AUTUMN 2016 | VOL. 98
TACKLING ALCOHOLFUELLED VIOLENCE FAIR WORK AUDITS – ARE YOU READY? OFFICE OF THE HEALTH OMBUDSMAN REFORM CAMPAIGN OBITUARY: EMERITUS PROFESSOR TESS CRAMOND AO OBE OSTJ
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CONTENTS 4
FROM THE EDITOR’S DESK
6
PRESIDENT’S REPORT
8
CEO’S REPORT
38
MEMBER NEWS
CURRENT ISSUES 16
WALK THE TALK
18
PREPARE FOR A FAIR WORK AUDIT
20
ASMOFQ UPDATE: MATER NEGOTIATIONS AND MOCA 4
22
OFFICE OF THE HEALTH OMBUDSMAN REFORM CAMPAIGN
24
HEALTH HUBS IMPROVING PUBLIC HEALTH
26
CLINICIANS AND CONSUMERS WEIGH IN ON OBESITY CRISIS
27
STATE BUDGET SUBMISSION
28
2016 A BIG YEAR FOR DOCTORS IN TRAINING
29
RURAL BONDED SCHEME A RAW DEAL FOR DOCTORS
30
MANAGING NEW INTERNS: ONE CONFIDENT STEP
33
GP CAN NOW EQUAL GREAT PARENTING SUPPORT
34
NAVIGATING THE IMMUNISATION REGISTER
36
AGM AND ELECTION NOTICE
PEOPLE & EVENTS 10
BANCROFT ORATION WRAP UP
12
MEMBER MILESTONES WRAP UP
32
RESEARCHER PROFILE: PROFESSOR SCOTT BELL
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LOCAL MEDICAL ASSOCIATION ROUND UP
44
EVENTS CALENDAR
46
OBITUARY: PROFESSOR TESS CRAMOND AO OBE OSTJ
48
SPEAKER PROFILE: PROFESSOR MUNJED AL MUDERIS
50
ANNUAL CONFERENCE HEADING TO INDIA
14
TACKLING ALCOHOLFUELLED VIOLENCE Queensland’s new lock out laws set to reduce the state’s problem with alcohol-fuelled violence.
18
FAIR WORK AUDITS Is your practice ready for a visit from a Fair Work Ombudsman inspector?
22
FEATURES 14 TACKLING ALCOHOL-FUELLED VIOLENCE
BUSINESS TOOLS 52
WHEN THE CORONER CALLS
54
WHEN RESTRAINT CLAUSES DO WHAT THEY’RE SUPPOSED TO
56
IS YOUR INCOME PROTECTION INSURANCE BREAKING THE BANK?
58
SUPERANNUATION: THE KEY FACTS
60
TAX CHANGES TO SUPER BACK ON THE AGENDA
61
DOES YOU CURRENT CAR MATCH WHERE YOU ARE IN YOUR CAREER?
62
RISK MANAGEMENT - MANAGING CYBER AND PRIVACY RISKS
OFFICE OF THE HEALTH OMBUDSMAN REFORM CAMPAIGN In 2016, AMA Queensland will be launching a campaign to reform the Office of the Health Ombudsman.
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LIFESTYLE 64
RESTAURANT REVIEW: THE JAM PANTRY
65
THE WORLD’S MOST EXOTIC OVERWATER BUNGALOWS
66
ANYTHING BUT CHARDONNAY
67
DENDY MOVIES
68
ALL ABOUT YOU
69
OCKER DOCTOR: THE BRAVEST OF THE BRAVE
70
IN PRINT
RURAL BONDED SCHEME A RAW DEAL FOR DOCTORS The Medical Rural Bonded Scheme budget still affects some 1,400 doctors, is not fit for purpose and disadvantages rural communities.
REPORTS
EDITOR’S DESK AMA Queensland has passionately supported the lock out laws since discussion began in January 2015. Research shows that reducing the time people have available to drink and pre-load on drinks should reduce alcohol-fuelled violence by 30 per cent. Read more about the new laws on p14.
A big welcome to our new intern members! Find an update from your interim Council of Doctors in Training Chair Dr Matt Cheng on p28. The Queensland Law Society has some great advice on navigating the immunisation databases on behalf of parents who have incorrectly ended up without childcare benefits (p34). Q
OBITUARIES The following AMA Queensland members have recently passed away. Our sincere condolences to their families. Professor Graeme Leslie BEARDMORE Dermatologist Late of Cleveland Member for 59 Years Dr Josse Corneel VAN OPDENBOSCH General Practitioner Late of Charters Towers Member for 23 years
Professor Teresa (Tess) Rita O’Rourke CRAMOND AO OBE OStJ DMG Palliative Medicine Physician Late of Clayfield Member for 64 years Past President Emeritus Vice President
Board of Directors Dr Chris Zappala President
Dr Kirsten Price Honorary Secretary
Dr Shaun Rudd Chair of Board and Council
Dr Dilip Dhupelia Appointed Director
Dr Bill Boyd Vice-President Dr Bav Manoharan Treasurer
Dr Richard Kidd Appointed Director Dr Sharmila Biswas Appointed Director
Council Dr Tom Arthur Greater Brisbane Area Dr Sharmila Biswas Far North Area Dr Kimberley Bondeson Greater Brisbane Area Douglas Brown Medical Student Observer Dr Lisa Byrom Greater Brisbane Area Dr Sarah Coll Specialist Craft Group Dr Dilip Dhupelia Part-time Medical Practitioner Craft Group Dr Jim Finn Full-time Salaried Medical Practitioner Craft Group
Dr Richard Kidd General Practitioner Craft Group Professor Steve Kisely Greater Brisbane Area Dr Luke Lawton North Area Honor Magon Medical Student Group Representative Dr Bav Manoharan Gold Coast Area Dr John F. Murray Specialist Craft Group Dr Paul Neeskens General Practitioner Craft Group Dr Kirsten Price Greater Brisbane Area
Dr John Hall Downs and West Representative
Dr Anil Sharma International Medical Graduate Representative
Dr Wayne Herdy North Coast Area
Dr Josie Sundin Greater Brisbane Area
AUSTRALIA DAY
Dr Brad Horsburgh Greater Brisbane Area
Congratulations to the following members who were recognised for their services on Australia Day. in the General Division of the Order Dr Vlasis Pitsonis Efstathis AM of Australia for significant service CStJ RFD to cardio-thoracic medicine as a Member for 46 years Dr Efstathis was named a Member surgeon and teacher in Australia in the General Division of the Order and overseas, and to professional of Australia for significant service medical groups.
Dr Harley Wilson Capricornia Representative
AMA Queensland Secretariat
to community health through leadership roles with a range of organisations, and to medicine as a practitioner. Dr Michael Anthony Gardner AM Member for 39 years
Dr Michael James MACLENNAN General Practitioner Late of Kangaroo Point Member for 40 years
Dr Edward William Weaver OAM Member for 26 years Dr Weaver received a Medal of the Order of Australia in the General Division for service to medicine and to medical education.
Dr Gardner was named a Member
Dr Sharon Kelly Specialist Craft Group
Jane Schmitt Chief Executive Officer Filomena Ferlan General Manager Corporate Services
Holly Bretherton General Manager Member Relations and Communications
. Editor: Michelle Ford Russ Graphic Designer: Nathan Pitt Journalists: Rachael Finley Advertising: Louise Glynn
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.
4 | Doctor Q Autumn
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Doctor Q Autumn | 5
REPORTS
PRESIDENT’S REPORT While some of you lounged on deck chairs at exotic beaches I spent a week in London trying to finish writing a paper I’ve been working on for many years (it’s still not finished). The week I was there coincided with two things: 1. The first junior doctor strike in England; and 2. The printing of an AMA Queensland opinion piece in The Courier Mail regarding the threats faced in the private health insurance sector The UK government is seeking to re-write contracts in England (but not Scotland or Wales) to re-classify weekend shifts as standard hours with a subsequent removal of penalty rates, but also fatigue/ safe-rostering protections. The lack of penalty rates was apparently compensated, but it was the removal of protections which was concerning and the reason just shy of 40,000 junior doctors in England went on strike for 24 hours (and picketed outside hospitals Yikes!). I had always viewed 6 | Doctor Q Autumn
penalty rates as compensation for working, as the English quaintly put it, ‘unsociable hours’. Much more than this however, penalty rates serve as a crucial disincentive to employers to compel doctors to work unsafe or potentially hazardous rosters. Upon reflection, this is actually the main purpose of penalty rates and the crux of the junior doctors’ concern in England.
and minimisation of risk. The durable and collegiate systems and practices we have in place that minimise patient and professional risk and therefore help contribute to high standards of care, will increasingly be sought as our prime defence against attempts by fund holders, whether a government body or an insurance company, to limit the care we can offer.
I understand working after hours is a critical and endogenous part of the job. As a junior doctor we do some of our most useful learning after hours. Penalty rates, fatigue provisions and safe rostering are all entwined and fundamentally matter to us all. Without these practices and protections we become exposed to risk and ultimately, patient care is in peril.
It is abundantly clear that the threshold of competence is slowly rising and the spotlight is getting glaringly bright. This is however, something to be embraced – partly because it is going to happen anyway, but more positively because broadly we individually offer very good care and should relish the opportunity to compare our practice and outcomes to colleagues and international standards (what doctor isn’t at least slightly competitive?). If practice is suboptimal, it is in everyone’s interests to correct it. Failing to deal with this, or only partially dealing with it, is our only real professional vulnerability.
This leads me on to the second issue around private health insurance – something I will write and talk incessantly about this year. As in this case, the huge majority of issues we will discuss will inevitably find their way to patient safety
The start of the year is a good time to make sure our continuing education is well planned for 2016 and that we aspire to be active participants of morbidity and review processes, infection rate audits, mortality comparisons and so on. Our defendable worth and credibility is not in our articulate parochial arguments or indignant protestation of unfair constrains to our freedom of decision-making based on our perceived worth to the system. Ensuring we can successfully rebut fund holder attempts to control how we practice medicine is not the responsibility of the hospitals we work at, and not the responsibility of the Colleges or professional societies. It is an individual, work unit and collegiate task. Our defendable credibility lies in the self-reflective, comparative data we must increasingly collect, to support what we do. Data that the health insurers and government have had for some time now. Q
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www.svphb.org.au Doctor Q Autumn | 7
REPORTS
CEO’S REPORT With 2016 in full swing, AMA Queensland is focusing on improving the health system, continuing to support members and working towards better health outcomes for Queenslanders. Workplace Relations AMA Queensland continues to serve on the frontline for members, protecting their workplace rights, conditions and entitlements. In December 2015, the Fair Work Ombudsman began a national campaign focusing on medical clinics’ legislative compliance with rates of pay, record-keeping and pay-slip obligations, and it is estimated that 200 private practices will be audited as part of the campaign. The audits have provided the opportunity for the Workplace Relations team to assist members in award compliance, payroll advice and reviews on contracts, policies and procedures. The AMA Queensland Workplace Relations Manuals have been an invaluable resource to clinics that were subject to audit. The three clinics represented by the Workplace Relations team all had a successful outcome. The support from the team also extends out to regional members with a series of Workplace Relations Training workshops scheduled across 12 different locations in Queensland. Topics presented to doctors, practice managers and staff have included: Managing Difficult Patients, Compliance with the Australian Privacy Principles and Bullying, Harassment and Discrimination.
8 | Doctor Q Autumn
Members engaged by Queensland Health have continual support from the industrial officers of the Workplace Relations Department. The team advocates and represents members who are dealing with complex bullying, harassment and discrimination matters whilst also providing assistance to those who need general advice on award interpretation, payroll disputes and assistance accessing leave. All advisors of the Workplace Relations team have specific health industry experience, providing a competitive advantage when assisting our Members. If you would like to raise a concern about your workplace or have a question on your conditions and entitlements, do not hesitate to contact the Workplace Relations Team on (07) 3872 2222. Supporting doctors’ health After a successful launch of AMA Queensland’s Resilience on the Run program at Rockhampton Hospital in August, we are looking forward to how this program might be expanded to support doctors across the state. Initial feedback for the program, which aims to provide junior doctors with the coping skills necessary to thrive in the medical profession, has been overwhelmingly positive. The program was developed following the results of a
beyondblue survey that found junior doctors have an increased rate of depression, anxiety and burnout compared to other professions. The interest and support for the program highlights a genuine interest in ensuring our medical professionals are equipped to cope with the challenges of the profession and are aware of the support options available to them. This program has the true potential to make a difference in the lives of young doctors and I look forward to sharing the pilot program results. AMA Queensland is also currently developing a new campaign that encourages doctors to live healthier, more active lives and walk the talk. Doctors spend so much time focusing on their patients’ health and sometimes need a gentle reminder to follow their own advice, so this campaign will touch on simple steps we can all take towards better health. Supporting a healthier Queensland begins with supporting the health of our doctors. Keep an eye out in Online News and via social media to learn more about our upcoming campaigns and how you can get involved. Expanding our Health Hubs The AMA Queensland Health Hubs were established as a way to promote healthier communities, improve access to GP services and provide simple, but often neglected,
health checks – such as BMI and blood pressure tests. Our inaugural Health Hub, held at the Eumundi Markets in October 2015, received positive community feedback and had a solid turnout. In 2016, we will be expanding the Health Hubs to other locations around the state, including Cairns and the Gold Coast. We look forward to working with local clinicians and community groups at Health Hub sites. If you are interested in volunteering, or if there is an event or community you believe could benefit from a Health Hub, please contact us on (07) 3872 2222. 2016 Council elections and AGM Nominations are open for the positions of President, Vice-President and Council of AMA Queensland. Serving as a Councillor is a unique opportunity to support and represent the profession, ensure members’ interests are being represented and influence change in Queensland’s health system. The election results will be announced at the AMA Queensland Annual General Meeting (AGM) on Friday 13 May. All members are welcome to attend the AGM in person or via proxy. More information about the AGM, the role of a Councillor and the election process is available on page 36. Q
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PEOPLE & EVENTS
BANCROFT ORATION More than 100 members and guests turned out to hear AMA Queensland’s 69th Bancroft Orator, Professor Paul Glasziou, a Professor of EvidenceBased Medicine at Bond University, on the topic of What medical research we should believe and use. Guests enjoyed a hearty topic and drinks afterward with a beautiful Brisbane night sky as a backdrop. The Bancroft Oration was kindly sponsored by MDA National. Q
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1. 69th Bancroft Orator Professor Paul Glasziou 3. Drs Caroline and Andrew Mercer 4. Drs Maria Heves and Margaret Kay 5. Dr David and Mary Backstrom 6. Josephine Bancroft, Sue and Shianne Joseph, and Vivienne Dydula 7. Drs Kay Strom, Eleanor Chew and Caroline Harvey 8. Chief Health Officer Dr Jeannette Young and Professor John Pearn 9. Drs Glenda Powell and Vernon Hill 10. AMA Queensland CEO Jane Schmitt, Professor Paul Glasziou, Dr Beres Wenck and Sean Launchbury (MDA National)
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PEOPLE & EVENTS
MEMBER MILESTONE 2015 Each year, AMA Queensland celebrates its members who have reached a significant milestone at a morning tea and ceremony. We were pleased to welcome so many of our longstanding members in early December for this occasion. Members enjoyed the chance to gather with many of their colleagues. It’s through their membership that AMA Queensland has been able to advocate on behalf of all doctors, for the betterment of the medical profession and for the benefit of doctors and patients. Q Our new 50 year members 1 2
Dr Robert Adam Dr John Blackford Dr David Campbell Dr David Cilento Dr Phillip Clarke Prof John Corbett Dr Desmond Dann Dr David Kidd Dr Harold Magee
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1. Members celebrating milestones 2. Drs Peter Heiner, James Kyranis and Terrence Darwin 3. AMA Queensland President Dr Chris Zappala 4. Drs Chris Zappala and Isobel Perry-Keene 5. Louise Dann, Dr Desmond Dann and Professor John Pearn 6. Professor John Corbett, Drs John Blackford and Chris Zappala, Professor John Pearn and Drs Desmond Dann, John McCarthy and Denis Nave
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FEATURES
TACKLING ALCOHOLFUELLED VIOLENCE In an attempt to address the number of tragic deaths caused by alcohol-fuelled violence, the State Government has implemented lock out laws which will affect regular venues and allocated safe night precincts.
Doctors working in any major hospital know all too well the sorts of cases they are bound to see on a Friday and Saturday night. Those nights will see facial and head trauma patients coming into the emergency department, the end result of what was meant to be a fun night out. Alcohol-fuelled violence is changing the lives of these patients and their friends and families. It is having a continual impact on our doctors, nurses, police and ambulance workers. And lest it be forgotten, it is also impacting on the lives of the perpetrator and their family who, through one alcohol-fuelled act of stupidity and violence, has potentially destroyed their own future. AMA and AMA Queensland are strong advocates for curbing this cycle of alcohol-fuelled violence. Federally, the AMA held a summit on the issue in late 2014 which brought together politicians from all major political parties as well as other stakeholders with an interest in the problem. AMA Queensland, in partnership with the Queensland Coalition for Action on Alcohol, advocated for lockout laws similar to those implemented in Newcastle as part of our Queensland Election Platform in 2015. We have kept the pressure on the Queensland Government to follow through on their commitment to implement these laws. 14 | Doctor Q Autumn
The end result of this advocacy is that Queensland has now implemented statewide laws which have real potential to save lives and reduce the numbers of assaults fuelled by alcohol. But why were these laws needed, and what do the laws actually propose to do? And will they mean an end to a good night out? The Extent of the Problem Alcohol abuse has an enormous social and economic cost, and our doctors, nurses, paramedics and police are all dealing with the violence that it causes. For instance, between September 2014 and September 2015, the Royal Brisbane and Womens Hospital (RBWH) reported that it required security assistance 1,798 times in the Emergency Department alone, of which three-quarters were related to alcohol-related incidents. The RBWH also reported “alcohol-related incidents have been in the top three primary diagnosis in [the] ED for the past five years and in the top 10 primary diagnosis for the past 10 years.” Of course, the problem is far-reaching. According to the Foundation for Alcohol Research and Education (FARE), alcohol presentations at Cairns Hospital have risen 35 per cent between 2009-10 and 2014-15 with the hospital recording the
second highest number of alcohol-related presentations (950) in the state in 2014-15. What does the Tackling AlcoholFuelled Violence Legislation Amendment Bill 2015 do? The bill will enact the following legislative changes once it comes into effect on 1 July 2016. A 2am last drinks policy in all venues throughout Queensland. This policy means the sale and service of alcohol will stop at 2am in every late night trading venues. Patrons will have a half hour grace period from 2am to finish their drinks, as per the current Liquor Act. 3am last drinks in conjunction with a 1am lockout for venues in a Safe Night Precinct The policy proposes that venues trading in a 3am safe night precinct can apply to trade until 3am, on the condition that a 1am one-way door or lockout is introduced in conjunction with the later trading. In effect this means if you are outside a venue after 1am, you will not be able to enter any other venue operating in a safe night precinct and if you leave before the venue shuts, you won’t be able to get back in. This aspect of the laws will come into force in February 2017, a result
“If you want to see the adverse effects of alcohol in Australia, feel free to show up to my emergency department at 1am on Saturday. Have a look at the injuries and unpleasantness, think about what it costs us as a community and think about what that time and money could be spent on instead. AMA Queensland North Area Councillor and Townsville Hospital Emergency Physician Dr Luke Lawton
of the compromise deal the Queensland Government made with the Katter Party to ensure passage of the the laws through Queensland’s hung Parliament. Ban on the sale or supply of rapid intoxication drinks from midnight High alcohol and rapid consumption drinks will be prohibited from being sold between 12midnight and 5am. The specific types and amounts of drinks will be prescribed by the Liquor Regulation following further consultation with stakeholders. The bill describes these types of drinks as alcoholic drinks that facilitate or encourage rapid consumption of alcohol or contain a high percentage of alcohol. Does this mean the end of Queensland’s nightlife? Critics of the law have claimed these laws will force pubs and clubs to close, suggesting this is what happened in Sydney and Newcastle when similar laws were enacted there. However, this is not supported by peer-reviewed, independent analysis1. Of the 14 pubs directly impacted by the NSW intervention in 2008, 11 remain open seven years on, and alcohol-related harm has been significantly reduced.
"This bill is more important, more powerful than any operation that I could ever do. It is powerful because it prevents harm. By my being here, if I have stopped 25 of our kids getting to the operating table it is far better than me operating on 100 of our kids. This bill stops injury and death."
“This is a great win for policing. We witness ... the blood baths first-hand. That means we’re going to see less victims, less offenders — the human misery and telling loved ones what’s happened to a family member. It also means police will not be the subject to these vicious violent attacks.”
Minister for State Development, Minister for Natural Resources and Mines, and Maxillofacial Surgeon Dr Anthony Lynham
Queensland Police Union President Ian Leavers
Two of the premises closed as a result of business issues, but the licences were subsequently on-sold and the new premises reopened in another part of the city where the restrictions are in effect. The last of the 14 licences was owned by the Council and the premises were demolished. In fact, annual reports from the New South Wales Office of Liquor and Gaming indicate the number of licences in Newcastle has increased each year following the implementation of the strategy, with an overall increase of 45 per cent for the period between March 2008 and July 2015. What is the intent of this legislation? The intent of this legislation is to directly reduce the effect on the number of alcohol-fuelled violence incidents, in turn reducing the impact this phenomenon has on doctors, nurses, police, paramedics and patrons of our nightlife. The evidence shows the majority of assaults in which alcohol was a factor happen outside venues on the streets of entertainment precincts like Fortitude Valley, from around 2am onwards. Under current laws, venues must impose a lockout after 3am and can remain open until 6am. This stretches the ability of
the police service to maintain safety on the streets. It is anticipated that the 1am lockout will result in people who are not inside a venue after this time will head home. Minister for State Development and Minister for Natural Resources and Mines, Maxillofacial Surgeon Dr Anthony Lynham was quoted by the ABC: “With these laws we will reliably see a onethird reduction in young people turning up in an emergency department on a Friday and Saturday night after assaults. Onethird less operations on victims of assaults, one-third less victims of alcohol violence in our intensive care beds, and one-third less parents looking into an empty bedroom.” So what happens next? This is a positive step in the battle to combat alcohol-fuelled violence. The government will be under enormous pressure from the industry and other sectors of the community in the weeks and months ahead. AMA Queensland will continue to support these laws as we consider alcohol-fuelled violence a public health issue and the impact it has on our members and the wider Queensland community is too devastating to ignore. Q 1 Report - No. 20, 55th Parliament - Tackling Alcoholfuelled Violence Legislation Amendment Bill 2015
Doctor Q Autumn | 15
CURRENT ISSUES
DOCTORS URGED TO WALK THE TALK While espousing the benefits of a healthy lifestyle to patients, Queensland doctors need to ensure they practise what they preach and work towards a healthy lifestyle of their own. AMA Queensland’s Walk the Talk campaign encourages doctors to take the 10,000 step challenge this month. Obesity and the plethora of lifestyle diseases it brings present the greatest health challenge Queensland has ever faced. Queenslanders think of themselves as a state full of carefree, sporty types who love nothing more than hitting the surf, but the reality is very different. Queensland is now the fattest state in Australia, with the number of obese and overweight residents expected to top 3 million within a few short years. AMA Queensland has led the charge by lobbying the State Government to take more robust action to address the problem through implementing the Health Vision, which recommends a range of public health measures including a ban on new fast-food outlets within 1 kilometre of schools and an increase in publicly-funded bariatric surgery. But we all know that actions speak louder than words and it is vital that Queensland doctors take individual action against obesity. This month will see the launch of AMA Queensland’s Walk the Talk campaign – a drive to ensure doctors practise what they preach when it comes to healthy living. Most doctors are naturally conscious of their weight and schedule in regular exercise but there is always room for improvement and many patients look to their doctor to lead by example. A 2013 study by The University of Queensland and Griffith University researchers demonstrated conclusively that how patients perceive their GP’s health and weight influences how receptive they are to the advice their doctors give. Basically, if doctors want to be heard when telling patients to eat well and move more, they need to Walk the Talk. 16 | Doctor Q Autumn
“ Walk the Talk won’t just make Queensland’s doctors healthier – it will get the lifestyle message through to those who most need to hear it. ”
So from 12 March, Queensland doctors are being asked to take part in a six-week challenge to live healthier lives. The aim is simple – for every doctor to take 10,000 steps a day. The 10,000 daily steps mark is the standard measure for an ‘active’ lifestyle and one which all Queenslanders should aspire to. Don’t be daunted by the number. Every step you take – whether it’s walking to work, going for a run or just taking the stairs instead of the lift – can be counted. All you need to take part is a pedometer or Fitbit-style device. If you have neither, you can download a pedometer app onto your smartphone (iPhones already include a pedometer in their health app). To register to take part, log to the 10,000 Steps website www.10000steps.org.au
on at
From 12 March, AMA Queensland will host its own page on the site and members will be able to register as individuals or as part of a local team. Flyers will also be sent out to participating doctors to let their patients know about Walk the Talk and to encourage them to increase their own activity levels. AMA Queensland President Dr Chris Zappala will be among the first signing up to Walk the Talk. “Patients must believe the goals we recommend for them are achievable,” Dr Zappala said. “The best way to convince them is to literally show them how it’s done. “Walk the Talk won’t just make Queensland’s doctors healthier – it will get the lifestyle message through to those who most need to hear it.” Q
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Doctor Q Autumn | 17
CURRENT ISSUES
PREPARE FOR A FAIR WORK AUDIT
Private practitioners should prepare for a visit from Fair Work Ombudsman (FWO) inspectors, who will be carrying out around 200 audits this year. The Fair Work Ombudsman (FWO) has started a new education and compliance campaign in the health care and social assistance industries, which commenced in December 2015. The campaign has been developed in consultation with key stakeholders including AMA, and focuses on raising industry awareness of Australian workplace laws, providing education on these obligations where needed and improving compliance within the industry. In the last three financial years, the FWO has taken the following actions against employers in the health care and social assistance industries: 43 formal letters of caution regarding workplace practices were issued to employers; Seven matters were taken to court for prosecution; and Eight employers received on-the-spot fines for infringements. 18 | Doctor Q Autumn
The FWO has indicated that the focus of the campaign is to ensure employers of reception and administrative staff in general practice and specialist practices are meeting their wage rate and record keeping obligations. It is estimated that around 200 medical practices will be assessed by FWO inspectors. Practices that are selected by the FWO to participate in the campaign will be directed to provide employee time and wages records for a recent pay period. Where an employer has more than 25 employees, they will be requested to provide a representative sample of no fewer than 10 employees. This sample should include (where applicable to the practice) a range of different employee classifications and employment types (full-time, part-time and casual) and must include all 457 visa employees. The time and wages records for the selected recent pay period will need to specifically include the following information: Payroll advice records or pay slips which clearly state amounts paid to employees, including base hourly rates of pay (or salary), loadings, penalties and allowances;
A sample payslip, which the FWO will assess against the payslip requirements prescribed in the Fair Work Regulations 2009. Compliance with payslip requirements will be one of the main areas of focus during the campaign, and FWO inspectors will have the discretion to issue on-thespot fines for breaches; Attendance records (i.e. time sheets and rosters) showing hours worked by employees, including any overtime; Records of any hours where employees attended training sessions or staff meetings (note: inspectors will be looking to see that employees are being paid for these meetings if they are held outside an employee’s ordinary working hours); Copies of any Individual Flexibility Arrangements (IFAs) made with employees; and Copies of any apprenticeship traineeship agreements. Q
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Doctor Q Autumn | 19
CURRENT ISSUES
ASMOFQ The Australian Salaried Medical Officers’ Federation Queensland (ASMOFQ) is currently negotiating three separate industrial agreements for doctors employed at the Mater Public Hospital. The current landscape at the Mater following the transfer of the Mater Children’s Hospital to the Lady Cilento Children’s Hospital has had a significant impact on the negotiations. The Mater advises that the financial position of the hospital and future services will be different and can no longer rely on past performance. This has made achieving members’ claims, which are predominantly aimed at gaining parity with Queensland Health doctors, difficult. Some of the proposed changes that raise concerns include: back-pay of wages from 1 July 2015 will be dependent on doctors accepting the first offer put to ballot;
removal of provisions that prevent the Mater from employing casuals to permanently fill, full-time and parttime positions;
no provision to prohibit the Mater from directing an SMO to work at another location;
removal of the Mater’s commitment to maintain staffing levels when a vacancy occurs;
only 12 weeks of paid maternity leave which was previously 14 weeks;
a reduction from three down to two special public holidays paid at 250 per cent; access to long service leave for Visiting Medical Officers (VMOs) and Senior Medical Officers (SMOs) will only be after 10 years instead of the current provision of seven years; changes to shift worker definition; no improvements to fatigue provisions, including having shared responsibility in fatigue management;
no payment for paternity leave;
changes to the maximum time Professional Development Leave (PDL) can be accrued for SMOs; and unions no longer being automatically informed of changes and a party to the consultation process. The negotiations for the Resident Medical Officer (RMO) group are progressing more quickly than the other groups. Although there are still concerns held in relation to the proposed agreement, a few items in principle have been reached for RMOs: 2.5 per cent pay increase per year;
MOCA 4 UPDATE It has been four months since doctors working in the public health system unanimously voted in favour of the Medical Officers Certified Agreement 4 (MOCA 4). The outcome of this vote was significant, as the implementation of this agreement saw the restoration of fairness to Queensland doctors. However, Australian Salaried Medical Officers’ Federation of Queensland (ASMOFQ) needs your support to ensure the agreement is implemented in line with the intent. MOCA 4 Oversight Committee As part of MOCA 4, ASMOFQ attended the first oversight committee on Thursday 4 February 2016. The committee has been established to ensure the agreement is correctly and consistently applied across each of the Hospital and Health Services (HHS). Meeting monthly, the committee will provide ASMOFQ with a platform to raise and resolve members’ concerns regarding MOCA 4.
20 | Doctor Q Autumn
Union Delegates
Campaigns
To assist in gathering data for MOCA 4 and help resolve matters of concern, ASMOFQ is seeking to appoint union delegates. This role will be supported by our two Industrial Advisors in Brisbane and will provide doctors with a local contact with whom concerns and options can be discussed confidentially. If you:
Over the life of the agreement, ASMOFQ, in partnership with delegates, AMA Queensland and its Council of Doctors in Training (CDT), will be seeking your feedback on key areas of concerns including:
have an interest employment rights;
in
doctors’
are comfortable with interpreting Awards and Agreements; seek to resolve issues through engagement and collaboration; and have a few hours a week to help, then please give our IR team a call to discuss the role and how to become an ASMOFQ Union Delegate.
access to Professional Development Leave (PDL) for Resident Medical Officers (RMOs); extended hours of work for Senior Medical Officers (SMOs); fatigue management; rostering and consultation; work completed whilst on call; and payment and rostering of public holidays. Your involvement is vital to gathering the necessary data to support discussions
three-year agreement; RMO vocational training subsidy of $2,000 per annum indexed at 2.5 per cent annually; RMO professional development allowance of $1,000 per annum (excluding those in receipt of the vocational training subsidy); and consideration of providing Clinical Support Time to RMOs. ASMOFQ is continuing to work with the parties to reach a fair and equitable agreement. If you currently work at the Mater, please ensure your contact details with AMA Queensland and ASMOFQ are up-to-date so that you are receiving vital communications. Q
with Queensland Health now and in the lead up to MOCA 5 negotiations. There are many other activities ASMOFQ is currently working on to ensure your rights at work are upheld. ASMOFQ would like to thank you for your continued support. The stronger our membership, the stronger we are in influencing change. Take the time to read the Mater negotiation update on changes occurring to your colleges working at the Mater. If you have any feedback please contact our Industrial Officers on (07) 3872 2205 or via asmofq@amaq.com.au. Q
Doctor Q Autumn | 21
CURRENT ISSUES
OFFICE OF THE HEALTH OMBUDSMAN REFORM CAMPAIGN
In 2016, AMA Queensland will be launching a campaign to reform the Office of the Health Ombudsman (OHO) to be the organisation that the public and profession deserve. Queensland requires an effective medical regulator. Ensuring a fair and fast response to the handling of medical complaints should be one of the highest principles of such a body. A well-resourced and appropriately governed regulator would help ensure the public is protected from both individual and broader systematic problems and would help to maintain high professional standards among the medical profession. By ensuring a fair and fast response to the handling of medical complaints, it would retain the trust and confidence of both the profession and the public. The OHO was established by the Queensland Government in 2013 to strengthen the health complaints management system. It replaced the Health Quality and Complaints Commission (HQCC), an organisation that had been criticised for fundamental deficiencies in the way it handled complaints, as well as unjustified delays. The OHO has, in our view, succumbed to the same inefficiencies and poor 22 | Doctor Q Autumn
complaints management processes that drove the government to replace the HQCC.
procedural fairness to both parties. Our members have found the OHO’s approach unnecessarily antagonistic.
AMA Queensland seeks to highlight the following problems within the OHO and possible areas for reform, namely:
4. Complaints taking an unreasonably long amount of time to resolve
1. The absence of medical practitioner leadership and guidance Clinical guidance and oversight is essential. We have concerns there are not legislated requirements for medical guidance and advice in the notifications process. It is possible, in theory, for a serious matter to be resolved without any clinical input whatsoever. 2. Structural conflicts that inhibit fairness and impartiality We have significant concerns over the structure of the OHO and its ability to truly act independently and fairly. We are concerned the independence of the OHO is compromised because it ultimately reports to, and can be directed to investigate by, the Queensland Health Minister. 3. Suspension of natural justice and procedural fairness in investigations Our members have repeatedly indicated they have had negative experiences with the conduct of the OHO in how it undertakes investigations. An effective medical regulatory system must maintain
Our members have consistently complained of the considerable delays in OHO making decisions, even where the matter is simply trivial or vexatious. Given the mandated time frames were a key feature of the Health Ombudsman Bill 2013 (Qld) they should be strictly followed and, if not, appropriate explanations must be given as to why not. This is aggravated by the bounce phenomena wherein complaints are part handled by the OHO and AHPRA further adding to delays in resolution. 5. Health Ombudsman weakening the national system We have major concerns that OHO, as it currently operates, weakens the national regulatory system through the creation of differing standards and thresholds between itself and the Medical Board of Australia. This, in turn, reduces the consistency of decisions, the comparability of data, and the ability of both medical practitioners and patients to have confidence in the decisions of both bodies. Q
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Doctor Q Autumn | 23
CURRENT ISSUES
HEALTH HUBS IMPROVING PUBLIC HEALTH After a successful Health Hubs in Eumundi last year, more are planned for Cairns and the Gold Coast.
These smaller Health Hubs obviously don’t propose to offer the same level of service or health benefits a fully fledged Health Hub could provide, but they are already reaping rewards for patient health.
The AMA Queensland Health Vision advocated for the Queensland Government to trial a rollout of Health Hubs, a concept that is modelled on the Patient-Centred Medical Home (PCMH).
The first Health Hub was held at the Eumundi Markets in November 2015. In attendance were two AMA Queensland members, Dr Mal Forbes and Dr Tom Boosey, on hand to give market goers free simple health checks.
Health Hubs would empower general practice to better coordinate the care of patients in the community to improve the quality of healthcare in Queensland and to reduce future potential costs by reducing demand on hospital services. The medical home has been used extensively overseas, dating back to 1967, and trials of a PCMH are now underway in the CarePoint trials occurring in Western Australia and Victoria. This provides us with a growing body of evidence demonstrating the effectiveness and efficiency of the model. Health Hubs in Queensland would be GP-led and encourage patients with (or at risk of) chronic diseases within the trial area to voluntarily enrol in the Health Hub, and educate them on the benefits of having their own GP, with provisions made to allow them to opt out or reverse their decision. To help promote this important public health goal, AMA Queensland has set up a rolling series of pop-up Health Hubs.
24 | Doctor Q Autumn
One particular patient who opted to get a blood pressure check was found to have elevated blood pressure. When he was asked when he had last seen a GP, David replied that he had not been to see a GP in 20 years! His interaction with the Health Hub made him realise it was time to see his GP and get a check-up. The second Health Hub will be held at the Cairns Markets on Saturday March 12. It is anticipated that this will be followed by a third Health Hub in April at the Gold Coast. We encourage members in these areas to come along, get involved and check them out! AMA Queensland will hold further pop-up Health Hubs throughout 2016 as we continue to advocate for a trial of the greater Health Hub policy. For more information on Health Hubs, both big and small, check out our website or contact our policy team at policy@amaq.com.au Q
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Healthy Profession. Healthy Australia. Doctor Q Autumn | 25
CURRENT ISSUES
CLINICIANS AND CONSUMERS WEIGH IN ON OBESITY CRISIS Dr David Rosengren, Chair of the Queensland Clinical Senate, discusses the outcome from the recent forum, where the Senate joined with the Health Consumers Queensland to tackle the obesity epidemic. More than 65 per cent of Queensland adults and 25 per cent of children are overweight or obese. If nothing changes, it is estimated that three million Queenslanders will be overweight or obese by 2020. Despite two decades of marketing campaigns educating us to eat more of the healthy foods, less of the junk and to exercise, Queensland holds the unenviable title of Australia’s most obese state. So what can we do differently to turn the tide on Queensland’s obesity epidemic? That was the question put to more than 150 senior clinicians and consumers at a joint Queensland Clinical Senate and Health Consumers Queensland forum. Bringing consumers and clinicians together to discuss obesity prevention strategies is believed to be a first for Queensland. Senate Chair Dr David Rosengren says it is critically important that health professionals work in partnership with the community they serve to tackle such a complex problem. To get a different outcome we need to do something different. And this is why we brought clinicians and consumers together to think through this problem that doesn’t have a simple or a single solution. We understand this is a long-term challenge that requires a multifaceted and system-wide approach. Recommendations from the 2015 forum included the establishment of a crossjurisdictional taskforce chaired by Queensland’s Chief Health Officer to identify, develop and oversee the implementation of obesity prevention strategies. In addition, delegates agreed that hospital and health services needed to create an environment within public healthcare facilities that actively promotes and
26 | Doctor Q Autumn
models the importance of healthy weight and lifestyle by: removing high sugar and soft drinks from healthcare facility cafes and vending machines; and committing to implementation healthier food choice strategies.
of
Promoting the acceptance of weight being measured as a vital sign alongside blood pressure was the third recommendation. And this must be supported by scalable interventions for those who are overweight or obese. Members of the Senate Executive met with Queensland’s Health Minister, Cameron Dick, and Queensland Health Director-General, Michael Walsh, late last year to discuss the recommendations. Discussions with the Minister are continuing. I believe that we’re all on the same page – something different has to be
done to tackle our state’s obesity epidemic. We must all step up and take responsibility for our future generation because if we don’t do something about it now, the next generation of Queenslanders is likely to have a lower life expectancy than their parents for the first time in modern history. Health Consumers Queensland Chair Mark Tucker-Evans said every single Queenslander is directly or indirectly affected by the obesity crisis. “This is a problem that requires a commitment from more than just our health professionals and the government. We need action from everyone in the community to tackle this issue. We have seen a welcome fall in smoking rates in Queensland, and we know it is possible to do the same with obesity,” he said. Q
“ We must all step up and take responsibility for our future generation because if we don’t do something about it now, the next generation of Queenslanders is likely to have a lower life expectancy than their parents for the first time in modern history.”
BUDGET SUBMISSION TACKLES QUEENSLAND’S HEALTH ISSUES AMA Queensland has proposed some practical ideas to Health Minister Cameron Dick ahead of the 2016-17 Budget being handed down in June. The article by the Queensland Clinical Senate adjacent makes for grim reading on the obesity crisis facing Queensland today. As the article notes, obesity is an issue successive governments have tried to tackle but the problem is only getting worse. The AMA Queensland Health Vision proposed a number of policy initiatives to help make Queenslanders lose weight, and these form the basis of our budget submission to the Queensland Government. The budget submission calls on the Queensland Government to trial a pilot program to subsidise fruit and vegetables for ‘at-risk’ communities, especially in remote areas. The pilot would run in communities where obesity is the biggest problem and target those on low incomes who have difficulty affording fresh fruit and vegetables for their families. We also advocate for Queensland Health to establish a multidisciplinary telehealth team comprised of dieticians, exercise
physiologists and specialist bariatric services whose primary purpose is to consult on chronically obese patients. Based in Brisbane, this team would be available to consult on patients who need help losing weight. As a last resort, we also recommend the Queensland Government increase public funding for bariatric surgery. This would be an option only when all other interventions aimed at helping a patient lose weight have failed, and would bring Queensland in line with other jurisdictions, such as the ACT and New Zealand, who have increased their funding for bariatric surgery. Combating obesity is not the only focus of AMA Queensland’s 2016 Budget Submission. We have a number of evidence-based policy solutions which we believe will help improve the way health services are delivered in Queensland. For instance:
A broader rollout of AMA Queensland’s Resilience on the Run strategy, which provides early career doctors with the resilience and coping skills needed to survive and thrive in the field of medicine;
A trial of the medical home in Queensland, which would help empower General Practice to better
coordinate the care of their patients and to reduce future potential costs by reducing demand on hospital services; Create connections and training opportunities between General Practice and hospital care by implementing a further trial of the Physician/Psychiatrist in the Practice Model that was run by GP Connections, Toowoomba; and Increasing funding for palliative care. With current funding levels, we know there is a great unmet need in parts of Queensland and that the length of palliative care is shorter than is usually recommended, so a strategic injection of funding is desperately needed for this service. AMA Queensland achieved some great successes with its 2015 Budget Submission, with the government working towards progressing ideas such as the whole-ofgovernment public health plan and the Queensland Medical Education Training Institute. We will continue to progress the ideas contained within the 2016 Budget Submission and the AMA Queensland Health Vision for the betterment of our members and the broader Queensland health system. Q
Doctor Q Autumn | 27
CURRENT ISSUES
2016 A BIG YEAR FOR DOCTORS IN TRAINING Dr Matthew Cheng, Chair of AMA Queensland’s Council of Doctors in Training (CDT) gives an update on the year ahead: Hospital Scorecards, Resilience on the Run and another huge Junior Doctor Conference.
As the interim Chair of CDT, I would like to take this opportunity to introduce myself and update you on how the CDT will continue advocating for you this year. I graduated from the University of Queensland in 2013 and have been working at the Princess Alexandra Hospital ever since. I joined CDT because I believe that without AMA Queensland, there would be no representative body advocating on matters important to patients and the medical profession.
“ AMA Queensland’s Council of Doctors in Training is integral to giving junior doctors a voice in the future of the health sector”
This year will be one of the busiest on record for the CDT, with several major initiatives on the go. We will focus on three key issues: (1) improving workplace conditions, (2) improving doctors’ health, and (3) increasing membership engagement. To improve workplace conditions, the major campaign we will be launching this year is the Doctors in Training Hospital Scorecards. We will be launching a survey in early March that will comprehensively score how well differing hospitals respond to the needs of junior doctors. The survey will encompass areas such as access to professional development leave, ease of payment of overtime and level of support. This data will be analysed and published before the commencement of the Queensland Health RMO campaign, ensuring you have all the information to make an informed decision on your application. This exciting annual program will allow us to track the progress of healthcare facilities over several years and help Queensland Health identify problem areas. Additionally, we will also be maintaining a watchful eye on the progress of the MOCA 28 | Doctor Q Autumn
4 agreement to ensure our members are paid fairly for the work they’ve done.
which promises to be bigger and better than ever.
In 2016, we will also be continuing our work to improve the health and wellbeing of doctors in training through the widespread rollout of the Resilience on the Run Program.
This extraordinary conference has attracted speakers including Winthrop Professor Fiona Wood AM, Nobel Laureate Peter Doherty AC, and Professor Munjed Al Muderis.
The successful pilot program in Rockhampton last year saw junior doctors empowered with skills to handle the stressful workplace.
Sessions on CV building and interview skills will be included. We have also revamped the career sessions in response to attendee feedback. If you haven’t already done so, I’d strongly encourage you to have a look at the program and register.
The CDT is committed to promoting the program to other regions to take up the initiative in the interest of junior doctor health and wellbeing. Membership engagement will be a key focus this year, and the CDT aims to achieve this by offering top quality professional development to members. This will be showcased at the AMA Queensland Junior Doctor Conference 2016, to be held on the 25 – 26 June 2016,
I’m extremely proud of these initiatives this year and hope to see you at Junior Doctor Conference 2016. AMA Queensland’s Council of Doctors in Training is integral to giving junior doctors a voice in the future of the health sector. If you’d like to add yours, please get in contact at yourcdt@amaq.com.au Q
CURRENT ISSUES
RURAL BONDED SCHEME A RAW DEAL FOR DOCTORS AMA Queensland’s Council of Doctors in Training Chair, Dr Malcolm Forbes, argues that the Medical Rural Bonded Scheme (MRBS) which was de-funded in the 2015 budget but still affects some 1,400 doctors, is not fit for purpose and disadvantages rural communities.
The MRBS was introduced in 2001 to reduce rural doctor shortages, providing funding for an additional 100 Commonwealth supported places annually. MRBS holders are financially supported during medical school. In return, following completion of their Fellowship, they are required to work for six consecutive years in rural or remote Australia (the ‘return of service’ period). There are currently 1,394 MRBS holders, with 108 completing their return of service period and 95 withdrawn from the scheme or in breach of contract. The majority of MRBS holders are medical students or doctors yet to attain Fellowship.1
What are the problems? 1. Doctors cannot complete their return of service until they have finished their Fellowship. For most specialties, postgraduate training currently occurs in large urban centres. Thus mentor-trainee relationships, life partnerships, work opportunities for partners, financial investments including the purchase of homes, and child care or schooling arrangement become established in urban centres.2 The MRBS scheme does not allow a doctor to commence their return of service period until they are a GP or specialist. Life circumstances often change dramatically in the eight to 17 years it takes from beginning medical school to completing Fellowship.3 Allowing doctors to begin their return of service period from postgraduate year one would foster an earlier commitment to rural work, one that is more likely to endure.
2. There is a 12-year ban on Medicare billing if there is a breach of contract and no buy-out option for doctors unable to meet the obligations of the scheme. The removal of access to a Medicare provider number for 12 years severely restricts the practice of medicine and may be a career-ending event for some doctors. Forcing doctors out of work is not in keeping with the aims of government and does little to address workforce maldistribution affecting rural areas. The Mason Review of Australian Government Health Workforce Programs recognised the magnitude of this penalty and recommended consideration of its removal.4 A buy-out option is available for a similar rural workforce scheme, the Bonded Medical Places (BMP) scheme, with no restrictions on Medicare billing. An equivalent opportunity should be afforded to MRBS holders. This will allow doctors who are unable to complete their return of service the opportunity to continue practising medicine, and allow the recouping of costs by government to reinvest into rural health programs. 3. Doctors who are MRBS holders who have completed their Fellowship and wish to spend a short period of time upskilling in a metropolitan area cannot do so. For a specialist working in a regional location, it may be necessary to spend a period of time working in a metropolitan area to undertaking specialty skill development. Under the current MRBS contracts, the doctor is unable to bill
Medicare for these services, which may render them unemployable by the hospital or health service. Such an arrangement is disadvantageous to MRBS holders, and is a loss to regional and rural communities who would benefit from skills being transferred from a metropolitan to regional or rural area. While a special exemption can be applied for, the rules around granting special exemption are not clear and rejection occurs without explanation.
What can be done? There is a review of the MRBS scheme currently underway. I encourage all medical students and doctors to contact the Department of Health at MRBscholarships@health.gov.au and request the following changes: 1. Allow doctors to begin their return of service period from postgraduate year one; 2. Remove the 12-year Medicare ban penalty for breach of contract and offer a buy-out option; and 3. Amend the existing contracts to allow doctors to upskill in metropolitan areas. Now is an opportune time to boost flexibility in the scheme, to the benefit of doctors and rural communities. Q 1 Senate Community Affairs Legislation Committee Estimates, 2 June 2015 2 Hudson & May, Med J Aust 2015; 202 (1):5 3 McNamara, Med J Aust 2012; 196 (8):528-530 4 Mason. Review of Australian Government Health Workforce Programs 2013
Doctor Q Autumn | 29
CURRENT ISSUES
ONE CONFIDENT STEP Each year we look at the experiences of a new intern, but how about those suddenly in charge of a new group of interns? New intern Dr Chris Maguire imagines life on the other side of the coin.
The new year commences. With a wistful last glance, you wish your experienced residents well as they depart and you prepare yourself emotionally and physically for the freshfaced newcomers. The risks of their arrival sit heavily in your mind and you regret none of the insurance you have taken out over your career. When the interns appear in the Emergency Department they look scared, hesitant and disorientated. Their plight has become more foreign to you over the years; the memory is there but the emotion of it – that sinking feeling in your gut that said you may not be up to the job – that, thankfully, disappeared long ago. Now the fear comes from a different place: it comes from having seen the consequences of junior mistakes and knowing they may occur under your supervision. It comes from knowing that even the best intentions may not be enough to prevent 30 | Doctor Q Autumn
mishap in the face of medical variance and uncertainty and it comes, ultimately, from knowing that medical school has not prepared them for the practicalities of life in the hospital – for many, their first full-time job. It’s the first shift and one of the new doctors introduces herself warmly to the team. You ask her a few questions and she appears to have the basic knowledge under control. Her temperament is nervous but committed to mastering the trade. Above all she isn’t apathetic – you hate apathy. Her initiative takes her to the bedside of a patient that hasn’t been seen and carefully she takes a history; perhaps a little too carefully because the patient has already been in the department three hours. An experienced nurse helpfully reminds her of a few basic investigations that need to be done and she reacts well – grateful for the assistance.
With a hesitant look in her eyes she approaches you to discuss the patient. “When did you become the scary one?” you think to yourself. Diligently she runs through her SBAR. There are some critical questions that she missed on the history and a few investigations you need to add. You try to break this to her in the kindest way possible. Nonetheless, she slumps her shoulders slightly as she moves to complete the new tasks. Each year you adjust your approach, and each year it never seems to work the way you want it to. Throughout the shift you pay close attention to each bed. Carefully assessing risk and guiding your interventions to those that are most in need of senior input. It’s tiring and you long for a time when the decisions weren’t yours alone. In that respect, you envy the interns. Suddenly there is an acute deterioration in one of the patients. You watch closely
as the girl who was, only a few months ago, a medical student begins to take action. Beside her you ensure the most important interventions are completed but you let her take ownership of them. The patient is stabilised and you breathe a sigh of relief. She breathes a bigger one. Some time later she approaches again; the additional investigations you requested are complete and the situation requires review. She suggests some approaches to management and hits most of the main points. You suggest the additional actions and point her in the direction of a senior nurse that can assist with the logistics. You can see the beginnings of a more purposeful stride in the way she walks away. That’s where her story starts; with one more step toward the patient. One more confident step. Q
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Doctor Q Autumn | 31
PEOPLE & EVENTS
PROFESSOR SCOTT BELL Queensland Health’s Health and Medical Research Unit present Research Fellow, Professor Scott Bell, an accidental hero at the forefront of cystic fibrosis (CF) research. Professor Scott Bell never planned to be a doctor, much less a clinical researcher. Now, research is his passion and with his expert clinical and research teams, he is creating positive changes in the thousands of people throughout the world afflicted with the chronic lung disease. “I feel great satisfaction knowing that the average survival rate for a person with CF has risen from 25 to over 40 years and there are now as many adults living with the disease as there are children. And it is exciting, yet humbling, that research I have been involved with over the past 20 years has in a small way contributed to this,” says Bell. Bell describes his career path as a serendipitous union of wonderful mentors, good luck and circumstance. “I was in the right place at the right time rather than any planned vision.” Bell has been a full-time clinician for the past 25 years, and has found time, usually before and after patient visits and on weekends at great personal cost to his family, to focus on his research. “I wanted to undertake translational research and since our area has recently changed enormously, I want to continue working on the interesting questions that the increased longevity in cystic fibrosis has presented to us.”
32 | Doctor Q Autumn
“My Fellowship research project is about understanding infection; how it is spread and the impact on CF patients. But beyond that specific area we are gaining an understanding of and invaluable information about the modes of transference of infection every day between people in hospitals and in public places. CF is a great model to translate new discoveries about airborne cross infection because bacterial spread is more easily and accurately measured than viral.” “Although most of our research is clinical, we are collaborating with aerosol experts and cough laboratories in Queensland to better understand the flight of infection particles. In this way our research not only helps those patients with cystic fibrosis, but also a broader spectrum giving the general public protocols for avoiding airborne disease like flu.” Whilst researchers continue to work towards a never ending goal list, Bell reflects that opening the internationally recognised cutting edge Cystic Fibrosis specialised single bed ward at The Prince Charles Hospital in 2014 is a brick and mortar reminder that he is on the right track. Equally, over 600 remarkable patients and their families who have benefitted from his research, encourage Bell and his talented team to forge onto the new challenges that longevity of CF patients has created.
“I am inspired by all my patients, particularly those who are older, have kept themselves well and are now living fruitful lives,” Bell says of those he calls his raison d’etre. “Shelley Shephard, an inspirational woman living with cystic fibrosis in the rugged North Queensland outback comes to mind as motivation. I looked after her for years until her early death at only 36. Now a memorial scholarship has been created and the first recipient, Laura Sherrard from Belfast, is now a part of our research team.” Undoubtedly proud of his team’s achievements, Professor Bell says the Health and
Medical Research Fellowships have given him, and several of his colleagues, the opportunity to explore research goals to develop improved clinical practices for CF patients, and enabled him to bond with a team that is achieving maximum scientific outcomes. “It is also attracting additional funding from overseas, which, added to the seed grants, is allowing us to shine on the international stage and pilot state-of-the-art clinical practises in our Queensland hospitals that will be used throughout the world,” adds Professor Bell. Q Provided by Health and Medical Research Unit, Queensland Health
CURRENT ISSUES
GP CAN NOW EQUAL ‘GREAT PARENTING’ SUPPORT If you’re a GP, no doubt you’ve had many a tired, stressed and overwhelmed parent at their wit’s end as to how to deal with their child’s behaviour. Thanks to Queensland Government funding, GPs can now access free training, resources and support to deliver the Triple P - Positive Parenting Program.
Mum is at wit’s end. She thought it was a phase but the terrible twos have carried over into the fearsome fours and little Harrison is showing no signs of settling down. His sleep is erratic, he refuses to eat anything he doesn’t like and he’s constantly in trouble at home and at kindy. Family doctor and the Chair of AMA Queensland’s Council of General Practice Dr Richard Kidd said most GPs probably come across a harassed and struggling parent on a daily basis. “We are often the first people parents turn to when they are struggling with the many challenges of raising children,” Dr Kidd said. “The problem for GPs is that we are not necessarily parenting experts, which is why a new state-funded program offering free, evidence-based parenting support training presents an opportunity to upgrade our skills in that area.”
With funding provided by the Queensland Government, GPs who provide services at no direct cost to parents can access free training, resources and support to deliver the Triple P - Positive Parenting Program. GPs may be able to claim professional development points for the training. Triple P is one of the most effective evidence-based parenting programs in the world and was developed at The University of Queensland. Its continuing success as a parenting intervention program has prompted the State Government to offer free training in the program to practitioners and free parenting support to parents of children up to the age of 16. Training in Primary Care Triple P equips doctors to provide parents with up to four 15-minute consultations over a four to six-week period about a specific parenting issue.
GPs can get free training to deliver Triple P parenting support to patients. Email qld@triplep.net to register your interest. Parents can visit www.triplep-parenting.net. Online, group and one-on-one help is available. Info-Med will distribute promotional materials to more than 700 surgeries over coming weeks.
Dr Kidd said one of the GPs in his own practice had been trained in Triple P and found it delivered tangible results for children with behavioural, sleep and eating issues. Triple P Queensland program director Carol Markie-Dadds said Triple P didn’t take a ‘one size fits all’ approach to parenting. “Triple P doesn’t give parents a rule book – it provides them with a range of strategies they can adapt to all kinds of situations and issues,” Ms Markie-Dadds explained. Research shows Triple P reduces problem behaviour in children and improves parents’ wellbeing and parenting skills. Parents using Triple P report they are less stressed, less depressed and are less likely to use harsh discipline¹.
Primary Care training for GPs involves one two-day session followed by a one and a half day workshop six weeks later. Ms Markie-Dadds encouraged GPs to find out more about the support now available to parents. “A range of group and individual parenting support sessions is now available to help as many Queensland families as possible – no matter where they are or what their situation is,” she said. “Parents can also do an online or workbook version of Triple P to complete at their own pace in their own home. “Every family can benefit from Triple P, and professionals who work with families can build on their skills by doing the training themselves.” Q
In communities where Triple P is widely available, children have fewer behavioural and emotional problems.
1 Sanders, M.R., Ralph, A., Sofronoff,
Triple P is an effective prevention and early intervention strategy that has been shown to lower rates of child abuse, reduce foster care placements and decrease hospitalisations from child abuse injuries².
problems in children making the
K., Gardiner, P., Thompson, R., Dwyer, S., & Bidwell, K. (2008). Every Family: A population approach to reducing behavioral and emotional transition to school. Journal of Primary Prevention, 29, 197-222. 2 Prinz, R.J., Sanders, M.R., Shapiro, C.J.,
Whitaker,
J.R.
(2009).
D.J.,
&
Lutzker,
Population-based
prevention of child maltreatment: The U.S. Triple P system population trial. Prevention Science, 10(1), 1-12.
Doctor Q Autumn | 33
CURRENT ISSUES
NAVIGATING THE IMMUNISATION REGISTER
HOW TO UPDATE THE RECORD WITH VIVAS
There are two ways a practice can update the record with VIVAS:
1
Submit the updated record electronically through medical software; or
2
Email, post or fax a letter to VIVAS with the following details:
The child’s details:
With the introduction of the no jab, no play, no pay policy on 1 January 2016, Queensland Law Society Policy Solicitor Louise Pennisi explains how to navigate the two immunisation databases so that compliant parents aren’t incorrectly penalised. On 1 January 2016 changes to state and federal vaccination laws came into effect. In Queensland, under the Public Health Act 2005 and Public Health Amendment Regulation (No. 1) 2015, a child who is not vaccinated, or is not up-to-date with their scheduled immunisations, may be excluded from an approved education and care service or may have conditions placed on their enrolment. Similarly, under the Federal Government’s No Jab, No Play, No Pay policy, families who do not have a medical reason and do not vaccinate their child or are not up-todate with their child’s vaccinations, will be excluded from receiving the childcare benefit, the childcare rebate as well as the Family Tax Benefit A annual supplement. In short, if a child’s immunisation record is not up-to-date or is not accurate, there are significant childcare and financial implications for the family. Practitioners may find that as a result of these changes, eagle-eyed parents may be more likely to be cross-referencing the immunisation schedule in Queensland Health’s Personal Health Record (the little red book) against the Australian Childhood Immunisation Register accessible to parents on the mygov website. If there are any discrepancies or inaccuracies, parents will likely follow up with their general practitioner to have the register corrected. However practitioners may not be aware or have the time to research how to correct the record. 34 | Doctor Q Autumn
QHealth has published an excellent resource: Immunisation records and data explained: A guide for vaccine service providers which particularises the process of reporting and checking immunisation records. The resource sets out that there are two immunisation databases used in Queensland: the Australian Childhood Immunisation Register (ACIR) and the Queensland Vaccine Information and Vaccination Administration System (VIVAS). Practitioners are encouraged to submit all vaccination records with VIVAS as whilst VIVAS shares the immunisation records with ACIR, if records are updated through the ACIR via telephone, fax or post, VIVAS is not provided a copy of this information. The resource also sets out common recording errors in vaccination records and how to avoid them. These errors include: missing or incorrect medicare numbers; not recording the batch number for each vaccine given; not providing a GP Medicare provider number; selecting incorrect vaccine names or not selecting the ‘combination’ option for multivalent vaccines; and not double checking that the date the vaccination was actually administered matches the vaccination date in the record. Q
full name (or alias); date of birth; gender; address; Medicare number (if available); and Aboriginal and Torres Strait Islander status (if applicable).
Confirm that you are correcting (or updating) the vaccine record and providing:
the name/s of the vaccine; the date the vaccine was given; the dose numbers; the batch numbers; and the Medicare provider number of doctor who administered vaccines.
VIVAS can be contacted via email on cdisvivas-support@health.qld.gov.au; fax: (07) 3328 9434 or Reply Paid 2368, Fortitude Valley BC QLD 4006.
HOW TO UPDATE THE RECORD WITH ACIR
There are three ways a practice can update the record with ACIR:
1
Through Medicare Online;
2
Using Health Professionals Online Services (HPOS); or
Manually by contacting ACIR via email: acir@humanservices.gov.au, fax: (08) 9254 4810 or Australian Childhood Immunisation Register, GPO Box M933 Perth WA 6843.
3
Practitioners are reminded, however, that any updates with ACIR are not sent to VIVAS. To save time, practitioners are encouraged to send any updates to VIVAS. VIVAS will then update the records with ACIR. For more information please see the QHealth immunisation website: health. qld.gov.au> public health and wellbeing > health topics > immunisation
The author would like to thank and acknowledge Deanna Sedgwick Fincher for her editorial assistance
Doctor Q Autumn | 35
ELECTION NOTICE 2016–2018 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:
Friday 13 May 2016
Venue: AMA Queensland 88 L’Estrange Terrace Kelvin Grove, Queensland
The Returning Officer invites nominations and will hold an election for the positions of President, Vice President and Council of the Queensland Branch of the Australian Medical Association.
President and Vice President 2016-2017 For election as President or Vice President of the Queensland Branch of Australian Medical Association.
One representative required (Any two (2) ordinary members may nominate another member).
Candidates for President or Vice President may submit with their Nomination Paper:
A short statement of no more than 250 words. Any words in excess will be discarded;
Business
A passport-sized head and shoulder photograph;
The business of the Meeting will be:
A brief CV of no more than 250 words. Any words in excess will be discarded; and
1. To receive and consider the accounts, balance sheets and reports of:
A video statement of no more than three minutes. This will be filmed at AMA Queensland.
(i) The Board; (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 Presidential and Vice Presidential Election and Council members. 3. The appointment of the Auditors and approval of the remuneration (if any) to be paid to the Auditors;
Councillor of the Queensland Branch of the Australian Medical Association 2016 - 2018 Nominations must be in writing and signed by the nominee, and two (2) nominators. All persons must be financial members of the Queensland Branch of Australian Medical Association. Any two (2) ordinary members may nominate another member provided all members belong to and are registered in the same Geographical Area, Craft Group or other position. Craft Group Representatives required:
One (1) General Practitioner Craft Group Representative;
One (1) Specialist Craft Group Representative.
4. The President’s address; and 5. To deal with all business which any statute, the Constitution, or the By-laws requires. Proxy Notice A member who is entitled to attend and register one vote at the Annual General Meeting is also entitled to appoint another member as a proxy to attend and vote in his or her place. Proxy forms can be downloaded from the AMA Queensland website (www.amaq.com.au/page/Election) or by phoning Leif Bremermann on (07) 3872 2203 and must be received by 6.30pm 11 May 2016.
Other Positions required:
One (1) Retired Doctors Representative 2016-2017;
One (1) Doctors in Training Representative 2016-2017.
Geographical Area Representatives required:
One (1) North Area Representative Postcodes 4799 - 4850 inclusive;
One (1) North Coast Area Representative Postcodes 4550 - 4601, 4619 - 4675 inclusive;
Notes The Dinner for the Profession will be held on Friday 10 June 2016 and will include the presentation of awards and prizes. Annual Report *The 2015 Annual Report will be available online from 31 March 2016 at www.amaq. com.au/page/About_Us/Annual_Reports
Nominations close 5pm Wednesday 13 April 2016
Three (3) Greater Brisbane Area Representatives Postcodes 4000 to 4199, 4300 to 4349, 4500 to 4513, 4514 to 4549 inclusive;
One (1) Gold Coast Area Representative Postcodes 4200 - 4299 inclusive.
Candidates for Council may submit with their Nomination Paper: A short statement of no more than 250 words. Any words in excess will be discarded; A passport-sized head and shoulder photograph; and A brief CV of no more than 250 words. Any words in excess will be discarded. What is required of a Councillor?
Availability to attend Council meetings five times per year, and relevant AMA Queensland events/functions such as the Dinner for the Profession;
Actively contribute to setting policy for the Association; Actively support membership retention and growth strategies;
Provide a written report (template provided) for council meetings; and
Availability to attend and contribute to AMA Queensland Committees.
If you need to make changes to your craft group, geographical area or other position in the register of members for the purpose of the election this must be done by 5pm Tuesday 12 April 2016. Return completed nomination forms by 5pm Wednesday 13 April 2016 to the Returning Officer. Further nomination forms can be obtained at www.amaq.com.au/page/Election
QUEENSLAND BRANCH OF AUSTRALIAN MEDICAL ASSOCIATION | ACN: 009 660 280 | ABN: 17 009 660 280
NOMINATION FORM
Nominations close 5pm Wednesday 13 April 2016
Nomination forms are to be returned to the Returning Officer, Andrew Vivian, by fax, email or post by 5pm, Wednesday 13 April:
Time Frames
Phone: (07) 3232 2900
13 April, 5pm: Nominations close
Fax:
(07) 3891 9292
Email: nominations@priestleyspfn.com.au Post:
The Returning Officer, PO BOX 1770, COORPAROO DC QLD 4151
12 April, 5pm: Final changes to register of members 22 April, 5pm: Ballot opens 10 May, 5pm: Ballot closes 13 May, 6.30pm: Annual General Meeting
We hereby nominate
(FULL NAME)
as a candidate for the position of PRESIDENT, VICE PRESIDENT OR COUNCILLOR Craft Group/Geographical Area/Other Position
(PLEASE CIRCLE)
(FOR COUNCILLOR NOMINATION ONLY)
Nominee’s details: I hereby consent to this nomination. Full name:
Member number:
Craft/Area/Other Position: Date of birth:
Telephone number:
Primary practice address: Residential address: Signature:
Nominator’s details x 2: Full name 1:
Full name 2:
Craft/Area/Other Position:
Craft/Area/Other Position:
Telephone number:
Telephone number:
Residential address:
Residential address:
Signature:
Signature:
Candidates can only nominate in either a) Craft Group, b) Geographical Area, or c) Other Position. They cannot nominate for a Craft Group, Geographical Area or Other Position as well as President and Vice President. Where nominating representative/s for Craft Group, Geographical Area or Other Position, both nominators must be registered in the same Craft Group, Geographical Area or Other Position (whichever applies) as the person being nominated. Nominations close 5pm, Wednesday 13 April 2016. For more information, visit the AMA Queensland website or contact the Returning Officer at (07) 3232 2900.
Access this nomination paper and the position description for the role of President and Vice President at www.amaq.com.au/page/Election
REPORTS
The strength of AMA Queensland is each individual member
MEMBER NEWS We’d like to extend our sincere thanks and appreciation to all of our members who have placed their 2016 renewal on time. In 2016, our advocacy, public campaigns and member programs will continue to support doctors and their patients - with the outcome of a healthier Queensland and a stronger health system. Here’s five ways your membership investment will help deliver on these objectives in 2016:
1
Expand health hubs to encourage people to see their GP
In 2015, AMA Queensland trialled the concept of ‘health hubs’ at markets and shows to reach people who avoid the doctors’ office and encourage them to see their GP again. In the first round, we reached people who hadn’t seen a doctor in over 15 years. In 2016, we’ll be rolling this concept across the state, from Cairns to the Gold Coast, to help give people the push they need to visit a doctor.
2
Help roll out the Resilience on the Run program to support doctors’ health
In 2015, AMA Queensland piloted the Resilience on the Run Program to help improve the health of doctors in training 38 | Doctor Q Autumn
and reduce their levels of burnout. This innovative program was well received at the pilot site at Rockhampton Hospital and has helped support junior doctors in navigating the stressors of intern year. In 2016, we’re expanding this program across the state to both junior and senior doctors to help you look after yourself so you can look after others.
3
Continue advocating for a whole of government public health plan
In 2015, AMA Queensland released our Health Vision for the state in 2020. An important part of this plan was the development of a whole of government public health plan that combined all the levels of government, from health, education, main roads, and communities to make a real difference in the battle against chronic disease. In 2016, we will continue advocating for the whole of government public health plan to become a reality and help save lives.
4
Escalate the fight against obesity across Queensland
In 2015, AMA Queensland declared war on obesity. We made obesity a cornerstone of our election campaign, ran dedicated
public health messages on regional television, and outlined common-sense measures such as making fresh food easily available. In 2016, we intend to continue this important fight for the sake of the 3 million Queenslanders expected to be overweight or obese.
5
Work with the Queensland Government to increase vaccination rates
In 2015, AMA Queensland worked with the Queensland Government on the drive to 95 (per cent immunisation rate) campaign. We will always advocate loudly for vaccinations, and their immense evidence base, so that the public is protected. In 2016, we will continue these initiatives to support you, your patients, and the wider community. Again we thank you for your continued support and we look forward to serving you as a valued member of AMA Queensland throughout 2016. Your renewed member pack including your new membership card and 2016/2017 Member Benefits Guide will be mailed to you by late March. Q
We’re also very pleased to announce our lucky early-bird and online renewals prize winners. A Sydney Escape
Courtesy of AMA Travel Winner: Dr Coralie Endean Your prize includes:
Daily breakfast for two people
Two return economy airfares Brisbane – Sydney
High tea for two
Two nights accommodation at The Langham Hotel
Dinner for two at Rockpool Restaurant
A Spicers Luxury Getaway Package Courtesy of Lexus of Brisbane Winner: Dr Michael Bryant Your prize includes: Overnight midweek accommodation for two guests Including gourmet breakfast
1 of 4 - $500 Coles/Myer vouchers Courtesy of AMA Queensland Dr Narcisa Zemek
Dr Susan Ireland
Dr Jonathan Stewart
Dr Helen Bothwell
NEW MEMBERS October 2015 Doctors in Training Dr Isabel Watt Dr Jessica Koentjoro Dr Matthew Klan Dr Alex Wong Dr Christine Tran Dr Joanna Ng Dr Etienne Du Toit Dr Matt Dentry Dr Jonathan O’Mullane Dr Justin Gibbs Dr Margarethe Sears Dr Leilani Corbett Dr Rohan Talagavara Jayaramaiah Dr Christine Ross Dr Mostayn Alam Dr Kylie Dean Dr Astley Thomson Dr Adam Keys Dr Martin Hanson General Practitioners Dr Bhavana Kulkarni Dr Ben Khodadad Davari
Dr Steven OsmanToddhall
Dr Peter Bourne
Specialists
Dr Adam Noble
Dr Michael Curley Dr Dean Morgan Dr Andrie Stroebel A/Prof Boris Ivanov Salaried Medical Officers
Dr James Lee Dr Umesh Sharma Dr Andrew RoggerAmies
Dr Shashikant Varsani
Dr Tammana Gupta
Dr Scott Allison
Dr Charles Smallhorn
Dr Catherine Stoyanov
Dr Nenad Alempijevic
November 2015 Doctors in Training Dr Joanne Miller Dr Nathan Schaefer Dr Sarah Ip Dr Michael Kan General Practitioners Dr Erin Baynes Dr Melissa McCann
Dr Maree Meier
Dr John Cheuk Yu Lau Dr Theo Theodoros
Part-Time Practitioners
Dr Rania Hussein
Doctors in Training Dr Zoe Burns
Specialists
Dr Alan Jones
Dr Sue Inglis
Dr Bradley Elliott
Dr Audra Gedmintas
Dr Vivien Wong
December 2015
Dr Wojciech Janus Dr Snezana Alempijevic Dr Elaheh Nemati Dr Hamish McKee
Dr Nicole Harris Dr Jennifer Crampsey Dr Mark Friel Dr Andrew Pattison Dr Anam Asad Dr Emerald Setbo
Dr Sutherland MacKechnie
General Practitioners
Salaried Medical Officers
Dr Shahzad Ahmed
Dr Michael Haines Dr Paul Sherwin Dr Carina Koorts Dr Prem Ram Dr Thian Barnard
Dr Preety George Dr Mohsen Ahmadi Amoli Dr Pulasthi Chamara Adikari Appuhamilage Dr Mushoriwa Zinatsa
Dr Genevieve Bishop Dr Prasad Challa Dr Woon Chong Dr Jo Deverill Dr Ali Sharafi Dr Soman Elangovan Dr Mikhail Mikhail Dr Bogdan Benga Salaried Medical Officers Dr Sunil Weerasekera Dr Olivia McDonnell Dr Vanessa Mccarthy Dr David Farlow Part-Time Practitioners Dr Catherine Benson Dr Jillian Warlow Other Dr Emily Moody
Dr Serena Keating Dr Jenny Dowler Specialists Dr Vidhya Gupta Doctor Q Autumn | 39
PEOPLE & EVENTS
LOCAL MEDICAL ASSOCIATION ROUND UP
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
Bundaberg
Fraser Coast Contact:
Drs Thomas Dunn and Paul Neeskens
Phone:
(07) 3281 1177
Contact:
Jo Bourke
Contact:
Dr Daud Yunus
Phone:
(07) 5479 3979
Phone:
(07) 4152 2888
Phone: daud.yunus@gmail.com
Meetings: 24 March Speakers: Dr Daevyd Rodda, Orthopaedic Surgeon SCUPH Topic:
Anterior Cruciate Ligament Injuries
28 April
Brisbane Northside Contact:
Dr Graham McNally
Phone:
(07) 3265 3111
Web:
www.northsidelma.com
Meetings:
26 May
12 March
23 June
14 June
Cairns
Ipswich and West Moreton Contact:
Dr Thomas McEniery
Phone:
(07) 3281 1177
Meetings: 21 April
Laubman & Pank Optometrists
16 June
Medico-Legal function Josh Sheaffe Lawyer
Redcliffe and District
Contact:
Dr Sharmila Biswas
Phone:
(07) 4036 4333
Meetings:
Contact:
Margaret McPherson
Phone:
(07) 3121 4043
Web:
www.rdma.org.au
12 March
Meetings:
Dr Chris Zappala to attend
29 March 27 April
Mackay
31 May
Contact:
Dr Bill Boyd
Phone:
0419 676 660
Meetings: 9 March
Dr Chris Zappala Visits LMA Meetings AMA Queensland President Dr Chris Zappala will attend a number of these meetings to meet members and hear their concerns. He will also discuss: Private health insurance reform
28 June
Nurse endoscopy / role substitution
Gold Coast
MBS item freeze
Phone:
The Queensland Medical Education and Training Institute (QMETI)
0419 780 505
Email: info@gcma.org.au
Central Queensland
Web:
Contact:
Dr Michael Donohue
Meetings:
Phone:
0419 715 658
17 March (AGM)
www.gcma.org.au
Health complaints process / OHO reform
21 April Clinical meeting
Toowoomba and Darling Downs
19 May
Contact: info@tddlma.org.au
16 June
Web:
www.tddlma.org.au
40 | Doctor Q Autumn
Can’t find your local area? If your Local Medical Association does not appear or your details are incorrect, please email amaq@amaq.com.au.
Helping you organise your committee
Partner with one of Australia’s most trusted not for profit organisations to handle the day to day management needs of your committee. MEETINGS Organising meeting dates and venues, agendas, minutes, reports, implementing committee tasks and projects.
C SPE
Event registration to the value to $100 or Free Award Subscription service for one year or
Member queries, renewals, all communication to members including newsletters, website updates and database management.
$100 off any Workplace Relations Manual
CONFERENCES AND EVENTS
BOOKKEEPING SERVICES Maintaining financial, reporting, BAS and audit obligations for your committee.
R
All new clients receive either:
MEMBER ENGAGEMENT
Coordinating venues, programs, marketing and promotional material, travel and budgets.
IA
FE F O L
Contact us today! P: (07) 3872 2222 W: www.amaq.com.au E:
bss@amaq.com.au Doctor Q Autumn | 41
RDAQ ADVERTISMENT
conference.rdaq.com.au
RDAQ 2016
27th Annual Conference
The Events Centre Caloundra 9 – 11 June 2016
Rural Doctors Association of Queensland 27th Annual Conference Conferencing with a difference RDAQ 2016 boasts seven networking events. Enjoy the company of old friends and make new contacts during our networking programs. Our evening events are always fun and interactive for spouses and children especially our inclusive family night. A family friendly atmosphere is a special part of our unique program.
RDAQ 2016 family program
A great value event
RDAQ 2016 and Queensland Rural Medical Family Network (QRMFN) offer a comprehensive family program. Your children can join the supervised activities and entertainment during the welcome reception and gala dinner. On Friday morning a children’s performance workshop offers fun preparations for the family dinner that evening.
RDAQ’s delegate and spouse registration fee is inclusive of all evening events. Family night tickets for children attending our family program are also included. It is a great value event for delegates bringing their families. Our warm welcome, great value and special adventures are why medical families return year after year.
Spouses and children will also be delighted with a day trip to Sea Life Mooloolaba. Experiencing Queensland’s best aquarium, they can surround themselves in the beauty of thousands of marine and freshwater creatures. More information on the family program can be found on the conference website.
RDAQ 20I6 – Register today! 42 | Doctor Q Autumn
RDAQ family night Bring your family along to experience the land of ‘RDAQ Far Far Away’. Dine in Hogwarts castle, taste the cakes at the Madhatter’s tea party, collect more gumdrops than Blinky Bill and try your luck in side show alley. Our fancy dress theme is ‘Storybook characters’, so let your creativity soar and join in the fun.
RDAQ 2016 program includes clinical updates and topical presentations, discussion and policy forums and RDAQ’s traditional medico-political forum. The conference will be held at The Events Centre, Caloundra on 9 – 11 June 2016.
RDAQ ADVERTISMENT
RDAQ 2016 David Horn Memorial Gala Dinner and Awards The weekend will culminate on Saturday night with our annual David Horn memorial gala dinner and awards. Join us in a ‘secret garden’ for an enchanted evening of delicious food and good company. Sing along to the sounds of the infamous Rural Rednecks and dance the rest of the night away to great entertainment.
Join us in Caloundra this June for the unique RDAQ conferencing experience Our theme this year is ‘Resourceful • Resilient • Remote – Big Sky Thinking’ and is designed to be challenging and reflective. I am excited by what the program offers and believe the team has pulled together a stellar line up of topics and speakers that will have us recognising the strengths we possess and challenge us to use them with far reaching impact. We will also be focusing on remote practice – where doctors (and their families) make an essential contribution to Queensland. I am looking forward to the whole package the weekend offers – beautiful Caloundra and great sessions. I invite you to spend time with colleagues and friends who are united by a common interest to improve the health and wellbeing of our rural and remote communities. Dr Tash Coventry President, RDAQ
CONTACT DETAILS Viv Culverwell & Renee Masters RDAQ 2016 Conference Managers Health Workforce Queensland GPO Box 2523, Brisbane, Qld 4001 Phone: 07 3105 7800 Fax: 07 3221 3748 Email: conference@rdaq.com.au Web: www.rdaq.com.au/conference Doctor Q Autumn | 43
PEOPLE & EVENTS
WHAT’S ON THIRD ANNUAL JUNIOR DOCTOR CONFERENCE 25 - 26 June
Brisbane Convention and Exhibition Centre
Ev en ee
AMA Q U EEN SL AND P R E S E N T S
Fr
PRIVATE PRACTICE SERIES
t
With the theme Looking after yourself, looking after others, AMA Queensland’s Third Annual Junior Doctor Conference features a range of inspiring speakers, medical leaders, and career and business experts to support you at this pivotal time in your career.
Dinner for the Profession
17 - 24 SEPTEMBER 2016
TRANSITIONING TO PRIVATE PRACTICE PRIVATE PRACTICE SERIES
TRANSITIONING TO DINNER FOR THE PRIVATE PRACTICE PROFESSION 14 April
10 June
Various locations around Queensland
AMA Queensland – Hunstanton Verandah
Victoria Park, Herston
17 – 24 September
Our Workplace Relations team and corporate partners will give a coordinated insight into the key elements to consider when moving to Private Practice, such as tax and business structure, risks and legal issues, banking and financial considerations, insurance, human resources and workplace relations matters.
AMA Queensland’s annual Dinner for the Profession is a great night to catch up with colleagues, celebrate the profession and enjoy a three-course meal and entertainment. Save the date and look our for your invitation in April.
India - Delhi, Agra, Jaipur
Workshops on the consultation process for termination, redundancy, performance management and changes to terms of employment will be held on the Sunshine and Gold Coast, Toowoomba, Brisbane North and South-East, Ipswich, Mackay, Townsville, Cairns, Bundaberg and Rockhampton.
6 – 27 April
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ANNUAL AMA QUEENSLAND CONFERENCE
Themed Research - turning it into reality, this year’s conference will focus on navigating the challenges and complexities of the medical research process.
PRIVATE PRACTICE SERIES
Consulting to avoid unfair dismissals and claims Understanding the Fair Work Process
SPECIAL OFFER! Bring an attendee and receive 30% off their fee!
Who should attend?
As an employer, are you confident in the consultation process for termination, redundancy, performance management, or changes to terms of employment?
Health practitioners
The Fair Work Act protects the rights and responsibilities of employers and employees alike, and allows employees to make claims to the Fair Work Commission. As an employer, your compliance with the legislation and its processes is critical. AMA Queensland’s Consulting to avoid unfair dismissals and claims workshop will provide an in-depth breakdown on a number of processes:
Support staff
Ending employment within the minimum employment period Performance managing staff Terminating as a result of underperformance or serious misconduct Redundancy due to major workplace change Changing hours of work Amending terms of employment within a contract Implementing the right templates and processes in your practice George Sotiris, AMA Queensland’s Senior Industrial Relations Officer, will provide an in-depth and interactive breakdown of the legislation and how it applies when you are consulting with staff. The workshop will canvass previous Fair Work Commission case studies so you can avoid some of the common errors in staff consultation and understand your legislative compliance requirements. This workshop will provide you with the skills to confidently follow the legislative framework when you’re placed in the position to make workplace changes. Delegates will receive free resources to support you in this process.
Practice managers Allied health professionals
Workshop details Inclusions: Tea/coffee on arrival, morning tea, and course notes
Cost
Prices include ‘special offer’ discount and GST
Award Subscription Members: First attendee: $67.50 Additional attendees: $47.25 AMA Members: First attendee: $75.00 Additional attendees: $52.50 Non-Members: First attendee: $99.00 Additional attendees: $69.30 Private Practice Series Sponsor
Doctor Q Autumn | 45
PEOPLE & EVENTS
EMERITUS PROFESSOR TERESA (TESS) RITA O’ROURKE CRAMOND
AO, OBE, OSTJ, DMG, MBBS (QLD), HON MD (QLD), DA (RCP&RCS), FFARCS, FFARACS, HON FFARCSI, FRCA, FANZCA, FFPMANZCA, HON FACHPM, DA, FRCA, RACP, D.UNIV (ACU) FAMA 2 December 1926 – 26 December 2015 Since Emeritus Professor Teresa Rita O’Rourke Cramond (née Brophy) died peacefully in her sleep on 26 December, much has been written and spoken of her amazing contribution to many areas of medicine and beyond. This obituary will focus particularly on Tess’ contribution to AMA.
Tess was born on 2 December 1926 in Maryborough to William and Jane Brophy, the second youngest of four daughters. Her father was a railway superintendent and Tess often commented regarding her parents’ commitment to education. On being awarded an Open Scholarship, Tess went to the University of Queensland to study medicine and graduated in 1951. Tess’ contribution to anaesthetics, resuscitation, and pain medicine are legendary and other obituaries have detailed her extraordinary achievements in those areas. A devout Catholic, Tess was a founding member in Queensland of the Order of Malta, a Catholic, lay organisation committed to care of the poor and the sick. Tess joined the then British Medical Association (BMA) in 1949 as a student member. On graduation, she immediately joined the association as a full member and her loyalty and ongoing support never wavered. From 1975 to 1983 she was a member of AMA Queensland Council, being elected to the position of President of the Branch 46 | Doctor Q Autumn
in 1981. She was the first woman to hold that office since its establishment in 1894. When Tess joined AMA Queensland, she immediately participated with her usual dedication and was a member of four committees, which involved Medical Education, Hospital Policy and the AMA Anaesthetic Deaths Committee. The AMA at that time provided clinical protocol advice to its members - an area that now would fall into the realm of the Speciality Colleges. A rural member of the Association sought from Branch Council clinical protocol advice with regard to anaesthetic care and of course there was one person well equipped to respond on behalf of the Association. In her first year on Council, Tess’ sharp mind clearly saw that if the AMA was to be an effective advocate it needed to focus on the important issues of policy and move them forward and not become just a ‘talkfest’. Most current Councillors would be unaware that it was Dr T Brophy who suggested in her first year on Council: ‘that items from formal reports from Council’s Sub-Committees be discussed in detail, only
if members of Council have requested they be “starred” …and they advise the Chairman of Council before the meeting’. Wasting time on endless discussions without purpose was no doubt as much an anathema to Tess as to those subsequent members of Council who would be grateful that her proposal was accepted by the then AMA Branch Council. Her second suggestion in the same letter to the President was that a set time be put aside at each meeting to discuss matters of medical policy. Focussing on the key issues to achieve real outcomes is a Tess hallmark, but always done with a gracious smile. In 1981 she took on the role of President of the Queensland Branch of the Australian Medical Association and her words in her first President’s Message in the August edition of the News Bulletin ‘ring as true’ today as they did in 1981. Unity is strength and it is my wish that this year the Queensland Branch can continue – and even foster further – the resurgence of interest in the Association among the fulltime salaried and University staff.
scheme, should now express opposition to assuming some responsibility for the cost of his own health care… As President of the Queensland Branch of the Australian Medical Association, Tess ensured the membership had the opportunity to raise their concerns with her, and have those concerns responded to both through her visits to the Local Medical Associations and through the annual Branch Convocation.
Having met on Council, Tess Brophy and Humphry Cramond married on 24 April 1985. To be successful in this venture, it is important to “get them young and train them early” and by being seen to be interested in their professional welfare, make the benefits of membership obvious. If Queensland is to attract and retain in senior medical posts, practitioners of high academic and professional qualifications, appropriate conditions of employment are essential. The Association provides a medium through which can be expressed the views of a united medical profession – administrators and clinicians, full-time salaried, University and private practitioners. I seek the support of all members to use their influence on non-member colleagues to join the Association so that it can achieve its objectives – to respond to the needs of society in striving for better preventive medicine and better health for all. In the September 1981 edition of the News Bulletin, a letter Tess wrote to The Courier Mail was published. The then Opposition Leader had been reported as advising Queenslanders not to take out private health insurance. I quote from the introductory remarks in Tess’ response: I was surprised and disappointed to read the intemperate remarks attributed to the Federal Opposition Leader, Mr. Hayden. From his experience as Federal Treasurer, Mr. Hayden is well aware that like ‘no free lunch’ there is ‘no free hospital system’, but a government funded system that must always be available to those who, in the event of accident or medical emergency, or, because of the nature of the medical or social circumstances, are best treated in a government-funded service. It is equally surprising that Mr Hayden, the architect of the compulsory health insurance
At the end of her year as President, in her Presidential Address, Tess chose the topic The Challenge of Terminal Care. This of course was a most fitting topic for her to address and reading the paper, Tess’ perceptive intelligence, her care for patients, her passion for the profession, her commitment to ensuring the highest standards in every aspect of care – medical, social, domiciliary – is very evident. In this address she also discusses the selection of students into medical school and again, this emphasises Tess’ own attributes – the vital importance of scientific academic endeavour as well as empathy and care for patients, right through illness to the time of the patient’s death. I quote from the address: More recently, there has been widespread, uninformed criticism because medical students are selected from the top two to three per cent of academic performers – and it is alleged that desirable qualifications empathy, supportive encouraging behaviour, personal integrity, tolerance, ability to make decisions and self confidence – are ignored. I have seen no scientific data which shows that to have intelligence, ability and industry, is incompatible with humanitarian attitudes… ...I believe that medical students reflect general standards in the community – they reflect the sense of values seen in their homes and their schools – despite the efforts of the media in sponsoring attitudes that are at best permissive – the sponsoring by the media of unscientific quack remedies for the care of the aged and for cancer patients is quite irresponsible. Further on, the paper discusses the essential elements of a hospice service, which must include good medical care and support and also the need for domestic housekeeping services and respite care and financial support for carers. Forty years on some progress has been made – due in no small part to Professor Tess Cramond. In 1983 the Australian Medical Association awarded Professor Teresa Rita O’Rourke Brophy Fellowship of the AMA. The citation concluded with the following words in regards to her Presidency: To that position, she brought not only her distinguished academic achievements and her vast professional knowledge, but also the dignity and charm which have been
characteristic of her dedication to the high ideals and practice of medicine. Her contribution to the practice and teaching of medicine and her services to the profession and to the community, merit special recognition through her admission to the Roll of Fellows of the Australian Medical Association. Tess continued to bring her wisdom to many AMA Queensland committees and working parties including the Ethics Committee, the Women and Medicine Committee, committees associated with the Centenary Celebrations in 1994, Options for Dying with Dignity and the Protocol Committee. AMA nominated Professor Cramond to be a member of the Commonwealth Pharmaceutical Benefits Advisory Committee. From 1982, Tess was a Trustee of the Medical Benevolent Association and later its Chair. The Association is a charitable organisation with the objective of assisting members of the profession in times of need. In 1993, Professor Tess Cramond was appointed as Vice President of the Queensland Branch of the Australian Medical Association. The letter of advice and congratulations stated: ‘The Council felt this honour should be accorded to you in recognition of your loyalty and service to the Association over many years. Your dedication to the profession and your steadfast commitment to our professional ethics are highly commended by your colleagues.’ It was through the AMA that Tess Brophy and Humphry Cramond came to marry on 24 April 1985. The Courier Mail, in an article at the time of their engagement in October 1984, stated the couple met at medical school but the romance started when Dr Cramond became AMA President in May (1984). As dual Vice Presidents of AMA Queensland, Tess and Humphry Cramond provided a continuing inspiration of commitment to the profession and to its representative organisations. Tess received many awards and accolades including an Officer of the Order of Australia (AO), an Order of the British Empire (OBE), an Advance Australia Award, a Red Cross Long Service Award, Queensland and Australian Surf Life Saving Life Membership, and the AMA Women in Medicine Award to name but a few. Tess’ funeral at St Stephen’s Cathedral in February was a testament to the many people and organisations her life had touched. She is survived by her sister, Joan, her nieces and nephew, Humphry’s children and their extended families, and her AMA family. Q
Doctor Q Autumn | 47
PEOPLE & EVENTS
SPEAKER PROFILE:
ASSOCIATE PROFESSOR MUNJED AL MUDERIS
Associate Professor Munjed Al Muderis battled extraordinary odds to come to Australia, and then to become a pioneer in the field of osseointegration. Hear more from Associate Professor Al Muderis and many other great speakers at this year’s Junior Doctor Conference.
In 1999, Munjed Al Muderis was a young surgical resident working in Baghdad when a squad of military police marched into the operating theatre and ordered the surgical team to mutilate the ears of three busloads of army deserters. When the head of surgery refused, he was executed in front of his staff. Munjed’s choices were stark - comply and breach the medical oath ‘do no harm’; refuse and face certain death; or flee. That day, Munjed’s life changed forever. He escaped to Indonesia, where he boarded a filthy, overcrowded refugee boat, bound for Australia. Like his fellow passengers, he hoped for a new life, free from fear and oppression, but for 10 months he was incarcerated in what became known as the worst of the refugee camps, Curtin Detention Centre in Western Australia. There he was known only by a number, locked in solitary confinement and repeatedly told to go back to Iraq. On 26 August 2000, Munjed was finally freed. Now, 14 years later, he is one of the world’s leading osseointegration surgeons, transforming the lives of amputees with a pioneering technique that allows them to walk again. 48 | Doctor Q Autumn
Munjed’s journey to become a world leader in osseointegration surgery started when he was a young child watching The Terminator movie. How to combine robotics and humans? This passion has driven him to search the world to find the best way to provide this technology for amputees, to enable mobility, to enhance comfort, reduce pain and to facilitate a better quality of life. To date Munjed has helped more than 80 amputees, trans femoral and trans tibial, walk with greater ease, comfort and control. Osseointegration enables the amputee to focus on the destination rather than the journey; this in itself has been life changing for all of Munjed’s patients. The Osseointegration Group of Australia (OGA) was developed in 2010 under the Chairmanship of Associate Professor Munjed Al Muderis. The desire to improve the choices and quality of care for amputees in Australia came about after Associate Professor Al Muderis returned to Australia having undertaken a Fellowship in Orthopaedic surgery in Germany where he was able to participate in the osseointegration process. Having
then examined the Swedish (Branemark) and German (Endo Exo – ILP) methods it was decided that this technology did have a place in Australia and that the optimal way of providing this to the Australian amputee community was by creating a multi-disciplinary team which would together examine applicants and determine their suitability for surgery. In December 2010, the first planning meeting of OGA was held and the first osseointegration surgery was undertaken in March 2011. Munjed has achieved a huge amount of success in a short amount of time and provided extraordinary change to the lives of not only amputees, he also provides services in hip and knee surgery. Munjed is married to Irina, and lives with his daughter Sophia in Sydney. He has three boys, Ahmad, Adam and Dean. His family is very understanding and appreciates that Munjed’s dedication to his patients impacts heavily on family time. It is their support that enables this devotion. Recently Munjed has released his book Walking Free. Q
SATURDAY 25 - SUNDAY 26 JUNE 2016 BRISBANE CONVENTION AND EXHIBITION CENTRE VISIT WWW.AMAQ.COM.AU FOR THE FULL PROGRAM OUR ANNUAL FLAGSHIP EVENT FOR DOCTORS IN TRAINING Preferential Member early-bird rates available
Doctor Q Autumn | 49
PEOPLE & EVENTS
ANNUAL CONFERENCE HEADING TO INDIA AMA Queensland’s 2016 Annual Conference will focus on the theme of turning research into reality in September this year and will take place in Delhi, Agra and Jaipur.
Delhi India’s capital and a major gateway to the country, contemporary Delhi is a bustling metropolis and one of the oldest capitals in the world. Delhi successfully combines in its folds - the ancient with the modern, and is a treasure trove for explorers. From Mughal monuments to modern malls, from traditional arts and crafts markets to trendy fashion shows, from skyscrapers to beautiful parks and gardens, a tour of Delhi will provide the discerning traveller with much to see and admire. Agra The city of Agra, the quintessence of the grand Mughal era, reigns to this day in the public mind as the embodiment of royal grace, imposing architecture and power. Agra is globally renowned as the city of the Taj Mahal. But this royal Mughal city has, in addition to the legendary Taj, many monuments that epitomise the high point of Mughal architecture. No tour to India can be complete without paying a visit to this 1
erstwhile capital of the Mughals and the city of the Taj Mahal, the world’s most beloved monument. With its laidback lifestyle and its immense wealth of architecture, handicrafts and jewellery, Agra is amongst the most remarkable cities of the world.
WHO SHOULD ATTEND? The AMA Queensland Annual Conference is tailored for medical practitioners, practice managers, registered nurses and industry professionals. As a conference delegate you will learn from world renowned Australian and international speakers and develop a better understanding of the medical issues that will affect you and your patients.
Jaipur A vibrant city, which was established in the year 1727, Jaipur has been acclaimed as the first planned city in India. The capital of the former Kachwaha rulers, Jaipur offers a multifaceted tourist destination. This thriving city has derived its name from the illustrious ruler Sawai Jaisingh II, whose progressive thinking gave birth to a perfectly planned city. The term Sawai has been bestowed upon him by the then Mughal Emperor as an honour to his multifarious personality. This poetic expression literally means Jaisingh was more valuable than one person. Widely acclaimed as the Pink City of India, Jaipur proliferates in its magnificent past, bellicose history, renowned tradition, architectural elegance and natural vista. Q
ITINERARY
The itinerary includes a tuk-tuk ride into the Old Delhi, then a rickshaw ride home through the bazaars in tiny alleys. The journey includes; Chandni Chowk, Fatehpuri Mosque and the Darya Ganj Book Market. Another day sees a visit to the Taj Mahal, listed as one of the seven new wonders of the world and a UNESCO World Heritage site. Once in Jaipur, a trip into Badi Chaupar will mean kiosks selling flowers, Itr (Indian scent), colourful stoles, sarees and all sorts of Indian goods. A Safawala (person deft at tying several types of Rajasthani turbans) will tie a safa on the heads of gentlemen and stoles will be presented to the ladies before a visit into the Maharaja’s residence, the City Palace.
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1. Bengal Tiger 2. Safdarjung tomb, Delhi 3. Hawa Mahal, Jaipur 4. Secretariat Building, New Delhi 5. Taj Mahal, Agra
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AMA QU EENS L A ND PR ES ENT S
17 - 24 SEPTEMBER 2016
Register now at www.amaq.com.au
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BUSINESS TOOLS
WHEN THE CORONER CALLS JANET HARRY
MDA National’s Medico-legal Advisory Services team regularly receives phone calls from members who have been contacted by the Coroner’s office in relation to an investigation involving the death of a patient. Here are some of the most frequent questions and concerns raised by members.
MDA National
Medico-legal Adviser P: 1800 011 255 E: peaceofmind@ mdanational.com.au As medico-legal adviser, Janet Harry’s role involves assisting members and their staff with medico-legal enquiries, complaints, investigations, medical negligence claims and legislative review.
Q. I’ve been asked to provide a report or statement to the Coroner – what should I do? A. We recommend that you always contact your medical defence organisation (MDO) for advice before providing a report to the Coroner. A well prepared report or statement can greatly assist the Coroner in understanding your role in the care of the patient.
Preferred Medical Indemnity Provider
If you’re a hospital-employed doctor, you may be asked by your hospital administration to prepare a report or to be interviewed for a statement. If you’re in general practice, you may receive this request directly from the Coroner’s office or the police assisting the Coroner. In either case, MDA National can assist you. Hospital-employed doctors may also be able to seek assistance from their hospital’s legal representative.
Q. Do I need to see the medical records before I prepare my report or statement? A. Yes, it’s important to refresh your memory from the medical records. If you’re hospitalemployed, the hospital will generally give you access to the records. Q. I’ve been asked to send the medical records to the Coroner – should I comply, or do I need authority from the family or executor of the deceased patient’s estate? A. You should comply. Doctors have a professional obligation under the Code of Conduct to assist the Coroner when an inquest or inquiry is held into a patient’s death, by responding to their enquiries and offering all relevant information.1 Q. Will the matter proceed to a hearing or inquest?
Disclaimer: This article is provided by MDA National. They recommend that you contact your indemnity provider if you need specific advice in relation to your insurance policy.
52 | Doctor Q Autumn
A. The Coroner’s office will review all relevant information obtained from the police, the forensic pathologist, the medical records, and statements from treating doctors and other interested parties, including the family, before deciding whether the matter should proceed to an inquest. Generally, less than five per cent of deaths reported to the Coroner proceed to an inquest.
Q. I’ve received a summons to give evidence at an inquest – what should I do? A. We recommend that you contact your MDO as soon as possible to discuss the matter and determine what assistance you may require. Q. What is a letter of adverse outcome and what does it mean? A. During the lead-up to an inquest, the Coroner may raise concerns about the care provided by an individual doctor and issue a letter advising the doctor of a possible adverse finding which could lead to a referral to the Medical Board. It’s essential that you obtain legal advice and assistance in this situation. It’s important to contact your MDO as soon as possible when you become aware of a request for medical records, a report or statement to the Coroner, or an inquest into the death of a patient. If you’re with MDA National, the sooner we know about the matter, the more effective our assistance will be. We can provide you with personal support and help you with: understanding the Coronial process; preparing reports and statements; and preparing for an inquest. Q 1 Medical Board of Australia. Good Medical Practice: A Code of Conduct for Doctors in Australia. Section 8.10.3. Available at: medicalboard.gov.au/Codes-GuidelinesPolicies/Code-of-conduct.aspx
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BUSINESS TOOLS
WHEN RESTRAINT CLAUSES DO WHAT THEY’RE SUPPOSED TO Rachel Drew and Edmund Burke from TressCox Lawyers explain the outcome of a fairly unusual restraint clause case in Victoria. RACHEL DREW
Partner
P: (07) 3004 3527 E: Rachel_Drew @tresscox.com.au
Restraint clauses are notoriously difficult to enforce and the principles that govern whether to grant even an interlocutory injunction enforcing the restraint were identified by the High Court in Australian Broadcasting v O’Neill (2006) 227 CLR 57. These were that the plaintiff must demonstrate a prima facie case; the balance of convenience must favour the granting of an injunction; and the injury which the plaintiff will suffer if the injunction is not granted is unlikely to be remedied in damages if they are ultimately successful at trial. As always, there may also be other discretionary considerations which militate against the grant of injunction.
EDMUND BURKE
Associate
P: (07) 3004 3526 E: Edmund_Burke @tresscox.com.au
Because the hurdles for success are set so high, restraint clauses normally define both the restricted geographical area and the restricted period by a cascading definition applying a lesser restraint in the event that a court held the greater restraint to be unreasonable or invalid. A recent case in the Supreme Court of Victoria Epic Health Pty Limited v Peng-Kung Yang [2015] VSC 516 is unusual in that it granted an injunction restraining the defendant doctor, until the conclusion of a trial, from providing any services associated with the carrying on of a general medical clinic, including as a medical practitioner, for a 10km geographical radius of the plaintiff’s inner city Melbourne clinic. The doctor had a restraint of trade clause in his independent contractor agreement which restricted his ability to practice as a GP within 10km of the clinic. While working for the clinic, he set up a rival medical clinic within the 10km restraint zone. There were a number of unusual circumstances in this case. In short, the Court found the defendant doctor had lied to the clinic, telling them that he was working elsewhere to help out a friend, when in truth he had a significant investment in the other clinic. The clinic’s enquiries had identified that in a period of six weeks, nine patients from their clinic had become patients of the defendant doctor at the new clinic. The plaintiff expressed fears that further patients would migrate to the new clinic if the injunction was not granted. The doctor submitted the medical practice had made a ‘generalised ruled up allegation’ and had not identified any particular patient who
54 | Doctor Q Autumn
had left her clinic for his new one. He denied that he had taken or otherwise solicited any patients from the plaintiff. However, because of his previous false assertions about the purposes of working in the other clinic and other reasons, the judge in this case found that: “although it is the experience of the courts that the enforcements of such restraints can occasion hardship, a contractor like the defendant who, fully cognisant of the terms and extent of the restraint, nonetheless sets up a competing business largely because it suits him to do so, could be thought to be the author of his own misfortune”. Such submissions are assessed by the courts on the balance of convenience and innocence. The assessment of the judge was that the plaintiff’s claim that the restraint which had been breached was valid and enforceable was not without merit and could be considered to be a strong claim. The court accepted there would be some financial hardship to the defendant doctor if the restraint was enforced until trial but was unpersuaded that the defendant doctor would be unable to find employment. On the other hand, the plaintiff would be permanently deprived of the protection afforded to its business by the contract. In this case the plaintiff was granted the relief that it sought and the injunction was granted until the matter went to trial. It is significant that in this case within a 10km distance by road of the clinic of the plaintiff there were 23 other medical clinics providing the same medical services as the defendant’s new clinic. In summary, if there is any simple rule to take out of the particular circumstances of this trial, it is that honesty is the best policy, unless one wishes to become “the author of his own misfortune”. Q
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We can help you with: Purchase and sale of medical practices Medical indemnity claims IR & Workplace Safety Registration issues Business structuring and contracts Corporatisation
Employment Contracts General practice and specialist practice issues Dispute resolution and litigation Regulatory investigations and proceedings Medicare Australia investigations Estate Planning and Wills
Doctor Q Autumn | 55
BUSINESS TOOLS
IS YOUR INCOME PROTECTION INSURANCE BREAKING THE BANK? CRAIG WRIGHT M: 0488 273 399 E: craig.wright @experien.com.au Craig Wright is a life and income protection insurance specialist for Experien Insurance Services, based in Brisbane. They are the preferred life insurance partner of AMA Queensland. He focuses on the medical industry and understands the unique needs of doctors. This has helped him to negotiate enhanced products for our sector from insurers.
Craig Wright from Experien offers an insider’s view of the price increases occurring in the insurance market. Income Protection insurance provides valuable protection against temporary and permanent illness and injury. The industry pays out hundreds of millions of dollars each year to people who claim on these policies. Unfortunately claims at some insurers for some conditions have risen sharply over the past year which has meant some insurers have been losing money on their products. Whilst some insurers are holding steady, many have needed to raise their premium rates up to around 10 per cent. What are the insurers doing? Each insurer is adopting a different approach. Some are not increasing premiums. Others are increasing some products by a small amount and others by a larger amount. Each person is affected differently (if at all). Stepped premium and CPI premium increases
Disclaimer: This information is of a general nature only and has been prepared without taking into account your particular financial needs, circumstances and objectives. While every effort has been made to ensure the accuracy of the information, it is not guaranteed. You should obtain a copy of the product disclosure statement and also obtain independent professional advice before acting on the information contained in this publication. Life Insurance services are provided by Experien Insurance Services Pty Ltd (ABN 99 128678 937). Experien Insurance Services Pty Ltd ABN 99 128 678 937 is a Corporate Authorised Representative (No. 320626) of ClearView Financial Advice Pty Limited ABN 89 133 593 012 AFS Licence No. 331367.
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If you have what is termed a ‘stepped’ premium policy, then your premiums generally increase each year regardless, as your risk of claiming generally rises each year. Your premium may also increase by an inflationary amount as your cover increases by a similar amount each year. The increases referred to in this article would be additional to any such increases. When do premium increases take effect? We are made aware early of a price increase (if any) planned by an insurer. These only take place on a policy anniversary. Our approach is to review this increase and then analyse what it means to each client. We then consider if affected clients could be better off with an alternative insurer or if there are other options to consider to mitigate the premium increase - such as increasing the waiting period associated with any claim. In some cases, no changes may be suggested or possible. We present any recommendations to you shortly before your next policy anniversary – which is the date that any price increase would take effect.
So what should you do about your insurance? If you already have insurance in place, we can provide a complimentary review to ensure you have the best cover. We generally have access to the cheapest personal insurance rates from the major insurers and it is unlikely that any other adviser would be able to obtain better rates for you. Unlike some other advisers, we have access to all the insurers in the industry. Whilst it is impossible to predict with certainty if future insurance premiums will rise or fall, we take great care to work with insurers that we believe are financially secure and have long-term stability with a great claims payment history and service. Q
Is the cost of your Income Protection and Life insurance breaking the bank? We have access to all of the insurers in the industry, comparing policy features and prices to obtain the best Income Protection and Life insurance cover for you. We also review any existing exclusions and health loadings on your policy.
Experien is the preferred life insurance provider to the AMA Queensland and one of the few national brokers that specialise in the medical sector. For a complimentary review or consultation, contact: Craig on 0488 273 399 or craig.wright@experien.com.au, or Justin on 0419 994 123 or justin.tyne@experien.com.au
Life Insurance services are provided by Experien Insurance Services Pty Ltd ABN 99 128 678 937. Experien Insurance Services Pty Ltd is a Corporate Authorised Representative (No. 320626) of ClearView Financial Advice Pty Limited ABN 89 133 593 012 AFS Licence No. 331367. General Insurance services are provided by Experien General Insurance Services Pty Ltd trading as Experien Insurance Services ABN 77 151 269 279 AFS Licence No. 430190. This information is of a general nature only and has been prepared without taking into account your particular financial needs, circumstances and objectives. While every effort has been made to ensure the accuracy of the information, it is not guaranteed. You should obtain a copy of the product disclosure statement and obtain independent professional advice before acting on the information contained in this publication.
Doctor Q Autumn | 57
BUSINESS TOOLS
SUPERANNUATION: THE KEY FACTS If you are wanting to make extra contributions to your superannuation, Paul Copeland from William Buck explains the best way to go about it. ANGELA JEFFREY
William Buck
P: (07) 3229 5100 E: paul.copeland @williambuck.com Angela Jeffrey is Business Advisory Director at William Buck Chartered Accountants and Advisors.
Don’t exceed the contribution caps Concessional contributions Concessional contributions where a tax deduction is claimed by you or your employer. Personal superannuation contributions made by you are only deductible in certain circumstances. Generally if you are working in private practice then these personal contributions will be deductible, however rules will apply if you are also still receiving employment income. You should seek professional advice if you plan to make a personal superannuation contribution this year. The annual concessional contribution caps are $35,000 for individuals between 50 and 75, and $30,000 for those under 50 years of age. These caps relate to your total contribution of superannuation for the year – not just from one source (that is, all employers and personal contributions). If you are between 65 and 75 you must meet the work test prior to making a contribution [this requires you to work and be paid for at least 40 hours in a 30-day period]. If your concessional contributions exceed the cap, the maximum which would be payable on the excess amount is 49 per cent (15 per cent payable by the superannuation fund and 31.5 per cent payable by the individual). The amount payable is based upon your marginal tax rate. Non-concessional contributions Non-concessional contributions are contributions made personally by the member of a fund where the member does not claim a deduction for the contribution.
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 (QLD) has a dedicated team of superannuation and taxation experts who are happy to speak with you regarding your self managed superannuation fund or any other issues regarding superannuation you may have.
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If your non-concessional contributions exceed the cap ($180,000 per year, or potentially $540,000 over three years under the ‘bring forward’ rules), the excess amount of contribution will be taxed at a rate of 49 per cent. As this is essentially a tax on after-tax money, you may end up paying as much as 93 per cent on the original earnings. Bring forward rules People under 65 years old may be able to make non-concessional contributions of up to three times their cap over a three-year period. For example, if you brought forward your contributions in 2015-16 year, it would be 3 x $180,000 = $540,000. This is known as the ‘bring-forward’ option.
Once you have maximised your three year cap under the bring forward rules, you are not allowed to make any further non concessional contributions to your superannuation account until after the three year period ends. Importantly if you are looking to make a contribution to superannuation for the 2016 financial year, your contribution needs to be in the superannuation fund before 30 June 2016. Contributions paid late or accrued will not be deductible in the 2016 financial year. Division 293 tax From 1 July 2012, Division 293 tax has been applied to an individual’s taxable concessional contributions for those individuals earning above the $300,000 threshold (high income threshold). Division 293 tax is payable at 15 per cent, on the concessional contributions made by you, up to the cap of $35,000. Division 293 tax is not payable on excess concessional contributions that have been taxed under excess contributions tax. Pension Payments/ superannuation income streams Superannuation really becomes beneficial when you commence an allocated pension. You commence an allocated pension when you start to withdraw money from your superannuation fund. Importantly, when you commence an allocated pension, the superannuation fund will pay no further tax on earnings on your account. Provided you meet certain triggers, you are able to access your superannuation when you reach preservation age and retire (can be age 55 if you were born before 1 July 1960) or when you turn 65, even if you haven’t retired. The real benefits of superannuation can be seen where the allocated pension is accessed after the individual is over age 60. Q
“ If you are looking to make a contribution to superannuation for the 2015/2016 financial year, your contribution needs to be in the superannuation fund before 30 June 2016. ”
SPECIALIST
ADVISORS TO THE MEDICAL
INDUSTRY WITH A DEDICATED HEALTHCARE PRACTICE, WILLIAM BUCK CAN HELP YOU STRUCTURE YOUR PERSONAL INVESTMENTS TO ACHIEVE THE AFTER-HOURS LIFE THAT YOU WANT.
William Buck is experienced at structuring personal investments such as property or self managed superannuation funds, and can assist you with the following: — Advice on setting up appropriate investment structures — Comprehensive assistance with your personal taxation affairs — Develop strategies to help you make the most out of your superannuation and investments, including assessing the taxation consequences — Securing your financial freedom with business and retirement planning CONTACT PAUL COPELAND OR ANGELA JEFFREY FOR A CONFIDENTIAL & COMPLIMENTARY CONSULTATION
Phone: + 61 (7) 3229 5100 Email: Paul.Copeland@williambuck.com Angela.Jeffrey@williambuck.com
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BUSINESS TOOLS
TAX CHANGES TO SUPER BACK ON THE AGENDA ROSS NOYE
Macquarie Private Wealth P: (07) 3233 5805 M: 0438 779 955 E: ross.noye@macquarie. com
Changes to the superannuation system raised in the 2014 Financial System Inquiry (FSI) included a number of recommendations related to restructuring the superannuation tax concessions to make it more equitable for low income earners. While the 2015-16 Budget steered clear of making any substantial changes to super taxation, the issue was highlighted in the government’s Tax White Paper released in March 2015. So, super changes are clearly back on the agenda. With this in mind, superannuation fund members should be considering how to position their super accounts balances to minimise the effects of any tax changes. Fund members should keep in mind the proposed changes are designed to shift the tax breaks from higher income earners to lower income earners by restructuring the concessional tax rates. Low income earners to pay less super contributions tax One of the proposals is to tax super contributions at marginal rates minus 20 percentage points. Under this proposal super fund members on a taxable income under $37,000, who currently get hit with a 15 per cent tax on their concessional contributions (i.e. contributions where they claim a tax deduction) would no longer pay any tax on those contributions. This information has been prepared by Macquarie Private Wealth, a division of Macquarie Equities Limited ABN 41 002 574 923 AFSL 237504. It 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. .
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High income earners to pay more super contributions tax However, high income earners would pay 10 per cent extra tax on their tax deductable (or concessional) contributions based on the top marginal rate (excluding the Medicare and budget repair levies) of 45 per cent minus 20 per cent. This would mean high income earners would pay a 25 per cent rate rather than the 15 per cent flat rate now applied
to all contributions. For those with taxable incomes of $80,000 to $180,000 salaries, the new rate would be 17 per cent. Higher account balances to pay more tax on investment earnings Another proposal is to tax the investment earnings of assets supporting the payment of a super pension. Currently taxed at 0%, the proposal is to apply a tax rate of 15% on each dollar of income over $75,000. While this raises a number of questions around the definition of income and notwithstanding Mr Turnbull’s promise to take any changes to super to an election, many fund members are planning to implement their strategies well in advance of the 2016 May Budget announcement. What can I do? There are three strategies that super fund members should consider now to help minimise the effects of any proposed changes: 1. Even up your account balance with the client’s spouse. This will have the effect of enabling access to two pension income thresholds of $75,000 and can be achieved by making additional non-concessional contributions to the spouse with the lower balance. For those already retired and under 65 they might take advice on a withdrawal and re-contribution strategy. 2. Continue to make the maximum concessional contributions. The low tax environment provided by the super fund continues to be the most attractive structure for retirement, particularly if adjusted income is between $180,000 and $300,000. The annual maximum concessional contribution is $30,000 unless the client is 50 or are older when the cap is $35,000. 3. Start a Transition to Retirement pension. If a fund member is aged 56 or over and not retired and hasn’t commenced a transition to retirement pension (TTR) they might consider doing so, but it is worth seeking proper financial advice. Q
DOES YOUR CURRENT CAR MATCH WHERE YOU ARE IN YOUR CAREER? Jeff Miller from BOQ Specialist explains why it can pay to partner with a specialist bank for your future car financing needs. For most working professionals a high-quality, reliable car is a necessity. However, with the pressures and demands of the job, a number of medical professionals could be relying on their car choices of years gone by which, in many cases, would be out of sync with their current career status. Medical professional clients are generally time poor, so you may not have much time to thoroughly research your options. In many cases clients simply don’t realise which models are comfortably within reach, given the stage they are at in their career. It is also important to weigh up the benefits of managing your car finance through a specialist bank, such as BOQ Specialist, rather than through the dealer itself before rushing out to the dealership for your next car purchase. We take a highly tailored and personalised approach – ensuring you are better informed and in control of the decision making process. There are a range of ways we can finance a car loan to suit your particular needs and cash flow. Depending on how quickly you can pay off the loan, we can structure it from six months through to five years and can set up the loan as a low-start, up front or stepped payment. We also take the time to ensure you are fully informed and understand the implications
of things such as balloon payments, how long you expect to own the vehicle as well as how it’s likely to be used so the appropriate tax treatments may be applied. These initial considerations may save you a great deal over the long run.
JEFF MILLER
BOQ Specialist
P: (07) 3018 8119 E: jeff.miller@ boqspecialist.com.au
For busy professionals having a quick, easy and seamless car finance process in place can also be an attractive prospect. A member of our team was able to get a vascular surgeon client’s loan approved within 24 hours, all while the client was juggling lectures and procedures. The client had an initial conversation with us at the beginning of the week and then was able to drive their new car away before the weekend. We were careful not to add to their already demanding schedule and kept paperwork to an absolute minimum. Earning frequent flyer points with the car purchase makes for an added bonus. With BOQ Specialist’s Signature and Platinum cards, clients can arrange to purchase a new car through their credit card*, and then roll the expense into a fixed term finance contract with BOQ Specialist allowing them to earn Qantas Points** or Velocity Points*** on each repayment. Q
Disclaimer: The credit provider is BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL and Australian credit licence no. 244616 (“BOQ Specialist”). Terms and conditions, fees and charges and lending and eligibility criteria apply. We reserve the right to cease offering these products at any time without notice. * A 1.5 per cent processing fee applies on the purchase price. Points are earned on eligible purchases only. Fixed term finance contract is to be approved prior to purchase. If you elect to make loan repayments on your BOQ Specialist Credit Card a 1.5 per cent processing fee applies on the amount of each repayment. Repayments on overdrafts and lines of credit are not available to be made via BOQ Specialist Credit Card. ** Qantas Points are earned in accordance with the BOQ Specialist Qantas Rewards Program Terms and Conditions available at www.boqspecialist.com. au/card. Qantas Points and bonus Qantas 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 Points and membership are subject to the Qantas Frequent Flyer program Terms and Conditions available at qantas.com/terms. See definition of Eligible Transaction in the BOQ Specialist Qantas Rewards Program Terms and Conditions. Please allow 6-8 weeks once you have made the purchase for the points to be credited to your account. BOQ Specialist 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. ***To earn and redeem Velocity Points you must be a Velocity member. Velocity membership and Points earn and redemption are subject to the MemberTerms and Conditions, available at velocityfrequentflyer.com, as amended from time to time.
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BUSINESS TOOLS
RISK MANAGEMENT – MANAGING CYBER AND PRIVACY RISKS CHRIS MARIANI
AMA Queensland Insurance Solutions
Running a medical practice exposes the owners and management team to a complex range of risks, increasingly privacy breaches. Whether it’s a sophisticated cyber-attack or a disgruntled employee, it’s worth finding out if your practice is equipped to deal with the fallout.
P: 1300 883 059 M: 0419 017 011 E: chris.mariani @amaqis.com.au Authorised Representative No. 434578 Chris Mariani is a medical indemnity specialist at AMA Queensland Insurance Solutions.
A 2013 survey released by McAfee found 45 per cent of surveyed small-medium businesses (between 25 – 250 employees) had been the target of an electronic attack in the prior year and 46 per cent had suffered a data or security breach perpetrated by disgruntled and current employees. Cyber security should be on your Risk Register and in your ‘top 10 risks’ in 2016. Some practical risk management steps you can take include: develop a business continuity plan/disaster recovery plan for system downtime; develop a data breach response plan; make sure you are aware of all regulatory requirements (for example is your Privacy Policy updated to address the 13 Australian Privacy Principles; conduct employee training to ensure your staff are aware of risks the company faces;
Disclaimer: AMA Queensland Insurance Solutions is a trading name of KSLR Pty Ltd, a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, AFSL 240549. Corporate Authorised Representative No: 366807. The information provided in this article is of a general nature and does not take into account your objectives, financial situation or needs. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.
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develop appropriate policies such as a ‘bring your own device to work’ policy and internet usage while connected to the company network; review contracts with third party vendors providing data storage and other IT services. Are there limitations of liability? conduct an external penetration test to highlight potential areas to address; review system protection you have in place, such as anti-virus, firewalls etc. and update regularly; and
to understand the limitations/cover provided by traditional policies and what a cyber policy covers. Recently I received a call from a doctor who believed his MDO would cover a successful cyber attack which breached patient privacy. The reality however is there are several risks and issues to consider, which the doctor hadn’t considered. While a patient bringing a civil claim for breach of privacy would likely be covered by the doctor’s MDO (refer to your own policy terms and conditions) there are numerous other risks which may not be covered, such as: The costs to investigate the breach and restore the IT system/data - such as IT forensic teams to ascertain the cause of the data breach and potentially remove the hacker from your system; The legal fees to manage the data breach response, for example, whether there is an obligation to report the incident to the Office of the Australian Information Commissioner (OIAC); The costs to provide support to patients such as credit monitoring services, public relations firm to help repair damage to your brand; legal costs for notifying your affected customers; The potential fine sought by the OIAC, which from 1 March 2014 is up to $1.7 million for companies and $340,000 for individuals for serious or repeated invasions of privacy; and
keep all your systems and software patched up.
The loss of revenue the practice may suffer in the event the practice is unable to trade due to, for example, ransomware.
From an insurance standpoint, adding a cyber insurance policy is needed in order to cover the complex range of risks faced. It’s important
Broad specialist cyber and privacy protection policies are designed to cover the above risks. Q
ONE LESS THING ON YOUR TO-DO LIST Have all your insurance needs covered through AMA Queensland Insurance Solutions
Free insurance health check
www.amaqis.com.au
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 an insurance healthy practice, contact AMA Queensland Insurance Solutions on 1300 883 059. Doctor Q Autumn | 63
LIFESTYLE
THE JAM PANTRY All children have dreams of what their life will be like when they grow up. Some want to be doctors, others want to be astronauts. Mine was to have a trendy breakfast cafe open up within a five minute walk of my house. Late last year, my childhood dreams came true when The Jam Pantry opened up at the end of my street. With a spring in my step and an insatiable appetite for brunch I was ready to see whether The Jam Pantry lived up to my childhood dreams, or whether I should’ve stuck with the astronaut one. The Wait List The first point of The Jam Pantry is that you’ll have to put your name on a waiting list when you arrive to get a table, and you will wait. While it’s not the same wait as a category five in a metropolitan emergency room on a Friday night, you’ll still be asked to return in half an hour or so. Thankfully, the staff are extremely professional in their list taking and the second a table gets up to leave they’re already shepherding you in. Additionally, 64 | Doctor Q Autumn
there’s a well-stocked news agency just across the road to allow you to grab the paper while you wait. Atmosphere The Jam Pantry prides itself on a Hampton’s style interior, with a cool almost beach-like vibe. It wouldn’t be out of place on Hastings Street, Noosa. The setting ensures that everyone is relaxed including, by some form of magic, small children who are too busy with their food to yell. Acoustically, it’s not the best for sensitive conversations, as the absence of soft surfaces ensures that voices carry. All in all, great for a Sunday catch up with friends, not a great place to meet your lawyer. Service At its heart, The Jam Pantry is a highperforming cafe. So long as you’re not expecting your napkins to be folded, ala Aria, when you step out for a call you’ll be pleasantly surprised. The Jam Pantry has resisted the temptation of many restaurants and cafes in this climate and actually rosters on an appropriate number of staff. While young, they’re attentive and we never had difficulty in receiving service. Food The Jam Pantry’s true talent is combining flavours and textures that have no earthly business being combined, and doing so with considerable flair. We both enjoyed nims’ eggs, which consisted of poached eggs, streaky bacon, banana chutney, pesto, roasted Roma tomatoes
and toasted sourdough. Generally, the only place you see banana and bacon together is in the dictionary but here, it just works. I could continue to wax lyrical about how the flavours just work, how they’re perfectly balanced, and how you’ll feel guilty at your next meal for washing the flavours away. But I’ll leave it at this, the food is amazing. They were perfectly washed down with, hands down, the best hot chocolate in Brisbane. Overall Rating The Jam Pantry is like a surgeon with an extremely low complication rate. It’s good, at the top of its game and it knows it. If its food was any less exceptional, its confidence would be seen as arrogance. The fact that you have to wait to even sit down would be seen as inexcusable. However, The Jam Pantry pulls it off with a confidence in its food and drinks that makes for an incredibly satisfying experience. We will return, and I highly recommend that you try it as well. Q
5/5
stethoscopes
THE WORLD’S MOST EXOTIC OVERWATER BUNGALOWS Where is your happy place? Is it elevated over the ocean where you can escape and listen to the sound of the water? Are there huge wraparound decks, private plunge pools or glass-panelled floors? Most importantly, is there a ladder leading down to the water? Ros Bulat from AMA Travel Queensland gives us the top five overwater bungalows in places you might not have expected.
KohQuen and Koh Bong, Cambodia The Song Saa Private Island, locally known as ‘The Sweethearts’ is built on two islands connected by a footbridge. The bungalows feature indoor and outdoor showers, private pools and uninterrupted views of the sea. Once you tear yourself away from the villa there is so much to see and do - kayaking, hiking, beach picnics and visiting the PrekSvay fishing village on the neighbouring island. Belize, Cayo Espanto This private island resort has only seven villas, and those looking for total privacy can rent the entire island. One Cayo Espanto Villa, the Casa Ventanas, is built over the water, located off a 150-foot long dock and surrounded on all sides by the Caribbean Sea. The Casa Ventanas has a glass-panelled floor, which reveals fish swimming right under your bungalow.
Photo credit: Bernardo Salce
Riviera Maya, Mexico Rosewood Mayakoba
Malaysia PangkorLaut Resort
Rosewood Mayakoba is connected by a series of lagoons. All rooms are contemporary design, the Deluxe Overwater Lagoon Suite sits above the resort’s lagoon and comes with its own deck and private plunge pool. You can sign up for the daily guided eco-tour of the resort’s lagoon which is led by the resort on-site biologist.
Located off the coast of Malaysia in the Straits of Malacca, this resort offers a mix of overwater and garden bungalows. The sea villas are built on stilts above the water, which has an unusual green hue thanks to the abundance of surrounding vegetation and feature large balconies and bathtubs with seaside views. When you feel the need to leave your bungalow, there is lots to do by exploring the surrounding area. Q
Neuchatel, Switzerland Hotel Palafitte As Europe’s only overwater bungalows, this hotel is built on stilts over Lake Neuchatel. With an industrial-modernist look, the rooms resemble shipping containers. Don’t miss the Musée d’art et d’histoire de Neuchâtel, known as MAHN. Highlights include three frescos by Léo-Paul Robert, and the 18th-century Jaquet-Droz automatons.
Ros email all or c n atio form land. 0 ore in eens 6 720 For m Travel Qu ) 555 A F: (07 at AM 2 885 .au 00 26 .com P: 18 u amaq com.a l@ e v a ravel. E: tr orldt .w q a .am www
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LIFESTYLE
ANYTHING BUT CHARDONNAY!
Whether wooded or not, the 90s did some damage to the wine drinker’s idea of chardonnay. Phil Manser from Wine Direct tells us that the Anything But Chardonnay (ABC) set are missing out on something great. What a decade the 90s was! A quick poll in the office had my colleagues recalling happy pants, grunge, MC Hammer, 90210, mobile phones, the twilight of the Hawke/Keating era, Monica Lewinsky and of course… Chardonnay. It’s important to note that Chardonnay was here well before the 90s but this was the decade it was introduced to us, the masses, in two very distinct phases – wooded and unwooded. Phil Manser Wine Direct 1800 649 463 phil.manser@winedirect.com.au
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The wooded era came to us in the early 90s when many of the larger companies were serving up Chardonnay so cloaked in oak flavour and so oily in texture that the variety itself was lost in the noise. I kept hearing descriptors like ‘coconut and vanilla’ to describe the nose and ‘sweet’ to describe the taste. This was a time where we got to learn more about the application of oak in all its forms (chips and
barrels) and residual sugar added in spoonfuls. Inevitably the overcorrection came where suddenly producers were scrambling to unleash their unwooded Chardonnay on us. This polarised Chardonnay drinkers more than VHS and Beta ever did but front of mind was always Chardonnay in whatever form it came in. Sadly, many of these unwooded wannabes looked more like Sauvignon Blanc and once again the true varietal character of Chardonnay remained hidden from the drinking public. By the time the early 2000s came around, Sauvignon Blanc seized its chance and became the preferred drink to an emerging drinking set known as the ABCs (Anything But Chardonnay). Whilst Chardonnay didn’t disappear from our shelves, the confusion created in the 90s
made new white drinkers more reluctant to try Chardonnay and to this day I still see the ABC movement alive and well at tastings and lunches. What many ABCs have missed is the renaissance in Chardonnay winemaking a result of local innovation, research and experience in wine regions that have made Chardonnay for centuries. There is now a plethora of brilliantly made, complex and beautifully balanced Chardonnay on the market that I’ve had the pleasure of serving up to clients, friends, family and most importantly, the ABCs. Modern Australian Chardonnay now leads with fruit first supported by a combination of judiciously applied oak, oxidative handling, lees stirring and more. Drop me a line as I have a very long list of Chardonnays you ought to try and as always, special AMA pricing will apply. Q
LIFESTYLE
UPCOMING MOVIES*
BOLSHOI BALLET
BOLSHOI BALLET
The Lady of the Camellias
Don Quixote
A young bourgeois, Armand Duval, falls madly in love with Marguerite Gautier, a gorgeous courtesan celebrated by the Parisian high society. Despite her infidelity, Armand will do all he can to win the beautiful woman’s heart and convince her to leave her indulgent life. The Bolshoi breathes new life into John Neumeier’s tragic masterpiece, inspired by Alexandre Duma’s novel and accompanied by Chopin’s exquisite score.
Cervantes’ eccentric hero Don Quixote leaves on a journey full of adventures with his loyal squire in search of his perfect woman. On the way he meets Kitri, the dazzling daughter of an innkeeper who he thinks might be his ideal love. The Bolshoi’s panache and excellence are combined in Fadeyechev’s critically acclaimed staging of this exalting performance with Leon Minkus’ famous score.
12 March 10am, 13 March 2pm
3 March
The Lady in the Van
17 March
The Daughter
The Witch
24 March
Batman V Superman: Dawn of Justice
My Big Fat Greek Wedding 2
7 April
The Huntsman: Winter’s War
Jungle Book
14 April
The Boss
21 April
Mr Right
Eddie the Eagle
Whiskey Tango Foxtrot
28 April
Captain America: Civil War
Mother’s Day
*Please note upcoming films are subject to change
7 May 10am, 8 May 2pm
KENNETH BRANAGH THEATRE LIVE
BOLSHOI BALLET The Taming of the Shrew
Romeo and Juliet
Many suitors dream of marrying the lovely and docile Bianca, including Lucentio. However her father will not let anyone marry her before her elder sister, the ill-tempered shrew Katherina, is herself married. French choreographer Jean-Christophe Maillot lands a coup with his adaptation of Shakespeare’s comedy tailored specifically to the Bolshoi dancers. 16 April 10am, 17 April 2pm
The Kenneth Branagh Theatre Company Live cinema season continues with a new vision of Shakespeare’s heartbreaking tale of forbidden love. Branagh and his creative team present a modern passionate version of the classic tragedy. A longstanding feud between Verona’s Montague and Capulet families brings about devastating consequences for two young lovers caught in the conflict. Reuniting the stars of his celebrated film of Cinderella, Kenneth Branagh directs Richard Madden and Lily James as Romeo and Juliet and Sir Derek Jacobi as Mercutio. 27 August 1pm, 28 August 1pm, 29 August 6pm, 31 August 10am
WIN MOVIE TICKETS FOR TWO! Name:
Portside Wharf, Remora Road, Hamilton P: (07) 3137 6000 www.dendy.com.au
Telephone:
Member no:
Fill out the form and fax it to (07) 3856 4727 or email competitions@amaq.com.au. Entries close 31 March Doctor Q Autumn | 67
LIFESTYLE
ALL ABOUT YOU WORLD’S GREATEST SHAVE 10-13 March Look out for World’s Greatest Shave events near you this month. Brave participants have the choice to shave, colour or wax hair on their head, chest or face to show solidarity with those affected by blood cancer. Funds raised go towards blood cancer research and support for families when they need it most, providing people with leukaemia, lymphoma and myeloma with a free home-away-from-home near hospital during their treatment. Check out www.worldsgreatestshave.com
THE MAYNE INHERITANCE
FERRERO ROCHER BLISS BALLS
Rosamond Siemon Opening with a macabre mid-nineteenth century murder, The Mayne Inheritance unfolds like a gothic thriller. Was it the murder victim’s money that founded patriarch Patrick Mayne’s Queen Street business empire? Were the whispered accusations of murder and genetic madness true? For 150 years, scandal and mystery have surrounded the Maynes, a wealthy family who donated the magnificent site on which the University of Queensland now stands.
From Bianca Slade’s book This and That, available at www.wholefoodsimply.com 2 cups hazelnut meal 12 medjool dates, seeds removed 2 tablespoons cacao or cocoa 1 tablespoon coconut cream (optional) Heat a large frypan over medium heat. Add the meal and stir continuously for 3 – 4 minutes or until fragrant and becoming golden. Pour the meal into your food processor. Add the remaining ingredients and blend at high speed until well combined and resembling a fine sticky crumb. Use your hands to press and shape the mixture into balls. Place in the fridge to set. Enjoy.
TENNIS Mix up the same old exercise with a game of tennis. According to Tennis Australia, tennis gets your heart rate to 70 or 80 per cent of your VO2 maximum, which puts it up there with jogging and cycling for increasing fitness. Playing singles for one hour can burn around 600 calories in men and 420 calories in women and helps you regulate serotonin levels and improves alertness. Lob on to Tennis Australia at www.tennisaustralia.com.au for a list of local courts.
“ Try to learn to breathe deeply, really to taste food when you eat, and when you sleep, really to sleep. Try as much as possible to be wholly alive with all your might, and when you laugh, laugh like hell. And when you get angry, get good and angry. Try to be alive. ” Ernest Hemingway 68 | Doctor Q Autumn
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THE BRAVEST OF THE BRAVE Commemorating the centenary of WWI, our Ocker Doctor Matt Young tells the story of British doctor and Olympian, Noel Chavasse. death. The randomness of shrapnel bursts, the endless clatter of machine guns and the repugnant idea of hand to hand mortal combat, bayonets and clubs. The incessant loss of best mates, meeting their demise in the most horrendous ways.
I must admit I am captivated by the humanity of World War One. It was a war of paradox. It brought out the finest and the most disgraceful traits of our species. Despite the dreadful violence and inhumanity, remarkable resilience and adaptability of our species, the most human of characteristics seemed to survive, thrive and endure as well. I am enthralled by what made just under 417,000 young Australian men enlist and head off to a war that belonged to a different continent in a different hemisphere. Adventure, duty, mateship and even financial opportunities drove many. I wonder how they coped with the twin horrors of the omnipresent threat of personal death and maiming, and the chilling, nauseating requirement to kill other people. I often find myself questioning how sensitive, civilised, often well educated young men coped in the trenches of the Somme and how they survived psychologically with their job description being defined by
At least as a doctor, the expectation of killing was very much diminished. The Great War afforded many brave young doctors the chance to display the very finest qualities. Bravery, heroism, selflessness and valour. In the British military, the highest award for bravery is the Victoria Cross. A VC is emblazoned by just two words, For Valour. Just 100 Australians have been awarded this immense accolade and the very first one was a doctor. He was Major General Neville Howse, a doctor who served in the Boer War. His citation describes his great bravery in rescuing a man under heavy fire in Vredefort, South Africa, back in 1900. I feel proud to be a doctor quite often. It is a great and noble profession, but when I read about some of the doctors that have won VCs I get a bit choked up. The rarest of all military decorations is a VC and bar. In other words, two VCs. Only three men have ever received this tremendous honour and two of them were doctors. Perhaps the more remarkable of these two men was a young doctor who served in the Royal Army Military Corps.
Noel Chavasse was born in 1884 in England and dusted off First Class Honours at Oxford before attending medical school and graduating in 1909. The year before he earned his MBBS he casually ran for England at the 1908 London Olympics. He decided surgery was his passion and happened to win The Derby Exhibition which was the premier medical prize for his final surgical exams. When war broke out, he was in the thick of it straight away. He won a Military Cross in Belgium in June 1915, before being mentioned in despatches in November the same year. At Guillemont (France) in August 1916, he repeatedly crawled across No Man’s Land (NML) to within 25 meters of the German front line, despite being wounded himself by shell fragments. Under
machine gun fire, grenades and rifle fire, he dragged 20 wounded men back to safety. For his conspicuous bravery, he was awarded the VC. A year later, he added a bar to his VC at Wieltje in Belgium. This time he was severely wounded while carrying wounded men to safety. For two whole days he operated despite heavy enemy fire, as well as making regular forays into NML to bring more of his men back to the safety of the Aid Post. Tragically after two days of incredible altruism and humanity, Noel succumbed to his wounds and blood loss. He is buried at Brandhoek New Military Cemetary in Belgium. Captain Noel Chavasse, Olympian, Doctor, VC and Bar. The best that our species and certainly our profession can be. Tragically killed at 32 years old. Q
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IN PRINT
TINTINALLI’S EMERGENCY MEDICINE The eighth edition of Tintinalli’s Emergency Medicine provides the depth and breadth of coverage that reflects the complexity and expertise needed to practice emergency medicine successfully in today’s fast–paced environments. It is an important contemporary clinical emergency care resource for physicians, NPs and PAs who practice emergency medicine and for emergency medicine and pediatric emergency medicine fellows. It remains the preferred study guide for in-training and board examinations and recertification. Doctor Q has a copy of Tintinalli’s Emergency Medicine - Eighth Edition to give away. Fill out the form to the right and fax it to (07) 3856 4727 or email competitions@amaq.com.au. Entries close 31 March
Full-color design with more tables than ever to succinctly present key information Extensive updates to all sections, incorporating the latest guidelines, evidence-based protocols and relevant research
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Professor David Paterson Don’t forget to enter in this Doctor Q edition to win. 70 | Doctor Q Autumn
Online access to more than 30 videos, covering a wide range of procedural and diagnostic topics and focusing on the latest ultrasound-guided techniques. Q
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