Doctor Q May 2013 by AMA Queensland

MAY 2013 . VOL 84

AMA Queensland Membership Magazine

SPRINGBORG ON PRIVATISATION EXCLUSIVE INTERVIEW

INTERN CRISIS GETS ATTENTION WENDY HARMER TO SPEAK AT WOMEN IN MEDICINE

COMPASSION TRUST KNOWLEDGE AMA QUEENSLAND’S HEALTH VISION

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DoctorQ MAY 2013

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CONTENTS

THIS ISSUE COMPASSION TRUST KNOWLEDGE:

AMA QUEENSLAND’S NEW VISION TO GUIDE OUR ADVOCACY WORK, AMA QUEENSLAND IS DEVELOPING A POLICY PRIORITIES FRAMEWORK.

Current issues

18 PRIVATISATION AND INDIVIDUAL CONTRACTS 20 HEALTH PROFESSIONALS’ HEALTH CONFERENCE 24 CAN LEADERSHIP REALLY BE TAUGHT? 28 EVOLVE OR PERISH 29 INTERN CRISIS GETS ATTENTION

business tools 48 SWITCHING MEDICAL INDEMNITY INSURERS

Wendy Harmer to speak at Women in Medicine breakfast

50 NEGATIVE GEARING AND YOUR INVESTMENTS

31 July

52 THINKING OF SELLING YOUR BUSINESS? 54 MEMBERS ARE LOVING THE INVESTEC CREDIT CARD

people & events 10 FOUNDATION RELAUNCHED

FEATURE STORies 22 PRIVATISATION: WHAT QUEENSLAND’S HEALTH MINISTER HAD TO SAY 30 GETTING STEPHEN HAWKING TO SPEAK

12 HYPOTHETICAL WITH GEOFFREY ROBERTSON QC 36 EVENTS CALENDAR 45 OBITUARY: DR JOHN TONGE CBE

46 DR WHO: DR MICHAEL HARRISON

REGULARS

Life

FROM THE EDITOR’S DESK

PRESIDENT’S REPORT

57 WINE

CEO’S REPORT

58 INVESTING

56 TRAVEL

14 MEMBER NEWS

32 LOCAL MEDICAL ASSOCIATION ROUND UP

59 ALL ABOUT YOU

60 MOVIES 61 ON STAGE 62 IN PRINT

DoctorQ MAY 2013

editor’s desk

OUR UNDERLYING VALUES MICHELLE FORD RUSS Doctor Q Editor Most of this edition was pieced together while sitting on a laptop in the kid’s ward at the Mater Hospital. While our little daughter’s operation was nothing too serious, our doctor clearly illustrated the vision we all aim for: treating our family with dignity and respect, explaining and allowing us to be part of the decision making process and staff were incredibly compassionate in recognising our natural concern as parents. In this edition, we outline AMA Queensland’s clear vision (p16): our guiding values, principles and desired outcomes. In amongst comprehending politician’s plans (p22), disagreeing on teaching priorities (p24) and negotiating intern placement (p28 and p29) we must practise compassion, trust and knowledge and go forward with the best outcome for patients, carers and the broader community. We’d love to hear your opinion on the framework and we’ll be carrying out consultation around

Queensland in the coming months. Contact us on (07) 3872 2222 or policy@ amaq.com.au. We sat down to get Health Minister Lawrence Springborg’s clarification on privatisation (p22) and find out more about what’s happening with the Sunshine Coast University Hospital. Another area of concern at the moment is the idea of individual contracts (p18) so we try to get to the bottom of what this will mean for you. On a brighter note, we found out more about the NeuroSwitch, an invention from local-lad-done-good Peter Ford, a well regarded journalist here and in the States, who ‘dabbles’ in some electronics and came up with a device to help people who are unable to speak (p30). All too quickly, election time has come around again and we look forward to welcoming Dr Christian Rowan as our new President in the next edition and introducing our new Board, Council and President-Elect. Enjoy. Q

OBITUARIES AMA Queensland sadly wishes to advise that the following members recently passed away: Dr John TONGE CBE Pathologist Durack Member for 73 years

Dr Colin PLINT Diagnostic Radiologist Runaway Bay Member for 54 years

Dr Graeme JENSEN Psychiatrist Ashmore Member for 47 years

Dr Adrian GROESSLER Internal Medicine Specialist Marian Member for 8 years

Dr Owen POWELL OAM Internal Medicine Specialist Yeronga Member for 64 years 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.

MAY 2013 DoctorQ

BOARD OF DIRECTORS Dr Alex Markwell President

Dr Sharmila Biswas Honorary Secretary

Dr Christian Rowan President-Elect

Dr David Alcorn Elected Member

Dr Sharon Kelly Chairperson

Dr John W. Cox Elected Member

Dr Chris Zappala Treasurer

Dr Richard Kidd Elected Member

COUNCIL Dr David Alcorn Greater Brisbane Area

Dr Bav Manohoran Greater Brisbane Area

Dr Tom Arthur Gold Coast Area

Dr Deborah Mills Part-Time Medical Practitioner Craft Group

Dr Sharmila Biswas Far North Area Dr Kimberley Bondeson Greater Brisbane Area

Dr Stephen Morrison Specialist Craft Group

Dr John W. Cox Downs and West Area

Dr John F. Murray Full -Time Salaried Medical Practitioner Craft Group

Dr Ben Duke Greater Brisbane Area

Dr Carl O’Kane North Area

Dr Larry Gahan General Practitioner Craft Group

Dr Shaun Rudd General Practitioner Craft Group

Dr Noel Hayman Greater Brisbane Area

Dr Anil Sharma Capricorn Area

Dr Sharon Kelly Specialist Craft Group

Dr Jonathon Shirley Greater Brisbane Area

Dr Richard Kidd Immediate Past President

Dr Mason Stevenson General Practitioner Craft Group

Mr Nicholas Gattas Medical Student Group

Dr Vanessa Grayson Residents and Registrars Craft Group

Dr Wayne Herdy North Coast Area

Dr Chris Zappala Specialist Craft Group

AMA QUEENSLAND SECRETARIAT Jane Schmitt Chief Executive Officer Filomena Ferlan General Manager Corporate Services Colleen Harper Manager - AMA Queensland Foundation

Holly Bretherton General Manager Member Relations and Communications Andrew Turner Manager - Member Services

Editor: Michelle Ford Russ Graphic Designer: Erin Sticklen Journalist: Barbara Ferres Advertising: Louise Glynn Doctor Q is published by AMA Queensland Contact Phone: (07) 3872 2222 Postal Address: PO Box 123, Red Hill QLD 4059 Print Post Approved PP490927/00049 Email: amaq@amaq.com.au

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PRESIDENT’S REPORT

A FEW THINGS BEFORE I GO... RIGHT THEN, BEFORE WE DISCUSS PRESIDENT DR ALEX MARKWELL’S LAST DOCTOR Q EDITION, WE’VE GOT TO GET THROUGH BLUEPRINTS, PUBLIC HEALTH SERVICE CLOSURES, BILLING PRACTICES, RMO RECRUITMENT AND COMPLAINTS HANDLING BEFORE WE GET TO ANY GOODBYES!

DR ALEX MARKWELL President, AMA Queensland 2013 continues to fly by at a cracking pace. Over the last few months, AMA Queensland has engaged with government on big issues including the Blueprint for Better Healthcare in Queensland, the audit and review of health complaints management in Queensland and continued closure of public health services such as the Biala Sexual Health Clinic. AMA Queensland and our partner union ASMOFQ have recently advised Minister Springborg of member concerns regarding the Blueprint. The move to privatise services such as medical imaging and pathology, as well as proposed individual contracts for senior medical officers, have sparked intense debate amongst our salaried doctors.

appointment process for 2013. It appears that issues identified after last year’s disastrous campaign have been largely addressed, including sequential cascading appointment of registrar, PHO and RMO positions and improved information on how to preference facilities and positions. The impact of the austere funding environment continues to be revealed, with the announcement of the closure of the Biala Sexual Health Clinic. There is trepidation that this short-sighted decision will lead to disruption of specialist services that support the many vulnerable patients who rely on Biala for multi-disciplinary care. We understand the HIV clinic will remain open in a scaled-back form. Unfortunately, there is an unrealistic expectation that GPs will be able to absorb this additional patient load. Given the very strict requirements

The move to privatise services such as medical imaging and pathology, as well as proposed individual contracts for senior medical officers, have sparked intense debate amongst our salaried doctors.

Concurrently, there are reviews into the senior medical officer Right of Private Practice as well as the Auditor-General’s review of private billing practices in Queensland Health. We expect to receive more information about contracts and the Right of Private Practice over the next few weeks, and the Auditor-General’s report is expected in June. We will continue to update members as information becomes available.

that GPs who prescribe HIV treatment must meet, it is unreasonable to expect the handful of credentialed doctors in Queensland to accommodate the hundreds of patients visiting Biala. AMA Queensland has written to Dr Paul Alexander, Chair of Metro North Hospital and Health Service outlining these issues, as well discussing them with the Minister and in the media to raise public awareness.

Students and Doctors in Training will be heartened to hear AMA Queensland has met with the Office of the Principle Medical Officer (OPMO) to discuss improvement of the RMO recruitment campaign and

Finally, the biggest issue facing our profession in many years has surfaced over recent months. Reviews and audits of the health complaints system in Queensland revealed it is inconsistent and inefficient. On

MAY 2013 DoctorQ

16 April the Minister announced the creation of a Health Ombudsman to provide a single entry-point for complaints with streamlined assessment. This should expedite the assessment of cases requiring immediate action and also reduce process duplication. This model was strongly favoured by the AMA Queensland Council and we publically supported the announcement. We will continue to work closely with government, the Medical Board of Australia, the Health Quality and Complaints Commission and other stakeholders to ensure a fair, transparent and consistent system is implemented for the benefit of both patients and doctors. As my term draws to a close, this is my last Doctor Q article and I would like to take the opportunity to thank the AMA Queensland staff, Board, Council and committees who have supported me throughout my Presidency. Over the past year we have visited members the length and breadth of Queensland; welcomed hundreds of students and doctors in training to the profession; congratulated our milestone members on their loyalty and commitment to the Association; engaged Hospital and Health Service and Medicare Local Chairs throughout Queensland; influenced health policy direction and implementation on important issues such as the Queensland TB Clinic, management of health complaints, provision of rural health services, and junior doctor training capacity. I would particularly like to thank our tireless CEO Jane Schmitt and PresidentElect Dr Christian Rowan for their hard work and considered advice and guidance. I wish Christian all the very best for his term, and I know the members of AMA Queensland will be in very good hands. Q

Dr Alex Markwell AMA Queenslnad President 2012 - 2013

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ceo’S REPORT

REGISTER YOUR VOTE THE BALLOT IS CURRENTLY OPEN FOR THE AMA QUEENSLAND COUNCIL AND PRESIDENT-ELECT. MAKE SURE YOU VOTE BY 13 MAY TO HAVE YOUR VOICE HEARD.

JANE SCHMITT Chief Executive Officer, AMA Queensland PRESIDENTIAL NOMINATIONS AND INAUGURATION As we bring you this issue the nominations have now closed for the positions on both AMA Queensland Council and for President-Elect 2013-2014. You will have the opportunity to read more about nominees and then vote in the election by following the details listed in your personalised emails and letters. The ballot opened on Monday 29 April and will close on Monday 13 May. I strongly encourage you to have your say on who you would like to see representing your Association. Election results will be announced at the Association’s Annual General Meeting on 21 May and celebrated at the Presidential Inauguration, Stamford Plaza on Friday 14 June. We welcome you to attend these significant events which are always memorable highlights of our calendar year. AMA NATIONAL CONFERENCE 2013 – AUSTRALIA’S HEALTH SYSTEM: WHAT’S THE TREATMENT? The annual AMA National Conference is being held at the Westin, Sydney from 24-26 May 2013. Discussions will include how to shape and fund health policy and partner and is coupled with a Doctors-inTraining Leadership Development dinner and Gala dinner. In a Federal election year, we are urging grassroots doctors to attend the conference and demonstrate to the Government and Opposition a genuine commitment to improving our healthcare system. You can register for the conference at https://ama.com.au/ nationalconference. AMA QUEENSLAND POLICY FRAMEWORK FOR THE NEXT THREE YEARS The past year has been a tumultuous time for health in Queensland. The change of government, introduction of health reform and budget constraints have caused considerable upheaval in the system. The upcoming federal election promises more change and uncertainty. 8

MAY 2013 DoctorQ

AMA national conference wil be held at the Westin Hotel, Sydney from 24-26 May 2013.

To guide our advocacy work over the next few years, AMA Queensland’s Council has been working with our policy team to develop a Vision for the Health System. This Vision sets out AMA Queensland’s values and guiding principles that will guide our advocacy work into the future. To ensure we have captured a vision representative of your values and aspirations, we are offering consultation with members to draw on firsthand experience and knowledge of the health system in Queensland. To find out more, turn to page 16 of Doctor Q or visit our website at www.amaq.com.au. AMA QUEENSLAND’S 2013-2014 STATE BUDGET SUBMISSION Ahead of what is expected to be another tight State Budget, AMA Queensland was pleased to present our Health System Rehab-2013-14 Budget Submission to the Health Minister. This document outlines key strategies for the distribution of health expenditure to ensure Queenslanders get the best value for money out of publicly funded health services. We believe that this plan offers the Government a range of logical, meaningful and practical initiatives to consider when planning their 2013-2014 Budget. For more detail on AMA Queensland’s Health System Rehab please visit our website at amaq.com.au.

FAREWELL TO OUTGOING 2012-13 PRESIDENT DR ALEX MARKWELL Each AMA Queensland President faces challenges throughout their term but it Is fair to say that 2012-2013 President, Emergency Physician Dr Alex Markwell, has had more than her fair share. The past year has been particularly turbulent with the introduction a new LNP Government, National Health Reform, austere budget and cuts to Queensland’s health jobs and services. Throughout all of these challenging moments, Dr Markwell has been a stalwart for the Association and medical profession as a whole. Her tireless passion and commitment to serving our membership and her fellow clinicians has been admirable. As a President, Alex has been an enthusiastic advocate on behalf of doctors but also of patients and the community, particularly in regards to issues of public health. She has also been a popular member of the AMA Queensland Secretariat and her contribution to the team has been greatly appreciated. We look forward to continuing to work with Dr Markwell as a member and Past President and thank her again for a year of dedicated service. Q

DoctorQ MAY 2013

FOUNDATION

WEDNESDAY 13 MARCH

ABOVE: Dr Jaikisan Patel and Dr Michelle Parameswaran

FROM LEFT: Debbie and Dr Steve Hambleton, Jane Schmitt, Tim Fairfax AM and Gina Fairfax

FOUNDATION RELAUNCHED

ABOVE: Jenny Sparrow and Margot Hill

OVER 50 DONORS ATTENDED THE RECENT AMA QUEENSLAND FOUNDATION’S THANK YOU TO DONORS EVENT AT MACQUARIE BANK’S LUXURIOUS QUEEN STREET OFFICES.

During the delightful evening, the AMA Queensland Foundation was officially relaunched and the new interactive website was previewed. Foundation President Dr Steve Hambleton said “The Foundation succinctly is about: doctors doing good. And through your donation and support — some dating back to the very beginning — can our achievements continue to be realised”. He also reminded guests about the Foundation’s continued “long term commitment to addressing those ‘cracks’ in the public health system that otherwise leave patients – particularly Queenslanders – at a disadvantage”.

The Foundation would like to take this opportunity to thank Ross Noye and Macquarie Bank for providing the complimentary venue. The view over the Brisbane River and their art collection provided a magnificent backdrop for the event.

Foundation Patron, Tim Fairfax AM and his wife Gina enjoyed chatting to the guests about the many successes of the Foundation.

Visit the new website at

To keep up to date with our activities, please have a look at our exciting new website www.amaqfoundation.com.au or contact Colleen Harper, Foundation Manager on c.harper@amaq.com.au or (07) 3872 2204. Q

ABOVE: Leo Hopsick, Louise Gunston and Archie Tait

ABOVE: Denise and Dr Michael Harrison

www.amaqfoundation.com.au

AMA Queensland Foundation Partners:

to our donors

MAY 2013 DoctorQ

FOUNDATION

TROPICS TEXTBOOK GOES GLOBAL Dr Chris Schull’s book Common Medical Problems in the Tropics has been distributed to doctors, nurses and health workers in developing countries around the globe, who, in Dr Schull’s words, “Often have no textbooks, no laboratory services and rarely have the help of any consultant but are confronted daily with complex problems and life-threatening situations”. The AMA Queensland Foundation donated $40,000 to produce Common Medical Problems in the Tropics. Q

thirds 2 two OF THE WORLD’S 3

BELOW: Students in Vanuatu receive the first textbook that they are allowed to take home to study.

poor LIVE IN AUSTRALIA’S REGION

Myanmar Somaliland

sri lanka east timor Papua new guinea

uganda

Indonesia Malawi

locations of Dr Schull’s book Common Medical Problems in the tropics BELOW: Sri Lanka

Northern territory vanuatu

pacific islands

BELOW: Neil Mackintosh delivers in Myanmar

AUSTRALIAN AID WILL TRAIN

more than 300 300 by 2015 NEW MIDWIVES IN EAST AFRICA

FACTS: www.ausaid.gov.au/about/pages/fastfacts.aspx

DoctorQ MAY 2013

People & EVENTS

HYPOTHETICAL

WITH GEOFFREY ROBERTSON QC THE WESLEY HOSPITAL, ST ANDREW’S WAR MEMORIAL HOSPITAL, GP PARTNER AMA QUEENSLAND

More than 330 delegates from Brisbane’s medical fraternity gathered to see Geoffrey Robertson QC, the mastermind behind the Hypotheticals TV show, lead a panel of experts through clinical scenarios exploring the latest in medical innovations and technology.

Dr Mark Baldwin, Dr Alex Markwell

Mr Robertson QC, a prominent human rights lawyer, academic, author and broadcaster, kept the crowd enthralled with his quick wit and understanding of how medical advancements pose ethical and moral dilemmas for the 21st century doctor. Part two of the series – the Q&A – based on the award-winning ABC TV program hosted by Tony Jones, is set to draw an even bigger crowd in July. Part three, The Great Debate, will be held in November. Q

Lesley Holden, Geoffrey Robertson QC, Dr Christian Rowan, Jane Rowan, Helen Whelan

With GP partner:

MAY 2013 DoctorQ

S NORING N ARCOLEPSY O BSTRUCTIVE SLEEP APNOEA R ESTLESS LEGS

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IF YOUR PATIENT HAS ANY OF THESE RED FLAG PROBLEMS TIRED DURING THE DAY SLEEPY AT THE WHEEL

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CARDIAC DYSRHYTHMIAS

Please write a referral for: BULK BILLED OR PRIVATE OVERNIGHT SLEEP STUDY Professor John Corbett Neurologist & Credentialled Sleep Physician Dr Sean Tolhurst Credentialled Sleep & Thoracic Physician

FAX REFERRAL TO (07) 5571 0682 (1800 1 76673 ) Email: snore@snoreaustralia.com.au

Web: www.snoreaustralia.com.au

DoctorQ MAY 2013

AMA Queensland NEWS HAVE YOU RECEIVED YOURS YET?

EXPERT EVIDENCE SEMINAR WRAP-UP More than 40 members attended the recent Expert Evidence Seminar which detailed all doctors need to know about giving expert evidence before a court or tribunal. Katharine Philp, Partner TressCox and Andrew Took, Director of Medico-Legal and Workplace Relations, AMA New South Wales co-presented this free member event. Delegates enjoyed an interactive and engaging presentation which stepped through best-practice court etiquette, tips for surviving cross-examination, techniques for drafting medico-legal reports and insight into recent cases.

DATE CLAIMER

Mark your diaries for the 2013 AMA Queensland Medico-Legal Conference, held on Saturday 26 October in Brisbane. Further details will be available in the July edition of Doctor Q and in the events calendar on the AMA Queensland website. To express interest in attending the conference, please email Holly Bretherton, General Manager – Member Relations h.bretherton@amaq.com.au Q 14

MAY 2013 DoctorQ

This is what our members had to say: I would like to see such seminars continue on a regular basis I liked the case presentations This was an informative presentation I would like to see a special interest group started in this area. AMA Queensland extends our sincere thanks to Katharine and Andrew and to TressCox for their generous support of this event. Q

2013

MEMBERSHIP KITS HAVE LANDED By now you should have received your 2013 membership kit which includes the 2013 Member Benefits Guide, outlining the expansive range of services and commercial benefits you’re entitled to as an AMA Queensland member. If you haven’t received your membership kit, please contact the Membership team on (07) 3872 2222 for a replacement to be sent. Q

YOUR FEEDBACK AND IDEAS WELCOMED AMA Queensland is continually looking for ways to improve and build on our services to make sure we’re meeting the needs of members. We welcome your feedback and suggestions on how we can improve and any ideas for new services you think would be valuable to members. Please feel free to contact the Membership team on (07) 3872 2222 to discuss or email membership@ amaq.com.au Q

AMA Queensland

DoctorQ MAY 2013

Feature story

AMA QUEENSLAND’S HEALTH VISION OVER THE NEXT MONTH, AMA QUEENSLAND WILL BE REACHING OUT TO MEMBERS AND ASKING THEIR OPINION ON THE FRAMEWORK AND DOCTOR Q HAS A SNEAK PREVIEW. The past year has been a tumultuous time for health in Queensland. The change of government, introduction of health reform and budget constraints have left the health system bruised and exhausted. At this time, the system needs medical leadership more than ever. AMA Queensland aims to be that leader and will draw on the wisdom, clinical knowledge and experience of the profession to advocate for the best health system for Queenslanders. To guide our advocacy work, AMA Queensland is developing a Policy Priorities Framework. This Framework sets out AMA Queensland’s values and vision for the health system.

UNDERLYING VALUES

PRINCIPLES

& KEY POINTS

COMPASSION

DoctorQ MARCH 2012

TRUST

KNOWLEDGE

WELLNESS

SAFE & EFFECTIVE

ACCESSIBLE

KNOWLEDGEDRIVEN

Health status is influenced by a range of genetic, social, cultural and environmental factors.

Patients should not experience preventable harm.

Every Queenslander should have access to appropriate health care.

Care should be given in accordance with the best evidence-based practice.

Need balance between service efficiency and local accessibility.

Information relating to the best health evidence should be easily available.

Health literacy has a direct impact on an individual’s ability to be healthy and stay healthy. Primary and secondary prevention are essential to delivering a better quality of life. Promoting good health is everyone’s responsibility.

Patients should understand potential risk. Systems must support and enforce safe practices to minimise error. Quality of services can be improved by learning from mistakes (and near-misses) and regular performance review.

Resources should be redirected to improve accessibility. Health literacy is essential in seeking out health services in a timely way. The health system must recognise and respond to the most vulnerable members of our community, especially Aboriginal and Torres Strait Islander people.

Introduction of new technology should be driven by evidence and cost-effectiveness. The health system must value the knowledge and wisdom of its workers, as well as information and data generated by the system. The system must support and nurture learning and provide sustainable training pathways for our workforce.

Feature story

AMA QUEENSLAND

VISION Queenslanders are healthier - enjoying a better quality of life and a peaceful death. We would prefer if Queenslanders never saw the inside of a hospital. We want people to get the most out of life and the best way to help people to be healthy and stay healthy is by delivering evidenced-based and preventative health strategies that are supported by effective and affordable primary care. When treatment is required, patients and their carers should have the knowledge, information and power to be actively engaged in the decision making process. Patients must be supported to experience a peaceful death with access to high quality palliative care.

OUTCOMES For patients, carers and the broader community Individuals and families play a positive role in their own health and wellbeing. Patients have confidence they are receiving quality services and experience good health outcomes. Every patient is treated with dignity and respect.

For health services All Queenslanders have their own general practitioner. Clinicians are influential in the scope, design and delivery of health services. Integrated, effective and accessible services that are supported by robust clinical and organisational governance.

For the health system The health system enjoys visible and effective leadership. Everyone working in the health system has pride in the services they deliver and feel valued and recognised. The health system is underpinned by strong and collaborative partnerships. Health investments deliver the best value for future generations. Q

ETHICAL

OPEN & ACCOUNTABLE

VALUE FOR MONEY

COLLABORATIVE

Health services must maintain ethical standards, recognising the worth and dignity of the whole person including their biological, emotional, physical, psychological, cultural, social and spiritual needs.

A culture of openness should be nurtured to solve problems and improve services.

Funds should be allocated efficiently and resources should flow effectively to the front line.

Governments must collaborate to effectively plan, fund and coordinate the health system.

Duplication, red tape and wastage should be minimised.

Health services, public and private clinicians, and the community must collaborate to plan local services and coordinate complex and high-need care where it cannot be provided locally.

Patients and their families should be kept informed about the treatment they will receive and the timeframe in which it is to be given. Everyone is responsible for the ethical use of valuable health resources.

Accountability extends to individual health services and health professionals. The decisions governments, other funders and providers make in managing our health care system should be clear and transparent. The responsibilities of the Commonwealth and state governments and the private and non-government sectors should all be clear.

Funding mechanisms should reward best practice models of care. There should be balanced, effective and ethical use of both public and private resources. New technologies should, where shown to be cost-effective, be implemented promptly and outmoded clinical practice and technologies should be de-funded. Evaluation and review is an integral part of continuous improvement.

Clinicians should collaborate in team care arrangements. Patients should collaborate with their treating clinicians to plan and continue their care and improve their lifestyle choices to support their health.

WE WANT TO MAKE SURE THE FRAMEWORK REPRESENTS THE VALUES OF OUR MEMBERS.

FORWARD THINKING We have a duty to leave the health system in a strong position for the future. A responsible forwardlooking approach demands that we actively monitor and plan the health system of the future to respond to changing demographics and health needs. Participating in research and creating new knowledge should be acknowledged and resourced appropriately as an integral activity of the health system.

DoctorQ MAY 2013 DoctorQ MARCH 2012

17 17

CURRENT ISSUES

PRIVATISATION AND INDIVIDUAL CONTRACTS RECIPE FOR SUCCESS OR DISASTER?

BOTH THE AMA QUEENSLAND AND THE AUSTRALIAN SALARIED MEDICAL OFFICERS FEDERATION OF QUEENSLAND ARE CONCERNED ABOUT THE IMPACT FROM PLANS FOR PRIVATISATION AND INDIVIDUAL CONTRACTS.

ANDREW TURNER

Workplace Relations Manager, AMA Queensland

Given the very complex nature of the Queensland public hospital system, very few of the changes proposed in the Blueprint can be properly considered in isolation from each other. Of particular concern are the proposals to remove award coverage and introduce individual contracts for senior medical officers. Any changes to current arrangements need to be undertaken in a consultative and considered manner otherwise unintended consequences will likely result. The experience in Victoria in this regard is instructive. The attempts to de-regulate the Victorian industrial arrangements for senior medical officers were protracted and caused significant quality concerns and extensive disputation.

BLUEPRINT

DIRECT FROM THE

Similarly, the proposal contained in the Blueprint to introduce ‘flexible, simplified employment contracts’ may significantly change the culture of patient care, teaching and research in Queensland’s teaching hospitals if contracts are short term and short sighted.

The attempts to de-regulate the Victorian industrial arrangements for senior medical officers were protracted and caused significant quality concerns and extensive disputation. Senior medical officers undertake the bulk of specialist clinical and teaching work and research in Queensland public hospitals and provide the majority of participants in Queensland public hospital committees. While Visiting Medical Officers and staff on short-term contracts make a valuable contribution to many of these activities, it is senior medical officers who provide both the pivotal and permanent contribution.

The Blueprint contains proposals regarding the commercialisation of public pathology and medical imaging services. Any proposal to change current arrangements must consider that both these services provide Queenslanders with access to services that, because of complexity or low activity volumes, are not commercially viable in the private sector. Often these services are associated with research activity, which again is generally not supported in private pathology and medical imaging services.

We also note that the current Medical Officers Certified Agreement (MOCA) is in place until its nominal expiry date of 30 June 2014.

We will keep you informed of developments. Email me on a.turner@amaq.com.au or call (07) 3872 2207 for more information or if you wish to register your concern or comment. Q

Our senior doctors are earning in excess of $300,000 per year, many earn a lot more, and they are still covered by an award and receive overtime payments and allowances in a system that is meant to benefit lower paid workers.

The use of Awards to cover senior roles will end. For professional categories of employment awards, they impose restrictive and outdated conditions that were eliminated in the private sector long ago. Consistent with the best practice employers, flexible, simplified employment contracts will be become the norm in the public healthcare sector.

Blueprint for Better Healthcare in Queensland, 2013, p36. State of Queensland (Queensland Health)

MAY 2013 DoctorQ

DoctorQ MAY 2013

CURRENT ISSUES

HEALTH PROFESSIONALS’ HEALTH CONFERENCE 2013 CONFERENCE CHAIR DR MARGARET KAY INVITES YOU TO REGISTER NOW FOR THE HEALTH PROFESSIONAL’S HEALTH CONFERENCE 2013 ON 3 – 5 OCTOBER.

DR MARGARET KAY

Doctor’s Health Advisory Service Queensland

This conference recognises the enormous benefits for doctors, nurses, dentists, physiotherapists, pharmacists and other allied health professionals who engage collaboratively in the creation of a healthier workforce.

We will have international speakers who will confront us and rejuvenate our passion to re-create a positive culture within our workplace.

Building on our previous experience hosting doctors’ health conferences, we will provide a positive forum with our theme of Caring for you; Caring for others.

our workplace by ensuring we are truly informed about the complexity of the issues around health professionals’ well-being.

Whether we work in a small private practice or a large health institution, this conference will challenge us all to make personal and organisational decisions to enhance our own health. By focusing on promoting resilience and balance in our lives, this conference will move beyond documenting the health issues that confront health professions and focus on the positive transformation and empowerment of the health workforce. Clearly this will enhance our capacity to deliver better quality care to our patients. We will have international speakers who will confront us and rejuvenate our passion to re-create a positive culture within

Researchers will present the most up-todate research in this field, while clinicians and medico-legal experts will guide us through difficulties that affect all of us in our day-to-day work. Our dynamic pre-conference workshops presented by experienced clinicians and experts in self-care are designed to teach us how to care for our colleagues and to develop our skills to maintain our health. Whether you teach students, care for health professionals or just need to know more about professional issues such as mandatory reporting, I’d like to encourage you to register for this conference now.

caring for you, caring for others

This will be a vibrant learning experience in which you can meet with the experts in this important part of our clinical practice. I am looking forward to sharing this opportunity with you. Q

eLT aHltP RHO FPE SrSoI OfNeA LsSs’ i o n a l s ’ HH EA H E A LT H C O N F E R E N C E 2 0 1 3

H e a lt H C o n f e r e n C e 2 0 1 3

3rd – 5th october 2013 Sofitel Brisbane

Organised by DHAQ on behalf of ADHN

MAY 2013 DoctorQ

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DoctorQ MAY 2013

Feature story

PRIVATISATION:

WHAT QUEENSLAND’S HEALTH MINISTER HAD TO SAY FOLLOWING THE RELEASE OF BLUEPRINT FOR BETTER HEALTHCARE IN QUEENSLAND MANY AMA QUEENSLAND MEMBERS CONTACTED US WITH CONCERNS ABOUT PROPOSED PRIVATISATION OF SERVICES. WE TOOK SOME OF YOUR QUESTIONS TO THE MINISTER FOR HEALTH, LAWRENCE SPRINGBORG, AND HERE’S A WRAP UP OF WHAT HE HAD TO SAY...

Q. What’s your understanding of the business rationale for privatisation – is this about cost or is it because there is a public service dysfunction that means you can’t get public hospitals to achieve the efficiencies you see in private hospitals? I think it’s a combination of all of those things; some of our public hospitals have been very innovative in trying to drive down costs. It’s certainly true there’s been a culture that’s permeated in the public sector, not only in front line service delivery but also organisationally, that “we’re the public sector so we’re not subject to the sorts of normal financial imperatives that actually exist in someone’s own home or business somewhere”. We don’t live in a parallel universe, because this is public money we have to make sure that we’re getting maximum dollar for the public money that we spend. Q. There’s been a lot of talk about privatising the Sunshine Coast University Hospital, what other hospitals or service provisions are you currently assessing to go out to tender? I don’t want to get ahead of ourselves with the Sunshine Coast University Hospital. I’ve met with a group of senior clinicians in their various areas and explained what it was all about and they were very comfortable. I commend the work that’s been done to date in a range of areas; we all know where the cost curves are in health, this is an open process now, KPMG are in there, they’re going to be engaging with those clinicians. It’s going to be very open, no decision has been made. What I want out of it is to make sure we’ve got the best possible practice

22 22

MAY 2013 MARCH DoctorQ DoctorQ 2012

and the most efficient practice for delivering our health care services – that we’re getting maximum value for our dollar in delivering free public health services. Q. What about research, training, professional development - how do you ensure that a private provider is giving those opportunities? They are all the things that need to be properly considered because that’s the one thing that we need to be very clear about. That’s the most significant challenge that’s going to require innovation. Notwithstanding that, we’ve got block funded components where we quarantine amounts of money for training, that’s set aside. We’ve got a very high expectation in our service agreements with our Hospital and Health Services that training is an important part of what we actually do. We’re talking about a hospital funded by the public sector continuing to provide all of the services and training opportunities a big public sector training hospital would do, that’s what it would be and no-one pays anything for it. It’s about making sure we get the most efficient value for the taxpayer because the more that we actually do that, means that we can deliver more quality health services for the Sunshine Coast. Q. Does the Government have a set timetable for making decisions about the privatisation of the Sunshine Coast University Hospital? We’re pushing it through as quickly as we possibly can. I’ve been saying that I’d like to have a very clear picture about where we’re going early next year.

Feature story

“What I want out of it is to make sure we’ve got the best possible practice and the most efficient practice for delivering our health care services.”

Q. How do you alleviate the concerns of doctors who are worried that the public sector is going to be sidelined in favour of the private providers? My principal obligation is to deliver the best possible health services in Queensland for the best value for money. I think our Hospital and Health Service Boards have been doing a good job, they’re getting more mature around the clinician engagement process, [and] they’re working in a more collegiate way to integrate services within their districts and I think that’s a good thing. We’re finding some of our great ideas are coming forward from clinicians. I want an alignment between the objectives of clinicians and Queensland Health, that’s the important thing in this. Our objective is better quality patient care, how [it’s] delivered or who delivers it is probably not the biggest consideration – it’s about making sure we deliver it the best way.

talking about privatising the delivery of existing core clinical services such as EDs and wards but when it comes to some support clinical services, we’ve got to. When we’ve got business units, we have to make sure they’re efficient. We’re talking about private and not-for-profit sector assisting us to run some of our new hospitals in Queensland and getting the best possibly value for that. This is not about sidelining clinicians.

THIS IS HOW T HE MINISTER E X P LAINS PRIVATIS ATION – W HAT DO YOU T HINK? Please sen d your fee dback to membe rship@ amaq.com .au

I consult widely with a variety of stakeholders including AMA Queensland, as well as other unions and interested groups. Although we frequently share different perspectives we also share a common purpose on a broad range of issues. Q

Q. Will there be consultation more widely, particularly around the privatisation issue? Absolutely. I think we need to understand privatisation. We are very interested in how the private sector might be able to take on some of our responsibilities, that’s why we’re looking at contestability. We’re not

DoctorQ MAY 2012 2013 DoctorQ MARCH

CURRENT ISSUES

CAN LEADERSHIP REALLY BE TAUGHT? PROFESSOR MALCOLM PARKER, HEAD OF MEDICAL ETHICS, LAW AND PROFESSIONAL PRACTICE AT THE UQ SCHOOL OF MEDICINE WEIGHS IN ON THE DEBATE ON TEACHING LEADERSHIP TO UNDERGRADUATES.

PROFESSOR MALCOM PARKER UQ School of Medicine

If you want to develop and exploit a new field, first describe a ‘crisis’ that you can then plausibly claim demands an urgent response. The ‘crisis in health care’ is tailormade for the emerging field of medical leadership. Access problems, waiting lists, insatiable demand, the ageing society, social inequities and an increasingly complex health system are easily spun into a crisis, and crises cry out for leaders. Voila! New training programs spring up to satisfy the contrived need for leaders. But the medical leadership phenomenon, like a number of other medical developments, is parasitic on an earlier explosion in perceived leadership needs in the corporate world, and is subject to similar criticisms.

be two categories of leaders? In fact, leadership courses promise something that is achieved in much more tacit and unpredictable ways, that will never be completely understood. Leadership, like consciousness, appears to be a highly contextual and emergent phenomenon, and not a set of competencies that can be taught. Another problem is that the idea of leadership increasingly stands in for other things, in part to justify the new programs. For example, the ability to advocate for the patient, to respond appropriately to a patient’s refusal of treatment, and to recognise one’s own limits (Doctor Q Nov 2012 p23), are included in the qualities exhibited by medical leaders. But these are amongst the things that medical training

responding to urgent situations and crises, and reflecting on their work, but they would think being called a leader on the basis of these abilities both odd and unnecessary. Leadership is like clinical expertise, insofar as it emerges with time and experience. It is logically contradictory, and hence a wasted effort, to attempt to train medical students to be medical experts by the time of graduation. Likewise, training for leadership during the undergraduate years is a fruitless goal. But further, the very idea of training for leadership at any stage of professional development is like training to become an entrepreneur, another novel, increasingly popular, but conceptually bizarre field in university education. If these observations are approximately correct, it remains to explain the real

Leadership, like consciousness, appears to be a highly contextual and emergent phenomenon, not a set of competencies that can be taught. Many leadership programs admit candidates who have already been identified as potential leaders, so do these courses actually generate leaders, or merely add a few specific competencies to something more fundamental? How do program instructors identify these candidates? That analysis is something that leadership courses seem to show little interest in, although this is not surprising. Too much attention to explaining the selection criteria would threaten to undermine the subsequent training. There have always been medical leaders, and they have not undertaken leadership training. From now on, what will be the status of someone who is demonstrably a leader, but who did not undertake a leadership course? Will there 24

MAY 2013 DoctorQ

has more recently set out to achieve without any reference to the language and concept of leadership. Although leadership language is clearly unnecessary to discuss, teach and implement these abilities, leadership fashionistas have annexed and rebranded them as elements of leadership. Once this occurs, it is then easy to then proclaim, as a number of authors are doing, the importance of educating all potential doctors to be leaders. There has been no need in the past to invoke the language of leadership in regard to examples like these because they are simply not elements of leadership. If they were, then all good doctors would be leaders already, and this would drain the concept of leadership of its central meaning. Most doctors are capable of, for example,

reasons that we are now seeing this vogue for leadership and leadership training in medicine. One possibility is an unconscious desire on the part of the medical profession to cast itself as responsible and trustworthy, in the face of continuing public criticism of its various recent failures in accountability. No doubt it is a complex story, which remains to be properly analysed and told. One thing at least is true. Genuine leaders seldom, if ever, talk about leadership, particularly their own, whereas many people in leadership positions, who do have a lot to say, are often extremely poor leaders. Everyone is familiar with ‘leaders’ who espouse the clichés of leadership, but who treat their staff or followers in ways that contradict the leadership rhetoric. Even more alarmingly, some of these ‘leaders’ run leadership training programs. Q

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DoctorQ MAY 2013

for Rural Health Living and Working on the Land

24th Annual Conference Mackay Entertainment and Convention Centre 7th â&#x20AC;&#x201C; 9th June 2013

Clinical Update

Leadership Development

Education and Doctors in Training

Rural Cardiology

Rural Medicine and Social Media

The Future is You: Doctors in Training

Dr Spencer Toombes will address the management of acute coronary syndrome in rural settings without immediate access to tertiary facilities and resources. Dr Toombes will update doctors on topics such as current management of acute coronary syndrome, preparing the cardiac patient prior to transfer and decision-making based on local resources and ensuring the best outcome for the patient.

Social media and networking has an increasing utility for health professionals. This session will focus on using social media in medical education and health advocacy.

This panel discussion will involve the rural training provider organisations to discuss the integrated nature of rural medical training along with the varied options and end points associated with rural medical training.

Dermoscopy Symposium

Exceptional Community Conversations

Student Presentations

Doctors will be involved in a highly innovative and very interactive forum including actual case studies submitted by conference participants, and reviewed by our highly respected specialist team. Selected cases will then be presented at the Symposium, with an opportunity for the treating doctor to highlight the challenges and triumphs involved in delivering quality skin cancer care in rural Queensland.

Clinical and health policy leaders will develop skills in engaging communities as partners in health service development and how to build communities' literacy in health policy.

You will hear four clinical case reports relevant to the conference theme â&#x20AC;&#x153;Digging Deep for Rural Health; Living and Working on the Landâ&#x20AC;?, written and presented by RDAQ Academic Award finalists. The overall winner will be announced at the conference finale dinner.

Retreivals and Evacuations

Universities Session: User Friendly New Technology in Teaching

Leading clinicians, including Dr Alex Markwell, will join a panel discussion on emergency medicine, retrievals and evacuation and the role of IT and social media. An excellent update session for rural doctors on innovations and new technologies involved in retrievals.

A practical workshop co-hosted by representatives from University of Queensland, James Cook University and Griffith University. Medical students and teachers will discuss the way that information technology is changing how we teach and learn and the issues raised by these changes.

CURRENT ISSUES

EVOLVE OR PERISH: RMO SURVIVAL WITH 76 RMOS STILL SEEKING EMPLOYMENT WITH QUEENSLAND HEALTH, DR VANESSA GRAYSON, COUNCIL CHAIR OF DOCTORS IN TRAINING COUNTERS THAT IT MAY BE AN ABILITY TO ADAPT THAT KEEPS US MOVING.

DR VANESSA GRAYSON

Chair, Council of Doctors in Training

I have spent the better part of the last month working night shift and watching documentaries on the Galapagos Islands. Now that I am back on days, I find myself procrastinating from my primary exam study and reflecting on Charles Darwin’s work. The more I consider the rapid evolution that took place on the Galapagos, the more I realise that we too as a medical profession are under external pressures to evolve. We have known for many years that the ‘student tsunami’ was on its way and that we would be faced with bottlenecks at various stages of our training. Unfortunately, last year we saw the first wave of this with 500 RMOs without jobs. While this scenario was artificially induced secondary to political and economic stressors, it will not be an isolated event. Just prior to entering the realm of nights, I took part in a meeting between Queensland Health and AMA Queensland to discuss the 2014 RMO Campaign. The overall feeling in the room was one of collaboration, with both parties having a vested interest in improving the outcomes for DiTs. The main discussion points were on improving the transparency and fairness of the selection process. In previous years, the RMO campaign has run in a parallel fashion with Registrar and PHO positions being offered at the same time as the SHO and JHO positions. This year, Queensland Health are moving toward a sequential campaign. This means that positions will be allocated in the following order: Advanced Trainee Registrar, Basic Registrar, PHO, and finally SHO and JHO positions. While the AMAQCDT welcome this change in allocation, we are acutely aware that there will naturally be teething process. For example, we have expressed reservations on the tight turnover times between each round of offers. Nevertheless, we are keen to work

MAY 2013 DoctorQ

closely with Queensland Health to improve this process and in disseminating information to DiTs as soon as it becomes available. Also at this meeting, we were presented with data from the 2013 Campaign. Of the 500 RMOs who initially did not have jobs, there were still 76 who were registered as still seeking employment in Queensland Health. Interestingly, a significant proportion of this group were offered jobs in regional or rural centres but declined, as they wanted a job in a metropolitan centre. There are a number of personal factors that one must consider when accepting a job offer. As a non-married woman with no children, I will not pretend to understand how difficult it would be to uproot ones family in order to continue my training. However if we are to listen to the workforce projections and move toward a selfsustainable workforce, there needs to be a shift in the willingness to work in regional, rural and remote areas. There is a lesson that we could learn from Darwin’s observations of the Galapagos, and I will leave you with one of his quotes,“It is not the strongest of the species, nor the most intelligent that survives, but the ones most responsive to change.” Q

There are more doctors-in-training across Australia than ever before. The AMA is committed to ensuring that they have access to high-quality undergraduate, prevocational and vocational education and training, as well as appropriate working conditions.

It is not the strongest of the species, nor the most intelligent that survives, but the ones most responsive to change.

CURRENT ISSUES

INTERN CRISIS GETS ATTENTION DR MICHAEL BONNING, REPRESENTING AMA COUNCIL OF DOCTORS-IN-TRAINING, SPOKE AT THE NATIONAL MEDICAL INTERN SUMMIT IN SYDNEY EARLIER THIS YEAR.

DR MICHAEL BONNING

AMA Council of Doctors-in-Training

It is a testament to the AMA, AMSA, Medical Deans and those behind the #interncrisis social media campaign, both highlighting the impending training pipeline bottlenecks and creating government embarrassment by unmasking the political brinksmanship, that this issue finally received co-operative ministerial attention at the end of 2012. Given the way in which the Summit was announced, you would be mistaken for thinking that the situation precipitating it had only just materialised. In reality states and territories, the funders of the majority of hospital-based postgraduate training (including internships) have baulked at increasing training capacity further after massive growth over the last six years. Previous increases were to accommodate the more than 200 per cent increase in medical students graduating over the last decade. This not only precipitated the #interncrisis but the cannibalisation of more senior positions to create internships resulted in the lack of post-internship positions prevocational positions in Queensland in 2012.

Graphic courtesy of http://interncrisis.org/be-informed/

The convening of a National Medical Intern Summit recently was the next move in a long line of political posturing that has been endemic in medical training over recent years. The Summit brought together all those involved in the brinksmanship of 2012 where graduating medical students were used as a political hatchet to wedge the Commonwealth government into funding additional medical internships around the country.

The crisis has far deeper themes than the simplistic media message typified by statements such as ‘unemployed doctors driving taxis’ signifies. It is indicative of a difference in opinion between state and federal agencies regarding the future of the Australian medical workforce. States and territories deploy arguments that the employment of these additional graduates, who are international students, does not have a long-term benefit to the system and are a burden on coffers and the training system. The Commonwealth government, and for that matter the profession, recognises that international students are part of a self-sufficient future for the Australian medical workforce. Health Workforce 2025 modelled the future health workforce required for Australia and proposed a number of possible futures. In the baseline scenario, based upon current graduate trends, Australia was found to be more than 2,000 doctors short by 2025.

#interncrisis

http://interncrisis.org

FYI

Is the social media campaign run by Medical Student Action on Training (MSAT) which is a grassroots movement to raise awareness and demand political action on medical training shortages.

The geographic misdistribution of medical workforce and poor alignment of training pathways to the health requirements of the community is anticipated to further amplify perceived shortages. We recognise that a self-sufficient, high quality health system stems from training a workforce that can meet the needs of the population that it is there to serve. Especially in Queensland there are significant inroads in delivering better service, particularly for those already disadvantaged by distance, through the Rural Generalist program. The Summit gave fresh air to ideas that have been floating around for many years including the provision of intern and wider prevocational training in general practice and the private sector. These ideas are welcome as they accept the realities of the changing burden of disease. Furthermore, a realignment of training towards preventative health and health promotion must be considered both for health and budgetary reasons. The Standing Committee on Health meeting, will consider an options paper drafted by NSW Health. As we view the outcomes from that meeting the AMA and AMSA must arm the public with better knowledge to engage them in this fight for the spirit of the public health system. The end game of any argument in health needs to end with the patient – will this result in better services, better care and better outcomes. Q DoctorQ MAY 2013

Feature story

GETTING STEPHEN HAWKING

TO SPEAK

THE BROTHER OF WELL-KNOWN QUEENSLAND DOCTOR TOBY FORD, PETER FORD, HAS CREATED A DEVICE TO GIVE A VOICE TO THOSE UNABLE TO SPEAK – AND TAKEN IT ALL THE WAY TO STEPHEN HAWKING. 30 30 30

MAY 2013 DoctorQ MARCH DoctorQ 2012 MARCH DoctorQ 2012

Feature story The life of a locked-in syndrome sufferer is riddled with unimaginable frustration and heartache. Patients have complete cognitive function and awareness but cannot move or talk due to paralysis of all voluntary muscles in the body except for the eyes. The condition affects social interaction in every way imaginable. Everything from a knowing wink to a simple hug is inhibited. But thanks to the efforts of a failed University of Queensland medical student turned

“If you want to take your homework to anyone, you take it to Hawking. He’s the toughest marker I’ve ever come across,” Mr Ford says.

BELOW: NeuroSwitch inventor Peter Ford, Mark Britten and James Schorey with Prof.Stephen Hawking.

ABOVE: Brothers, Peter and Toby Ford.

journalist, Peter Ford, these patients’ ability to communicate and form their own identity has received a significant shot in the arm. Mr Ford’s company Control Bionics is behind NeuroSwitch, softwarethat allows people with extreme disabilities to use assisted technologies to form sentences and project speech. “Currently, patients who have some movement can use a switch – which can take the form of a button, a straw in their mouth, their eyes or even light reflected off their head - to control scanning technology and communicate,” Mr Ford says. “The problem for severely disabled people is the inability to use traditional switches, which is where NeuroSwitch comes in. “The software detects electrical signals sent from the brain to the body, stabilises them and uses them to interact with a computer program or keyboard.” Mr Ford says users can access the technology through pain free, topical sensors. “Even if a muscle is paralysed, the brain sends a neuro-chemical reaction along the muscle which creates an electrical signal,” he says.

“What we do is take the brain signal sent to a specific muscleand use mathematics to normalise it to the point that it becomes a switch to interact with a computer. “For the first time, somebody who is completely paralysed has a device to control this amazing scanning technology that already exists to form sentences and express themselves.” NeuroSwitch has been a labour of love for Mr Ford, a self-taught code writer who grew up on a farm in Miles in western Queensland. His father was a dentist and his mother a chemistry teacher. In 1969, he dropped out of University and joined the Army but then went back to study economics and law at the University of Queensland. In the 1980s,he was one of the first Australian news anchors hired by CNN and NBC and had a long career reporting from some of the world’s hotspots. A turning point came when the former Channel 7 host convinced renowned scientist Stephen Hawking to help refine the NeuroSwitch.

“He beta-tested the first prototype of NeuroSwitch and continued to help us with testing all the way through development. “When we loaded him up with the initial prototype of NeuroSwitch he used the software to make the statement, ‘I’m always being mistaken for Stephen Hawking’ within about 30 seconds. He thought it was very funny.” Through NeuroSwitch’s long development – from a pipe dream in the seventies to being patented in 12 countries – Mr Ford says he was constantly inspired by the plight and resilience of patients suffering locked-in syndrome. “As a humanist, the most valuable thing about us humans is our identity - who we are, where we’re from and what we can do,” he says. “Being able to provide Hawking, or anybody else who has locked-in syndrome, with the ability to reach out of that diving bell that they’re trapped in is an enourmous privilege and a constant motivator.” Q

“If you want to take your homework to anyone, you take it to Hawking. He’s the toughest marker I’ve ever come across,” Mr Ford says. DoctorQ MARCH 2012

AROUND THE REGIONS

LOCAL MEDICAL ASSOCIATION ROUND UP

JOIN YOUR LMA

STAY CONNECTED WITH COLLEAGUES AND UP TO DATE WITH THE LATEST HEALTH NEWS AND ISSUES AFFECTING YOUR LOCAL AREA. DON’T STAND ON THE SIDELINES —JOIN YOUR LOCAL MEDICAL ASSOCIATION TODAY AND MAKE A DIFFERENCE.

SUNSHINE COAST

CAIRNS

BRISBANE NORTHSIDE Next meeting: 11 June

Next meeting: 23 May and 25 June

For information on meeting dates and membership contact Cairns LMA President Dr Sharmila Biswas.

Venue: Maroochydore Surf Club

Phone: (07) 4036 4333

Monthly dinner meetings are generally held on the fourth Thursday of each month.

Convenor: Jo Bourke Phone: (07) 5479 3979 Fax: (07) 5479 3995

TOWNSVILLE

Email: jobo@squirrel.com.au

For information on meeting dates and membership contact Townsville LMA President Dr Carl O’Kane.

For further information or to join visit www.sclma.com.au

Phone: (07) 4433 1111

Convenor: Dr Graham McNally Phone: (07) 3265 3111 For further information or to join, visit www. northsidelocalmedical.wordpress.com

REDCLIFFE & DISTRICT Next meeting: 27 March Venue: Golden Ox Restaurant, Redcliffe Time: 7pm for 7.30pm

GOLD COAST

Convenor: Margaret MacPherson

Next meeting: 23 May and 13 June

CENTRAL QUEENSLAND

For information on meeting dates go to www. gcma.org.au or email info@gcma.org.au

For information on meeting dates and membership contact Central Queensland LMA Secretariat Dr Harley Wilson.

A membership form can be downloaded from our site.

Phone: 0419 277 611

Phone: (07) 3409 4429

TOOWOOMBA & DARLING DOWNS

Email: harleywilson00@gmail.com

For further information, go to www.tddlma. org.au or email info@tddlma.org.au

Email: info@gcma.org.au

BUNDABERG

FRASER COAST

For information on meeting dates and how to join, contact Bundaberg LMA President, Dr Daud Yunus.

Membership to the Toowoomba and Darling Downs LMA is just $50. To join, download an application form at www.tddlma.org. au/membership.html

Phone: (07) 5575 7054 Fax: (07) 5575 7551

For information on meeting dates and how to join, contact Fraser Coast LMA President, Dr Shaun Rudd.

Phone: (07) 4152 2888 Fax: (07) 4153 3245 Email: daud.yunus@gmail.com

Phone: (07) 4128 3644 Fax: (07) 4124 0660

CAN’T FIND YOUR LOCAL AREA? 32

MAY 2013 DoctorQ

If your Local Medical Association does not appear above or your details are incorrect, please email Libby Hargreaves at amaq@ amaq.com.au with corrections, contact details, how to join, web address, dates for upcoming meetings and who to contact for further information.

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You can access QXRWeb today if you have an existing QXRWeb Images account – simply use your existing username and password at www.qxrweb.com.au. Call Doctor Direct on 1800 77 99 77 to set up an account. DoctorQ MAY 2013

GROWING YOUR PRIVATE PRACTICE

CONFERENCE 2013 | 19 - 20 JULY | VICTORIA PARK, HERSTON Starting and working in private practice can seem like an enormous task, but AMA Queensland is making it easier with the upcoming Growing your Private Practice Conference 2013. The conference is a two-day workshop structured to give attendees insight into private practice considerations. Last yearâ&#x20AC;&#x2122;s program has been refreshed and upgraded so the conference is now offering two streams, beginner one for those considering their options in private practice, and advanced stream for those already in private practice who are looking to improve their current practice. Representatives of regulatory bodies, renowned speakers and reputable industry professionals who specialise in assisting private practice and practitioners, come together to share knowledge on key topics such as risk management, staffing, accreditation, business structure, billing, marketing and much more. If you are considering starting your own private practice or already have a private practice, this conference is ideal to commence your learning or build upon your existing knowledge.

WHO IS IT FOR? This comprehensive program is designed for: Registrars about to finish specialist training, both GP and specialist, who are considering their options in private practice. Residents and students interested in the option of private practice for their future . Other doctors, business owners and practice staff who are looking to establish their own private practice or considering working in private practice. Those already in private practice who are looking to gain valuable information and insight into running a successful practice or improving their current practice.

CONTINUING PROFESSIONAL DEVELOPMENT POINTS *Subject to approval

SPONSORS

Download a brochure from the events page at www.amaq.com.au

DoctorQ MAY 2013

MAY 2013 DoctorQ

DoctorQ MAY 2013

MEMBER NEWS

CONGRATULATIONS to the following doctors who are now elected members of AMA Queensland.

FEBRUARY

MARCH

DOCTORS IN TRAINING

Dr Amrith Gnanasingham Dr Karla Pungsornruk Dr Glenn Jenkins Dr Eleri Carrahar Dr Nigel Da Silva Dr Alice Dobinson Dr Julia Kelly Dr Scott Whiting

Dr Wesley Ko D Rakesh Arora Dr Ahmed Elsedfy Dr Guybon Howes Dr Maureen Khan Dr Claire Fotheringham Dr Andrew Gottke Dr Tony MillerGreenman Dr Ria Warfe Dr Melissa White Dr Mbakise Matebele Dr Amjid Muhammed Dr Paul Robrigado Dr James Millsom Dr Julius Soriano Dr Grant Fraser-Kirk Dr Kristy Fraser-Kirk Dr Chaitanya Kotapati Dr Ritu Arora

GENERAL PRACTITIONERS Dr Dennis A Evans Dr Meiqing Han Dr Tibor Konkoly Dr Tim Sampson Dr Bram Singh

PRIVATE SPECIALISTS Dr Paul Bailey Dr Bill Boyd Dr Adem Can Dr Peter Gochee Dr Dennis PP Hartig Dr Brigid Hickey Dr Bryan Kenny Dr Klaus J Loibl Dr Charlotte Mooring Dr Rozeena Musa Dr Brendan O’Sullivan Dr Gary V Persley Dr Monica Trujillo Dr Daragh Weldon

PART-TIME PRACTITIONERS Dr Anthony Hayek Dr Wang Kwok Dr Heinz W Albrecht Dr Leanne J Barron Dr Julia Lisle Dr Catherine Lee Dr Takavada Mapfumo

SALARIED PRACTITIONERS Dr Benjamin Chen Dr Mila Goldner-Vukov Dr Laurie Moore Dr Usman Malabu

JOINT PRACTITIONERS Dr Loani Foxcroft

MAY 2013 DoctorQ

GENERAL PRACTITIONERS Dr David MS Lai Dr Michael P Bromet Dr Saeideh Beigi Dr Sally Kidson Dr Holly Zhou

PRIVATE PRACTITIONERS Dr Pooi Lee Dr Catherine Llewellyn Dr Craig A Phillips Dr Otilie Tork Dr Matthew Russell

PART-TIME PRACTITIONERS Dr Jia Tho Dr Cynthia Jackson Dr Lakshmi Ramalingam

SALARIED PRACTITIONERS Dr Mark Kelly

CONGRATULATIONS TO OUR NEW 2013 INTERN MEMBERS Dr Linda Abenthum Dr Antony Adelman Dr Danielle Allan Dr Kamelya Allez Dr Hasna Ameti Dr Tim Amos Dr Samrata Anand Dr Danielle Andreussi Dr Clare Applegarth Dr Ashley Arellano Dr Althea Askern Dr Mohit Bajaj Dr Nicholas Barker Dr Louis Beak Dr Henry Beem Dr Jennifer Bellaby Dr Astra Bellette Dr Kiva-Marie Belt Dr Hannah Bennett Dr Samir Bhagwat Dr Terri Biscak Dr Caitlin Black Dr Daniel Black Dr Arienne Blanco Dr Bapesh Bollu Dr Jonathan Bowers Dr Merali Boyle Dr Barbara Bradshaw Dr Julia Brandenburg Dr Kathryn Brandon Dr Gurbir Brar Dr Gabrielle Buckley Dr Jessica Bunker Dr Justine Cain Dr Patrice Callaghan Dr Sarah Caporale Dr Julie Cappello Dr Robert Carroll Dr Amy Chahal Dr Fang-Wei Chen Dr Venkata Chikatamarla Dr Anubhav Chopra Dr Katie Christensen Dr Peter Christensen Dr Dianne Clayton Dr Victoria Coles Dr Brent Collins Dr Kelly Collins Dr Nathania Cooksley Dr Scott Cooper Dr Joseph Coory Dr Damian Cornelius Dr Marianne Cossens Dr Tom Crawley-Smith Dr Christopher Cummerford Dr Amy Cunningham Dr Kelly Cunningham Dr Anthony Dat Dr Natalie Davidson Dr Kerina Denny Dr Marcus Dickey Dr Marilla Dickfos Dr Rai Divyajeet Dr Kyle D’Netto Dr Jessica Donaghue Dr Dara Donnelly Dr Francesca Dowland

Dr Gregory Down Dr Ruth DuCommun Dr Adam Ebringer Dr Rachel Effeney Dr Karl Eisner Dr Sarah Emmett Dr Andrew Evans Dr Mitchell Evans Dr Matthew Fanning Dr Kylie Ferguson Dr Erika Fernandes Dr Helen Fraser Dr Michael Fry Dr Karen Furlong Dr Robyn Gillett Dr Anne Gisik Dr Ivan Goh Dr Hobia Gole Dr Thomas Goregues Dr Sarah Grainger Dr David Griffin Dr Rosemary Gunningham Dr Lindsay Haase Dr Keita Hada Dr Joanne Haladyn Dr Keith Hall Dr Elizabeth Hamwood Dr Xiaozhun Hang Dr Mary Hardimon Dr Joshua Hatch Dr Cameron Hayden Dr Ying He Dr Simon Ho Dr Jennifer Hogan Dr Lisa Hong Dr Kendra Hopper Dr David Howell Dr Kevin Hsieh Dr Dennis Huang Dr Ian Hunter Dr Joanna Hutcheon Dr Peter Hutson Dr Stephanie Huxley Dr Jodie Hyde Dr Vikram Iyer Dr Carla Jensen Dr Kate Johnstone Dr Alison Jones Dr Sarah Jongbloed Dr Mohammed Kafil Dr Serne Kemp Dr Stephen Kent Dr Minkyung Kim Dr Stephen Kinder Dr Lynnette Knowles Dr Cassandra Krogh Dr William Kuo Dr Candy Kwan Dr Monisha Lalji Dr Abigail Lane Dr Thomas Langford-Ely Dr Bruce Lavarack Dr Kristen Lefever Dr Jacinta Lewis Dr Tom Liang Dr Kate Lilley Dr Karen Lim

Dr Slavoljub Ljubincic Dr Bentley Logan Dr Alexander Lott Dr Kerry Lowe Dr Katherine Lynch Dr Catherine MacDonald Dr Kerry Mackenroth Dr Nicole Maggacis Dr Jordyn Mahanga Dr Simone Mangan Dr Christopher Manley Dr Amanda Marshall Dr Kris Masters Dr Andrew Maurice Dr Kimberley May Dr Bruce Maybloom Dr Laura McAulay Dr Vanessa McAuliffe Dr Benjamin McDonald Dr Michael McLaughlin Dr Christopher McMullen Dr Chelsie McMullin Dr Ashlie Meigh Dr Thomas Mew Dr Sophie Michieletto Dr Luke Miller Dr Anjni Mistri Dr Genevieve Molloy Dr Samuel Morcom Dr Maelle Morgan Dr Marian Morrissey Dr Jessica Moss Dr Andre Motteroz Dr Lucy Mudie Dr Arief Mulyadi Dr Teresa Munce Dr Cassidy Nelson Dr Scott Newman Dr Michael Ng Dr Melissa Ng Liet Hing Dr Peter Nicholas Dr Bryce Nicol Dr Rachael Nightingale Dr Charles Noonan Dr Rachel Norton Dr Phoebe O’Hare Dr Sharne O’Reilly Dr Amy O’Sullivan Dr Jae Park Dr Georgina Parker Dr Justin Parr Dr Fiona Paxton-Hall Dr Josephine Pearson Dr Linda Perkins Dr Kim Pham Dr Lyndal Phelps Dr Nicholas Phillips Dr Jessica Phillips-Yelland Dr Margaret Pollard Dr Terence Pollard Dr Lauren Prictor Dr Robert Puchalski Dr James Purnell Dr Brett Quabba Dr Charlotte Quain Dr Brodie Quinn Dr Kathrin Rac

Dr Anand Ramineni Dr Tavis Read Dr Sarah Reilly Dr Alice Reye Dr Benjamin Ryan Dr Bawar Saeed Dr Bayden Sales Dr David Samson Dr Kate Saunders Dr Rina Savage Dr Adam Scorer Dr Brenton Seidl Dr Abdul Shaik Dr Meng Shen Dr Eleasa Sieh Dr Anthony Silva Dr Bhavneet Singh Dr Carla Smerdon Dr Aimee Smith Dr Angela Smith Dr Bailey Smith Dr Corinna Smith Dr Dugal Smith Dr Samuel Smith Dr Thomas Solano Dr Shampavi Sriharan Dr Adam Stafford Dr Nick Starkey Dr Curtis Staunton Dr Peter Stickler Dr Tony Swain Dr Carly Talbot Dr Stephanie Tan Dr Amanda Tapiolas Dr Samuel Thambar Dr Joel Thomas Dr Emily Tinniswood Dr Jennifer Tucker Dr Stephanie Turner Dr Declan Tuttle Dr Jessica Vidler Dr Heidi Vogelbusch Dr Andree Wade Dr Shelley Walker Dr Claire Walter Dr Nicole Waters Dr Luke Watson Dr Jana Westerhof Dr Anthony Whitfield Dr Joseph Whitfield Dr Nicholas Whitworth Dr Louise Wilson Dr Danielle Wiltshire Dr Aung Win Dr Kate Windle Dr Brendan Winkle Dr Caitlin Witt Dr Brittany Wong Dr Chris Woo Dr Dale Wood Dr Drew Yates Dr Yong Yeung Dr Nicholas Yim Dr Sahra Zanuso Dr Leigh Zhu Dr Shi Zhuge Dr Omar Zubair

obituaries

Photo courtesy of: David Kapernick, The Courier Mail

Dr John Iredale Tonge, a name synonymous with forensic pathology in Queensland for nearly 70 years, died on 28 February 2013 at the age of 96.

DR JOHN IREDALE TONGE CBE MBBS FRCPA Born in Melbourne in 1916, the youngest of six children, Dr Tonge was educated at Melbourne Grammar, Hurstpierpoint College, Sussex and at The King’s School, Parramatta. Dr Tonge commenced his medical studies in 1934 at the University of Sydney. Upon graduation in 1939, Dr Tonge was appointed as a resident at the Prince Alfred Hospital. At this time, due to the absence of many senior staff on war service, residents were given responsibilities far beyond their training, skills and knowledge. Dr Tonge recalled being appointed as “registrar of anaesthetics”, responsible for six theatres, despite having no practical anaesthetic experience at all. Upon joining the Royal Australian Army Medical Corps in December 1940, Dr Tonge initially assisted in establishing the Blood Bank in Sydney. Later he worked at Cowra, Bathurst and at Concord Military Hospital.

Research Unit at Cairns and remained there until his discharge from the Army in 1946. In July 1946 Dr Tonge was offered a position as pathologist in the Department of Microbiology and Pathology in Brisbane. Following the appointment of the then director, Dr EH ‘Ted’ Derrick, to the fledgling Queensland Institute of Medical Research in 1947, Dr Tonge became Director of the Department, a position he held until his retirement in 1979. Dr Tonge was responsible for expanding the Government laboratory and introducing new services including a TB laboratory, a virology unit, and increasingly sophisticated forensic services. Dr Tonge’s special interests were sudden infant death syndrome, road trauma and aviation pathology.

In 1943 he joined the 2/2 Army General Hospital on the Atherton Tableland as a pathologist and later took command of the 104th Australian Mobile Bacteriological Laboratory and served with it in New Guinea and New Britain.

Largely through the lobbying of Dr Tonge and his team and the neurosurgeon Ken Jamieson, the Queensland Parliament introduced legislation imposing limits to drivers’ blood-alcohol level (1968), governing the wearing of crash helmets by motorcyclists (1970) and seat belts in motor vehicles (1972).

In 1945 he was ordered to undertake malaria research at Wewak and subsequently transferred to the world famous Malaria

Dr Tonge was one of the founders of the Royal College of Pathologists of Australasia and was its third President in 1959-1961.

Dr Tonge lectured medical students at the University of Queensland on forensic medicine for over 30 years. In retirement, Dr Tonge served on many boards and committees including the Queensland Sudden Infant Death Research Foundation (now SIDS and Kids), the Royal Queensland Bush Children’s Health Scheme, the RSPCA and the council of the, then, Queensland Institute of Technology. The John Tonge Centre housing the pathology and forensic biology functions of the Queensland Health Department was named in his honour in 1992. In 1947 Dr Tonge married Loddie Marks, a member of a well-known and highlyrespected three generation Wickham Terrace medical family. Dr and Mrs Tonge have four children, David, Margaret, Sam and Stephen. A cultured, modest and deeply compassionate man, Dr Tonge lived and breathed his role as a medical practitioner until his death. He was acutely proud of his membership of the Australian Medical Association which spanned over 73 years. Dr Tonge donated his body to the University of Queensland School of Biomedical Sciences. Contributed by Dr Tonge’s son Stephen. Q

DoctorQ MAY 2013

MEMBER PROFILE

DR MICHAEL HARRISON

THEY ARE KNOWN AS THE DOCTORS’ DOCTOR, UNSEEN AND UNKNOWN BY PATIENTS BUT THEIR WORK UNDERPINS ALMOST ALL ASPECTS OF MEDICINE FROM THE DIAGNOSIS AND MONITORING OF DISEASES TO DETECTING GENE MUTATIONS WHICH PREDICT RESPONSE TO PARTICULAR TREATMENTS. THEY ARE RESPONSIBLE FOR THE DIAGNOSIS OF EVERY DETECTED CANCER. HEATHER GRANT SPOKE WITH ONE OF QUEENSLAND’S LEADING PATHOLOGISTS, DR MICHAEL HARRISON.

Q. Pathology is not a medical specialty that immediately jumps to mind. Does it have an image problem? Absolutely. It is not an obvious medical career choice. We already have a workforce shortage in Australia and our College is gravely concerned about how to attract young doctors to the specialty and then train them. In part, it’s because medical students and junior doctors in their immediate postgraduate years are not often exposed to the specialty. They will request tests and receive the results—but have little knowledge of what happens in between. For 95 per cent of medicos, pathology laboratories are like a black box, a great unknown.

MAY 2013 DoctorQ

Q. Is pathology taken for granted? About 70 per cent of all clinical decisions require pathology test results and over 70 per cent of all diagnoses are made solely by pathology testing. A doctor may suspect a condition but won’t know for sure what it is without a pathological diagnosis. Often times the diagnosis is first suggested by results from initial testing rather than the presenting symptoms. Likewise cancer is not simply cancer. It requires pathologists to define and classify it to determine its response to treatment. When I started, there were only a few known forms of leukaemia. We now can define hundreds of sub-types.

CONTENTIOUS

ISSUES IN PATHOLOGY USE OF CT SCANS AND MRIS OVER AUTOPSIES TO DETERMINE CAUSE OF DEATH “An autopsy is the final audit of the medical process. It offers great learning opportunities. As many as one-third of recorded causes of death are shown to be incorrect but despite that there is undue reliance on diagnostic imaging rather than pathological investigation.”

Dr Michael Harrison — and SNP as a corporate body — enable AMA Queensland Foundation to fulfil its mantra of doctors doing good.

“I feel for the GP who is asked by an asymptomatic patient to request a PSA test. It’s a very difficult conversation to have because a one-off test is not a guarantee. That’s why as a College we do not advocate widespread screening.”

VITAMIN D DEFICIENCY “Testing has been the subject of criticism recently. The fact remains that this deficiency is common in Australia, even in Queensland, and is likely to have serious consequences. As long as universal supplementation is not supported, identification by testing of that substantial minority will be required.”

WHO?

Q. What was it that attracted you to the specialty?

Q. How does one ‘give’ and to whom? So many are in need.

I was a junior house officer in Cairns after graduating from UQ in 1977. While there, I saw many unusual and neglected conditions that only pathology was able to unravel. One case I particularly remember was an elderly Aboriginal lady. She was terribly embarrassed about a condition she had suffered for 30 years. On examination, I found no skin on her vulva and a 100 square centimetre ulcer involving her entire perineum. The immediate thought was advanced cancer but pathology testing showed it to be a sexually transmitted disease (granuloma ingratia) which could be easily treated. With the correct diagnosis, she was cured.

Giving takes many forms. We’ve set up laboratories and trained staff in the Congo and Ethiopia. We send outdated but perfectly useable equipment like microscopes to third-world countries. Much of our giving as a company results from the passion of a staff member – or their awareness of a need. For example a scientist who worked in Fiji for many years supports a village community, taking highly valued but basic items such as school supplies provided by SNPers. They go in by canoe as that is the only means of access. A pathologist and her fellow staff members raise money for a refugee support agency through a huge community dinner that she prepares herself. Then there are morning teas and beach volleyball competitions for ovarian cancer— SNP matches, dollar for dollar, the donations staff raise. We’re involved in Landcare projects too. We encourage volunteerism. But certainly some of our biggest ‘gifts’ are at Christmas. Instead of sending Christmas puddings or cakes or biscuits to referrers, we channel that money—about $50,000 each year—into charities chosen by the staff. Some are household names like Royal Flying Doctors; others are smaller community groups without profile but doing good work.

Five years as a General Pathology trainee culminated in my Fellowship with the Royal College of Pathologists of Australasia in 1984. I joined Sullivan Nicolaides Pathology in 1985 and have been here ever since.

PSA TESTING FOR PROSTATE CANCER

DOCTOR

Q. You’re now managing partner and chief executive officer of SNP. What is it that kept you here? “Rusted on” is one way of putting it but I’m not alone in my long service at SNP. A lot of people here love the place, the work and the people. We are all in health care and do care for others and that flows through the whole practice in our community engagement. It’s often called corporate social responsibility now but SNP has been giving back to society since John Sullivan and Nick Nicolaides founded the practice in 1956.

Q. Why are you a member of the AMA? I joined AMA because it is our profession’s voice, just as I am active in the College of Pathologists. We need to be the leaders in medical ethics and health policy and be heard on medico-political matters. We are the learned experts in all areas of medicine and we need to provide frank and fearless advice to politicians and bureaucrats. Q

DoctorQ MAY 2013

BUSINESS TOOLS

SWITCHING MEDICAL INDEMNITY INSURERS? AVOID EXPOSING YOUR ‘TAIL’ AMA QUEENSLAND INSURANCE SOLUTIONS’ NEW MEDICAL INDEMNITY SPECIALIST CHRIS MARIANI EXPLAINS HOW TO KEEP YOURSELF COVERED IF YOU CHANGE INSURERS. Chris Mariani AMA Queensland Insurance Solutions 1300 883 059 chris.mariani@amaqis.com.au

AMA QUEENSLAND INSURANCE SOLUTIONS

WELCOMES CHRIS MARIANI TO THE TEAM

AMA Queensland members can now get expert advice from a medical indemnity specialist - Chris has over 18 years of insurance experience and prior to joining AMA Queensland Insurance Services, he was a senior manager at a medical indemnity insurer where he managed corporate clients and brokers as well as underwriting and leading the products department where he was responsible for the development and management of medical indemnity policies. Chris has a thorough understanding of medical indemnity legislation and holds numerous insurance qualifications and a Master of Applied Finance. He is uniquely placed to advise AMA Queensland members. Please feel free to contact Chris on 0419 017 011 if you need advice on any insurance matter.

Doctors often cite their major concern when switching medical indemnity insurers is whether their ‘tail’ will be covered, as in – “I’ve practised for 10 years and been insured with the one insurer. If I move to a new insurer, will they cover a claim that develops tomorrow from a patient I treated 10 years ago?” The good news is your ‘tail’ will be covered, as long as you avoid the traps. But the decision to switch should be based on a number of other equally important factors, as summarised in the below table. This article focuses on the four Medical Defence Organisations (MDOs), as it was recently announced

TOPIC

the commercially owned Invivo sold to MIGA. This means doctors will have four MDOs to choose from when selecting a medical indemnity provider. Doctors tell us they consider switching after experiencing poor service, when their colleagues suggest they switch, or when they discover another insurer is cheaper. So if the time has come to switch, how do you do it safely? If you are thinking of switching, seek expert advice based on your particular circumstances – medical indemnity and the legislation surrounding it is complex. A whole book could be dedicated to switching and further information is available from www.amaqis. com.au or by calling us. Q

SUMMARY Cover Your ‘Tail’

Report all Claims and Circumstances

Ensure your tail (known as retroactive cover) is protected with the new insurer. Legislation* requires the insurer to provide a retroactive offer. The insurer will rely on the retroactive details you provide so ensure these are correct. *The Medical Indemnity (Prudential Supervision and Product Standards) Act 2003 Cth requires an insurer to make a compulsory offer covering all ‘otherwise uncovered prior incidents’.

You can’t insure your house after it has already burnt down. A medical indemnity policy will generally exclude: • claims already made against you, and • circumstances you are aware of that could develop into a claim in the future So it’s vital to ensure you report all claims and circumstances to your existing insurer before you switch. If in doubt, report it.

Continuous Cover

Some policies provide ‘continuous cover’ which means as long as you stay continuously insured with that insurer, you can late notify a claim that you should have notified in an earlier policy. You lose this benefit when switching.

Policy Coverage

Review your current policy coverage. Does the new policy suit you and your practice structure? Coverage between the MDOs varies widely.

Membership Benefits

What membership benefits will you lose when leaving your current MDO, against those you may gain from the new MDO? E.g. one MDO provides a loyalty payment which reduces premiums on an increasing scale based on membership tenure.

Future Premiums

Don’t just look at the premium quoted. Ask what your premiums will be in future years, especially where you are starting in private practice, changing specialities or billings - as these can all significantly change future premiums.

Plan for the Future

Understand your circumstances. Eg if you’re retiring next year at 58 and have been with your MDO for 10+ years, you may be entitled to a $50 run-off policy annually for three years. After that, free ROCS (Run-Off Cover Scheme) should apply. But if you switch insurers, the $50 run-off policy won’t apply and you could spend thousands in run-off costs until you become ROCS eligible.

DISCLAIMER: AMA Queensland Insurance Solutions is a joint initiative of AMA Queensland and Insurance Advisernet Australia Pty Limited ABN 15 003 886 687 AFS Licence 240549. AMA Queensland Insurance Solutions is a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, Authorised Representative No: 320115. The information provided in this article is of a general nature and does not take into account your objectives, financial situation or need. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.

MAY 2013 DoctorQ

www.amaqis.com.au

Insurance renewal time getting you down? Letâ&#x20AC;&#x2122;s face it insurance is boring. But necessary. We know doctors have a busy schedule, and while it may be easy to renew your insurance each year without proper revision, changes may have occurred for which you may not be fully covered and premiums need competitive comparison. For peace of mind and taking the yawn out of renewal time, contact AMA Queensland Insurance Solutions.

All insurance needs covered for all members through AMA Queensland Insurance Solutions.

AMA Qu eenslan d Insuran ce Solution Your Ins s urance Speciali sts

For more information phone: 1300 883 059

DoctorQ MAY 2013

BUSINESS TOOLS

NEGATIVE GEARING AND YOUR INVESTMENTS NEGATIVE GEARING: THE PROCESS OF PURCHASING AN INCOME-PRODUCING ASSET, SUCH AS SHARES OR PROPERTY, USING BORROWED FUNDS. PAUL COPELAND FROM WILLIAM BUCK TELLS US A BIT MORE ABOUT THE STRATEGY AND SOME PRECAUTIONS TO TAKE BEFORE DIVING IN. Paul Copeland William Buck (07) 3229 5100 paul.copeland@williambuckqld.com.au

The strategy seeks to combine the capital gains tax benefits associated with long-term capital appreciation of the asset with the short-term tax benefits associated with the losses which arise in the early years under this strategy. This strategy has historically been associated with investment properties along with listed equity investments. However, the use of negative gearing with listed equities, in the form of margin lending, has greatly reduced since the global financial crisis (GFC) due mainly to the underlying volatility of the share market. Investment properties continue to lend themselves to negative gearing due to the large amount of capital required and a more stable market. The tax authorities have historically supported the concept of negatively geared properties because it contributes to keeping residential rental prices at affordable levels. It is due to the stability and relative security of property that most financial institutions are prepared to lend 80 - 90 per cent of the purchase cost. These borrowings increase the available investment options beyond the investments available when limited to your own investment capital. Generally interest and other associated costs of holding and renting a property, such as depreciation, rates and repairs, will exceed the rental income earned during the early years of ownership, generating income losses. The tax law allows these rental property losses to be offset against other income in the investor’s tax return. These losses can be applied to reduce your overall taxable income and as such reduce your overall tax liability. Non-cash deductions, such as depreciation and capital works allowances, are especially valuable because they allow taxpayers to obtain tax deductions without actually incurring the cost. Accordingly, we recommend our clients obtain a quantity surveyor’s report shortly after acquiring a new investment property.

MAY 2013 DoctorQ

No investment should be undertaken with tax as the sole consideration. The size of these tax benefits is dependent on the investor’s marginal tax rates. Accordingly, negative gearing is most beneficial to high income earners. For taxpayers in lower tax brackets, the lesser negative gearing tax benefit needs to be considered when assessing the overall return on the investment. While there may be significant tax benefits from negative gearing, no investment should be undertaken with tax as the sole consideration. You need to seriously consider the following issues associated with negative gearing: Cash flow – Do you have enough disposable income to fund the cash losses which are generated under this strategy? Capital appreciation - Does the expected capital growth of the asset over the period justify the costs associated with holding the investment? Exit strategy – What happens if for example you are unable to cover the cash losses which arise under the strategy each year? Financial goals – Is this strategy relevant and supportive of my future financial goals? Professional advice - Confirm and verify your profit estimates and also the appropriateness of the investment in light of your financial situation. Q

DISCLAIMER: The information contained in this summary is general in nature and should not be applied or relied upon without seeking additional professional advice. William Buck has a dedicated team of superannuation and taxation experts who are happy to speak with you regarding yourself managed super fund or any other issues regarding superannuation you may have.

You can count on us. William Buck is a firm of Chartered Accountants and advisors with a proud reputation for providing tailored services to the medical industry throughout Australia and New Zealand. With offices servicing every State and New Zealand, we are able to assist clients not only operating in the major cities but also in more remote locations that otherwise may struggle to find competent and experienced advisors. All firms have dedicated medical advisory specialists operating within all of our Business Advisory Divisions. In years gone by, we have assisted many doctors as they commence their careers and have developed tailored solutions to meet the range of needs and solve common problems that these clients have.

williambuck.com

CHARTERED ACCOUNTANTS & ADVISORS

BUSINESS TOOLS

THINKING OF SELLING YOUR BUSINESS? IF YOUâ&#x20AC;&#x2122;RE READY TO PACK UP YOUR BUSINESS AND TAKE ON A NEW ADVENTURE, TRESSCOX PARTNER LYNETTE REYNOLDS HAS SOME TIPS ON PREPARING FOR SALE.

Lynette Reynolds Partner (07) 3004 3555 lynette_reynolds@tresscox.com.au

If you are considering selling your business, then you should anticipate that any buyer will conduct a due diligence to investigate title to the assets and the financial viability of the business before

settlement. There are steps you can take to make the marketing, due diligence, contract negotiation and title transfer process smoother.

Get professional accounting advice early about the best way to structure the sale and the likely tax implications of the sale. Ensure any personal assets not intended to be sold (such as motor vehicles) are removed from the accounts. Ensure financial year, management accounts and tax records are complete and up to date with a view to them being ready for presentation to buyers. Ensure any service, trust or other arrangements with respect to plant and equipment are properly documented. If any equipment in the business is being financed or leased, you may need to make arrangements to pay out the lease, or to assign it to the new owner. Your lawyer can assist with this process. Separate any real property from the business and ensure a commercially realistic rent is being accounted for, or if the business premises are being leased from an unrelated third party, ensure there is a current documented lease in place that is not about to expire. Be aware that the consent of the landlord will be required to a change in tenant. Your lawyer can assist with this process. Obtaining landlord consent can take many weeks and require the replacement of cash securities, new personal guarantees from the directors of the buyer and/ or a bank guarantee. Ensure employee records and contracts are up to date, current and signed. Ensure accreditation processes and manuals are up to date and properly documented. If you are not continuing to work in the business, be aware that most buyers will require a restraint of trade for a period of years (often five) for a geographical area wide enough to prevent patients from travelling to see you. Provide all of the above information to your lawyer so that a complete contract can be prepared for submission to prospective buyers. Q

Be aware that most buyers will require a restraint of trade for a period of years (often five) to prevent patients from travelling to see you.

MAY 2013 DoctorQ

“We are well connected to the health industry, so we offer a deep understanding of the issues.”

TressCox has over 100 years experience representing Medical Practitioners in various areas of Health Law. Our Health Services Group is one of the largest and most experienced in Australia. We are well connected to the health industry, its peak bodies and key professionals, so we offer a deep understanding of the issues. When professional, ethical and commercial issues compete, our legal advice is sensitive to every nuance and reality for one particular reason: our health team has specialist expertise gained through long term relationships with the industry. • • • • •

Asset Protection Trusts Property transfers to related parties Conveyancing Leasing Employment arrangements

www.tresscox.com.au Phone: 07 3004 3500

• Acquisition of medical practices • Property syndicates • Deceased estate, Will and succession planning • Structuring of medical practices twitt e r.c om/ Tres s C o x linkedin.com/company/tresscox-lawyer s

BUSINESS TOOLS

MEMBERS ARE LOVING THE INVESTEC CREDIT CARD INVESTEC’S BRENT ZUROWSKI TELLS US WHY AMA QUEENSLAND MEMBERS HAVE EMBRACED THE NEW INVESTEC CREDIT CARD.

Brent Zurowski Investec 1300 131 141 www.investec.com.au/medicalfinance

If it wasn’t for his wife and his Investec credit card, Dr Christopher Price could have completely missed his mid-life crisis. “I’m turning 50 and my wife insisted I treat it as any potential crisis,” he says. “So now I own a convertible BMW, to be honest I didn’t want to, it’s just a bit of a menoporsche thing. I was shown the car online and told to go and buy it, so I did.”

and then easily establish an asset finance or loan contract as well to pay for the purchase over time. It’s a very simple process for our clients,” explains Investec’s Brent Zurowski.

What made Dr Price’s mid-life crisis purchase slightly different was that he did it on his Investec credit card. “I’ve been using Investec for 10 years to finance loans for my practice,” he says.

“The Qantas Frequent Flyer points are an important part of the offering. I think people place value on them. I think the other appeal is the relationship with the person at Investec, so when you might have an issue you can sort it out quickly.”

“Angela Warren from Investec’s Brisbane office, with whom I have done a considerable amount of work, brought the Investec credit card to my attention. I’ve always felt I had good advice and competitive rates from Investec, so when she mentioned it I reviewed the detail and said yes.” “Because Investec allowed a one-off increase in my credit limit, I could buy the car, and earn usual Qantas Frequent Flyer points one gets with purchasing something on the card. It all goes towards an overseas holiday with the kids.” While not everyone would think of making a major purchase like a car on their credit card, Investec can make it happen for their medical and dental clients.

DISCLAIMER: Investec Bank (Australia) Limited (IBAL) ABN 55 071 292 is authorised by the Australian Prudential Regulation Authority (APRA) in Australia to carry out banking business in Australia. IBAL is also authorized by ASIC in term of an, Australian Financial Services Licence 234975, Australian Credit Licence 234975. The terms and conditions of these licensing requirements are applicable. Qantas Frequent Flyer points are earned in accordance with the Investec/Qantas Terms and Conditions available at www.investec.com.au/cards. Points are earned on eligible purchases only. You must be a member of the Qantas Frequent Flyer program in order to earn and redeem points. Qantas Frequent Flyer points and membership are subject to the Qantas Frequent Flyer program Terms and Conditions. Full details are available at www.qantas. com/frequentflyer. Investec recommends that you seek independent tax advice in respect of the tax consequences (including fringe benefits tax, and goods and services tax and income tax) arising from the use of this product or from participating in the Qantas Frequent Flyer program or from using any of the rewards or other available program facilities. Advice does not take into account your personal needs and financial circumstances. Please consider if it is appropriate for you and read the terms and conditions, Product Disclosure Statement and Financial Services Guide before acquiring any product. Applications for credit subject to approval. Terms and conditions available on application. Fees and charges apply.

MAY 2013 DoctorQ

“Normally, a car dealer doesn’t like to accept a credit card for such a big value purchase but we are able to facilitate the transaction on the card

Investec donates $75 to the AMAQ Foundation for every approved and activated Signature card opened by our members.

“On top of that,” Zurowski continues, “they can make the monthly repayments on the card, and effectively earn twice the number of points.”

The service element was vital for Dr Price. “The application process was quick and simple as opposed to the usual paperwork.” According to Dr Price, “Investec made life easy. When I had a query about the card, the phone was answered quickly, by a real human who had the answers. In fact everything’s been easy and that’s worth paying for.” The advantages of an Investec credit card aren’t just for established clients either. Dr Sophia Petta recently moved to Sydney and had her eye on an investment property and a present for herself—a black convertible Infiniti G37. “The car I wanted came in to Australia at the same time as the Investec Signature card was released, and it seemed like a good idea to get one and use it to buy the car,” she says. But one of the most powerful points of difference— and the thing that really sold the idea to Sophia Petta—is the client’s ability to convert their purchase to a different type of loan with Investec. That may be a lease, or chattel mortgage, or whatever best suits their financial situation, and yet they still earnthe points from their purchase. Which is what Sophia did. She says she found the whole process of getting her Investec card to be as simple as filling out a single form. “After that,” she says, “it got approved and I bought the car on the credit card, then Investec drew up a lease and the balance on the card went to zero. Now I pay the lease off on my card, so I’m earning double the points. There was a credit card fee on the transaction, but $800 is well worth it for getting that many points in a single transaction.” Q

Quality Medical Consultation rooms available

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Located within Qscan Redcliffe the private medical consultation rooms are modern and practical in design, and offer accessibility to amenities, staff room and the administration office. There is also ample free onsite parking available to your patients. The room sizes are 4.25m x 3.0m equipped with desk, examination bed and a basin.

For rental fees and further information regarding the rooms, please contact info@qscan.com.au or 07 3357 0922

DoctorQ MAY 2013

lifestyle

HOLIDAY at Home WHILE WE GO ABOUT OUR REGULAR ROUTINE, WE OFTEN FORGET ABOUT THE MAGIC THAT IS SOUTH EAST QUEENSLAND WHEN PLANNING OUR ESCAPES. ROS BULAT FROM AMA TRAVEL TELLS US WHY A HOLIDAY AT HOME IS BEST WITH YOUNG FAMILIES.

During the last summer holidays I was doing the usual work and school holiday juggle and was finding it difficult to get away for an extended period of time. As a solution I decided to holiday at home. In speaking with some of the other school families it seems to be a growing trend. We decided to check into the Surfers Paradise Marriott Resort and Spa for three nights. I must confess, it was one of the best holidays I have had in a long time. Coming from a person who travels for a living, that is a big call. The benefits were: • No travel time • I was able to return home quickly and get the things “we” forget! • Caught up with friends for dinner at the hotel each night. The Surfers Paradise Marriott Resort and Spa has recently undergone a renovation. It offers great dining opportunities inhouse as well as in nearby Main Beach. The hotel offers free in-house parking, which for those from Brisbane may come as a surprise. Most hotel parking in Brisbane is in excess of $45 a night for inhouse guests. I asked my son what his favourite part of the holiday was. His answer was simply

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“the pool”. It’s not just a pool it’s actually a lagoon. Set amidst tropical gardens, the lagoon features a cascading waterfall, rock grottos, spas, water slide and more. You can swim and snorkel with an array of tropical fish without even leaving the hotel. They offered the rental of a range of equipment by the pool including sea scooters. While I resisted at first hiring the Sea Scooter, it was an amazing experience for my eight year old. Ask me what was my favourite part and I would perhaps say the Elandra Retreat Club. You can pay a surcharge of to have full access to the lounge. You then receive Breakfast (either in the lounge or at the main restaurant – value $39 on it’s own), access to basic non-alcoholic drinks in the lounge during the day, coffee and tea, morning tea, afternoon tea, evening cocktails and canapés. All in all good value if you plan to stay in-house. During the holidays the Surfers Paradise Marriott Resort and Spa offers a complementary kids club. They have a range of activities included both by the pool and inside (E.g. movies). Kids get to meet up each day and enjoy their time under the supervision of qualified staff. To make a booking, please contact AMA Travel or the hotel on 1800 809 090 or visit www.surfersparadisemarriott.com.au Q

HANDY HINT So you can experience the “Holiday at home” the Surfers Paradise Marriott Resort and Spa offers a great STAY 3 AND SAVE @ MARRIOTT. Stay three nights or more at their hotel and save 20% off the Stay for Breakfast packages. Rates start from $216* per night and are valid until 30 June 2013. *Rate and package is subject to availability and further conditions do apply.

For more inform ation call or email Ros and Stephanie at AM A Travel Queens land. PHONE: 1800 262 885 FAX: (07) 5556 720 0 EMAIL: travel@amaq.com .au WEB: www.amaq.worl dtravel.com.au

lifestyle

VINTAGE OF THE YEAR

PHIL MANSER FROM WINE DIRECT TAKES US ON A TRIP TO THE VINEYARD AS HARVESTING SEASON BEGINS AND WHILE 2013 ISN’T PRODUCING A GREAT YIELD, IT’S PROVING TO BE A GREAT VINTAGE.

I love this time of year, mild Autumn weather sets in and a vigneron’s thoughts turn to getting precious fruit off the vine and into winery. This conjures for many wine drinkers a romantic notion of wine maker or grower walking through the vineyard chewing on a grape or two, a thoughtful look at the sky then a knowing nod to the vineyard manager that ‘it’s time’. The reality is somewhat different as I experienced again this year in McLaren Vale as assistant dog’s body at Five Lazy Acres (nee Killibinbin Sandtrap), owned and operated by Liz and Ritchie Smith. It was an early start and we were out in the vineyard at 4am as the harvester started its rounds, the real back-breaking work hadn’t started for us yet, but I could see the stress levels rising as Ritchie began calculating in his head how much fruit was coming off and what it was going to convert to in real volume and ultimately income. Noel, senior member of the picking crew stood next to us still upright after only seven hours sleep over the past five days and speculated ‘looks like ten tonne this year, good looking fruit too’, Ritchie concurred and as it turns

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

out they were only out by 200kgs. There’s no substitute for experience and you’ll find guys like these everywhere in the industry, brimming with hands-on wisdom from long nights fuelled by coffee and/or adrenalin. Much later that day (noon), Ritchie’s shiraz had been processed and was bubbling away in open fermenters we had bucketed in during the morning. Beaumes were ideal with lovely wafts of rich fruit telling us a similar story to others in the district that although yields were down, 2013 vintage was going to deliver some outstanding wines. A few days later I got the low down from Tim Adams up in the Clare Valley and again the story was similar, lower yields but a ‘great’ vintage. In particular their shiraz was described as ‘an absolute monster’! Vintage rating has always been an annoyance to myself and especially wine makers. To blanketly describe an entire vintage as ‘bad’ in this country (of all places) is folly. Australia has led the world in innovation in all stages of the winemaking process and in most cases any ‘difficulties’ can be mitigated either in vineyard, winery or cellar. Not to mention the relatively stable climate most of our wine growing areas enjoy. Early in my career I was counseled to only buy the even vintages and ignore the odd ones which in reality is ridiculous. Mother Nature is simply not that well organised, if she was there’d be a lot less stress involved in farming full stop.

My point is simple, play the wine not the vintage. The world doesn’t stop turning after a difficult vintage and wine drinkers in turn don’t stop drinking. 2011 is one of those ‘difficult’ years yet already we’ve seen some exciting wines already emerge, Kalleske Greenock Shiraz immediately comes to mind, stunning, generous in fruit and body with silky structure to boot, one for the cellar. I have a long list of lovely 2011 whites and reds, send me an email and I’ll send you some info and a red hot price on the Kalleske. Q

...stunning, generous in fruit and body with silky structure to boot, one for the cellar.

DoctorQ MAY 2013

lifestyle

PRE-BUDGET SUPER ANNOUNCEMENT MACQUARIE’S ROSS NOYE EXPLAINS WHY RECENTLY PROPOSED CHANGES TO THE TAX ON SUPERANNUATION EARNINGS RETAIN THE SUPER FUND STRUCTURE AS THE MOST ATTRACTIVE VEHICLE FOR RETIREMENT SAVINGS AND INVESTMENT.

ROSS NOYE

Senior Advisor, Macquarie Private Wealth

Currently all earnings (including dividends, interest, rent, and capital gains etc) on assets supporting superannuation income streams (assets in the pension phase) are tax-free – earnings are classified as exempt current pension income of a superannuation fund. Superannuation fund earnings in the accumulation phase are taxed at 15 per cent – as these earnings form part of the fund’s assessable income. According to the recent Federal Government announcement, from 1 July 2014 the amount of exempt current pension income available to superannuation funds will be limited to $100,000 a year for each individual. Fund earnings, derived from pension assets, above this limit will be taxed at 15 per cent, the same tax rate that applies to super fund earnings in the accumulation phase. This proposed $100,000 limit will be indexed to the Consumer Price Index (CPI), and will increase in $10,000 increments. Currently, when a superannuation fund makes a capital gain on assets in the pension phase, the capital gain amount is also treated as exempt current pension income (and therefore exempted from tax). However, a capital gains tax event is only triggered in the year that the fund disposes of the asset.

As such, special arrangements will apply for capital gains on assets purchased by a fund before 1 July 2014: For assets that were purchased before 5 April 2013, a full tax exemption will continue to apply to capital gains that accrue before 1 July 2024 For assets that are purchased from 5 April 2013 to 30 June 2014, individuals will have the choice of including in the $100,000 limit the entire capital gain, or only that part that accrues after 1 July 2014; and For assets that are purchased from 1 July 2014, the entire capital gain will be included in the $100,000 limit. WITHDRAWALS TO REMAIN TAX-FREE It is important to note that this reform will not affect the tax treatment of withdrawals (both lump sums and pensions) made from a superannuation fund. Withdrawals will continue to remain tax-free for those aged 60 and over, and be subject to the existing tax rates for those aged under 60. The Government will also ensure that members of defined benefit funds (including federal politicians) are impacted by this new reform in the same way as members of defined contribution funds (i.e. that there will be a corresponding decrease in concessions in the retirement phase).

INCREASE TO TAX DEDUCTIBLE CONTRIBUTION LIMIT FROM $25,000 TO $35,000 The Government had previously announced that it planned, from 1 July 2014, to allow individuals aged 50 and over, with superannuation balances below $500,000, to make up to $25,000 more in concessional contributions than allowed under the standard $25,000 concessional contributions cap. As part of the announcement, the Government will instead provide an unindexed $35,000 concessional cap, regardless of the size of that person’s superannuation balance, and bring the start date forward to 1 July 2013 (for certain individuals) as follows: For people aged 60 and over, this new higher concessional contribution cap will apply for contributions made from 1 July 2013; and For individuals aged 50 and over, this higher concessional contribution cap will apply from the current planned start date of 1 July 2014. Please note that the proposed changes detailed above must be introduced and passed in Parliament. At this stage, with much of the detail unclear and an upcoming federal election, the timing of these changes is unclear. Q

Withdrawals will continue to remain taxfree for those aged 60 and over, and be subject to the existing tax rates for those aged under 60. DISCLAIMER: This information has been prepared by Macquarie Equities Limited ABN 41 002 574 923 (“MEL”) participant of Australian Securities Exchange Group, Australian financial services licence No. 237504, No 1, Shelley St, Sydney NSW 2000, and does not take into account your objectives, financial situation or needs. Before acting on this information, you should consider whether it is appropriate to your situation. We recommend that you obtain financial, legal and taxation advice before making any financial investment decision. Members of the Macquarie Group or their associates, officers or employees (“Macquarie”) may have interests in the financial products referred to in this advice by acting in various roles including as investment banker, underwriter or dealer, holder of principal positions, broker, lender or adviser.

MAY 2013 DoctorQ

all about you The iPhone app that helps you achieve your weight loss goals. A clever little iPhone app from the team at Calorie King, ControlMyWeight™ is a fast, simple calorie counter app that provides calorie targets to ensure healthy weight loss. Seeing is believing! Not only does the app count your calories, it also keeps track of your weight and visualises your progress with beautiful, easy-to-read graphs. Q

BOOK CLUB Looking for a new book to read?

Join us in reading a variety of books for the chance to win a copy of next edition’s book club book. Send your feedback to editor@amaq.com.au. Q

APP SNAP

THE QUEEN’S GAMBIT CONTEMPORARY

ControlMyWeight ™

ELIZABETH FREMANTLE Divorced, beheaded, died, divorced, beheaded, survived. The court of Henry VIII is rife with intrigue, rivalries and romance - and none are better placed to understand this than the women at its heart. A tale of female friendship and betrayal, passion and deadly intrigue, Queen’s Gambit tells the story of Henry VIII’s sixth wife Katherine Parr, a dynamic and intelligent woman who negotiated the danger of Henry’s Tudor court with skill and discretion.

ENGINEERS OF VICTORY

WAR

THE PROBLEM SOLVERS WHO TURNED THE TIDE IN THE SECOND WORLD WAR

Control MyWeight™ also allows you to record exercise and water intake.

PAUL KENNEDY The focus of this book is not upon the commanders who directed the Allies military forces, nor for the most part on the soldiers on the ground, but on the problem-solvers, the men in the middle who actually worked out how to achieve some formidable objectives in practice.

CHALLENGE THAT UNHELPFUL THINKING “Chasing the ice cream truck does not count as a summer fitness program.”

Catastrophising

Jumping to Conclusions

Catastrophising occurs when we blow things out of proportion and we view the situation as terrible, awful, dreadful, and horrible, even though the reality is that the problem itself is quite small.

We jump to conclusions when we assume we know what someone else is thinking (mind reading) and when we make predictions about what is going to happen in the future (predictive thinking).

Thanks to the Centre for Clinical Interventions www.cci.health.wa.gov.au DoctorQ MAY 2013

lifestyle NATIONAL

THEATRE

THIS HOUSE

LIVE

8 and 9 June

It’s 1974 and the corridors of Westminster ring with the sound of infighting and backbiting as Britain’s political parties battle to change the future of the nation, whatever it takes. In this hung parliament, the ruling party holds on by a thread. Votes are won and lost by one, fist fights erupt in the bars, and ill MPs are hauled in to cast their votes.

ORE FOR M ISIT INFO VOM.AU

MET OPERA

.C DENDY

Francesca-da-Rimini Giulio Cesare

4, 5 and 9 May 18, 19 and 23 May

Carmen

23 and 27 June

BALLET Enjoy ballet performances from the world’s greatest dance companies, including Nederlands Dans Theater and the Bolshoi Ballet. Screenings at 1pm.

THE GREAT GATSBY Opens 30 May

Esmeralda

12 and 16 May

An Evening with Ekman

Starring: Leonardo DiCaprio, Tobey Maguire, Joel Edgerton, Carey Mulligan, Isla Fisher, Jason Clarke, Elizabeth Debicki, Amitabh Bachchan

COMING FILMS

Directed By: Baz Luhrmann The Great Gatsby follows would-be writer Nick Carraway (Toby Maguire) as he leaves the Midwest and comes to New York City in the spring of 1922, an era of loosening morals, glittering jazz, bootleg kings, and skyrocketing stocks. Chasing his own American Dream, Nick lands next door to a mysterious, party-giving millionaire, Jay Gatsby (Leonardo DiCaprio), and across the bay from his cousin, Daisy (Carey Mulligan), and her philandering, blue-blooded husband, Tom Buchanan (Joel Edgerton). It is thus that Nick is drawn into the captivating world of the super rich, their illusions, loves and deceits. As Nick bears witness, in and out of the world he inhabits, he pens a tale of impossible love, incorruptible dreams and high-octane tragedy, and holds a mirror to our own modern times and struggles.

2 May

Big Wedding

9 May 16 May

Spring Breakers Star Trek: Into Darkness

23 May

Hangover 3

30 May

The Great Gatsby Sinister Happiness Never Comes Alone

13 June

After Earth

20 June

Despicable Me 2 in 3D Monsters University World War Z

27 June

Man of Steel

ROMAN HOLIDAY (1953) 6 May, 10am and 7pm

THE GREAT GATSBY (1974) 27 May, 10am and 7pm

CORPORATE EVENTS & GROUP BOOKINGS We love hosting corporate film nights and group bookings at Dendy. Hosting a corporate screening event is a great way to thank clients or staff – or perhaps you have a favourite charity that you would like to raise some money for? We have a functions pack and cinema package to suit all requirements. Contact Events & Publicity Manager Jenny Sonter on jennys@dendy.com.au for a free quote.

WIN MOVIE TICKETS FOR TWO Name: Postal address: Portside Wharf, Remora Road, Hamilton Ph: (07) 3137 6000 www.dendy.com.au 60

MAY 2013 DoctorQ

2 and 6 June

Phone:

FAX BACK TO (07) 3856 4727 or email amaq@amaq.com.au by 31 May

lifestyle lifestyle VALENTINA LISITSA 8 June, Concert Hall, QPAC Sensational pianist and YouTube phenomenon Valentina Lisitsa is set to make her Australian debut. With her multi-faceted and expressive playing described as ‘dazzling’, Ukrainian-born Valentina Lisitsa’s vast repertoire, ranging from Bach and Mozart to Shostakovich and Bernstein, has earned her a staggering 55 million hits on YouTube, making her one of the most sought-after classical musicians on the web.

SOUTHERN CROSS SOLOISTS

ORE FOR M ION MAT INFOR M.AU CO QPAC. 246 OR 136

23 June, Concert Hall, QPAC Southern Cross Soloists take a spin in a new direction with the addition of rhythm and dance to their traditional chamber repertoire. Featuring percussionist Timothy Constable and dancers Stacey McCallum, Kimberley Davis, Shane Weatherby, Rhythm and Dance includes an eclectic mix of works from the Baroque to the brand new, with something for everyone.

MOTHER COURAGE AND HER CHILDREN

JOAN BAEZ 12 August, Concert Hall, QPAC For the first time in more than 20 years America’s legendary folk singer, songwriter and activist Joan Baez, returns to Australia. Joan Baez is a musical and political force of nature whose influence is incalculable - marching on the front lines of the civil rights movement with Martin Luther King, inspiring Vaclav Havel in his fight for a Czech Republic, singing on the first Amnesty International tour and standing alongside Nelson Mandela when the world celebrated his 90th birthday in London’s Hyde Park.

WIN DOUBLE PASSES TO MOTHER COURAGE AND HER CHILDREN

25 May – 16 June, Playhouse, QPAC Bertolt Brecht’s epic morality tale about the ravages of war is given a unique twist by Queensland Theatre Company Artistic Director Wesley Enoch and Paula Nazarski in a dazzling new translation. Instead of the ‘Thirty Years’ War of 1600s Europe, this near-future incarnation of the age-old story is set against the bleak backdrop of a post-apocalyptic desert where Mad Max might be at home - an Australia ravaged by devastating conflict, where life is cheap but business is still business. Featuring an all-Indigenous cast, starring Ursula Yovich and David Page.

Name: Postal address:

Phone:

FAX BACK TO (07) 3856 4727 or email amaq@amaq.com.au by 31 May DoctorQ MAY 2013

lifestyle

THE GOOD DOCTOR WHAT PATIENTS WANT RON PATERSON

What makes a good doctor? Can we inject more information, more trust and more assured competence into the medical system? Drawing on his years of dealing with patient concerns, Ron Paterson makes challenging arguments additional regulation, information overload for doctors, judging peers with problems and laws and practices in place to check that doctors remain up-to-date.

Doctor Q has a copy of The Good Doctor: What Patients Want to give away. Simply fill out your details in block letters on the form and fax it to (07) 3856 4727 or email amaq@amaq.com.au.

Entries close 31 May 2013

COMPETITION WINNERS

CHECK FOR YOUR NAME!

MAY 2013 DoctorQ

inform patients better and to revalidate doctors periodically, all key ways we might improve patient care. The Good Doctor will be prescribed reading for doctors, patients and policymakers—all of those determined to make sure patients get the medical care they deserve. Published by Auckland University Press, The Good Doctor retails for $39.99. Q

Paterson concludes the book with proposals to lift the veil of secrecy, to

WIN THIS BOOK!

Name: Postal Address:

Telephone:

DENDY WINNERS

QPAC WINNERS

BOOK WINNER

DOUBLE PASS WINNERS

Dr Ray Kerr and Dr Lynn Kennedy won double passes to Cirque de la Symphonie at QPAC in April.

Dr Rachel Bidgood won Successful Practice Management: Exceeding Patient Expectations, an extensive guide to running a successful medical practice.

1. Dr John O’Sullivan 2. Dr Susan Bennett 3. Dr KF Bowes 4. Dr Brian Wilson-Boyd 5. Dr Mitesh Gandhi 6. Dr Rosemary Campbell 7. Dr Allan Tham 8. Dr Siaw Kang Ho 9. Dr Beth Molnar 10. Dr Marjorie Busby

2013 Annual General Meeting The Annual General Meeting of the Members of the Queensland Branch of the Australian Medical Association will be held at: Time: 6.30pm Date: Tuesday 21 May 2013 Venue: Hunstanton, 88 L’Estrange Terrace Kelvin Grove, Queensland

BUSINESS The business of the Meeting will be: 1. To receive and consider the accounts, balance sheets and reports of: (i) The Board of Directors; (ii) Any committees instructed to report to the meeting; and (iii) The Auditors. 2. The declaration of the results from the election of; (i) The President Election and Council members. 3. The appointment of the Auditors and approval of the remuneration (if any) to be paid to the Auditors; 4. The President’s address; and 5. To deal with all business which any statute, the Constitution, or the By-laws requires.

AMA QUEENSLAND

BOOKKEEPING SERVICE

PROXY NOTICE A member who is entitled to attend and register one vote at the Annual General Meeting is also entitled to appoint another member as a proxy to attend and vote in his or her place. Proxy forms can be downloaded from the AMA Queensland website (www.amaq.com.au/AMAQ2013elections) or by phoning Andrew Turner on (07) 3872 2207 and must be received by 6.30pm 19 May 2013.

NOTES The Presidential Inauguration and presentation of annual AMA Queensland awards will be held on Friday 14 June 2013 at the Stamford Plaza, Brisbane city, where the following business will be conducted: 1. Installation of Dr Christian Rowan as President 2013-2014; and 2. Presentation of Awards and Prizes.

ANNUAL REPORT *The 2012 Annual Report will be available online from 19 April 2013 at www.amaq.com.au.

The Business Support Services team at AMA Queensland provides professional and confidential financial services for your organisation. We offer a service that includes a full function payroll (including superannuation, PAYG and payroll tax), creditors, debtors, bank reconciliations, provision of monthly financial reports as well as the completion and lodgement of business activity statements. We communicate with your tax accountants to ensure services are performed efficiently: reducing doublehandling and saving you money.

Quality service Competitive price Help available when you need it five days per week Experienced in the medical industry

Call us to discuss your bookkeeping requirements

(07) 3872 2222

Email: bss@amaq.com.au Fax: (07) 3856 4727

Secure, long-standing organisation with a reputation you can trust Services are flexible to suit your business needs CPA qualified accountant leading the team Registered BAS agent References available

PO Box 123, Red Hill Qld 4059 88 L’Estrange Terrace, Kelvin Grove, Qld 4059 www.amaq.com.au

DoctorQ MAY 2013

The smoothest operation you’ll ever perform Buy a car or equipment with your card and take a holiday sooner

It takes a specialist bank to create a credit card for specialists Investec has come up with a card specially designed for the medical profession. It’s quite clever: for instance, buy a car or equipment on your Investec card and you can earn Qantas Frequent Flyer points on that eligible purchase and then roll it over into a lease with Investec. You can also pay off your new and existing equipment or fit-out contracts with your card to earn even more points. Then all you have to do is start planning your next holiday.

Take a look at investec.com.au/medical or call one of our financial specialists on 1300 131 141 to find out how we can help.

O u t o f t h e O r d i n a r y™

Home loans | Car finance | Transactional banking and overdrafts | Savings and deposits | Credit cards | Foreign exchange | Goodwill and practice purchase loans Commercial and industrial property finance | Equipment and fit-out finance | SMSF lending and deposits | Income protection and life insurance All finance products are issued by Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL 234975, Australian Credit Licence No. 234975 (Investec Bank). All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Information contained in this document is general in nature and does not take into account your personal financial or investment needs or circumstances. We reserve the right to cease offering these products at any time without notice. You should obtain independent financial, tax and legal advice, as appropriate. Qantas Frequent Flyer points are earned in accordance with the Investec/Qantas Terms and Conditions available at www.investec.com.au/card. Points are earned on eligible purchases only. You must be a member of the Qantas Frequent Flyer program in order to earn and redeem points. Qantas Frequent Flyer points and membership are subject to the Qantas Frequent Flyer program Terms and Conditions. Full details are available at www.qantas.com/frequentflyer. Investec Bank recommends that you seek independent tax advice in respect of the tax consequences (including fringe benefits tax, and goods and services tax and income tax) arising from the use of this product or from participating in the Qantas Frequent Flyer program or from using any of the rewards or other available program facilities. Insurance products are offered by Experien Insurance Services (Representative No. 320626) , the preferred supplier of insurance products to Investec Bank.