about misuse of codeine. You realise you have no notes, and you now have to confess and disclose your relationship to Ahpra.

The impaired GP You are a year away from retiring after 45 years in practice.

Your staff have worked with you for a number of years, and they often tease you about your terrible memory.

You continue to work full-time, despite chronic pain from osteoarthritis, declining cognition and issues with sleep.

N E R IS SA F E R R I E Medico-legal Adviser

You don’t have your own GP, and you don’t think you need one! As a solo practitioner, you don’t have time to see a doctor; if you need a script or referral, you just write it yourself.

Most of your patients are older, long-term patients, and they seem happy to laugh off your ‘funny ways’ - but this changes when the son of one of your patients makes a report to Ahpra.

The lengthy complaint includes a number of examples of when you were not at your best. Ahpra start talking about possible impairment, and you are shocked when they issue a Notice of Immediate Action on receipt of your prescribing history.

You are surprised by the number of scripts you wrote for yourself over the previous year including Valium, Amitriptyline and Endone. You remember writing the odd script, but it looks so much worse now that it is all listed.

Ahpra’s view According to Good medical practice: a code of conduct for doctors in Australia 2 , good medical practice includes: having a general practitioner seeking independent, objective advice when you need medical care, and being aware of the risks of self-diagnosis and self-treatment not self-prescribing keeping accurate, up to date and legible records that report relevant details of clinical history, clinical findings investigations, diagnosis, information given to patients, medication, referral and other management in a form that can be understood by other health practitioners whenever possible, avoid providing medical care to anyone with whom you have a close personal relationship.

If treating yourself or those close to you puts you on the wrong side of the Code of Conduct, it may be time to re-think your approach.

1 www.dhas.org.au/wellbeing/having-our-own-gp.html 2 www.ahpra.gov.au/documents/default.aspx?record=WD20%2f30051&dbid=AP&chksum=9BSTs75R4%2fcPJY7vrmzHPg%3d%3d This article is provided by MDA National. The information and associated resources provided in this article contain generic information only and don’t account for requirements of any particular individual. Nor do they account for particular facts relevant to any legal, financial, medico-legal or workplace issue. We recommend that you contact your indemnity provider if you need specific advice in relation to your insurance policy or medico-legal matters. Members can contact MDA National for specific advice on freecall 1800 011 255 or use the “contact us” form at mdanational.com.au. We may also refer you to other professional services.

The MDA National Group is made up of MDA National Limited ABN 67 055 801 771 and its wholly owned subsidiary, MDA National Insurance Pty Ltd (MDA National Insurance) ABN 56 058 271 417 AFS Licence No. 238073. Insurance products are underwritten by MDA National Insurance. Before making a decision to buy or hold any products issued by MDA National Insurance, please consider your personal circumstances and the relevant Product Disclosure Statement, Policy Wording and any supplementary documentation available at mdanational.com.au.

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Dr Maria Boulton Company Director Family Doctors Plus, General Practitioner

Dr Fiona Raciti Company Director Family Doctors Plus, General Practitioner

Member since 2003

Member since 2013

Keep on practising with confidence With MDA National, you have the support of industry-leading doctors, lawyers and medical defence experts just a click or phone call away.

Our highly experienced team are always ready and available to provide you with personalised medico-legal advice — on call in emergencies.

Comprehensive cover

Individualised support

Our professional indemnity is designed to provide doctors with maximum protection from complaints and claims. Cover includes defending you against allegations of defamation, civil proceedings arising from telehealth and acts of Good Samaritan*.

Our Case Managers have a genuine understanding and care around the impact a complaint or claim can have on your health and wellbeing. You can have peace of mind that one expert will manage your issue till its resolved - no triaging.

Expert in-house medicolegal advice Our medico-legal experts will help you through any emergency or issue, providing unbiased advice and support - including matching you with the best legal team for your situation.

Scan the QR code to request a quote mdanational.com.au

1800 011 255

*Please refer to the Policy Wording for full details of terms and conditions, available at mdanational.com.au/insurance-products.

MDA National Insurance products are underwritten by MDA National Insurance Pty Ltd (MDANI) ABN 56 058 271 417 AFS Licence No. 238073, a wholly owned subsidiary of MDA National Limited ABN 67 055 801 771.

Please consider your personal circumstances and read the Important Information and Policy Wording at mdanational.com.au before deciding to buy or hold any product issued by MDANI. AD470

A N DR E W H A R R IS O N Medical Insurance Advisor iMed Insurance

Underinsured and overexposed

Whenever a major loss event happens in Australia – hailstorms, cyclones and bushfires are among the most common examples – it’s only a matter of time before heart-wrenching stories emerge of the devastation experienced by uninsured households and businesses.

But arguably worse are the stories of those who thought they were adequately protected but weren’t. In other words, those who were underinsured.

P: 1800 988 522 E: imedinsurance@ cutcher.com.au

Why are so many underinsured?

When an individual or business has inadequate insurance to cover their legal liabilities or the full cost of loss or damage to their assets.

There will always be some businesses that actively choose not to have insurance. However, the data shows there’s also a significant portion of underinsured businesses who have made no such choice and don’t even realise it. Typically, we find these tend to be businesses that choose to ‘go it alone’ and aren’t partnering with an insurance adviser.

Perhaps they’re not fully aware of the risks they actually face? Maybe they’ve underestimated their sums insured should a loss event occur, such as repair or replacement costs for buildings, vehicles, stock, and other assets that have appreciated considerably in value? Have they accurately factored in the bottom-line impact if their business operations were interrupted for weeks, or possibly even months, on end?

The numbers are alarming!

Always know your cover

Australia has long been considered one of the most underinsured nations in the developed world. A study conducted by one of the country’s largest insurers, QBE, in 2019 suggested as many as 62 per cent of all Australian small to medium enterprises (SMEs) were likely to have inadequate insurance.

They say ‘ignorance is bliss’, but when it comes to being underinsured, it’s to be avoided at all costs. Knowledge is everything.

What is underinsurance?

The same study also found 87 per cent of small business owners felt a major business liability claim had the potential to put them out of business, or at the very least cause them to lose significant revenue or dry up their cash flow.

A separate report from the Insurance Council of Australia found that 26 per cent of SMEs are operating with no form of general insurance – including a whopping 40 per cent of sole traders.

Our very strong advice is: take the time to review your risks at regular intervals understand the details of your cover, and take whatever steps are necessary to ensure you are – and remain – one of the 38 per cent of Australian businesses that are adequately protected.

After all, you can never be overprepared when it comes to underinsurance.

The material contained in this article is in the nature of general comment only, and neither purports, nor is intended to be advice on any particular matter.

Persons should not act or rely upon any information contained in or implied by this article without seeking appropriate professional advice which relates specifically to his/her particular circumstances. iMed Insurance expressly disclaim all and any liability to any person, whether a client of iMed Insurance or not, who acts or fails to act as a consequence of reliance upon the whole or any part of this article. iMed Insurance is a Corporate Authorised Representative of Insurance Advisernet Australia Pty Ltd. AFSL No. 240549 - Corporate Authorised Representative No. 1260321

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Helping medical professionals with 20 years of industry experience.

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Take the hassle out of insurance. imedinsurance.com.au

Newcastle Sydney Brisbane

Getting your practice ready for expansion

Z AC H E R PS Managing Director (07) 3228 6117 zac@hillhouse.com.au

When it comes to setting up, expanding or selling your practice, the decisions you make from day one are crucial. Setting up your practice using the cheapest and easiest structures and systems can be tempting but could be costly in the long run as you may sacrifice tax effectiveness, growth and scalability or simply not have an attractive business to sell.

Whether you are actively looking to expand your practice, are thinking about growing someday, or are in the early stages of establishment, investing early in your business structure, operation practices and documentation is a good idea. Obtaining early expert advice will help to ensure your business is efficient, properly structured and you will be ready to reap the benefits when you decide to expand or sell your practice.

A good medical practice should be clear in its structure and ownership, easy to operate and most importantly, profitable and tax effective. You need to carefully consider and obtain advice as to what is the appropriate legal and business structures for your present and future practice.

Changing your structure or hurriedly setting up structures at a later stage can be very costly so it is wise to seek advice before you open the doors.

No matter what stage you are at, you should ensure all systems, key agreements and accounts and records are documented in a form that can be readily understood by people inside and outside of your business. You should always prepare your practice as though you are selling it to a third party with no prior knowledge of its operation.

For more established practices who have not turned their minds to such matters, this may require a lot of work to update documentation and agreements. We have seen many practices that have not reviewed their service agreements, employment or contractor agreement and other key arrangements for many years – if those documents exist at all. Preparing a business for expansion or sale is an excellent opportunity to review, modernise and implement all necessary agreements.

Concurrently it is vital that you protect your patient and referral database and your practice name and brand.

Your patient and referral database is arguably your greatest 58

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asset as a medical practitioner, so it is important to discuss with an advisor appropriate protection for your databases and referrers so such things cannot be misused by current employees or contractors.

When it comes to your brand, we recommend practices register either their logo or brand name (usually both) to prevent their competitors from claiming an association with their business or registering the same name. Domain names and URLs should also be protected and registered.

For most practices, you should consider adopting agreements and policies for: employee, associate and contractor engagement services required supplier arrangements protection of your brand, intellectual property and client data protection of your domain names, website and internet addresses arrangements between multiple owners and/or shareholders.

Even if you are expanding your practice with people you know and trust, it is important that you properly document the transaction and the arrangements and then stick to the plan. Being disciplined throughout this process will give all parties involved clarity and certainty, and keep the protections their advisers have crafted during the negotiation process in place.

If you would like to have a discussion about any of your future or current plans or any of these issues, or indeed any legal issue please do not hesitate to reach out. We are here to help.

The changing face of travel In the last two years the world has hit the reset button on many facets of our lives previously taken for granted.

Certainly, I am sure we can all agree that travel tops the list. How we travel, where we travel, who we travel with…. just to name a few.

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As a valued member of the travel industry’s leading luxury network, Virtuoso, Orbit World Travel can share some valuable insight from our combined knowledge into the way things will move forward.

Who is Virtuoso?

A specialised group of more than 20,000 travel advisors, spanning 26 countries, connected to elite travel companies, hotels, cruise lines and suppliers that join together to deliver knowledge and products to their clients that exceed expectations. Their connections to properties and itineraries around the world are unparalleled.

What do we know?

The cruise market in 2022 is already forecast to reach 85 per cent of 2019, pre-COVID bookings.

Based on current 2022 forecasts, international outbound travel is already at 73 per cent of the 2019 pre-COVID levels.

Based on current projections, a full recovery to pre-COVID levels will occur mid-2023.

By 2025, international outbound travel will be up 32 per cent on pre-COVID levels.

By 2027, international outbound travel will increase to a massive 69 per cent on pre-COVID levels.

Demand for luxury travel is growing three times faster than any other market.

Millennials and Generation X are a growing affluent market.

Multi-generational travel has become very common.

Never in the history of the planet has there been four generations of people all travelling at the same time, in the numbers that they’re travelling.

These facts are all contributing to reshaping the future landscape of travel.

What does that mean to the travel products?

A client once said to me, “Why would I pay to stay in something less than what I live in!”. They didn’t just mean square metreage, they meant the experience. Suppliers are needing to lift their game and deliver unique and personalised touches. This is where our Virtuoso Products lead the way with value added product exclusively for our clients.

Marriott hotels is set to double the number of properties in Asia Pacific alone in the coming years.

The list of luxury hotels being built or due to open in coming years is almost never ending.

With a focus on more environmentally sustainable travel, the future of aircraft is predicted to set a new standard in coming decades. Already In the first quarter of 2022, Boeing has received 167 new aircraft orders and Airbus 253.

What does this mean to the consumer?

The need for a knowledgeable travel advisor is paramount to assisting travellers sift through the choices and matching individuals with their ideal travel product.

Plan in advance. We are already seeing many products in 2023 and 2024 fully booked.

Take out travel insurance at the time of your initial booking. Don’t just rely on credit card insurances. Select from single trip and multi-trip policies that give full coverage for your future trips, including COVID cover!

Contract Ros and Linda at Orbit World Travel: Phone 1300 262 885 or email ros.bulat@orbitworldtravel.com.au

WINTER | DOCTOR Q

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All about you

Listen

Read

Parental as Anything

Black River – Matthew Spencer A long, burning summer in Sydney. A young woman found murdered in the deserted grounds of an elite boarding school. A serial killer preying on victims along the banks of the Parramatta River. A city on edge.

Adam Bowman, a battling journalist who grew up as the son of a teacher at Prince Albert College, might be the only person who can uncover the links between the school murder and the ‘Blue Moon Killer’. But he will have to go into the darkest places of his childhood to piece together the clues. Detective Sergeant Rose Riley, meanwhile, is part of the taskforce desperately trying to find the killer before he strikes again. Adam Bowman’s excavation of his past might turn out to be Rose’s biggest trump card or it may bring the whole investigation crashing down, and put her own life in danger.

WIN THIS BOOK: Enter by 30 July 2022

How much screen time should your kids have?

How do you talk to your tweens and teens about sex and consent? How do you keep your cool when your child throws a tantrum?

Maggie Dent, one of Australia’s favourite parenting authors and educators, gives you practical tips and answers to real-world parenting dilemmas. Maggie talks to parenting experts from around the world to find practical solutions to the challenges every parent is facing today. She’ll help you be the parent you really want to be and give you ideas on how you can raise healthy kids who thrive.

Listen for free from the ABC listen app, Apple Podcasts, Google Podcasts or your favourite podcast app.

Watch

Worst Roommate Ever Have you ever had a roommate upend your entire life? Not just the kind who leaves dirty dishes in the sink or uses all the hot water. Netflix docuseries, Worst Roommate Ever, features four true stories about roommates with malevolent and sometimes violent intentions who turn the lives of their unsuspecting victims into real-life nightmares.

WIN This book: Black River

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Name:

Member no:

Through mostly the stories of the survivors, this docuseries brings victim accounts of people who found their seemingly harmless roommates to be cold-hearted killers. A murderous old granny, an obsessed lover, a marathon-running hustler, and a serial squatter contribute to five episodes of gruelling true-crime storytelling.

Telephone:

Fill out the form and fax it to (07) 3856 4727 or email competitions@amaq.com.au Entries close 30 July 2022 Doctor Q Summer 62

Coming soon 30 JUNE

Ali & Ava 6 JULY

Thor: Love and Thunder

21 JULY

Official Competition

The Black Phone

Lucia di Lammermoor Met Opera | Release: 6 August

Turandot

Met Opera | Release: 9 July Two of today’s most thrilling voices share the title role of the legendary cold-hearted princess: Christine Goerke, the Met’s reigning dramatic soprano, and superstar Liudmyla Monastyrska, making her long-awaited Met role debut after providing a hair-raising preview in 2019’s New Year’s Eve Gala. Tenors Yusif Eyvazov and Yonghoon Lee trade off as the bold prince determined to win Turandot’s love, alongside sopranos Gabriella Reyes, Michelle Bradley, and Ermonela Jaho as the devoted servant Liù and bass-baritone James Morris and basses Alexander Tsymbalyuk and Ferruccio Furlanetto as the blind king Timur.

In recent seasons, soprano Nadine Sierra has brought down the house at the Met with virtuosic vocalism and captivating stage presence as Gilda in Rigoletto, Susanna in Le Nozze di Figaro, and Ilia in Idomeneo. Now, she takes on one of the repertory’s most formidable and storied roles, the haunted heroine of Lucia di Lammermoor, in an electrifying new staging by in-demand Australian theater and film director Simon Stone, conducted by Riccardo Frizza.

Show-stopping tenor Javier Camarena adds to the bel canto fireworks as Lucia’s beloved, Edgardo, with baritone Artur Rucinski as her overbearing brother, Enrico, and bass Matthew Rose as her tutor, Raimondo.

Venice: Infinitely Avant-Garde Documentary | Release: 20 August

This tour of the city takes in masterpieces by Tiepolo, Canaletto, Rosalba Carriera and the intellectuals who fell in love with Venice: from Canova to Goethe, Byron to Walter Scott, down to the great Hollywood stars drawn to its unique, yearly Film Festival. Venice, 1,600 years after its legendary foundation, continues to be unique: for its urban environment, made of stone, earth and water, and for its history, that has entered the realm of legend. But above all, Venice is unique for its identity, which combines contrasting DNA blueprints: the charm of decadence and the excitement of being on the cutting edge.

WIN Dendy Tickets

Name:

Member no:

Telephone:

Fill out the form and fax it to (07) 3856 4727 or email competitions@amaq.com.au Entries close 30 July 2022 Doctor Q Summer 63

WINTER | DOCTOR Q

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DR M AT T YO U N G General Practitioner, Inala Medical Centre

The perks of saying g’day I have met some amazing people in my life. I have been lucky. Starting with my Grandad. Grandad was a bloke who’d walk down the street and have a yarn to anyone.

He knew everybody and everybody knew Tom. Fighting two World Wars gave him an appreciation of people and just how every soul was valuable. He always said g’day. I learnt that from him. Saying g’day has been the starting point of many outstanding friendships.

I said g’day to an American once, 20 years ago. Mike was about a decade older and wiser than me. We were both rafting the Colorado River as it snaked its way through the Grand Canyon. It was an inspiring spot and he was an inspiring person. He wasn’t big on small talk and conversation moved quickly to the keys to happiness.

He espoused three things. Humility, gratitude and passion.

I wrote them down and I have integrated them into my life ever since.

I recently thought about how medicine has impacted my life. It was a tough slog all those years of study and training. Long hours, lost social opportunities. I missed a lot of cricket too, being stuck at work on Saturdays. Despite the trade-offs, it has been worth it. It certainly pays the bills and helps me provide for my family. It has given me a sense of purpose and fulfillment in life. Helping people in their hours of need certainly makes me feel good about myself. But the number one thing that medicine has provided for me is some phenomenal friends.

I said g’day to a young medical student that I was tutoring, 15 years ago. Frankie was a very driven young bloke. Sharp, altruistic, highly committed to medicine, but he loved a laugh and didn’t take himself too seriously. He loved life.

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He flew planes, went parachuting and even had a backhoe licence and offered to landscape my backyard. We hit it off immediately, particularly when it transpired he loved cricket. We ended up opening the batting together all round the world for more than a decade. Besides Brisbane, we played in the swelter of Mexico, jungles of Belize, soccer stadia in Morocco, the foothills of the Andes in Chile and on the beaches of Vanuatu. We even drank pisco sours on Easter Island as we discussed the keys to happiness.

Opening the batting together and facing the new ball’s heat bonded us like brothers. As much as I enjoyed batting with Frankie, I have also enjoyed watching his medical career unfold. He topped just about every exam he ever sat at medical school and found his way into general surgery. As if licences for parachuting, flying and backyard excavating weren’t enough, he also embarked on qualifying with a PhD in surgery. The examiner was succinct in his feedback with the word ‘flawless’. He even won the AMA Queensland Registrar of the Year Award a few years back. His old opening batting partner nominated him. Maintaining the balance in his life, he married and has three terrific kids. Our kids have played soccer together but sadly not cricket yet. I have seen him evolve and mature from a keen young student to being a fully qualified general surgeon.

My Mum was pretty crook over Christmas. She had some surgical complications. Her surgeon was terrific but was on holidays on Christmas Day. I needed a surgical opinion urgently and so called my mate, Frankie. I was very worried.

When the role of panicky son usurps the role of doctor, thinking objectively dissolves. I was scared but the wise words of my cricketing mate quickly dissipated all of my concerns. Certainly, Mum was not quite on the trajectory towards recovery that she might like to be but that is nothing too unusual, he said. And just as we had said to each other so many times as we walked out to bat together, he said “she’ll be right mate”. And with that all my anxiety was released.

I’m grateful that Grandad taught me to say g’day to people like Mike and Frankie and that my American mate taught me his three keys to happiness. And of course, I’m grateful for the incredible doctors I have met and befriended like the great Frankie.

The real cost of a vineyard

PH I L M A NS E R Wine Direct 1800 649 463 phil.manser@winedirect.com.au

As the curtain closes on 2022 vintage, I breathe a familiar sigh of relief that the job is done, ferments are pressed out, equipment serviced and put away and for a couple of months I can just enjoy the view.

And what a view it is – inspirational and aspirational, a work place like no other but if you’re looking to follow suit there’s a lot more to consider than the view.

People In this country they’re expensive so when you bring contractors onto your vineyard, make sure they’re good.

Don’t always stampede to youth, they may be quicker but if you’re running a premium vineyard, slow and steady wins the race. For example, our pruning crew is often referred to as ‘dad’s army’ but what they lack in speed is made up for in expertise. When we first acquired our vineyard at Manser Wines we had a lot of variation amongst our vines but this wily crew has brought consistency to our blocks and evenness to our spur positions which reflects in better airflow (less disease risk), more even canopy and better spaced bunches which ultimately reflects in the quality of fruit we give to The Silver Fox, aka Phil Christiansen, our craftsman/winemaker.

Sales Most people ignore this because sales people are annoying right? Is it really that important? Absolutely. If you don’t have a path to market, whether it’s just the fruit you’re selling or the finished product, you’re doomed to fail.

This is where the conversation about vineyard ownership should start. Not very glamorous I know but in this ever growing ocean of wine we’re in, a sound sales strategy should be in place first then build the rest around it.

Reality check When you’re romancing the idea of vineyard ownership, reach into your pocket, pull out some $50 notes and set fire to them (or buy a boat), both will warm you up for the ugly part. If that still hasn’t put you off then start looking now.

There are thousands of acres of vineyard for sale across Australia boasting views almost as good as ours.

Whether you’re buying a vineyard or just visiting one drop me a line, there’s some real gems out there, phil.manser@winedirect.com.au WINTER | DOCTOR Q

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Restaurant review

Manly Boathouse Showcasing stunning seafood with unrivalled views of Moreton Bay, the Manly Boathouse is the kind of venue that truly caters for everyone. Situated at the most eastern tip of Manly on one of the largest marinas in the Southern Hemisphere, a splendid afternoon in the salty sea breeze of the Manly Boathouse is only a 30-minute drive from Brisbane City.

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This picturesque seaside dining precinct features everything from casual eats at the patio café, to the finer dining of the restaurant, and plenty of snacks at the bar in between.

For the early birds out for a morning stroll along the marina, The Patio is the place to be, with its café and patisserie serving pastries made on-site using locally sourced ingredients. For a casual lunch, the Fish and Chippery is exactly as advertised with fresh or fried seafood, salads and all the sauces to be enjoy by the water.

The restaurant is awash with neutral hues of beige and white, giving it a classy yet very relaxed atmosphere.

With a spectacular view over the marina, it is the perfect place to spend a Sunday lunch with a glass of Pinot Gris in hand. Small plates include wagyu beef tataki with ponzu and yuzu mayo; BBQ confit octopus with chorizo jam; pan-fried gnocchi with local mushrooms and truffle crema; and large ocean king prawns with café de Paris butter and lemon. For mains, barramundi fillet is served with shallot burnt butter and spinach, while the ‘fish of the day’ comes with green nam jam and chutney. Sand crab linguine with abalone broth, Riverina lamb loin with garlic foam and

DR K AT G R I DL E Y Emergency Medicine Staff Specialist, Mater Brisbane and Mackay Base Hospital

saltbush and a 1.4kg black onyx tomahawk with roasted garlic and mustard round out the grill menu. For larger groups, there is also the $75pp set menu served familystyle down the centre of the table with oysters, truffle croquettes, miso scallops, popcorn chicken, market fish, slow cooked lamb shoulder, broccoli salad and fries.

If you don’t feel like fish and chips but aren’t in the mood for a large meal either, then pull up a seat in the bar area and feast on their enviable menu of ‘bar snacks’, accompanied by one of their staff-signature cocktails (the Cherry Bomb comes highly recommended!). There is also an impressively large wine list, 14 beers on tap, and even a rather wonderful strawberry lychee mocktail if you’re after something alcohol-free that’s more adventurous than a soda with lime.

There is nary a peanut or crisp in sight on the ‘bar snack’ menu. These are less like a traditional bar snack and more like a wonderful selection of the restaurant entrees!

Buckets of prawns, oysters and flash fried squid with chilli caramel and ginger mayo feature alongside three cheese toasties with truffle mayo, whipped hummus with chilli oil

and popcorn chicken with kale furikake. The real heroes of this menu though are the unbelievably good BBQ Tassie scallops lovingly smothered in miso, and the impeccable Moreton Bay bug sliders served with a soft brioche bun, sweet bug meat and a tangy but not too spicy cocktail sauce. The sashimi of yellowtail kingfish is also a must try – the heat of the red curry sauce is offset entirely by lashings of coconut, with a hint of pomelo to cut through the creaminess. Divine!

While there will always be something alluring about the rooftop bars of the CBD or the dimly lit fine diners of Fortitude Valley, there is something to be said about spending your rostered day off going on a little adventure to the other side of town, to be rewarded with the fresh sea air and spoils of Moreton Bay. If you’re lucky you may even spot a dugong!

Located on Trafalgar Street in Manly, The Patio is open from 7am, while the bar, restaurant and Fish and Chippery are open from 11.30am – see manlyboathouse.com.au for details.

WINTER | DOCTOR Q

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DR DI LI P DH U PE LI A AMA Queensland Foundation Chair

amaqfoundation.com.au

AMA Queensland Foundation With the South East Queensland floods devastating entire communities, businesses and homes, the AMA Queensland Foundation wanted to support people during this heartbreaking time.

Thanks to our donors, the AMA Queensland Foundation was able to offer flood assistance grants to help patients, doctors and medical practices get back on their feet after experiencing hardship due to the floods.

Members of the public, doctors and medical practices were able to apply for grants ranging from $1,000 to $5,000 to help restore medical services in their communities.

In total, the Foundation provided: 25 x $1,000 grants to the public, 2 x $5,000 grants to medical practices, and 1 x $1,000 grant to a doctor in training.

While we acknowledge the grants were just a drop in the ocean compared to the magnitude of devastation experienced by so many Queenslanders, we are proud of our efforts to support those in need.

We hope the grants gave some relief to those who were doing it tough as well as some comfort to know they were not alone.

It has been incredibly challenging for our healthcare heroes during the pandemic to then see whole medical practices wiped out in the floods was heartbreaking for the patients, doctors and communities who rely on them.

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AMA Queensland Foundation Flood Assistance Grant recipient and practice owner Dr Bee Kho had his entire Rocklea practice flooded with water up to a metre high, destroying everything.

Almost two months after the floods, he still had not reopened his practice due to the extensive damage and ongoing repairs.

“The extent of the damage was quite bad,” said Dr Kho. “We have to replace all the flooring, all the furniture, computers, fridges, beds and dispose of things safely, as well.

“The cleaning process was quite tedious.

It took up to a week and a half to get things cleaned out and dispose of things properly.

“But the bad thing is with Rocklea being in that area, we’re not covered by flood insurance, so the AMA Queensland Foundation Flood Assistance Grant helped us out tremendously.”

While Dr Kho said the flood was devastating to his practice, it made him realise the importance of teamwork and asking for help.

“Don’t be afraid to call up for help in times of need, you’d be surprised that a lot of people would be contributing, and trying to contribute to help you out,” he said.

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