May 2015 . vol 94
AMA Queensland Membership Magazine
Interview with Health Minister Cameron Dick No jab, no pay – is it the right approach? PROFESSIONAL DEVELOPMENT ASSISTANCE FOR DOCTORS IN TRAINING
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^ Recommended drive away price includes 12 months registration, 12 months compulsory third party insurance, dealer delivery and stamp duty. Excludes Enhancement Packs and Premium Paint. Vehicles registered and delivered by 30/06/2015. Lexus of Brisbane Group reserves the right to extend any offer.*Complimentary scheduled servicing expires at 3 years or 60,000km from the date of first registration, whichever occurs first. Conditions apply. See your Lexus dealer for further details. # As part of Lexus DriveCare Program outlined at Lexus Owner Benefits terms and conditions. See your dealer for further details. **Offer applicable to Private and ABN buyers, who are current members of AMAQ, on all new vehicles purchased between 1st January - 31st December 2015 and delivered by 31st January 2016. The Lexus of Brisbane Group reserves the right to extend any offer. Excludes demonstrator and pre-owned vehicles. You must be a member of the Qantas Frequent Flyer program to earn and redeem points. Complimentary membership will be offered to customers who are not already members. Membership and Qantas Points are subject to the terms and conditions of the Qantas Frequent Flyer Program available at Qantas.com/terms. To earn Qantas Points, Qantas Frequent Flyers must provide their membership number. Please allow six weeks for the points to be credited to your account. Points can only be awarded on the purchase of an eligible new vehicle between the 1st January -31st December 2015. Points paid on total net contract price of vehicles after discount but before trade-in.
CONTENTS
this issue health vision
ama queensland is proud to launch Part one of its health vision, the first of five documents that will guide our advocacy and policy efforts over the course of the next five years.
30
AMA QUEENSLAND’S
HEALTH VISION PART ONE: PUBLIC HEALTH AND GENERATIONAL DISADVANTAGE
40
18
24 REGULARS
42
people & events
6
From the Editor’s desk
28 local medical association round up
8
President’s Report
36 member news
10 CEO’s Report
37 obituary: dr walter mirosch
34 Foundation News 36 Member News
40 Liver transplant surgeon Dr Kellee Slater to speak at JDC
Features
42 ama queensland annual conference
18 interview with health minister cameron dick 30 health vision
Current issues
14 PROFESSIONAL DEVELOPMENT ASSISTANCE FOR DOCTORS IN TRAINING
38 Calendar
business tools 44 Business interruption 46 HOMEOPATHY WEBSITE PROSECUTED FOR UNSUPPORTED CLAIMS 48 Selling your Practice
16 No jab, no pay – is it the right approach?
50 Protect your income
18 Patient expectations of benefit and harms
53 How to ensure you’re feathering your nest
20 asmofq update
55 Owning your practice property through your SMSF
22 Doctors off duty 24 Junior doctor council’s new strategy 26 Resident and registrar recruitment
Life
56 Travel 57 Wine 58 movies 60 ocker doctor 61 all about you 62 In print
DoctorQ May 2015
5
editor’s desk
from the editor’s desk Board of Directors
Michelle Ford Russ Doctor Q Editor We’ve been keen for quite some time to interview Health Minister Cameron Dick on your behalf. We know you had so many burning questions for the Minister and how things were going to be run under a new Labor government. We asked those questions and more on page 12. There’s been some really interesting health issues coming up at the moment: Dr Paul Neeskens has given us some commentary on patient’s high expectations when it comes to medical tests (p18), and we had a look at the Federal Government’s no jab, no play policy (p16).
held on 12 June. Find out more on p39. Our second ever Junior Doctor Conference is coming up in June as well. With speakers like Professor Ian Frazer AC, Emeritus Professor John Murtagh AM, Former Assistant Health Minister Dr Chris Davis and liver transplant surgeon Dr Kellee Slater (p40), the conference is set to build on it’s wild success last year. I hope to meet many of you at one of our events soon. Michelle
Dr Shaun Rudd President
Dr Kirsten Price Honorary Secretary
Dr Chris Zappala President-Elect
Dr Dilip Dhupelia Appointed Director
Dr Bill Boyd Chair of Council
Dr Richard Kidd Appointed Director
Dr Bav Manoharan Treasurer
Dr Josie Sundin Appointed Director
Council Dr Tom Arthur Greater Brisbane Area
Dr Sharon Kelly Specialist Craft Group
Dr Sharmila Biswas Far North Area
Dr Richard Kidd General Practitioner Craft Group
Dr Kimberley Bondeson Greater Brisbane Area
We have some really big events coming up at the moment too: our first Dinner for the Profession, which will incorporate the Presidential Inauguration, will be
Dr Bill Boyd Capricorn Area Dr Lisa Byrom Greater Brisbane Area Dr Thomas Campbell Greater Brisbane Area
obituaries Dr Henry Paul DYER Anaesthetist Late of Coorparoo Member 65 Years
The following AMA Queensland members have recently passed away. Our sincere condolences to their families. Dr Walter MIROSCH Physician Late of Nundah Member 53 Years
Dr Vicki June NAUMANN Psychiatrist Late of Teneriffe Member for 1 year Dr Gavin James DOUGLAS Orthopaedic Surgeon Late of Townsville Member for 66 years Dr Frank Ellison HADDAN General Practitioner Late of Toowoomba Member 63 Years
Dr Dilip Dhupelia Part Time Medical Practitioner Craft Group Dr Malcolm Forbes Doctors in Training Representative Dr John Hall Downs and West Area Dr Wayne Herdy North Coast Area
Dr Luke Lawton North Area Dr Kelly MacGroarty Specialist Craft Group Dr Bav Manoharan Gold Coast Area Dr John Murray Full Time Salaried Medical Practitioner Craft Group Dr Paul Neeskens General Practitioner Craft Group Dr Kirsten Price General Practitioner Craft Group Dr Josie Sundin Greater Brisbane Area
AMA Queensland Secretariat Jane Schmitt Chief Executive Officer Filomena Ferlan General Manager Corporate Services
Holly Bretherton General Manager Member Relations and Communications Andrew Turner Manager - Member Services
Editor: Michelle Ford Russ Graphic Designer: Nathan Pitt Journalist: Rachael Finley Disclaimer – All material in Doctor Q remains the copyright of AMA Queensland and may not be reproduced or transmitted in any form without permission. While every care is taken to provide accurate information in this publication, the material within Doctor Q is for general information and guidance only and is not intended as advice. Readers are advised to make their own enquiries and/or seek professional advice as to the accuracy of the content of such articles and/or their applicability to any particular circumstances. AMA Queensland, its servants and agents exclude, to the maximum extent permitted by law, any liability which may arise as a result of the use of the material in Doctor Q.
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May 2015 DoctorQ
Advertising: Louise Glynn
Doctor Q is published by AMA Queensland Contact Phone: (07) 3872 2222 Postal Address: PO Box 123, Red Hill QLD 4059 Print Post Approved PP100007532 Email: amaq@amaq.com.au
editor’s desk
A special business offer for AMA Queensland members. To help keep your business moving, Commonwealth Bank has a special offer for AMA Queensland members. Just open a new Commonwealth Bank Business Transaction Account by 31/12/2015 and link it to your existing or new Commonwealth Bank merchant facility.
To take advantage of this offer, just contact AMA Queensland on 0477 744 775 .
Important Information: Offer available to referrals made via AMA Queensland between 01/01/2015 and 31/12/2015. *This offer is applicable to existing and eligible new merchant facilities, excluding the Albert EFTPOS device. To maintain the fee waiver, you must retain the required products contained in this offer (including settling your merchant facility to your linked Commonwealth Bank Business transaction account). Otherwise the offer may be withdrawn. #To maintain the fee waiver, you must retain the required products, otherwise the offer may be withdrawn. Offer includes the monthly account maintenance fee of currently $10 on the Business Transaction Account linked to the merchant facility. Please refer to terms and conditions. ^Establishment fee waiver and two free tokens are available to new CommBiz customers only. This offer may be extended beyond the specified end date at the discretion of the Commonwealth Bank. Interest rates and fees are subject to change. Full conditions of use will be included in our Letter of Offer. Applications for finance subject to the Bank’s normal lending criteria. AMA Queensland may receive a fee from the Commonwealth Bank of Australia for each successful referral. Referral Fees are not payable on referrals from existing relationship managed Commonwealth Bank customers. This has been prepared without considering your objectives, financial situation or needs, so you should consider its appropriateness to your circumstances before you act on it. Terms and conditions are available from commbank.com.au Commonwealth Bank of Australia ABN 48 123 123 124. Australian credit licence 234945.
DoctorQ May 2015
7
PRESIDENT’S REPORT
dr ShAUn Rudd President, AMA Queensland
Securing fairer contracts for SMOs I’m particularly proud of the work we did last year to support our SMO members through the Queensland contracts dispute. Creating the best healthcare system for patients in Queensland can only happen when doctors are provided with fair and equitable working conditions. The original contracts lacked a number of critical provisions. AMA Queensland, with the support of Federal AMA, ASMOFQ and a number of key stakeholders, were able to work with government to address these concerns and create a much fairer contract.
Scrapping the co-payment At a Federal level, the viability of general practice was threatened when the Federal Government announced its intention to introduce a co-payment on GP, pathology and radiology services. The flawed model would have created a number of administrative and financial burdens for general practice while imposing additional costs on vulnerable patients. Recognising, this, AMA, AMA Queensland, ASMOF, ASMOFQ and our counterparts in other states were able to work together to successfully advocate for the scrapping of the co-payment. We continue to fight the four year freeze on Medicare rebates. This demonstrates more than just a win for general practice, but is demonstrative of the achievements that can be made when AMA and its state branches work collaboratively.
Addressing the Queensland obesity crisis Over the last year, the AMA Queensland Lighten Your Load campaign has focused on tackling the obesity epidemic in Queensland. With as many as 75 per cent of Queenslanders overweight in some areas, this truly is an emergency for the state. The first part of the campaign included a video launch to highlight the obesity problem and encourage those struggling with their weight to speak to their GP. The second part of the campaign was targeted towards promoting healthy eating habits in children and included a regional visit to Cairns, Townsville, Mackay, Rockhampton and Hervey Bay to visit local schools and discuss exercise and healthy eating. As doctors, proper nutrition and exercise seem like no-brainers to preserve our health and quality of life, but there is still a lack of understanding in many communities. This campaign was successful in highlighting this problem and launching a dialogue about weight in Queensland.
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May 2015 DoctorQ
The Health Vision, which will guide AMA Queensland’s advocacy work over the next five years, was developed to ensure we are advocating on the issues that matter most to members and allow us to work towards long-term goals that will ultimately create a healthier Queensland.
Launching our Health Vision After many months of member consultation, AMA Queensland recently launched part 1 of our Health Vision strategy, focusing on public health, to a receptive media and public audience. The Health Vision, which will guide AMA Queensland’s advocacy work over the next five years, was developed to ensure we are advocating on the issues that matter most to members and allow us to work towards long-term goals that will ultimately create a healthier Queensland. The Health Vision will be released in five parts. You can read more about the Health Vision on page 30.
A team effort The work AMA Queensland has done in the last year to support members though advocacy, member offerings, events and public health initiatives cannot be summed up into one article. I would like to take a moment to thank AMA Queensland’s Council, committees, our CEO and staff members for their dedication and hard work. Our achievements would not have been possible without their support and efforts. Q
PRESIDENT’S REPORT
What do you see when you look in the mirror? REAL TIME
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DoctorQ May 2015
9
ceo’S REPORT
JANE SCHMITT Chief Executive Officer, AMA Queensland
Meeting with the Health Minister Since the change of government occurred in February, many members have raised questions about the new Health Minister’s key priorities, public health initiatives and vision for healthcare in Queensland. In this edition of Doctor Q, we had the opportunity to sit down with Minister Cameron Dick and get answers to many of those questions. Since he took office, AMA Queensland President Dr Shaun Rudd and I have met with Minister Dick to discuss our key priorities such as reducing wait times, ensuring the doctors are provided with fair working conditions and addressing lifestyle diseases such as obesity. Time will tell what steps are implemented, but I welcome the Health Minister’s consultative approach and look forward to working with him. The interview with Minister Dick is available on page 12.
Board Member Nominations open 18 May In order to facilitate greater involvement of members in nominating for key positions on the AMA Queensland Board of Directors, the Association’s Constitution was amended in 2014 to allow ordinary members to nominate for the Board positions of Chair, Treasurer and Honorary Secretary. Previously, the applicant pool was drawn from current members of Council only. This important governance improvement takes effect from June 2015, with nominations for these 3 director positions on the board opening on 18 May 2015. You will be able to access nomination forms and information about the positions on our website and Online News. We encourage you to consider whether you have the skills and qualities sought and if so, to put your name forward. Council will review the nominations and a ballot will be held at the June Council meeting.
Ensuring the health of our members is being looked after In recent years, concerns have been raised about the mental and emotional health of doctors in training. A beyondblue report found junior doctors are at increased risk for depression, burnout and suicide, and recent media focus has raised the question of whether problems of bullying and sexual harassment exist in hospitals. The health and wellbeing of our members is our primary concern and AMA Queensland is currently launching several initiatives to support doctors facing workplace issues and stress. We recently distributed a survey to doctors in training to find out what issues they are facing in their workplace or college training program. The results of this survey will be used to determine the concerns and needs of members so AMA Queensland can work to address these.
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May 2015 DoctorQ
Additionally, this year we are launching our pilot resilience and wellbeing program at Rockhampton Base Hospital with the view to expand to hospitals across the state. The program will focus on mindfulness, resilience, and coping strategies to reduce stress and burnout in young doctors. We will continue to keep members updated on the program, its development and results.
Private Practice Conference In recent decades, technology has had an immense effect on the field of medicine. Our abilities to conduct research, gather information and manage records are unprecedented. Unfortunately, technology has also exposed doctors to a new set of risks and considerations including cyber security, social media and data backup. It is fitting then that our Annual Starting and Working in Private Practice conference will be canvassing these topics and more with the theme ‘21st Century Medicine.’ Speakers from the medical, legal and business fields will be discussing crucial topics for practice management including Medicare, financial practice fundamentals, employee management and risk management. We also look forward to welcoming Professor Kerryn Phelps AM and Dr Steve Hambleton, both past presidents of AMA. More information about the conference is available on our Events Calendar at www.amaq.com.au.
Dinner for the Profession AMA Queensland will hold its inaugural Dinner for the Profession at Cloudland in June, in what promises to be a sparkling affair, complete with a three-course meal, drinks and a jazz band. The dinner will incorporate our Presidential Inauguration, where Dr Chris Zappala will be installed as our new President. It will be a great opportunity to mingle with colleagues, mentors and friends in a social setting. Purchase your ticket now at www.amaq.com.au. Q
The health and wellbeing of our members is our primary concern and AMA Queensland is currently launching several initiatives to support doctors facing workplace issues and stress.
ceo’S REPORT
2015 DATES FOR YOUR DIARY CPD Weekends 7 - 8 March
How to Treat…Case by Case
Marriott, Surfers Paradise
10 - 11 October
GP Dilemmas – Innovative Solutions
Sheraton Mirage, Gold Coast
Saturday Symposiums 23 May
Sports Meet 2015
Sofitel, Brisbane
29 August
Women’s Health Symposium
Hilton Hotel, Brisbane
18 March
Endocrine and Gastroenterology
Clovely Estate Cellar Door, Red Hill
6 May
Gastroenterology / Bariatric Surgery
United Service Club
22 July
Skin Cancer / Plastic Surgery
Clovely Estate Cellar Door, Red Hill
19 August
Cardiology / Vascular Surgery
United Service Club
18 November
Men’s Health
Gambaro Hotel, Brisbane
CPD Evenings
Q&A with Tony Jones 13 June
Day ALM + Evening Gala
Brisbane Convention Centre
For more information: Contact Susan Walsh, Business Unit, on (07) 3834 4371,fax (07) 3834 4576 or email susan.walsh@uchealth.com.au
www.standrewshospital.com.au/gpeducation
We look forward to seeing you in 2015
DoctorQ May 2015
11
Feature story
Interview with Health Minister Cameron Dick
Since the change of government occurred in February, many members have raised questions about the new Health Minister’s key priorities, public health initiatives and vision for healthcare in Queensland. Doctor Q had the opportunity to sit down with Minister Cameron Dick and get answers to many of those questions.
You’ve had a couple of months to settle into the portfolio, what’s your impression of how Queensland Health is performing and delivering health care? It is the largest, most complex but also the best portfolio in Government because it is the most human. It has some of the most extraordinary researchers and clinicians working, not just in our nation but internationally, in our state. I’ve been pleased to travel though some parts of the state to meet Hospital and Health Service staff directly and I’ve been pleased with the great commitment I’ve seen from staff in the Queensland Health system. I think the devolved system, which the last Labor government implemented as part of the national health reform program, is serving Queensland well. That was rolled out and supported by the last government and I’ve made it clear that I’m going to support that system.
you had any early feeling about what might be changed or have you any plans for additions or alterations to how things are operating at the moment in the health system? I think the system’s working pretty well. It’s still, in a sense, in an early stage of development. I don’t plan any major reforms at this stage to the operation of our hospital and health systems. We are doing a review of how the central department is working and that picks up on some of the threads of what was happening under the last government. And are doctors’ opinions and views on that being encouraged and accepted and welcomed? Yes, very much so. I’ve spoken to Rachel Hunter, former Public Service Commissioner
We know those [HHS] changes are under review at the moment and you’re looking at whether or not they have achieved what was set out to be achieved. Have
The previous administration of this portfolio was very much top-down. It was very much things were ‘done’ to people rather than ‘with’ people.
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May 2015 DoctorQ
and former Director-General in previous Governments in Queensland (and someone who’s done a review of the Commonwealth Health Department as part of the Federal Capability Reviews); I’ve spoken to Rachel personally about the need for consultation. I think one of the problems in the previous administration of this portfolio was very much top-down. It was very much things were ‘done’ to people rather than ‘with’ people. An example was the doctors’ contract debacle. I think that was done ‘to’ doctors not working ‘with’ doctors and I think that is an example to all of us of how bad policy can be implemented. I don’t want to see that replicated ever again. My approach generally, across the board, is to listen to people at the coal face, people doing the work, to try and understand their
Feature story
went into those election commitments. Certainly at a thematic level I don’t have any argument with where the AMA wants to go. How we get there is another issue. We’ve got the same sort of commitment as a government to dealing with issues rising out of alcohol, including our response to alcohol fuelled violence; issues around those public and preventative health measures we’ve talked about; supporting improved ICT in hospitals if we can, that is a big challenge in this portfolio and I am not going to deny that presents some significant challenges I am working through. We will work with AMA constructively to try and get the best outcome on those matters of concern to the AMA and its members. You mentioned the importance of the role of the family GP. Do you think enough Queenslanders are aware of that, that they need someone they can confide in about their health issues?
Minister Cameron Dick getting his flu shot from AMA Queensland member Dr Wendy Burton.
needs and to then work with them to get the best outcomes. That contract dispute early last year caused enormous amounts of unhappiness and unrest within the SMO/ VMO ranks. What plans do you have for building a really robust, productive and happy culture within Queensland Health? Certainly my approach is consultation, engagement and listening. That is an example that’s been set from the top by our Premier who’s made it very clear she wants her government and ministers to work on a consensus basis with all individual and stakeholders. On a practical level, there are some knots to be untangled but I need to be thoughtful and deliberate about that. Things will take a little bit longer because of the need to consult, to work with affected parties across a range of issues, let alone the contracts, but it will be done in a thoughtful, methodical and careful way before we get an outcome. When you say “knots”, what are you referring to? There are some concerns about how the contracts not only were developed and enforced but how they continue. We made some election commitments about reviewing that process and reviewing the outcome. I need to know what have the consequences been, what have the outcomes been, how is it affecting doctors, how is it affecting the system, what (if anything) needs to be
changed as a result. That’s not easy because you’re dealing with people, with their employment, with their livelihood; I don’t want to unnecessarily upset people again but we made a commitment to look at how that worked and it’s one of the many projects we’re working on as a government. Is it an option to wind back the contracts? At this stage, we’re going to just look at how they’re operating, look at what we’re doing. There was some discussion about that by the Labor party in opposition; I need to work through all of those issues with all of the stakeholders including representative bodies, not just the AMA but other representative bodies, to work out the way forward. You mentioned consultation is important to you; do you have any formal processes in mind in terms of consulting GPs when it comes to policy development? I’ll be meeting with the AMA on a very regular basis. I’ve agreed with Shaun Rudd, the current President, to work with him and meet with him very regularly. I’ve been very pleased and very happy with my discussions with Shaun so far, it’s been very productive. Have you had an opportunity to look at AMA Queensland’s election platform and what it’s been calling for around public health issues such as obesity, vaccination, alcohol abuse etc.? Yes I’ve had a look at the work of the AMA and clearly there was a lot of thought that
I hope they do. I think it’s part of our culture where people have a strong relationship with their GP. We’re all busier, we’re all under time pressures now which means some of those health issues often fall to the side. I am confident that Queenslanders have very strong and deep relationships with their GP and I am happy to support that, particularly to have those regular checks, to take preventative action, which can often stop a problem developing to a more severe or acute level. What do you see as the biggest challenge for health in Queensland? I think those chronic lifestyle illnesses. The numbers I’ve seen about diabetes, effectively the amount of money we’ll need to respond if diabetes continues to grow at the rate it has, will double in the next ten years or so. The challenge of lifestyle chronic illnesses in the community is a big one but that leads to a broader discussion about funding and I think that funding our health system is a critical issue at this point in time. We know that the last federal budget resulted in $57 billion coming out of the health system over the seven years from 2017 onwards. In Queensland, that will have an impact of $11.8 billion on our health system. So I am very concerned about that; I’ll be taking the fight up to Canberra, I’ll be raising it with my counterparts in other states and I’ll be doing that at a Health Ministers’ meeting coming up soon. I’ve asked for that to go on the agenda, what the implications of those cuts mean, and asked my colleagues to work on some further project work around that. Whether that’s accepted or not, I don’t know, but I will certainly make that a centrepiece of my time as the Minister. Q
DoctorQ May 2015
13
CURRENT ISSUES
PROFESSIONAL DEVELOPMENT ASSISTANCE FOR DOCTORS IN TRAINING
With Medical Officer Certified Agreement negotiations beginning this month, AMA Queensland’s Council of Doctors in Training Chair Dr Tom Arthur looks at how we measure up in Queensland when it comes to professional development assistance for doctors in training.
Dr Tom Arthur Chair, Council of Doctors in Training Health employers around Australia recognise the importance of continuing professional development through the provision of professional development assistance. This assistance is largely through the provision of leave to attend educational activities, as well as financial allowances to cover the cost of these activities. Not all professional development assistance schemes are created equal. Health providers of the states and territories differ widely in the provision of financial support for ongoing education expenses. How this support is administered also varies, with health providers either providing assistance regularly in divided payments across the year, or as a reimbursement initiative - where the cost for educational activities is first borne by the doctor and then an application for reimbursement is made.
Queensland doctors in training are falling behind when it comes to professional development assistance (see table below), with states like Western and South Australia leading the way. The next iteration of the Medical Officer Certified Agreement, for which negotiations begin in May, provides an opportunity for this deficit to be addressed.
If you would like to be involved, please contact the AMA Queensland Council of Doctors in Training - amaq.cdt@gmail.com - or Ken Lewis, AMA Queensland’s new Workplace Relations Manager – k.lewis@amaq.com.au Q
Interstate comparison of professional development financial assistance State
Assistance method
Classification
Amount ($, 2014)
QLD
Allowance
Interns
0
WA
SA
Allowance
Reimbursement
Resident
0
Registrar1
2,000
Interns
5,306
Resident
5,306
Registrar
9,284
Interns
4,000
Resident
4,000
Registrar
8,000
Interns
1,500
Resident
1,500
Registrar
2,500
Interns
0
Resident
0
Registrar
0
Interns
2,000
Resident
2,000
Registrar
3,000
Interns
2,100
Resident
2,650
Registrar
3,755
Interns
2,184
Resident
2,8142 5,4643
Registrar
8,196
1
TAS
The next iteration of the Medical Officer Certified Agreement, for which negotiations begin in May, provides an opportunity for this deficit to be addressed.
NSW
ACT
VIC
NT
Reimbursement
Nil
Reimbursement
Allowance
Allowance
Limited to registrars on a vocational training pathway 2 Medical Officers PGY 2-3 3 Medical Officers PGY 4-5 1
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May 2015 DoctorQ
CURRENT ISSUES
76673 Freecall 1800 00 SNORE
DoctorQ May 2015
15
CURRENT ISSUES
No jab, no pay – is it the right approach?
The Commonwealth Government will end the conscientious objector and religious exemptions on children’s vaccination for access to child care and family tax benefits from 1 January 2016. The new legislation sends a warning shot to a growing percentage of anti-vaxxers and has been a hot topic of debate on the rights of a patient and public health policy.
Australia’s vaccination rate currently sits at 92.2 per cent, falling short of the minimum 95 per cent recommended for herd immunity. More than 39,000 children aged under seven are not vaccinated because their parents are vaccine objectors. This figure has increased by 24,000 over 10 years, largely due to the rise in non-credible sources of medical information available.
convince the 39,000 families who object, including the percentage of these who do not attend formal care.
Existing exemptions on medical grounds will continue, however a religious objection will only be available where the person is affiliated with a religious groups where the governing body has a formally registered objection approved by the Government. After discussions with the Christian Scientists, the only religion in Australia with a formally registered objection, their exemption was not seen as current or necessary, and the church is no longer advising parishioners to not vaccinate.
“Parents who vaccinate their children should have confidence that they can take their children to childcare without the fear that their children will be at risk of contracting a serious or potentially life-threatening illness because of the conscientious objections of others.”
Currently, parents who have not lodged a conscientious objector form, signed by their doctor, are unable to access these benefits. In Queensland, these children are still able to attend day care at the full fee. Conscientious objectors are still able to attend day care, but this legislation will mean they too, will pay full fees. Without the Child Care Benefit (up to $200/week), Child Care Rebate (up to $7,500/year and the Family Tax Benefit Part A (up to $726), it is certainly enough money for even the most objectionable to reconsider. But not all children attend day care. Many families, both wealthy and not, don’t have kids in formal care until they reach school age. Money is likely to be only one factor in the fight for vaccination. AMA President Associate Professor Brian Owler said “it is really another mechanism, another lever to pull, to try and get the vaccination rates up. It’s not going to solve all of the problems, but I think it’s probably a step in the right direction.” While the no jab, no pay idea is a fairly big stick, the consensus is that a carrot needs to go hand in hand. Greater education is still needed to
There are a few other issues to note: children can start day care at six weeks, before they have begun any of the immunisation schedule. When introducing the changes, Prime Minister Tony Abbott commented:
The policy has certainly been a popular one for Tony Abbott, but reactions have varied in the medical community. There is some suggestion that forcing an objector’s hand might cause them to dig their heels in further, and shut down discussion that could contribute to a more educated decision. Associate Professor Kristine Macartney, Discipline of Paediatrics and Child Health at University of Sydney, wasn’t convinced that the policy was the right way to go. “Removing childcare subsidies carries the risk that children of lowincome non-vaccinating families may not attend childcare or access much needed financial support to visit the doctor at all – a terrible outcome. Removing welfare payments would obviously have a devastating effect on these children and their families,” she said. Time will tell whether the no jab, no pay policy increases vaccination rates. Either way, more education and awareness is needed to counteract the barrage of non-credible information available. Q
In addition to Queensland Health’s Queensland Immunisation Strategy 2014-17, AMA Queensland has made several recommendations on immunisation in its Health Vision. Fund a mobile immunisation clinic, staffed by doctors, with a private area in which patients can rest should they need to do so. Records of immunisations provided should be sent to the patients regular GP. Consider a targeted patient transport plan that would assist patients who require vaccinations to travel to and from their appointments. Consider ways in which Queensland Health can assist GP practices to review their patient data and identify and contact those patients who need to have their immunisation updated. This can be achieved by either outlining the process or actually visiting the practices to provide hands on assistance.
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May 2015 DoctorQ
CURRENT ISSUES
Q:Who sets the standard in winning cases for its members?
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CURRENT ISSUES
Patient expectations of benefit and harms
A recent study by Bond University found most patients overestimate the benefits of medical tests and treatments and underestimate their harms. AMA Queensland Council of General Practice representative Dr Paul Neeskens comments on the need to properly manage patient’s expectations when it comes to diagnosis.
Dr Paul Neeskens
AMA Queensland Council of General Practice
Assessing the benefit and harm of medical intervention is a fundamental process in a range of contexts, from clinical decision making with individual patients to the licensing of new products, and to policy decisions for funders such as government or insurers. The overuse of medical treatments and tests has been recognised and there is a growing interest and data relating to the phenomenon of overdiagnosis, with one definition of overdiagnosis being ‘the diagnosis of “disease” that will never cause symptoms nor death during a patient’s lifetime’. The analysis of medical interventions is increasingly including the number of cases of overdiagnosis1 and/or overtreatment, as well as the usual numbers needed to treat (NNT) and relative risk reduction. The recently published article by Bond University based Tammy Hoffman and Chris Del Mar 2 systematically reviewed 35 rigorously selected studies that assessed patients’ expectations of benefits/harms of a treatment or test. The review included treatments and tests for known diseases as well as screening tests, and limited to studies where quantitative information was provided to the patient/participant. One example of quantitative data from one included study was the question “Of 5,000 people aged 50-70 years with osteoporosis, how many hip fractures would be prevented by taking medication for 10 years to reduce the risk of this?” 3 Another example was “If 100 similar patients with Crohn’s disease had the same symptoms and were treated with Remicade, how many patients out of those 100 will be in complete remission after one year of regularly taking the drug?” 4 Studies of participant expectation without quantitative estimates (eg “much better”) were excluded. In the discussion, Hoffmann and Del Mar identify that this was the first systematic review of patient or public expectation of benefits and harms. They comment that participants rarely had accurate expectations, and for many interventions irrespective of whether it’s a treatment, diagnostic test or screening test, they had a tendency to incorrectly estimate benefits and harms.
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May 2015 DoctorQ
Overdiagnosis: the diagnosis of disease that will never cause symptoms nor death during a patient’s lifetime The review concluded, “The majority of participants overestimated intervention benefit and underestimated harm. Clinicians should discuss accurate and balanced information about intervention benefits and harms with patients, providing the opportunity to develop realistic expectations and make informed decisions.” As clinicians this review is a timely reminder of our duty to provide our patients with balanced and accurate information. In assessing the interpretation of quantitative data by individuals, the review also raises the question of what type of information should be presented to our patients to facilitate informed decision-making. It also raises the question as to how well do we as advisors to our patients, genuinely understand the limitations of treatments, diagnostic tests and screening. Many of these perspectives are considered in the discussion section of the review. It is recommended reading. Q 1. Overdiagnosed: Making People Sick in the Pursuit of Health, H. Gilbert Welch, Lisa Schwartz, Steve Woloshin. 2012. 2. Hoffmann TC, Del Mar C. Patients’ expectations of the benefits and harms of treatments, screening, and tests: a systematic review. JAMA Intern Med. Published online December 22, 2014. doi:10.1001 / jamainternmed.2014 3. Hudson B, Zarifeh A, Young L, Wells JE. Patients’ expectations of screening and preventive treatments. Ann Fam Med. 2012;10(6):495-502. 4. SiegelCA, LevyLC, MackenzieTA, SandsBE. Patient perceptions of the risks and benefits of infliximab for the treatment of inflammatory bowel disease. Inflamm Bowel Dis. 2008;14(1):1-6
CURRENT ISSUES
Friday - Saturday 3 – 4 July 2015
Annual Starting and Working in Private Practice Conference
21 CENTURY MEDICINE ST
Featuring renowned General Practitioner advocates Professor Kerryn Phelps AM, Former AMA President and Dr Steve Hambleton, Immediate Past AMA President, the Annual Starting and Working in Private Practice Conference has got you covered for all aspects of practice start up and existing practice growth and expansion.
Topics include:
Medicare – what’s changing and how it will impact your practice Innovative case studies in private practice set up Employee management 101 Financial myth-busting - Common mistakes in accounting and financial management Legal and intellectual property considerations for private practice Cloud computing – managing the risks in practice The essentials of digital and website marketing Making social media marketing work in private practice Cyber security and risk management
Early-bird closes 1 June Brisbane Convention & Exhibition Centre 3 - 4 July 2015 See the full program at www.amaq.com.au To register your interest in the meantime, please email registrations@amaq.com.au or phone (07) 3872 2222 RACGP points available DoctorQ May 2015
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CURRENT ISSUES
ASMOFQ update
Australian Salaried Medical Officer Federation (Queensland)’s new Senior Industrial Officer Kelly Cooper gives Doctor Q an update on their latest campaigns.
Kelly Cooper
Senior Industrial Officer, ASMOFQ
2015 is shaping up to be an interesting and important year in Queensland’s public health sector industrial relations. The Palaszczuk Government’s commitment to restore fairness to Queensland workplaces and to reinstate employment security for public servants sits in stark contrast to the legislative framework left by the previous government. This intersection of existing law and future intent comes at a time when the nominal expiry date for the Medical Officers Certified Agreement 2012 (MOCA3) is approaching (30 June 2015) and when SMOs and VMOs are experiencing real problems accessing their entitlements under the high income guarantee contracts. Senior Medical Officer and Visiting Medical Officer Contracts Survey Results The feedback we received from the April 2015 survey into the impact of the SMO/VMO Contracts provided us with insight into your concerns arising from the introduction of the SMO and VMO contracts. The survey revealed the following key issues: Remuneration; KPIs; and, Administration of contracts. Remuneration Approximately 14 per cent of respondents said their remuneration has increased under the contracts, 27.43 per cent have not noticed any impact and approximately a quarter of respondents are not sure of the impact. However, over 33 per cent of respondents noted that their remuneration has decreased. Some respondents attribute this reduction in remuneration to the fact that they were not paid penalty rates – or not paid at all – for public holiday work, overtime and/or on-call work. KPIs Respondents expressed concern about the link between KPI achievement and remuneration. Some respondents’ concerns relate to the vague wording and implementation of KPIs. Other concerns include that hospitals are actively making it difficult for staff to achieve their KPIs.
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May 2015 DoctorQ
The survey showed 48.67% of respondents said department moral was much worse since the contracts were introduced. Administration Survey Respondents are experiencing frustration regarding administration. Respondents expressed the view that hospital administrators have little understanding of SMO and VMO contracts and how they should operate. Given these results, it is not surprising that over 60 per cent of respondents indicated were uncertain about their ability to obtain reliable and accurate advice from their employer and 75 per cent of respondents indicated they believe that the introduction of the SMO/ VMO contracts has resulted in a reduction of moral within their department (26.55 per cent said morale was slightly worse, 48.67 per cent said much worse). ASMOFQ and AMA Queensland will ensure that these issues are raised within the Queensland Health Contracts Advisory Committee (QHCAC). Meeting with Health Minister’s office Given the current industrial landscape, ASMOFQ and AMA Queensland are dedicated to lobbying on your behalf to ensure that the Government keeps its election promises. To that end ASMOFQ and AMA Queensland have each met with the Health Minister’s staff. These meetings were productive and assured us that the Minister is genuinely committed to negotiating with us to restore and protect your employment terms and conditions. The Hunter Review of Queensland Health In April, the Acting Director-General of the Department of Health, Dr Michael Cleary,
announced that Rachel Hunter has been appointed to conduct an independent review of the Department of Health’s organisational structure and governance. In his announcement, Dr Cleary assured staff members that the Hunter Review: is not intended to reduce staff numbers; will reflect the Palaszcuk Government’s commitment to reinstating conditions for public servants in relation to employment security, contracting-out and organisational change; and, will be conducted in an open and consultative fashion. On 23 April 2015, ASMOFQ and AMA Queensland attended a Union Briefing Session at which Ms Hunter outlined the scope, processes and principles of the review. Notably, the Review is limited in scope to the Department of Health (Corporate) and will not include a review of the structure and organisational capabilities of Queensland’s Hospital and Health Service Districts. Instead the review will concentrate on whether the Department has the capabilities to fulfil the Chief Executive’s statutory functions under the Hospital and Health Boards Act 2011 (HHB Act), including: to provide strategic leadership and direction for the delivery of public sector health services in the State; to promote the effective and efficient use of available resources in the delivery of health services in the State; to establish the conditions of employment for health services employees, including issuing health employment directives; and, to monitor the performance of Services, and take remedial action when performance does not meet the expected standard. ASMOFQ and AMA Queensland consulted with members and made submissions to the Hunter Review. Q Australian Salaried Medical Officers’ Federation Queensland (ASMOFQ) represents salaried doctors in Queensland. Phone: (07) 3872 2222. Email: asmofq@amaq.com.au gov.au.
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CURRENT ISSUES
Doctors off duty
The Ethics and Medico-Legal Committee come to the rescue in another ethical dilemma: what happens when you catch a colleague smoking a bong while off duty?
Dear Ethical Agony Aunt, I am a GP who works at a large practice on Brisbane’s Southside. There’s one GP who I work with, let’s call her Mary, who attends many of the same social gatherings on a Friday night that I do. For the last few events I’ve noticed that she has been recreationally smoking marijuana from a ‘bong’. I’m uncertain of what to do with this information given Mary only works Tuesday to Thursday and her performance as a doctor has never been in question. What are my legal and ethical obligations Agony Aunt? Many thanks, 50 Shades of Hay
Dear 50 Shades of Hay, Ethical We have a relatively undemanding duty of care to protect our colleague from herself, because at the end of the day she is a grown doctor who can make her own decisions. Having said that, we should be opening a door for her to discuss her habit and what it might be doing to her and her career. Sometimes illicit substance use may be a coping mechanism for a deeper issue that could benefit from collegiate discussion and assistance. If you or Mary are not comfortable having the conversation, then you could advise that she contact the Doctors Health Advisory Service (Queensland) (DHASQ). DHASQ is a free and confidential service where Mary can talk to a fellow practitioner and get help for any issues that have caused her to turn to illicit substances. We have a much higher duty of (ethical) care for our/her patients. Marijuana does impair judgement. Some cannabinoids have very long half-lives, and her patients could potentially be at risk. If you believe that Mary’s habit is compromising the safety of her patients then you do have the option of making a voluntary notification to the Medical Board of Australia. Legal As a doctor you are required to report “notifiable conduct”.1 Based on your query, there are two potential grounds of notifiable conduct that may come into play namely a) practicing while intoxicated and c) placing the public at risk of substantial harm because the practitioner has an impairment. The first is easily dealt with. The guidelines clearly state that the National Law does not require mandatory notification of a practitioner who is intoxicated when they are not practising their health profession.
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May 2015 DoctorQ
This brings us to the ground of impairment. In summary, in order for the GP in the question to have an impairment, she needs to have a physical or mental impairment, disability, condition or disorder that detrimentally affects her capacity to practice the profession. The trigger for a mandatory notification under this ground requires reasonable belief that the practitioner has placed the public at risk of substantial harm. The next question to ask is “did the risk of substantial harm arise in the practitioner’s practice of the health profession?” If both of these questions are answered in the affirmative then there is a mandatory obligation to report the GP to AHPRA. If not, you may still make a voluntary notification. If there is any doubt about conduct which you observe, especially in the practice of your profession, then you should seek legal advice to assist you in deciding what to do. Summary: No requirement to mandatorily report in this situation Think about discussing her habit, and what it might be doing to her career with her, or suggest she ring the Doctor Health Advisory Service (Queensland) (07) 3833 4352 Whether to report voluntarily is a personal question based on whether you feel her patients are in trouble Q 1. Section 141 of the Health Practitioner Regulation National Law Act 2009 (National Law); Section 140 of the National Law
do you have an ethical issue? The experts from our Ethics and Medico-Legal Committee answer your ethical dilemmas. Send your ethical dilemma to policy@amaq.com.au.
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CURRENT ISSUES
Junior doctor council’s new strategy
There is no doubt a challenging year awaits the AMA Queensland Council of Doctors in Training (CDT). Just as well, we have had a fresh intake of residents who have filled our extra representative roles and working parties, which has seen the CDT grow in neoplastic proportions.
Dr Matthew ChEng Council of Doctors in Training
Communication To complement the growth of the CDT, over the past couple of years the committee has expanded its tools to engage the junior doctor cohort. We have utilised social media and have created a website. This year led by Drs Rhys Thomas and Tim Hanrahan, we hope to utilise these media platforms, which comes in good timing with the MOCA negotiations. Our goals: Provide regular updates during MOCA negotiation via Twitter and Facebook Create an avenue to facilitate feedback during negotiations Redesign The Rounds to be more reader friendly Rural
We have embraced Richie Benaud’s philosophy of “less is more” and have set out to focus on a consolidated number of issues. We see our primary role in advocacy. Therefore our focus this year will be on the upcoming MOCA 4 (Medical Officers’ Certified Agreement) negotiations. Whilst advocacy does not usually attract much interest from junior doctors uninvolved, the MOCA discussions will certainly garner attention from all young medicos. Industrial Relations The MOCA 4 negotiation will be the dominant discussion under this portfolio led by Drs Ben Wakefield and David Sparks. A major concern is that with the next round of negotiation, Queensland may fall behind other states in terms of their updated awards and entitlements or worse, lose them completely. The major issues we hope to target in the upcoming industrial relations include: Professional development leave Professional development entitlement Fatigue and overtime On call entitlements
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May 2015 DoctorQ
The focus this year will be on continuing relationships with rural doctor organisations to ensure doctors across regional and rural Queensland are represented at the MOCA negotiations. Our portfolio lead, Dr Eshini Perera, will maintain a dialogue with rural junior doctors and rural health advocacy groups to ensure the unique challenges facing these groups are assisted, where possible, by the CDT. Education and Training This portfolio led by Drs Katherine Gridley and Mila Dimitrijevic will tackle issues of
internship (which will be under review), RMO recruiting and preparation of applications for training positions. Our goals: Advocate for an internship which protects clinical education and skills Assist in the introduction of a fair, transparent merit based recruitment system for hiring RMOs in Queensland Develop and run interview and CV skill sessions for prevocational doctors Membership and Events Headed by Drs Jaimie Aslanidis and Alice Ayres, a major project of the CDT this year is to include additional member benefits that are more suited to junior doctors. We are looking at including discounted food, petrol, clothing (such as RM Williams and Cue), courses and fitness. We have three major events in our calendar for junior doctors but the highlight of the year will be the Junior Doctor Conference (JDC) on 27 28 June. Coming off the back of the successful JDC last year, which was the first conference of its kind for junior doctors in Australia, we have expanded the event to include a wider range of speakers and panellists. Last year’s event sold out, so register now at www.amaq.com.au. Q
The CDT continues to grow in numbers and influence each year. However, this relies on a strong membership base. If you are a junior doctor and wish to be involved with the CDT, or just be kept updated on the issues affecting you, please email: amaq.cdt@gmail.com or contact Drs Tom Arthur (Chair), Malcolm Forbes (Deputy Chair) or Matthew Cheng (Deputy Chair). /AMAQCDT
CURRENT ISSUES
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DoctorQ May 2015
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CURRENT ISSUES
Resident and registrar recruitment
More than 20 Queensland public and private hospitals recruit junior doctors as part of the annual Resident Medical Officer and Registrar Campaign. Principal Workforce Planning Officer James McNulty gives us the heads up on how the process works.
Queensland Health administers an e-recruitment system on behalf of participating hospitals and assists candidates with any technical help they require to complete applications. The e-Recruitment system has been used for Intern and RMO recruitment since 2011. RMO and Registrar appointments within Queensland Health have increased nearly 15 per cent since 2012, providing medical graduates with greater mobility and opportunities within Queensland. Appointments made via the annual Queensland Health RMO and Registrar Recruitment Campaigns 2012 to 2015 Campaign JHO SHO PHO Registrar PFY year
Total Appointments
2012
741
563
545
1,849
31
3,729
2013
697
552
576
2,068
18
3,911
2014
741
611
585
2,261
27
4,225
2015
837
582
601
2,290
36
4,346
Queensland Health Vocational Training Pathways—the e-Recruitment system includes dedicated application processes for Vocational Training Pathways supported by the department and Hospital and Health Services including: Basic physician training Basic paediatric training General medicine advanced training Intensive care medicine (basic and advanced training) Palliative medicine advanced training Geriatric medicine advanced training Nephrology advanced training
How to apply
Clinical haematology advanced training
Applications for RMO and Registrar positions must be submitted through the Queensland Health e-Recruitment system which can be accessed on the RMO Recruitment Campaign website.
Anaesthesia training—coordinated by the Queensland Anaesthesia Rotational Training Scheme (QARTS).
Personal information and supporting documentation provided as part of previous applications is retained to enable a quick application process. Applicants are required to provide: a current curriculum vitae details of two referees (who will be asked to complete an online referee report) up to five preferences for positions across participating hospitals and specialties. The 2016 recruitment campaign for RMOs and Registrars will open Wednesday 10 June 2015. Applications close Wednesday 8 July 2015. Applications for the Rural Generalist Pathway Advanced Skills Training Program will be open between Monday 4 May 2015 and Friday 15 May 2015) There are a number of key players involved in the recruitment of RMOs and Registrars: Hospital and Health Services—as the employers they are the key source of information in relation to the opportunities available in Queensland hospitals. Directors of Clinical Training, medical education officers and medical administration and recruitment staff are the best people to speak to.
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Medical specialty colleges—determine the eligibility criteria for entry into a training program. Prospective trainees must succeed in a competitive selection process for a fixed number of accredited training positions, or a place in an accredited facility or an accredited training program. RMOs should consider these eligibility requirements when preferencing Junior and Senior House Officer positions as some hospitals may be able to provide access to required terms more easily than others.
May 2015 DoctorQ
Detailed information on these pathways, hospital profiles, ‘how to apply’ and ‘how to preference’ guides are available on the recruitment campaign website. Selections to RMO and Registrar positions will occur in several rounds starting on Monday 20 July 2015. Successful applicants who do not receive their initial preferences will be given the chance to amend their selection if necessary. The full schedule is available on the recruitment campaign website. All applicants who applied for a position in 2015 will be emailed several weeks before applications open and advised of the 2016 application process. The campaign will also be advertised on the Department of Health and Queensland Government SmartJobs website: www. smartjobs.qld.gov.au. Q
RMO Recruitment Website: www.health.qld.gov.au/rmo Email: RMO-Recruitment@health.qld.gov.au.
CURRENT ISSUES
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DoctorQ May 2015
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People & EVENTS
join your lma
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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 Contact: Jo Bourke Phone: (07) 5479 3979 Cairns Contact: Dr Sharmila Biswas Phone: (07) 4036 4333 Townsville Contact: Dr Carl O’Kane Phone: (07) 4433 1111 Central Queensland Contact: Dr Harley Wilson Phone: 0419 277 611 Email: harleywilson00@gmail.com Toowoomba and Darling Downs Email: info@tddlma.org.au Web: www.tddlma.org.au
Bundaberg Contact: Dr Daud Yunus Phone: (07) 4152 2888 Email: daud.yunus@gmail.com
fraser Coast Contact: Drs Thomas Dunn and Paul Neeskens Email: tomdunn@bigpond.com.au
Brisbane Northside Contact: Dr Graham McNally Phone: (07) 3265 3111 Web: www.northsidelocalmedical. wordpress.com
ipswich and west moreton Contact: Dr Thomas McEniery Phone: (07) 3281 1177
Redcliffe and District Contact: Margaret McPherson Phone: (07) 3121 4043 Web: www.rdma.org.au Gold Coast Phone: 0419 780 505 Email: info@gcma.org.au Web: www.gcma.org.au
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May 2015 DoctorQ
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DoctorQ May 2015
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health vision
AMA Queensland Health Vision
AMA Queensland is proud to launch Part One of its Health Vision, the first of five documents that will guide our advocacy and policy efforts over the course of the next five years. It is appropriate that the Health Vision begins by examining the topic of Public Health, an issue of vital importance in ensuring Queenslanders live healthy, productive lives. Sadly, growing health inequality and unhealthy lifestyles in both Queensland and Australia, especially in children, and an ageing population are increasing problems that are jeopardising the ability of our health care system to provide adequate care for Queenslanders.
The Health Vision aims to ensure that in five years time a child who was born today will be healthier and be best placed to live longer. We believe this can be done by implementing the following initiatives.
Target One: A whole of government public health plan
TARGET ONE
By 2020, Queensland must have a whole of Government public health plan. Given its central importance, this should be coordinated by the Premier in co-operation with the Health Minister and administered by Queensland Health. It will foster a co-ordinated approach to addressing Queensland’s biggest health challenges including smoking, obesity, chronic disease, alcohol abuse and mental health. Such a plan has been implemented in South Australia with bipartisan support. This
Target Two: Overweight and obese Queenslanders will be slimmer by 2020
TARGET TWO
Queensland is suffering an obesity epidemic and concerted action is needed to stem this problem. To this end, AMA is advocating: Banning fast food outlets opening within 1km of schools – in co-operation with local government and the food industry, to reduce rates of obesity in children; A pilot program to subsidise fruit and vegetables for ‘at-risk’ communities – especially in remote areas with high rates of obesity;
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model transcends the three year electoral cycle and allows long-term investment in public health. To get Queensland moving on the road to this plan, AMA Queensland will spearhead a Public Health Improvement Partnership (PHIP) group, which will draw upon the expertise of its members to develop a blueprint for what public health in Queensland looks like. PHIP will partner with other health advocacy organisations, local councils, community organisations and Queensland Health. All other targets will fall within the remit of the PHIP.
Expand the use of telehealth to fight obesity – allowing multidisciplinary teams comprised of dieticians, exercise physiologists and specialist bariatric services to consult on chronically obese patients; Publicly fund bariatric surgery – as a last resort, AMA Queensland advocates increased funding to allow more bariatric surgery to be performed in chronically obese patients who have failed conservative management.
health vision
TARGET three Target Three: By 2020, Queensland will be closing in on the gap Aboriginal and Torres Strait Islander health outcomes are among the worst in the world. Interventions in the past have been criticised for lack of consultation and for being inappropriate for the communities they seek to assist. In order to avoid such problems, AMA Queensland will establish a committee of experts in Indigenous health, led by an expert from the Aboriginal and Torres Strait Islander community. They will begin by consulting with relevant stakeholders to determine the most effective strategies to improve Aboriginal and Torres Strait Islander health, tailored to individual communities. Their work will feed into the PHIP and will advise what the Government should be doing to improve Aboriginal and Torres Strait Islander health outcomes in Queensland.
Dr Malcolm Forbes AMA Queensland Health Vision Advocate A recipe for enhanced public health in Queensland Dr Malcolm Forbes is an National Health and Medical Research Council postgraduate scholar currently based at the Centre for Excellence in Chronic Disease Prevention at the Cairns Institute. Dr Forbes is a great supporter of the proactive stance within the Vision. Queensland has been referred to as the sunshine state. It’s been referred to as the smart state. By 2020, Queensland must be making significant ground to being the healthy state. Queenslanders are living longer lives than they did half a century ago. But frequently these lives are impaired by chronic disease. Effective public health measures can reduce rates of chronic disease. The evidence for this is incontrovertible. Despite laudable government policies on individual public health issues, we have hitherto never seen
TARGET Four Target Four: A booster shot Queensland’s vaccination rates
for
Some communities in Queensland have vaccination rates as low as 86 per cent. This is insufficient to provide herd immunity. While some of these low rates are through conscientious objection to vaccinations, a considerable portion of the low level of vaccination is related to lack of access, awareness or affordability. To improve access, the Health Vision advocates the following initiatives: The Queensland Government should fund a mobile immunisation clinic, staffed by doctors, with a private area in which patients can rest should they need to do so. Records of immunisations provided should be sent to the patients’ regular GP.
There are four more sections of AMA Queensland’s Health Vision to come, which will be delivered progressively over the course of 2015.
a dedicated, whole of government public health policy. As doctors, we know from our clinical practice that siloed, segmented and sub-specialised medical practice leads to increased costs without a commensurate improvement in the health of our patients. The same applies to public health strategy. To focus on individual issues – smoking, alcohol, obesity – without addressing the determinants of poor health, would be costly and lead only to short-term improvements in public health. It was therefore pleasing to read that the first chapter of the AMA Queensland Health Vision, which focuses not only on the most pertinent and pressing public health issues in Queensland, but makes a point of the importance of addressing intergenerational disadvantage and the social determinants of health.
Consider a targeted patient transport plan that would assist patients who require vaccinations to travel to and from their appointments. Consider ways in which Queensland Health can assist GP practices to review their patient data and identify and contact those patients who need to have their immunisation updated. This can be achieved by either outlining the process or actually visiting the practices to provide hands on assistance outcomes in Queensland. View AMA Queensland’s Health Vision now at www.amaq.com.au or phone (07) 3872 2222. Q
Part two: Workforce and Training Part three: Reprioritising Health Funding Part four: Unifying the Health System Part five: End of Life Care
to-day practice. We must be investing our time and efforts now for the benefit of future generations of Queenslanders. To co-opt the words of Sir William Osler, when it comes to public health, “the best preparation for tomorrow is to do today’s work superbly well”. Q
The best preparation for tomorrow is to do today’s work superbly well
I commend the AMA Queensland Health Vision on its public health initiatives. I hope members will read the statement, support its strategies, and continue to implement preventive health measures in their day-
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Rural Doctors Association of Queensland
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Program Highlight: Origins of Outreach Pioneering services into remote indigenous communities
Introducing RDAQ President-elect Dr Tash Coventry Dr Natasha Coventry is looking forward to her term as President of RDAQ.
Dr Richard Heazlewood
RDAQ President-elect Dr Tash Coventry has invited some of far north Queensland’s clinical legends to RDAQ 2015. Dr Clive Hadfield, a general physician, pilot and former director of medicine at Cairns Base Hospital, established an outreach program in the early 1990s to deal with problems of chronic disease management in the adult population in remote communities of the Cape York Peninsula. Dr Hadfield recognised the need to bring health care to the communities with the death rate for Indigenous people being 1.9 [1] times the rate for non-Indigenous people. In 1994, Dr Richard Heazlewood, a rural general practitioner with extensive paediatric experience and Ms Patsy Bjerregaard, a paediatric occupational therapist, joined Dr Hadfield and formed the Cape York Paediatric Outreach Program. By delivering developmental, paediatric and consultant physician services to Cape York and Torres Strait communities, the program made a real difference to isolated communities. The tyranny of distance was particularly felt by families when other children would need to be left so they could transport a sick child for care. The clinic prioritised following up children who were recently discharged
and the timely assessment of children for respiratory disease, developmental delay, failure to thrive or hearing loss, reducing the burden of travel. Parental education targeted improving infant health by demonstrating the effects of tobacco, alcohol and drug use in pregnancy. Services extended in the Cairns and hinterland district through the involvement of this outreach program. Dr Lara Wieland has continued the legacy of primary health care in Mulungu and Kowanyama for some 15 years. She has seen the benefits of continuing the specialist outreach services pioneered by Drs Hadfield and Heazelwood and their colleagues. Dr Coventry described Dr Wieland’s advocacy for health care in remote communities as fearless and inspirational. “Her commitment to improving health outcomes reaches beyond the clinical health space through her involvement in community leadership and holiday programs in Kowanyama. These programs provide life skills and promote healthy life choices and resilience amongst school age indigenous children,” Dr Coventry said. RDAQ 2015 conference will hear more from these pioneering clinicians on Sunday 7th June 2015 at 9.30 am.
Australian Indigenous HealthInfoNet (2014). Overview of Australian Indigenous health status, 2013. Retrieved 15/04/2015 from http://www.healthinfonet.ecu.edu.au/health-facts/overviews
[1]
“I expect the year ahead will be challenging and I am looking forward to the opportunity,” Dr Coventry said. Her inclusive leadership style will be a real asset in steering the organisation through a time of changing government policy, especially at the federal level. Dr Coventry is currently Medical Superintendent of Cooktown Hospital. She completed her GP training in far north Queensland, including DRANZCOG (Basic) and Anaesthetics (JCCA). She took up the permanent position of Medical Superintendent of Cooktown Hospital as a Rural Generalist - Anaesthetist in 2007. Dr Coventry continues to practise procedural Anaesthetics and leads Cooktown as an educational ‘hub’ for Rural Generalist registrars and medical students. Cooktown reopened an elective birthing service in early 2015, only the second maternity service to re-open in Queensland in more than 15 years. When she’s not at work or busy with RDAQ, Dr Coventry enjoys time with her family, husband Justin and children, Josh (6) Mary (4) James (3) and Jonathan (1). “We love the far north Queensland lifestyle and are great fans of fishing, camping and 4WD adventures.”
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RDAQ Conference - a family affair Families and partners of rural doctors have signed up for RDAQ’s 2015 conference in unprecedented numbers. RDAQ offers families and partners an integrated program. The highlight for the past five years has been Saturday night’s family function, a casual affair with a family friendly atmosphere. 2010 started the tradition with a starlit Arabian nights fiesta. Children showcased new belly dancing skills after attending workshops during the day. Similarly the kids took centre stage during dinner at Tjapukai in 2011, showing off musical skills they had learnt that afternoon when they joined indigenous performers on stage.
while children of all ages joined in a Wii dance-off and treasure hunt. Prizes were hotly contested on the chocolate wheel and hoop toss. The evening highlight was the children’s circus performance, following the afternoon’s workshop. RDAQ’s 25th anniversary in 2014 boasted a theatre performance from the children and special appearances from the adult children of rural doctors. These very talented young vocalists, like their parents, remember the early days of RDAQ. The family night is always a special event,
offering hospitality that is unique to RDAQ as new families are embraced and old friends are reunited. This year promises to be just as exciting, as RDAQ families experience a trip around the world at the Cairns International Cruise Terminal. There will be international cuisine and games to entertain everyone while guests will receive a passport to be stamped at each country on their adventures. Everyone will be ready for the unexpected with the fancy dress theme of ‘Around the world in 80 days’.
A Greek theme in 2012 honoured the Olympic year. Families dressed in togas and pinned the eye on the fearsome cyclops. In Mackay, the family night featured a custom-built country fair in 2013. A abandoned mineshaft lined with gems extended the ‘Digging Deep’ theme,
RDAQ 2015 photo competition
Event Management services for RDAQ 2015 provided by Health Workforce Queensland
CONTACT DETAILS Tracey Lowe & Renee Dobbin RDAQ 2015 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
This year, RDAQ would like to see what the “Treasuring our Icons” theme means to you. We will be running a photo competition and the winners will be announced on Saturday evening. Winners will also be published in the RDAQ e-newsletter and all entries will be on display for the duration of the conference. Theme: Photo depicting the RDAQ 2015 conference theme “Treasuring our Icons”. Capture the people of Queensland who are icons to you. Conditions: Entries must include images of people and you must have written consent from the subject to use the image. How to enter: Email entries to conference@rdaq.com.au Photographic files should be supplied in JPEG format in high resolution and emailed with your entry form which can be downloaded via conference.rdaq.com.au by 22nd May 2015. Prizes: The winner from each category will receive a professionally mounted copy of their winning photo and the runner up will received a $30 photo book voucher. Judging: Judging will be open to the public. Simply go to the RDAQ Facebook page, https://www.facebook.com/RDAQ.Page from 25th May and ‘like’ the photo you think should win.
For more information on RDAQ 2015 please go to: conference.rdaq.com.au
FOUNDATION
Resilience on the Run pilot program AMA Queensland are piloting a Resilience on the Run well-being program for 2015 Interns at Rockhampton Hospital. The program has been fully funded by the AMA Queensland Foundation, and seeks to address the findings raised in the recent beyondblue report into depression in the medical profession. This program consists of four workshops commencing on 21 August 2015 and will cover: Managing difficult interpersonal relationships (patients, colleagues, and patient families) Managing difficult scenarios on the job Resilience and mindfulness Practical steps in how to ask for help/seek assistance
The program will be measured with validated, widely accepted assessment tools in order to establish if the program has made a significant improvement to the well-being of participating interns. Measurements will be taken before the program commences, at the conclusion of the program, and three months post course completion and will include the intervention site (Rockhampton Hospital intern group) and a control site (Cairns Hospital intern group). Discussions are also underway with the University of Queensland Medical School with respect to support of the research and statistical component of the project. Upon completion of a successful pilot and submission of the findings to the Medical Journal of Australia we are hoping to secure further funding (from a range of sources) to
make the program more widely available to Hospitals from 2016 and beyond. The AMA Queensland Foundation and AMA Queensland extend our thanks and appreciation to the Resilience on the Run working group including Drs Malcolm Forbes, Lisa Byrom, Margaret Kay, Ira van der Steenstraten and Alex Markwell. Q
Doctors doing good The AMA Queensland Foundation is about supporting you and your medical colleagues who are filling in the gaps, delivering and championing vital services and projects outside of those catered for by the public health system for Queenslanders in need. Established in 2000 by a group of like-minded doctors, the Foundation is your way of making a real and tangible difference in the lives of those suffering at the hands of a failing health system - beyond what you can achieve in your day-to-day work. Your donations provide an alternative means for financing essential services for people in need, medical research, and education.
Dr Steve Hambleton
AMA Queensland Foundation President
Government funding for equipment and services is limited and insufficient. More often than you realise, those with genuine needs
and causes that don’t fit into the neat boxes of other health-specific charities continue to suffer or go without vital equipment and medical treatment. The medical community must band together, not only to support the work of the Foundation but to advocate on behalf of those who need our support. We need a far wider commitment by doctors - as well as those in the community touched by the good work of medical practitioners - to ‘do good’. “It’s time to step up to the mark, colleagues, and pronounce that we are doctors doing good and that we invite colleagues and patients who are passionate about helping others to know of our work.” - Dr Steve Hambleton, AMA Queensland Foundation President Q
Do you know of a project which needs financial assistance? Contact the AMA Queensland Foundation 34
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Phone: (07) 3872 2222
Email: amaqfoundation@amaq.com.au
Website: www.amaqfoundation.com.au
St Vincent’s Private Hospital Brisbane at Kangaroo Point specialises in medical care for those with chronic, complex and multiple health needs. We offer services for adolescents to the elderly. General medical
Palliative care
• Acute and chronic disease management
• 24-hour Community Specialist Palliative Care Service
• Acute geriatric medicine and evaluation management programs
• 30-bed inpatient unit (24 single rooms)
• Neurosciences for adolescents and adults (epilepsy, post-stroke care, movement disorders, acquired brain injuries, sleep disorders)
• Adolescent palliative care
• New physiotherapy and occupational therapy complex At St Vincent’s Private Hospital Brisbane we have modern, spacious and comfortable patient rooms – most are private rooms with adjoining ensuites. Radiology, pathology, pharmacy, EEG and sleep studies are also available onsite.
Spring Hill
iver ne R Brisba
Bradfield Hyw
Brisbane CBD
New Farm
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Kangaroo Point
Av e
Shafsto n
Vulture St
Ipswich Rd
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St Vincent’s Private Hospital Brisbane
Vulture St
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Fortitude Valley
Story Bridge
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• RECHARGE for life – adult pain management program (over 21 years)
• Multidisciplinary approach
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• LEAP into life – adolescent pain management program (14 to 21 years)
• Full functional assessments and tailored programs for adolescents and adults
ley
• Brisbane Centre for Pain Management – specialist assessment and consultation, medication and prescription advice, surgical procedures
Rehabilitation
Ann er
Pain management
• Patient and Family Support Service
East Brisbane
Stanley St
Woolloongabba
To find out more about our services, please contact us: 411 Main Street, Kangaroo Point Qld 4169 Phone: 07 3240 1111 Email: info@stvincentsbrisbane.org.au
www.svphb.org.au
MEMBER NEWS
Congratulations to the following doctors who are now elected members of AMA Queensland. February 2015
March 2015
doctors in training
doctors in training
Dr Casey Steele Dr Tamin Rezwani Dr Skye Nissen Dr Julia Zhu Dr Emma Borg Dr Natalie Lawrence Dr Arun Nadarajah Dr Sahan Semasinghe Bandaralage Dr Lisa Abdel-Malek Dr Guido Marks Dr Nasar Ahamed Dr Clair McCartney Dr Heng Kan Dr Shuichi Suetani Dr Joseph Jabbour Dr Bronte Appleton Dr Andrew McBride Dr Shih-Han Tsai
Dr Emerald Stewart Dr Chen Li Dr Isuravi Widanapathirana Dr Matthew Balcerek Dr Jason Kovan-Boss Dr Katie Fletcher Dr Marlow Coates Dr Emma Forrester Dr Kellie Tathem Dr Jane Davidson Dr Maryann Turner Dr Sonia Anwar
General Practitioners
Dr Olivia Page Dr Jonathon Farrah Dr Brett Kennedy Dr Anju Basu Dr Natasha Frost Dr Catherine McDougall Dr Sylvio Provenzano
Dr Michael Clem Dr Patrick Tomasiello Dr Janet Fairweather Dr Chuck Fung Kong Dr Brinthan Kathirgama Kanthan Dr Michael Clements Dr Marie Carmody Morris Dr Vidya Krishna Dr Kuamaragewattage Muthuthantri
specialists Dr Tuang Loy Dr Salman Rahman Dr Sunil Warrier Dr John Albietz Dr Alexander Ritchie
part-time Practitioners Dr Min Li Ho A/Prof Peter Nash Dr Rajeappan Ushadevi Dr John Beck
SALARIED
General Practitioners Dr Luke Dwyer Dr Clive Shulman Dr Harold Strong
specialists
Part-time Practitioners Dr Mellissa Naidoo
Salaried Dr Gregory Wiseman Dr Anil Gautam
MAY MEMBERSHIP NEWS Membership packs arriving soon Keep an eye out for your membership packs that will be arriving in the mail shortly. In response to your feedback and requests, we have included an updated member certificate for each member. The new 2015/2016 Member Benefits Guide provides a comprehensive overview of all of your member benefits, including a profile on each of our corporate partners and how they can assist you professionally and personally. All members will be emailed with a Tax Invoice for the 2014/2015 tax year in early July. Looking for help with your tax return? Whether you are Brisbane-based, or regionally based, contact our Corporate Partners in Accounting, William Buck, who can assist with all of your tax and business needs - phone (07) 3229 5100 for a chat with Julie Smith or Paul Copeland. Doctorportal We’ve reviewed our hard-copy Directory of Members publication and advise that this offering has been discontinued this year. It is replaced with the new, live online Doctorportal. It is a fully searchable database where you can search for colleagues by location or specialty right across Australia. Members of AMA are displayed in the online directory with the AMA logo, reflecting their valued membership. Additionally, Doctorportal includes the latest medical profession news, blogs and a national jobs board. You simply need to create a profile to log into the site, using your AHPRA details: Visit www.doctorportal.com.au to set up your user profile and login to view your listing. Member entries for Doctorportal are drawn from the Medical Directory of Australia, and if you would like to update your listing or your listing does not appear, please contact Doctorportal support support@doctorportal.com.au Membership team out and about in May and June Leigh Holohan, Membership Manager, and Holly Bretherton, General Manager of Member Relations and Communications will be out and about at the following events in May and June: RACGP Clinical Practice Weekend – Brisbane, BCEC (2 – 3 May) Bond University Orientation Day (15 May) Griffith University Medical Society - Ward Call Series (18 May) University of Queensland Medical Society – Medical Specialties Evening (19 May) RDAQ Conference, Pullman International, Cairns (5 – 7 June)
Dr Adriane Sinclair
Academic Dr Ali Salajegheh
Come and say hello to Leigh and Holly and find out the latest membership news and upcoming member events and offerings. Inaugural Medical Society Executive Day program Student Council Representative Chris Maguire, along with the membership team, have worked closely with all Medical Societies including UQMS, GUMS, MSSBU and JCUMSA to initiate a joint student sign up process, whereby student members can opt-in for free AMA Queensland student membership at the time of joining their Medical Society. This will help to strengthen the relationship between AMA Queensland, the Medical Societies and our Student Members and will help to ensure student members can gain an understanding early on in their student careers about the important advocacy work AMA Queensland undertake to future-proof junior doctor medical careers. The membership team have been busy at UQMS, Griffith and JCU University O-week meeting our new student members and we look forward to attending the Bond University O-week in May. AMA Queensland will also host a free education day for Medical Society Executive Members on 9 May on the essentials of running a Medical Society. The program will cover topics such as risk management, governance, legal structuring, accounting, marketing and event management fundamentals to help support new Medical Society Executive Members in their volunteer roles. Q
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OBITUARY
Dr Walter Mirosch MBBS DRACR MRACP 13 October 1938 – 26 December 2014 Walter Mirosch died in Suva after being ill for the past two years. At the time he was doing what he loved – travelling. Walter’s life journey was a classic Australian story of a boy born in a time of great adversity, who succeeded in overcoming many obstacles before reaching a prominent position in the medical community of Queensland. Walter was born in Ukraine. His family was swept up in World War II and his father killed in defence of Stalingrad. This was followed by the repatriation of Walter with his German mother, Elizabeth, to Germany in 1943. Walter, an only child, and his mother arrived as refugee immigrants in Australia in 1950. After an initial placement at Parkes Migrant Hostel, they moved to Brisbane, where he began his secondary education at Brisbane State High School. At the time Walter spoke very little English but he overcame this to secure a Commonwealth Scholarship that allowed him to enter medical school at the University of Queensland. After graduation he became an intern at the Royal Brisbane Hospital and the following year entered the Queensland Radium Institute, obtaining his Diploma in Radiotherapy.
the sum of his various parts. He was greatly respected and supported by other GPs as well as his specialist colleagues in Ipswich. He was renowned for being a superb diagnostician.
Walter then decided to become a general physician, training initially at the Royal Brisbane Hospital and later at Princess Alexandra Hospital.
Integral to Walter’s achievements was the unwavering support and love of his oftenbemused wife Jean. A trained nurse, Jean was very much his rock providing the stability and forbearance essential to sustain a busy medical practice.
In 1970 he was admitted as a member of the Royal Australasian College of Physicians.He started his consultant practice the following year. He was appointed a visiting medical officer at Ipswich General Hospital in 1973, eventually retiring in 2006 after 33 years. In private practice he consulted at St Andrews Private Hospital, Ipswich, as well as Laidley and Boonah Hospitals. Walter spent the next six years relieving at Logan Hospital and assisting his dear friend, Jonathan Douglas, at Wesley Hospital with after-hours care. Walter’s life was devoted to his patients and to providing them with the highest possible medical care.
Their children Andrew, Natascha, Nicholas and Richard have all inherited, to a varying degree, Walter’s capacity for hard work, his single-minded determination, high selfstandards and refusal to accept mediocrity. Walter was also intensely proud of his grandchildren and felt his great achievement was to see all his children and grandchildren emerge as worthwhile human beings. Walter, of course, had a life outside medicine. He was never happier than when relaxing with friends – a glass of good red by his side and a platter of cheese before him.
He provided unstinting service at any hour of the day and never complained about his heavy workload.
Over the years he became an authority on food and wine. He was a foundation member of the Amberswich Beef and Burgundy Club in the 1970s and subsequently owned the successful Brisbane restaurant, Two Small Rooms.
In discussing Walter’s attributes with his friends, it was clear he was much more than
Walter also enjoyed managing his financial affairs and worked hard to ensure his family
and extended family would be financially secure – possibly reflecting his own rather challenging childhood. Walter was a keen globetrotter. In later years he and Jean travelled extensively, visiting their network of friends around the world as well as developing new ones. The couple were truly birds of a feather, delighting in each other’s company and in their shared experiences. Walter had a wicked sense of humour, too. He was happy for others to make jest of his own peccadilloes and delighted in starting an argument with a somewhat controversial point of view and then thoroughly confusing everybody by changing sides midstream. Stories about Walter in Ipswich are legendary, such as the time he ‘lost’ his car outside the police station, which was adjacent to the hospital. When he reported the loss, the police delighted in informing him his car was still outside the station, having rolled in a large semi-circle without hindering traffic before coming to rest some 50m from where he had parked it with the handbrake off! Walter is a remembered as a good man who did great things. He lived life to the fullest and left a huge impression on the fabric of Ipswich, his adopted city. He is survived by Jean, who he married in Ipswich in 1963; his four children and 10 grandchildren. Q DoctorQ May 2015
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events calendar
27-28 june
2nd annual
junior doctor Conference Brisbane Exhibition Centre This year’s theme is ‘Be extraordinary: making the most of your medical career’. Junior doctors will be inspired to reach their potential by exposure to world-leading, widely respected orators from medical and non-medical fields, including Professor Ian Frazer AC, Professor John Murtagh AM and former Greens leader Dr Bob Brown AM.
what’s on
To view the full events calendar
3-4 July
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Or to register for an event, visit amaq.com.au or contact the AMA Queensland Membership team on (07) 3872 2222 or email registrations@amaq.com.au
9 September
Women in Medicine
20-26 September AMA QUEENSLAND State conference
Brisbane Exhibition Centre
Brisbane Exhibition Centre
New York City
Featuring renowned General Practitioner advocates and past AMA Presidents Professor Kerryn Phelps and Dr Steve Hambleton, the Annual Starting and Working in Private Practice Conference has got you covered for all aspects of practice start up and existing practice growth and expansion for medicine in the twenty-first century.
This year’s topic, The Art and Science of Happiness will explore the medical, scientific and spiritual aspects to happiness. Professor Kerryn Phelps AM will chair and commentate discussion on actively living a happier life in a time-poor world of increasing pressures, personal and work demands and encroaching technologies.
With the theme “A BIG Apple a Day keeps the doctor away – Strategies for a healthy and happy life,” this conference will focus on the importance of enjoying and maintaining good health, with discussions on mental health, obesity, doctors’ health and wellbeing, work/ life balance and preventative health.
Save the date May 2015 DoctorQ
7 November Medico Legal Conference
events calendar
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People & EVENTS
Liver transplant surgeon Dr Kellee Slater to speak at JDC
Dr Kellee Slater is a hepatobiliary and general surgeon based at the Princess Alexandra Hospital. Dr Slater’s book, How to do a liver transplant: stories from my surgical life, won The Courier Mail’s 2014 People’s Choice Queensland Book of the Year and we’re very proud to announce that Dr Slater will be a keynote speaker at our second annual Junior Doctor Conference in June. What’s the first piece of advice you would give to yourself as a junior doctor? Find your passion. Look at the mundane aspects of every specialty – chronic pancreatitis in general surgery, back pain in orthopaedics, angina in medicine. If you could take that history ten times a day for 30 years, then you have found your calling. Remember too, that your interests will change as you get older and that’s alright. You’ve been quoted as saying “I worry a lot, but this might not be a bad thing”. Why? A little bit of worry can be a good thing. It helps you anticipate, manage and even circumvent most of the complications a patient may experience. This makes me calm. There is no doubt however, that worry has sometimes been an impediment to my wellbeing. In recent years I have learned to harness anxiety to my advantage by working with an executive coach and practicing the techniques of mindfulness. Live in the now, do everything with your full attention, no matter how mundane it is. Fear comes from worrying about what might happen tomorrow. I have realised that performing surgery is as close to perfect mindfulness as you can yet. In my role as upcoming Deputy Chair of the Board in General Surgery, I would like to focus more on looking after the mental health of our junior doctors and arm them with strategies to deal with the rigors of the job, be it anxiety, depression or dealing with bullies and harassment. How did you get into liver transplants in particular? I did the transplant registrar job at Princess Alexandra Hospital as a general surgical trainee. Despite the hard work (I was on call 24/7 – these were the days before safe working hours), I loved the complexity of the surgery and the patients. They were gravely ill and what we did made them better. This was a powerful thing. The deal was sealed when I was offered the chance to do my transplant fellowship in the USA. Living in the States had been a lifelong dream, so all the pieces 40
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fell into place. Now, as well as transplant, I do liver and pancreatic resections, gallbladders and still perform a wide range of general surgery. My most recent passion is applying my critical care skills to complex incisional hernia and abdominal wall reconstruction. In your book, How to do a liver transplant: stories from my surgical life, you give a very candid insight into your life. How do you think that personality trait has helped you? Do you think being candid allows you to remain resilient?
think about the workplace in terms of gender. We are all skilled people doing a difficult job. Success for both men and women comes only from hard work and perseverance. I am not a believer in the “glass ceiling” in medicine. I tell my three daughters, that this is the best time in history to be a girl. We can do anything. Q
I am a better doctor for it. I hope my interactions with patients are always straightforward and candid. I share my life with them, just as they share their lives with me. Work and home often blend into one. The chronic nature of my patient’s illnesses mean I get to know them over many years. Many patients become like members of my extended family and we laugh and cry together.
I have realised that performing surgery is as close to perfect mindfulness as you can yet. You are one of only two female liver transplant surgeons in Australia. What challenges do you think you’ve faced that your male counterparts haven’t? None really, aside from the obvious - I have had four children and breastfed them at work. This job is challenging whether you are a man or a woman. That’s why only one or two people every five years go into this career. I was determined that I could have children and do this job and I am fortunate enough to have the support at home. I don’t like to
How to do a liver transplant: stories from my surgical life Dr Kellee Slater Top Australian surgeon Dr Kellee Slater invites us inside the operating theatre with her dedicated team as she performs life-or-death surgery on a newborn baby, brings a dying liver back to life with a staple gun in each hand, and undertakes the confronting task of removing donor organs. How to Do a Liver Transplant is an enthralling – and often blackly funny – glimpse over the shoulder of a gifted surgeon.
People & EVENTS
AMA Queensland Council of Doctors in Training presents
Be extraordinary Making the most of your medical career 2nd AMA Queensland junior doctor Conference Saturday 27 - Sunday 28 June 2015 BRiSBANE CBD DoctorQ May 2015
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Conference
EXCEPTIONAL AMERICAN SPEAKERS LOCKED IN FOR ANNUAL CONFERENCE Annual Conference Coordinator Neil Mackintosh has locked in some exceptional local speakers for this year’s conference in New York: Dr Alice Coombs, Dr Holly Lofton and Dr Peter Carmel.
Dr Alice Coombs Dr Alice Tolbert Coombs is a Past President of the Massachusetts Medical Society and a critical care specialist and anaesthesiologist with over 30 years of experience. Dr Coombs has worked with the American Medical Association, Medicare, the Massachusetts Board of Registration and the National Committee of Foreign Medical Education. Dr Coombs has pioneered and published research on workplace discrimination and has worked on developing Medicare recommendations to Congress through the Medicare Payment Advisory Commission. She has served as Vice Chair on the Massachusetts Board of Registration in Medicine, Patient Care Assessment Committee in assessment of the competency of Hospitals’ Safety and Patient Quality Programs. Dr Coombs will be delivering sessions on empowering patients and health care literacy and work/life balance.
Dr Holly Loft Dr Holly Loft is Director of the Medical Weight Management Program at the NYU Langone Medical Center, which has helped more than 1,000 patients lose and maintain their weight goals. Dr Loft has undertaken research studies on the Ghrelin Resting Energy Expenditure Number (GREEN Study) development of a community-based low-energy-density diet, bariatric surgery, hyperglycaemia and deep vein thrombosis prophylaxis.
Dr Peter W. Carmel Dr Peter Carmel is a paediatric neurosurgeon and Past American Medical Association President. Dr. Carmel has served in numerous positions in both the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS). For 17 years, Dr. Carmel was a CNS representative in the House of Delegates, the AMA’s primary policy-making body. He received the AANS Distinguished Service Award 2008. A committed researcher and advocate for neurological research, Dr. Carmel served as chairman of the National Coalition for Research in Neurological Disease and Stroke, and subsequently as chair of the National Foundation for Brain Research. Dr Carmel is New Jersey Medical School’s Chairman of the Department of Neurological Surgery and comedical director of the Neurological Institute of New Jersey. Dr Carmel will be speaking on the changing American Health System.
MACQUARIE INFRASTRUCTURE COMPANY CEO JAMES HOOKE TO SPEAK AT ANNUAL CONFERENCE Australian born, New York based Macquarie Infrastructure Company CEO James Hooke will speak at AMA Queensland’s Annual Conference this year. Since joining the New York Stock Exchange listed Macquarie Infrastructure Company Inc (MIC) as Chief Executive Officer in 2009, MICs market capitalisation has grown from around $50 million to roughly $5 billion and its share price from under $1 per share to in excess of $70 per share. James Hooke was appointed Chief Executive Officer of the Company in May 2009. He joined Macquarie Group in 2007, where he was responsible for corporate development and management of a portfolio company investment for MIC, the manager of two unlisted infrastructure funds responsible for investing and managing approximately $5.5 billion of investor commitments across
a range of North American infrastructure businesses. Prior to joining Macquarie, Mr Hooke served in various senior management positions with Fairfax Media Limited, the largest newspaper corporation in Australia and New Zealand. In addition to extensive experience in the media industry, James worked for five years as a management consultant for Bain & Company and Partners in Performance and as a lawyer for Phillips Fox Solicitors in Australia. He is the author of three books and lives in New York with his wife and three young children. Q James Hooke, centre, ringing the bell on the New York Stock Exchange
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EMPIRE STATE BUILDING MANHATTEN TIMES SQUARE NEW YORK YANKEES Conference
BROOKLYN BRIDGE LONG ISLAND
CENTRAL PARK BROADWAY THEATRE
MUSEUM OF MODERN ART QUEENS AMA Queensland AnnualConference 20-26 September 2015 REGISTER NOW AT: WWW.AMAQ.COM.AU
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professional services
Business interruption
One of the major risks in running a medical practice, often overlooked by practice owners, is business interruption. Chris Mariani from AMA Queensland Insurance Solutions talks about the right insurance cover if you find yourself unable to open your practice.
Chris Mariani AMA Queensland Insurance Solutions 1300 883 059 chris.mariani@amaqis.com.au Chris Mariani is a medical indemnity specialist at AMA Queensland Insurance Solutions.
What if you can’t open your rooms due to fire, storm, major theft damage, closure by public authority, or interruption to vital services such as electricity? These types of events can mean a significant loss of revenue, all the while the business continues to incur fixed costs. Without the right insurance cover, many businesses fail to re-open after such an event. As a business owner, there are a number of questions to ask yourself: If I couldn’t access my rooms, would I be able to continue trading in some form? In the event of a major event such as a rebuild being required due to fire, would I be able to find alternative premises to rent quickly and easily? How long would it take to get back to 100 per cent of the lost event revenue? As the tenant am I responsible for rent, even if I can’t use the rooms? What revenue should I think about insuring and for how long? For example, what should I do about the revenue generated from doctors engaged as independent service contractors? Do I have a business continuity plan that details the key people I need to speak to, how do I recover lost data, systems, patient files etc?
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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The good news is you can easily protect the risk of lost revenue via business interruption insurance. For example we recently assisted a small specialist practice in suburban Brisbane. They were a single site solo doctor practice and decided that it would take them no more than six months to find new rooms and return to 100 per cent revenue. They therefore insured 100 per cent of their revenue for a six month period which equalled a total of $500,000. The premium to cover this loss of revenue risk was under $500* annually, a small price to pay for such protection. Business interruption cover is usually part of a business package policy, which most practices will hold (as other sections include cover for contents, public liability and other covers). If you don’t have any business interruption cover, you should review if you are exposed to your rooms and if so, then seek quotations to include this within your insurances. AMA Queensland Insurance Solutions advise many AMA Queensland members on their insurance needs. Please contact us if you would like us to review your current situation. *the information above was based on a practice which was in a 24 hour security building, of concrete construction, not in a flood prone area. Premiums and the covers available will differ depending on your individual circumstances. Q
www.amaqis.com.au
Insurance renewal time getting you down? Let’s face it insurance is boring. But necessary. We know doctors have a busy schedule, and while it may be easy to renew your insurance each year without proper revision, changes may have occurred for which you may not be fully covered and premiums need competitive comparison. For peace of mind and taking the yawn out of renewal time, contact AMA Queensland Insurance Solutions.
All insurance needs covered for all members through AMA Queensland Insurance Solutions.
AMA Qu eenslan d Insuran ce Solution Your Ins s urance Speciali sts
For more information phone: 1300 883 059
professional services
HOMEOPATHY WEBSITE PROSECUTED FOR UNSUPPORTED CLAIMS
A recent decision serves as a warning to websites selling or promoting health products that, alongside the regulatory functions undertaken by the Therapeutic Goods Administration, the ACCC is willing to bring legal action against parties making claims which are unsupported by medical science. Claire Smith Senior Associate (07) 3004 3531 Claire_Smith@tresscox.com.au
As concern increases over families electing not to vaccinate their children, the Australian Competition and Consumer Commission (ACCC) has successfully brought proceedings against a website which promotes and sells homeopathy products online. On 22 December 2014, the Federal Court in ACCC v Homeopathy Plus! Australia Pty Limited & Anor1, found the website Homeopathy Plus! and its director had contravened the Australian Consumer Law (ACL). The respondents were found to have engaged in misleading and deceptive conduct, or conduct likely to mislead and deceive, as a result of publishing articles which represented that the vaccine for whooping cough was short-lived, unreliable and no longer effective protection. Whooping cough (or pertussis) is a highly contagious respiratory disease which is very serious for babies under 12 months of age. The vaccine for whooping cough is recommended by the Australian government as part of routine childhood vaccinations. In 2012 Homeopathy Plus! took down an article from the website regarding whooping cough and homeopathic prevention and treatment at the request of the ACCC. However the removal was short lived, and after similar claims were uploaded, the ACCC commenced proceedings.
The respondents... published articles which represented that the vaccine for whooping cough was short-lived, unreliable and no longer effective protection. 46
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The court accepted the ACCC’s contention that the whooping cough vaccine was an effective prevention against contracting the disease in a majority of people . The court found the website had been misleading in relation to the supply, or possible supply, of homeopathic products as being of a particular standard or quality. That is, saying that there was adequate foundation in medical science that homeopathic treatments were a safe and effective alternative to the vaccine, “… when no such foundation exists and the vaccine is the only treatment currently approved for use and accepted by medical practitioners in Australia for the prevention of whooping cough.”2 Central to the decision was the expert evidence. The expert reports relied upon by the respondents were largely deemed inadmissible. Of note, the court considered the report of Dr Isaac Golden, a homeopathic practitioner and Honorary Research Fellow at the University of Ballarat, “…cast no light upon the reasoning by which the opinions given were reached”3. The court emphasised that responsibility for presenting evidence in an admissible form lies with the legal representatives4. It was unacceptable to rely on the fact that an expert may be unfamiliar with giving evidence in an admissible form, or that the expert evidence was in the form
ordinarily presented in the relevant the field of expertise5 . Another key issue considered by the court was the element of the respondent’s defence that the articles were not made as part of ‘trade and commerce’ (a requirement in order to establish a breach of section 18 of the ACL), rather the articles were relevant to ongoing public debate6. In considering whether the conduct in question had the requisite commercial or trading character7, the court accepted that one of the main purposes of Homeopathy Plus! was to advocate homeopathy8. However, after assessing the placement and accessibility of the articles on the website, including their proximity to the online shop, the Court concluded the respondents were participants in trade and commerce by supplying and promoting homeopathic products. That the articles did not explicitly direct readers to the online store, did not lead the court to a differing view9. Interestingly, the court also found there was no widespread public debate about the use of homeoprophylaxis as an alternative to the vaccination for whooping cough. It was noted that even the Australian peak body for homeopathy, the Australian Register of Homeopaths, held the view that homeopopthylaxis should not be recommended as a substitute for immunisation10. Further evidence is to be taken in relation to penalties to be imposed. Q 1. ACCC v Homeopathy Pus! Australia Pty Limited and Frances Mercia Sheffield [2014] FCA 1412 2. Ibid 318 3. Ibid 318 4. Ibid 33
5. Ibid 38 6. Ibid 38 7. Ibid 303 8. Ibid 306 9. Ibid 307 10. Ibid 314 11. Ibid 317 and 266
, Partner
Simon Harrison, Partner Phone 07 3004 3535 Mobile 0449 533 315 Simon_Harrison@tresscox.com.au
, Partner
, Partner
, Partner
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, Partner
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
professional services
Selling your Practice
With the oldest baby boomers hitting 70 next year, retirement is the next big thing. If you’re hoping to join the throng and hang up your stethoscope, Julie Smith from William Buck is here to help you get your practice ready for sale.
Julie Smith William Buck (07) 3229 5100 julie.smith@williambuck.com
Julie Smith is Tax Services Director at William Buck Chartered Accountants and Advisors.
If the thought of retirement is sitting at the back of your mind, you are not alone. With the ageing of the Baby Boomers, the percentage of Australians set to retire in the next three years is on a dramatic increase and this will continue until approximately 2034. We can assume then that there will be an increasing number of medical practices being offered for sale.
of any purchase on their home life and not just on financial considerations. For example, a smaller practice which may require substantial after hours commitment from a doctor both administratively and medically may be far less attractive to a potential Gen Y doctor than a smaller investment in a larger practice which requires far less outside of work hours commitment.
To ensure your practice is attractive to buyers and you maximise your financial returns from this opportunity you need to ensure that the business side of your medical practice is cared for and professionally managed.
Commencing the process of preparing your practice for sale should be undertaken in a systematic way. Some ideas for getting started include;
In our experience, doctors tend to neglect the financial and business aspects of their practice meaning they are not able to achieve an optimal sale price. The ideal time to start planning your exit strategy is approximately four to five years before you want to retire. This is based on the following: Having at least two years (ideally three) of financial results showing strong trading results; Allowing one year to market the practice and find an appropriate buyer; and Allowing one year working in the practice after the sale to transition patients.
The ideal time to start planning your exit strategy is approximately four to five years before you want to retire.
While the time frames on the above three factors may vary slightly, one constant factor for all sales is that the potential purchaser will be considering their return on investment against the risks of ownership. When you own a medical practice there are really two businesses involved: 1. The medical business which is where you practice medicine and treat your patients; and 2. The service trust or medical centre which provides administration support and services to allow doctors to trade their medical business. When selling your medical practice, although both businesses are interdependent, it is the service business which holds the value. This is your saleable asset. It is worthwhile to take into account the generational characteristics of the buyer and how they differ from your own when planning the sale of your practice. Understanding your buyer and their motivations can be a key ingredient for a successful sale.
DISCLAIMER: This article has been prepared by Julie Smith of William Buck. The article is intended to be general in nature and should not be relied upon by any person without seeking advice concerning their own circumstances.
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Having dealt with many practice sales, and relating those experiences with the comments on generational attitudes, one factor which I believe rates highest is the desire for Gen Y to have a work/life balance. They will consider the impact
Review the current trading results of your business by benchmarking the financial performance of your practice against other medical centres. This process can help to identify areas of weaker financial performance and work can be undertaken to address these issues; Developing a budget for the business over the next financial year with the intention of renewing this for the second year; Have quarterly reviews of the financial performance of the business; Implement a marketing plan for the business; Review existing agreements with doctors and formalising these agreements. Importantly, as part of this process, ensure your advisors are experienced in the medical industry so you can benefit from their experience. Q
ARE YOU THINKING
OF SELLING YOUR
MEDICAL PRACTICE? WITH A DEDICATED HEALTHCARE PRACTICE, WILLIAM BUCK CAN HELP YOU SELL YOUR PRACTICE AND MAKE THE MOST OF YOUR FINANCIAL FUTURE. We understand that the sale of your practice is crucial to your retirement and can help you plan and prepare to achieve the best possible outcome. William Buck is experienced in managing the sale process for medical practices, and can assist with the following: — Valuing your practice — Negotiations and the purchase process — Due diligence — Prepare your financial data ready for sale — Structuring the sale and maximising tax outcomes — Benchmarking your practice against industry profit trends CONTACT JULIE SMITH FOR A CONFIDENTIAL & COMPLIMENTARY CONSULTATION Phone: + 61 (7) 3229 5100 Email: Julie.Smith@williambuck.com
professional services
Protect your income
Although most Australians have a strong understanding of the need to protect major assets, such as their home and car, with the appropriate insurance, most don’t consider extending this to their most important asset: their income. Craig Wright from Experien Insurance shines a light on the value of income protection insurance.
Craig Wright 1300 796 577 craig.wright@experien.com.au Craig Wright is a risk specialist for Experien Insurance Services. He has substantial knowledge and a comprehensive understanding of the insurance needs for doctors.
The roof over your head and the car you drive are important. However, for many of us the ability to earn an income is the one asset we could never afford to be without. Consider the case of a 32-year-old earning $120,000 a year. If they were involved in an accident that caused them to lose the ability to work for six months, they would forfeit tens of thousands of dollars in potential earnings – a figure that doesn’t address pay increases related to inflation or promotion. If this injury was permanent then the income loss would be $120,000 x 33 years = $3,960,000 potential loss of future income. (This is based on a claim to age 65 without taking inflation into account). Despite the strong case for income protection insurance, Australians have been slow to take it up when compared to their global counterparts. The value of income protection
The earlier you commence cover on a level premium, the cheaper the total cost of premiums will be in the long term. 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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Every day, Australian workers surrender their ability to earn an income due to factors such as serious illness and accidents. However, it’s not just extreme cases that can compromise your earning capacity. It’s surprising how a few months of not working can take a significant toll on your family’s financial health, security and wellbeing. Income protection insurance affords you a powerful safety net if you have an accident or illness and can no longer undertake work. The funds from an income protection policy can be used to cover your mortgage and rent costs, as well as essentials such as feeding your family and any unprecedented additional expenses that may arise.
Factors taken into account and tax deductibility Income protection premiums can vary between providers and are subject to factors such age, gender, occupation and lifestyle choices, such as smoking. They also fluctuate depending on your waiting period, your agreed or indemnity style policy and minimum working requirements. However, insurance protection policies are generally fully tax deductible. Sick leave, disability and worker’s compensation Many Australians view sick leave and disability pensions as adequate cover if they lose their income, but the grim truth is that these are unlikely to be adequate. Sick leave is only designed to address short absences from work and disability pensions are often too insignificant to meet the living standards of most Australians. Although worker’s compensation is another potential option, this only applies to injuries you incur in the workplace. Income protection insurance is an effective way to ward off the financial fallout from loss of income. Enlisting the right policy will ensure that factors that affect your income will not alter your family’s comfort or your way of life. Do not wait until claim stage to discover that you incorrectly or under insured! Q
1. Level premium does not mean your premiums are guaranteed or do not change. Level premium rates may increase over time due to rate increases, CPI increases and policy fee increases. However, unlike stepped premiums, a level premium (excluding CPI and the policy fee) doesn’t go up by age-related increases. All insurance premiums quoted are from leading Australian Life Insurers. Premiums are current at 10 July, 2014 and are for illustration purposes only. Insurance premiums quoted do not include policy fees or stamp duty; they assume a monthly payment frequency, non smoker rates and white collar occupational classification – Medical Professional; and all stipulated insurance cover has been medically underwritten and accepted by the Insurer at Standard Rates. Actual rates may vary depending upon a person’s individual circumstances (ie. health, occupation, hobbies, etc) and are not guaranteed until underwritten by the insurer. TPD insurance premiums quoted are based on the any occupation definition.
Did you know 83% of Australian’s say they have insurance for their car?
Yet only 31% have income protection. For the equivalent of an average annual car insurance premium you can insure your cumulative loss of income to age 70 (in excess of $2,000,000).* Experien is the preferred life insurance provider to the AMA Queensland and one of the few national brokers that specialise in the medical sector. Speak to Craig or Justin for a complimentary consultation or review. P 1300 796 577
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. *Based on an average annual car premium of $900.00. Comparison based exclusively on Male, non smoker, age 28, $5,500 monthly benefit and accurate as of 02/02/2015. Statistical source: lifewise.org.au
E info@experien.com.au
THE A R T AND SCI E NCE OF H APP I NES S WEDNESDAY 9TH SEPTEMBER BRISBANE CONVENTION & EXHIBITION CENTRE GREY STREET, SOUTHBANK 7:30AM – 9:00AM Dr Kerryn Phelps AM, General Practitioner, Integrative Medicine, Cooper Street Clinic
Dr Timothy Sharp, Psychologist, Happiness Institute
Venerable Robina Courtin, Teacher of Buddhist philosophy
The full program and registration form including discounted member rates will be available on the AMA Queensland website in May | www.amaq.com.au
Business
The business of the Meeting will be: 1. To receive and consider the accounts, balance sheets and reports of:
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 15 May 2015 Venue: AMA Queensland, 88 L’Estrange Terrace Kelvin Grove, Queensland
(i) The Board of Directors; (ii) Any committees instructed to report to the meeting; and (iii) The Auditors. 2. The declaration of the results from the election of; (i) The President Election and Council members. 3. The appointment of the Auditors and approval of the remuneration (if any) to be paid to the Auditors; 4. The President’s address; and 5. To deal with all business which any statute, the Constitution, or the By-laws requires.
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) or by phoning Andrew Turner on (07) 3872 2207 and must be received by 6.30pm 13 May 2015.
Notes
The Dinner for the Profession, incorporating the Presidential Inauguration, will be held on Friday 12 June 2015, where the following business will be conducted: 1. Installation of Dr Chris Zappala as President 2015-2016; and 2. Presentation of Awards and Prizes. Annual Report *The 2014 Annual Report will be available online from 31 March 2015 at www.amaq.com.au.
professional services
How to ensure you’re feathering your nest
Ross Noye from Macquarie explains why, with 30 June approaching, a well considered super contribution strategy is important for those close to retirement.
An appropriate super contribution strategy can make all the difference to your retirement nest egg. Superannuation generally provides a low tax environment for retirement savings. Income in the accumulation phase is usually taxed at 15 per cent and capital gains on assets held for 12 months or more are taxed at 10 per cent. In pension phase, income and capital gains are generally tax-free. Super contributions can be either Concessional Contributions (CC), effectively paid from pre-tax earnings and taxed at 15 per cent rather than personal marginal tax rates of up to 49 per cent, and Non Concessional Contributions (NCC) which are made using after tax dollars and no tax deduction is received. The Federal Government provides the tax benefits to encourage individual taxpayers to save for retirement, but limits the contributions able to be made by issuing contribution caps for both CCs and NCCs. A well considered contribution strategy to transfer investment assets into the super environment can make a material difference when building your retirement nest egg in the low tax super fund structure and will typically include making CCs and NCCs.
Both the CC and NCC caps have been increased for the 2014/15 financial year with the CC cap increasing from $25,000 to $30,000 and the NCC cap from $150,000 to $180,000 for the 2014/15 financial year. However, it should be noted that a temporary higher CC cap of $35,000 applies to individual tax payers aged 49 and over as at 30 June 2014. Those approaching retirement should be aware that individuals under age 65 years on 1 July in the relevant income year are able to make NCCs of up to three times their NCC cap by utilising the bring-forward rule. The bring forward rule allows individuals to bring forward their NCCs for the next two years enabling them to contribute up to three times the annual maximum NCC amount in a financial year. For the 2014/15 financial year, this is three times $180,000, or $540,000.
Ross Noye Macquarie Private Wealth (07) 3233 5805 0438 779 955 ross.noye@macquarie.com Ross Noye is a stockbroker and financial advisor at Macquarie who specialises in investment and retirement planning.
For a person to trigger the bring-forward rule for NCCsin 2014/15,they must not have exceeded the NCC contribution limit in the previous two years. If they are age 65 or more when making a contribution, they must have also satisfied the work test rule in that income year prior to making the contribution. Q
An appropriate super contribution strategy can make all the difference to your retirement nest egg. important information: This information is provided by Macquarie Equities Limited ABN 41 002 574 923 (“MEL”), participant of Australian Securities Exchange Group, AFSL 237504. This information contains general advice and does not take into account your objectives, financial situation or needs. Before making any investment decision we recommend that you consider whether it is appropriate to your situation and seek appropriate financial, taxation and legal advice. MEL is not an authorised deposit-taking institution for the purposes of the Banking Act 1959 (Cth). MEL’s obligations do not represent deposits or other liabilities of MBL. MBL does not guarantee or otherwise provide assurance in respect of the obligations of that entity, unless noted otherwise.
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Brain and Spine Conditions in Primary Care GP CPD WEEKEND 20 & 21 JUNE 2015 Sheraton Mirage, Gold Coast
Register now for the BrizBrain & Spine Conference Presentations include: • Reading brain and spine scans • Current glioma treatment • Spinal cord stimulation • Osteoporosis and the collapsing spine • Stroke • Low back pain • Pituitary presentations in practice
Registration: Early bird (until 30 April 2015) $320 full degate $140 day delegate Regular rate (from 1 May 2015) $384 full degate $156 day delegate
Earn 40 category 1 points with RACGP
More info and register online at www.brizbrain.com.au/conference
P: 07 3833 2500
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E: thyp@brizbrain.com.au
Operating Hospitals Mater Private Hospital South Brisbane
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NEUROSURGEON & SPINAL SURGEON
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professional services
Owning your practice property through your SMSF
Whether on the cusp of retirement or in the full swing of your medical career, Christian Goodall from BOQ Specialists explains why owning your practice property through your SMSF may have savings and tax benefits. Christian Goodall
Australians have long understood the benefits of investing in property and for medical professionals at various life stages, there are a range of reasons that it could make sense to buy your commercial premises. If you are one of the many doctors transitioning from practice to retirement, topping up your super to retire comfortably may be your first financial priority. This may be especially true for Baby Boomer doctors, who were working long before compulsory super was introduced. However, it can be very difficult to beef up your retirement savings when you are paying a hefty rent on your practice premises. We are seeing savvy medical professionals borrow through their Self Managed Super Fund (SMSF) to acquire a property in a way which utilises and grows super capital now. By using the current balance of your super as a loan deposit, you can pay the rent of your tenancy which you would pay your landlord, to yourself. To take advantage of these many benefits, the ownership of the property and the loan need to be structured in the correct way. The details are quite complex but your adviser will be able to set up the trust that you will need to hold the property in your SMSF. As experts who understand your business, BOQ Specialist can help leverage more of your super capital. We could lend up to around 90 per cent of the value of property that you are using for your professional rooms and up to 80 per cent for other property, at a competitive interest rate. For early or mid-career doctors, having a secure tenancy is another very good reason for considering a practice property purchase if it is within your SMSF investment strategy. The certainty that you will not have to vacate your surgery unexpectedly, perhaps leaving tens of thousands of dollars’ worth of fit-out investment behind, allows you to do what you do with a sense of control and security. You also don’t want to make improvements on an asset you don’t own, nor do you want to slow your productivity or professional development with out-of-date technology and rooms. Owning your own premises through your SMSF could
give you the confidence to invest in the expensive infrastructure and equipment that may help your practice to succeed well into the future. It could also ensure continuity for your patients, who we know take great comfort in your convenient and consistent location.
BOQ Specialist (02) 9293 2016 christian.goodall@boqspecialist.com.au
Things to rememberwhen considering borrowing through your SMSF: Choose your banker carefully. Refinances are possible, but can be very complex. It is important to have legal, tax and financial advice early in the process. Ensure that the proposed property purchase fits in with the SMSF’s strategy. It will be necessary to provide a written copy of the strategy Carefully consider the loan structure (eg fixed rate versus variable rate on the basis of the cashflows that are expected through the SMSF). Make sure that you can manage your gearing level under the Superannuation Industry (Supervision) legislation. Remember that SMSF contribution limits could change so you need some flexibility in your approach. Q
By using the current balance of your super as a loan deposit, you can pay the rent of your tenancy which you would pay your landlord, to yourself. Disclaimer: Financial products and services described in this document are provided by BOQ Specialist Bank Limited ABN 55 071 292 594 AFSL and Australian Credit Licence 234975 (BOQ Specialist). BOQ Specialist is a wholly owned subsidiary of Bank of Queensland Limited ABN 32 009 656 740 (BOQ). BOQ and BOQ Specialist are both authorised deposit-taking institutions in their own right. Neither BOQ nor BOQ Specialist guarantees or otherwise supports the obligations or performance of each other or of each other’s products BOQ Specialist is the credit provider. 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. BOQ Specialist is not offering financial, tax or legal advice. You should obtain independent financial, tax and legal advice as appropriate.
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lifestyle
INDIA
The history of India goes back 5,000 years, but while visiting India you could travel through several centuries in a day. Ros Bulat from AMA Travel explains why India has so many stories to tell.
Colourful, aromatic and happily chaotic bazaars, craftsmen still plying their trade the traditional way, ancient forts and tombs - all exist amidst a rapidly developing present. To get a glimpse of India’s history, one must visit its monuments. There are 2,500 caves in India housing veritable treasures of art- from the pre historic cave paintings of Bhimbetkato the exquisite murals (250BC to 650AD) of Ajanta and the soaring magnificence of the Kailasnatha temple at Ellora. The Taj Mahal represents the zenith of Mughal architecture in India, whilst in Southern India; Hindu architecture reached its peak in the seventeenth century at Hampi, around the same time as the Taj Mahal was completed. The superb rock cut sculptures of Tamil Nadu, the exquisitely decorated forts and palaces of Rajasthan and the richly carved step wells of Gujarat- each has a tale to tell and each introduces you to India’s rich past. These are but a few of the architectural treasures of the country.
ail Ros
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UNMEASURABLE FAITH
UNTAMED INDIA
As you travel through India you realise religion and religious sentiment runs high throughout Indian society. From road side shrines to towering works of art, temples are an intrinsic part of a visit to India. Each temple has a story of myths and legends and is a wonderful insight to the Indian people and the many rituals that guide us through each day.
India’s natural heritage is extraordinary. Across the country, each park has flora and fauna which is distinct and represents animals and birds that are often indigenous to each region.
FLAVOURS You can camp out in the desert in Northern India or spend the night in a palace, learn to bargain at local markets, track animals in the jungles or learn a craft from an expert. Indian cuisine changes every 300 miles. Get a taste of a fiery hot Andhra curry or the soothing comfort of a neerdosa. Take a cooking lesson from a celebrity chef or spend the day with a housewife in her kitchen. Take a walk in a street market and visit the food stalls, or better still, get your apron out and try your hand cooking street food at a live stall - whatever tickles your taste buds.
This vivid forested land has been an inspiration to many a writer such as Rudyard Kipling who wrote about it in his Jungle Book. The bamboo thickets, extensive grassland and dense forests are home to a wide variety of animals including wolves, sloth bears, wild dogs, bison, leopards, cheetahs, Asiatic lions and of course the Tiger- India’s vast and varied topography offers something for every adventurer. Q
lifestyle
Food with wine
Grüner Veltliner isn’t a common wine variety, but a couple of recent tastings of Australian Grüners inspired our wine expert, Phil Manser, to dig a bit deeper. Grüner Veltliner is an ancient white grape grown mostly in Austria also with significant plantings in Slovakia and the Czech Republic. Its genetic parents are Traminer and the obscure St GeorgenerRebe. It was not until the 1950s with use of Lenz Moser’s less labour intensive system of vine management that it began to flourish. Planting less densely allowed for better sunlight penetration of canopy and better ventilation. Quality of fruit improved and plantings expanded significantly from this point. In 2002 Jancis Robinson was invited to a blind tasting, featuring a selection of Grüners plus top end Chardonnay’s from Gaja, Eileen Hardy, Penfolds Yattarna, Louis Jadot, Domaine LeFlaive, Ramonet, Etienne Sauzet and more. The top two wines and five of the top seven were Austrian Grüner Veltliners. I reckon it is a very exciting prospect with the potential to become an Aussie mainstay. Grüner in Australia Larry Jacobs from Hahndorf Hill believes Grüner is particularly suited to the Adelaide Hills. “Grüner grows best in the lower Austrian regions of Kremstal, Kamptal and Wachau … good ripening days and cold nights allow an extended growing season … significant diurnal variation is one of the key quality defining factors. Of Australia’s
premium regions the Adelaide Hills has one of the highest diurnal variations in temperature,” he said. So, what’s it taste like – an Aussie and an Austrian. Hahndorf Hill There are no berries; it’s all textural with white pepper, apple and pear, minerality, tobacco with celery, even parsnip. For Larry, this makes it a perfect point of difference to Sauvignon Blanc. It’s a cracker, true to the leaner Austrian styles with fantastic texture and complexity. It should cellar very well. It is also unlike any other Australian white I have had. Hesketh Jonathon Hesketh is an Australian winemaker who also produces an Austrian Grüner from Krems. The Hesketh Gruner is superb, beginning with an upfront burst of acidity, rolling into white pepper, spice and celery, green apple crunch, complexity and length. Jonathon loves the complexity of Grüner, more complex that Sauv Blanc, less hard than Riesling and with clearer varietal definition than Pinot Gris. Q
Hahndorf Hill
Hesketh
Phil Manser Wine Direct 1800 649 463 phil.manser@winedirect.com.au DoctorQ May 2015
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lifestyle A View From the Bridge National Theatre Live
9 and 10 May 1pm, 11 May 6pm, 13 May at 6pm. Don’t miss a stellar cast led by Mark Strong (The Imitation Game; Tinker, Tailor, Soldier, Spy) in the Young Vic’s “magnetic, electrifying, astonishingly bold” production of A View from the Bridge. The great Arthur Miller confronts the American dream in this dark and passionate tale. In Brooklyn, longshoreman Eddie Carbone welcomes his Sicilian cousins to the land of freedom. But when one of them falls for his beautiful niece, they discover that freedom comes at a price. Eddie’s jealous mistrust exposes a deep, unspeakable secret – one that drives him to commit the ultimate betrayal.
La Donna del Lago Met Opera
Iolanta and Duke Bluebeard’s Castle
The Impressionists Great Art On Screen
Met Opera
30 May 10am, 31 May 1pm.
2 May 10.30am, 3 May 1pm, 7 May 10am.
Monet, Ceaznne, Degas, Renoir: some of the world’s most popular artists. Their works, and that of their contemporaries, fetch tens of millions of dollars around the globe. But who were they really? Why and how exactly did they paint? What lies behind their enduring appeal?
On the heels of her triumphant Met performances in Eugene Onegin, soprano Anna Netrebko takes on another Tchaikovsky heroine in the first opera of this intriguing double bill, consisting of an enchanting fairy tale (Iolanta) followed by an erotic psychological thriller (Duke Bluebeard’s Castle). Netrebko stars as the beautiful blind girl who experiences love for the first time in Iolanta, while Nadja Michael is the unwitting victim of the diabolical Bluebeard, played by Mikhail Petrenko. Both operas are directed by Mariusz Trelinski, who was inspired by classic noir films of the 1940s. Iolanta also stars Piotr Beczala, and Valery Gergiev conducts both operas.
hold your Staff or Corporate Party at Dendy!
To help answer these questions, this unique film secured unparalleled access to a major new exhibition focussing on the man credited with inventing Impressionism as we know it: nineteenth century Parisian art collector Paul Durand-Ruel. This eagerly anticipated international exhibition is possibly the most comprehensive exploration of the Impressionists in history.
We love hosting corporate film nights and group bookings at Dendy. It is a great way to thank clients or staff – or perhaps you have a favourite charity that you would like to raise some money for? We have a functions pack and cinema package to suit all requirements. Please contact Dendy Portside Events at portsideevents@dendy.com.au for a free quote!
13 June 10.30am, 14 June 1pm, 18 June 10am. Bel canto superstars Joyce DiDonato and Juan Diego Flórez join forces for this Rossini showcase of vocal virtuosity, set in the medieval Scottish highlands and based on a beloved novel by Sir Walter Scott. DiDonato is the ‘lady of the lake’ of the title, and Flórez is the king who relentlessly pursues her, their vocal fireworks embellishing the romantic plot in this Met premiere production conducted by Michele Mariotti.
COMING FILMS 7 May
Pitch Perfect 2
14 May
A Royal Night Out
Mad Max: Fury Road
28 May
Spy
Woman in Gold
4 June
Aloha
Entourage
11 June
Jurassic World
4 June
Inside Out
Minions *Movie titles/release dates subject to change
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An independent, confidential and colleague-to-colleague advisory service for doctors, dentists and the students of these professions.
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How the MBAQ can help you The Association provides financial assistance to help medical practitioners through crises. If you find yourself in a financial crisis, then make contact with the MBAQ to receive the application forms for assistance.
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lifestyle
Ocker doctor
The Silver Jubilee
A recent reunion invitation has our Ocker Doctor in flashback mode.
The grim spectre of supplementary exams ruining summer seemed to hover like the sword of Damocles
Dr Matt Young General Practitioner
I scored an invite courtesy of Australia Post recently. There was going to be a reunion because it seems that a quarter of a century has whizzed past since I graduated from med school. The silver jubilee. Just like the Queen had in 1977. They minted a special coin for her. I doubt I will score such an honour but I must admit I was pretty stoked to reflect on the fact that I haven’t been sued, suspended or struck off. I’ve still got most of my marbles. And all of my teeth. I’m pretty content and I can even look back over that 25 years with a fair bit of fondness. There have been a few laughs, a few moving moments and a few disasters averted. It made me a bit reflective too. I know lots of people reckon the med school years are the best days of their lives. Not me though. I was stressed the whole time. I was a pretty shy young fella when I was 17. No one in my family had ever been to university and so that scared me. Exams terrified me too and eight years at an all-boys school meant girls petrified me, even more. Selective mutism might describe it pretty accurately. Every exam season was a chance to fail and score a letter from the dean suggesting some other career might suit me better. The grim 60
May 2015 DoctorQ
spectre of supplementary exams ruining summer seemed to hover like the sword of Damocles. The threat of missing cricket season because of these blights on academia really caused me some sleepless nights. It was just like a footy or a cricket grand final every six months for the first three years and then every eight to ten weeks in the latter three years. The pre match nerves would have me vomiting on the way to exams. The irritable bowel would kick in. The pimples would swarm. I reflected on the social stratification of the lecture hall. There were the cool kids up the back. Kitted out in their country road gear, they were often called the ‘beautiful people’. I suppose by inference that made me part of the ‘ugly people’. The blokes were all at consummate ease when they flirted with their female equivalents. They had all the moves and all the banter. They all seemed to breeze through exams. Girls wanted to be with them and blokes like me wanted to be them. I would have been thrilled if anyone in the back three rows even talked to me. The front three rows were full of kids with coke bottle glasses, tape recorders and conscientious demeanours. A lot of the students from overseas habituated there. While I was scoring a home cooked meal every night and had my Mum bending over backwards to help me through, these kids were looking after themselves as well as
studying. They had it tougher than me. A big mob of fellas sat in the middle of the class. They wore chequered shirts and R M Williams boots and spoke a bit slower, even than me. They were from the west or the north of our great state. I used to love hearing about farm life. I had a mate from Nambour and I reckon he knew more about pineapples than anyone else in Australia. He was wasted in medicine. I really was in awe of their altruism. Most of them would be heading back to rural life to look after their local communities. As I look back now, there were plenty of positives to come out of med school for me. Going to med school taught me to talk to people and taught me how to relate to people from all walks of life. As a painfully shy kid, it did me a world of good. I even learnt to talk to girls. And so to the reunion. No matter what differences we all may have had, we at least had one huge thing in common. We shared six enormously life defining and character shaping years together. Tragically I was overseas on a cricket tour at the time and so I had to send my regards to my old class mates by proxy. I would have loved to have spent an evening reminiscing and immersing myself in nostalgic yarns. I wonder if the beautiful people were still beautiful and if the country folk still talked a bit slower. I bet my mate still knows his pineapples. Q
lifestyle
All about you Pistachio and pomegranate cake Rachel khoo’s kitchen notebook $39.99 From all good bookstores
300g natural yoghurt 100g pistachios, ground 150g caster sugar 150g sunflower oil 2 eggs, lightly beaten 1 tsp vanilla extract
300g plain flour 2 tsp baking powder 1/2 tsp sea salt 1/2 a pomegranate 250g icing sugar 50g natural yoghurt
Preheat the oven to 160°C (fan). Mix together the caster sugar and oil with an electric hand whisk or the whisk attachment for two minutes, until the sugar has dissolved. Gradually add the eggs and vanilla extract. Fold in the yoghurt, then add the flour, baking powder, salt and ground pistachios and gently fold them in. Spoon the batter into the tin. Bake for 50 minutes or until a skewer comes out clean. When the cake is cool, place the pomegranate skin side up in your hand with your fingers spread out. Hold the pomegranate just inside a big bowl before hitting the back of the fruit with a wooden spoon. The seeds will fall through the gaps between your fingers. Sift the icing sugar into a bowl, add the yoghurt and mix well to get a thick pouring consistency. Pour on top of the cooled cake, gently guiding it down the sides. Once the icing has stopped dripping, take the pomegranate juice and dot several drops along the top of the cake.Q
Last Week Tonight with John Oliver Described by The Washington Post as “another scathing, stick-it-to-’em critique of American mass media and politics shellacked in satire and delivered by a funny if almost off-puttingly incredulous man with a British accent... the goal is to make elected and appointed officials, as well as just about any corporate enterprise, look foolish and inept while slyly culling together television news clips that make the media look equally inept at covering such evident truths”. Check John Oliver out on YouTube as he hammers everything from the Miss America pageant and gun control to tobacco and sugar.
The News: A User’s Manual Alain de Botton
Why do we keep checking the news? Today, the news occupies the same dominant position in our lives as religion once did. But rarely do we consider how it touches us. Here, Alain de Botton examines a number of archetypal news stories - a plane crash, a murder, a political scandal, a celebrity interview - from a fresh perspective to ask intriguing questions: why do disaster stories titillate? Why obsess over love lives of the famous? Why smile when a politician falls from grace? In so doing, he brings clear sight and understanding to a force which, above all others, informs our view of reality.
APP SNAP Shoeboxed If you are in very real danger of drowning in receipts, Shoeboxed is an app that could help you track your expenses on your phone. Snap a picture and Shoeboxed will extract the vendor, total amount, payment method, date and also categorise the receipts into the most common tax categories. You can also instantly create expense reports (with original receipt images) that you can send right from your phone. The mobile app is linked to your account at Shoeboxed.com which you can access from any computer. It also integrates with nearly every popular accounting solution for bookkeeping services. DoctorQ May 2015
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In Print
General Practice Psychiatry General Practice Psychiatry is compiled by a combination of practitioners and academics working in general/family practice, psychiatry and psychology. As General or Family Practitioners (GPs) are often the first contact for clients with mental health issues, this book focuses on higher prevalence disorders and common problems that GPs may encounter, and offers a systematic, highly practical, problem-based approach to their diagnosis and treatment. General Practice Psychiatry also offers current guidelines on pharmacotherapies regularly used in the treatment of such psychiatric disorders and illnesses.
Doctor Q has a copy of General Practice Psychiatry to give away. Simply fill out your details in block letters on the form and fax it to (07) 3856 4727 or email editor@amaq.com.au.
Entries close 30 May
General Practice Psychiatry is published by McGraw-Hill Education and retails for $79.95. Q
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DENDY WINNERS
QPAC winners
Book WINNER
Double pass winners
Dr Jennifer Lockwood won a double pass to Expressions Dance Company’s The Host, thanks to the Queensland Performing Arts Centre.
Dr John Earwaker won a copy of Beneath the Surface: Medical Imaging, Radiotherapy, Nuclear Medicine and Children’s Healthcare: A Queensland Chronology by Professor John Pearn.
1. Dr Photene Weber 2. Dr Allan Tham 3. Dr Pauline Johnson 4. Dr Su Mien Yeoh 5. Dr Tim Briggs 6. Dr Ruth Susnja 7. Dr Nigel Dore 8. Dr Marjorie Busby 9. Dr David Clark 10. Dr Noel Saines
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Your new day starts today live the lifestyle you dream of at beautiful Peregian Beach, Sunshine Coast.
A position is available for a GP VR or Non VR, 3-4 days per week, fully Accredited and computerised, Practice Nurse and full reception support. DWS available. Great remuneration.
Email Practice Manager: julie@peregianfamily.com.au
SPECIALIST ROOMS FOR LEASE
Sunshine Coast General Surgeons have modern specialist rooms available for lease on the ground floor of the Sunshine Coast University Private Hospital. They are available on a full-time basis or for sessional times. Included in the lease are electricity and cleaning. We are able to offer full secretarial services if required.
Please contact our practice manager, Robyn Blackmore, for further information on 07 5493 7018, or reception@scgensurg.com.au
P: 07 5437 9788 F: 07 5345 5276 Suite 20, Sunshine Coast University Private Hospital, 3 Doherty St, Birtinya www.sunshinecoastgeneralsurgeons.com.au
PSYCHIATRIST REQUIRED FOR PRIVATE PRACTICE IN CAPALABA We are looking for a Consultant Psychiatrist to join our team in a well supported private practice. We will provide not only a consulting room but the equivalent of at least five to eight sessions with patients to fill your initial private practice needs.
Minimum requirements: Applicants must have FRANZCP and specialist registration with AHPRA. Our practice is well established and has been providing services in Capalaba for the last five years and offers both Psychiatric and Psychology services.
The centre has ample parking, is close to public transport and major shopping centres. The position has excellent potential to be both personally and financially rewarding.
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Financial products and services described in this document are provided by BOQ Specialist Bank Limited ABN 55 071 292 594 AFSL and Australian Credit Licence 234975 (BOQ Specialist). BOQ Specialist is a wholly owned subsidiary of Bank of Queensland Limited ABN 32 009 656 740 (BOQ). BOQ and BOQ Specialist are both authorised deposit-taking institutions in their own right. Neither BOQ nor BOQ Specialist guarantees or otherwise supports the obligations or performance of each other or of each other’s products. BOQ Specialist is the credit provider. 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. BOQ Specialist is not offering financial, tax or legal advice. You should obtain independent financial, taxDoctorQ and legal advice as appropriate. May 2015 BOQS001163 01/15