WINTER 2016 VOL. 99
RESIDENT HOSPITAL HEALTH CHECK THE SLIPPERY SLOPE OF HEALTH SERVICES IN COMMUNITY PHARMACIES GEARING UP FOR THE ANNUAL CONFERENCE IN INDIA
FEDERAL ELECTION 2016
Doctor Q is free to AMA Queensland Members
CONTENTS 4
FROM THE EDITOR’S DESK
6
PRESIDENT’S REPORT
8
CEO’S REPORT
26
CDT UPDATE: NEW TEAM, BRIGHT FUTURE
30
WHY BECOME AN ASMOFQ UNION DELEGATE?
42
MEMBER NEWS: RESILIENCE ON THE RUN - JUST WHAT THE DOCTOR ORDERED
72
CHANGING QUEENSLAND CHILDREN’S LIVES THROUGH FAST-TRACKED ENT SURGERY
CURRENT ISSUES 16
MEDICARE FREEZE
28
20
CLEAR VISION TO PROVIDE CLARITY FOR DOCTORS AND PATIENTS
QUEENSLAND BOARD OF THE MEDICAL BOARD OF AUSTRALIA - FRIEND OR FOE?
34
IS YOUR PRACTICE’S PRIVACY POLICY COMPLIANT?
ON THE ROAD TO THE HOLY GRAIL OF HEALTHCARE
67
QUEENSLAND MUMS AND DADS REVEAL PARENTING CHALLENGES
22
PEOPLE & EVENTS LOCAL MEDICAL ASSOCIATION ROUND UP
A DAY IN THE LIFE OF A MÉDECINS SANS FRONTIÈRES DOCTOR
44
NEW MEMBER LIST
46
OBITUARY: DR FRANK SULLIVAN OAM
RESEARCH FELLOWSHIP SUCCESS
48
JDC SPEAKER PROFILE: PROFESSOR FIONA WOOD AM
50
ANNUAL CONFERENCE SPEAKER PROFILE: PROFESSOR KAMESHWAR PRASAD AND DR ANJALI JIAPRAKASH
24
THE SLIPPERY SLOPE OF HEALTH SERVICES IN COMMUNITY PHARMACIES
RESEARCH EVENING WRAP UP
14
ON THE ROAD PHOTOS
32
36
38 CALENDAR
BUILDING YOUR CAREER THROUGH RESEARCH Members turned out in person and via webinar to hear from a panel of medical research experts.
16
MEDICARE FREEZE 40
12
12
The Medicare rebate freeze promises to take prime position in the Federal election campaign.
18
FEATURES 18
RESIDENT HOSPITAL AND HEALTH CHECK
BUSINESS TOOLS 52
BIG CHANGES TO SUPER DEMAND ACTION
58
REVISED REGISTRATION STANDARDS FOR 2016
54
PRIVATE HEALTH INSURANCE: WHAT’S IN THE JUNK?
60
THE VALUE OF INCOME PROTECTION INSURANCE
55
ADVANCE YOUR LEASE PAYMENTS
62
YEAR END TAX PLANNING – ARE YOU READY?
56
ROOT CAUSE ANALYSIS
64
MEDICAL INDEMNITY - FIND THE BEST OPTION FOR YOU
RESIDENT HOSPITAL HEALTH CHECK We surveyed junior doctors throughout Queensland to find out who should be your first choice when it comes to RMO applications.
48
LIFESTYLE 66
DENDY MOVIES
70
ALL ABOUT YOU
68
CHECK IN TO THE ICEHOTEL
71
69
LE MESNIL IS HERE
OCKER DOCTOR: WHAT’S IN A NAME?
74
IN PRINT
PROFESSOR FIONA WOOD AM Catch burns treatment pioneer Professor Wood at this year’s Junior Doctor Conference.
PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT REGULARS FEATURES REPORT EVENTS TOOLS
EDITOR’S DESK June is always a very busy time at AMA Queensland. We’re running around organising the Dinner for the Profession, looking at renewals, putting the final touches on the Junior Doctor Conference and gearing up for the June Council meeting with a few new Councillors to get started.
Throw in a federal election and AMA’s National Conference and it makes a busy time for staff and members alike. Me? I’m always happy to see an article from a member with an issue to raise or a problem to solve. Contact me at editor@amaq.com.au. Q
NOTICES Graduates from the University of Queensland’s MBBS 1971 are having a 45-year celebratory reunion conference at Twin Waters Resort, Mudjimba, from 7-9 October 2016. Enquiries to Dr M Busby cmbusby@tog.com.au or 0408 782 032.
Board of Directors Dr Chris Zappala President
Dr Kirsten Price Honorary Secretary
Dr Shaun Rudd Chair of Board and Council
Dr Dilip Dhupelia Appointed Director
Dr Bill Boyd Vice President Dr Bav Manoharan Treasurer
The following AMA Queensland members have recently passed away. Our sincere condolences to their families.
Dr Tom Arthur Gold Coast Area
Dr Geoffrey Hawson Retired Doctors
Dr Sharmila Biswas Far North Area
Dr Scott Horsburgh General Practitioner Craft Group
Dr Kimberley Bondeson Greater Brisbane Area Douglas Brown Medical Student Observer Dr Lisa Byrom Greater Brisbane Area Dr Thomas Campbell Greater Brisbane Area
Dr Sarah Coll Specialist Craft Group Dr Dilip Dhupelia Part-time Medical Practitioner Craft Group
Dr David George KIDD
Dr Peter James RYAN
General Practitioner Late of Toowong Member for 51 Years
Radiologist Late of Surfers Paradise Member for 57 years
Dr Jim Finn Full-time Salaried Medical Practitioner Craft Group
Dr Barry Anthony SMITHURST
Dr Umeshchandra DHANJEE
Physician Late of St Lucia Member for 65 years
Orthopaedic Surgeon Late of Middle Range Member for two years
Dr Katherine Gridley Greater Brisbane Area
Dr Andrew Malcolm JENKINS
Dr William James MATTHEWS
Surgeon Late of Ashgrove Member for 43 years
Radiologist Late of Malvern East, VIC Member for 70 years
Dr Francis Patrick SULLIVAN OAM
Dr William Ashton Robert BROWN
Ophthalmologist Late of Ascot Member for 61 Years Dr Reginald Sydney NEILSEN
General Practitioner Late of Nanum Member for 59 years
General Practitioner Late of Scarborough Member for 61 Years
Dr Sharmila Biswas Appointed Director
Council
Dr Matthew Cheng Doctors in training
OBITUARIES
Dr Richard Kidd Appointed Director
Dr John Hall Downs and West Representative
Dr Richard Kidd General Practitioner Craft Group Professor Steve Kisely Greater Brisbane Area Honor Magon Medical Student Group Representative Dr Bav Manoharan Greater Brisbane Area Dr John F. Murray Specialist Craft Group Dr Paul Neeskens General Practitioner Craft Group Dr Alex Ritchie Specialist Craft Group Dr Anil Sharma International Medical Graduate Representative Dr Harley Wilson Capricornia Representative
AMA Queensland Secretariat Jane Schmitt Chief Executive Officer Filomena Ferlan General Manager Corporate Services
Holly Bretherton General Manager Member Relations and Communications
. Editor: Michelle Ford Russ Graphic Designer: Nathan Pitt Journalist: Rachael Barr Advertising: Louise Glynn
Disclaimer – All material in Doctor Q remains the copyright of AMA Queensland and may not be reproduced or transmitted in any form without permission. While every care is taken to provide accurate information in this publication, the material within Doctor Q is for general information and guidance only and is not intended as advice. Readers are advised to make their own enquiries and/ or seek professional advice as to the accuracy of the content of such articles and/or their applicability to any particular circumstances. AMA Queensland, its servants and agents exclude, to the maximum extent permitted by law, any liability which may arise as a result of the use of the material in Doctor Q.
4 | Doctor Q Winter
Doctor Q is published by AMA Queensland Phone:
(07) 3872 2222
Address: PO Box 123, Red Hill QLD 4059 Email:
amaq@amaq.com.au
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PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT REGULARS FEATURES REPORT EVENTS TOOLS
PRESIDENT’S REPORT A couple of years ago I was at a meeting of a large medical staff association and there was animated discussion about what recommendations the MSA (MSA) should/could make to the hospital management regarding new executive director positions being considered. Without discussing otherwise, there was an entrenched pervasive view that while we fervently hoped the appointees would be medical and unanimous agreement they would optimally fulfil the prescribed duties, it was completely inappropriate for the MSA to say so at risk of offending other tribal groups within the hospital or being regarded as arrogant. When did we become so intimidated - and by what exactly? The erosion of strong medical leadership over the years represents a huge loss for our profession. The unbelievable thing is - not only did we let it happen, we encouraged it by being so timid and afraid of causing offence for not being seen to ‘muck in’. After the debacles of the last decade (Bundaberg Hospital, etc) and the subsequent cleansing government reports, it was clearly recognised that medical leadership was lacking. The pendulum started to drift back towards medical officers in senior leadership positions. That didn’t last long though! Who remembers that the Chair of the Medical Board of Queensland is not a doctor at all (but a nurse) and only four of the nine members are even doctors (unlike in other states)? I wonder what would happen if a doctor became the head of the Nursing and Midwifery Board of 6 | Doctor Q Winter
Australia? The nurses wouldn’t stand for it and nor should they – so why do doctors? The medical superintendent used to run hospitals – and I mean really run them. You knew who they were and their word was law. Now our medical leaders all are forced to manage upwards to their HHS and department overlords, not downwards to the staff and patients who depend on them! This is actually the crux of many of our problems. This unfortunate circumstance has developed partially because our medical leaders are often made scapegoats for disasters out of their control. We should never let this happen and there have been a few precious examples of when the medical staff have found their voice over such an injustice. Thank goodness! The Department of Health garners an enormous plethora of statistics from public hospitals and comparatively little from private hospitals, even though they licence them! But this cannot really affect change at the level where we need it to make us safer, more resilient to attack from regulators or fund holders and better at our jobs. The nuance of conducting effective peer review and clinical audit, dealing appropriately and early with bullying/harassment and conducting positive, useful performance review rests with our hospital and department leaders – in both public and private hospitals. This, however, is where our biggest gap is. I worry that our beleaguered and sparse medical leaders are preoccupied managing the interminable demands of the uninvolved bureaucratic overlords. Also dissuaded from
undertaking any clinical work if they desire, our medical leaders are in danger of losing sight of genuinely helping the doctors who depend upon them. I’m reasonably sure (hopeful?) that this is not their design. We desperately need to support our directors to amend their focus and philosophy back to what I’m sure they would prefer to be concentrating on – improving the doctor-patient experience. The changes we need to repel Medibank and the burgeoning burden of medical regulation, to turn the tide on the bullying/harassment threat and ultimately make us better doctors, has to be catalysed by our unit/division directors and medical superintendent/ executive directors of medical services. Besides the profession trading them away to obsequiously appear more inclusive, Queensland Health has disempowered them ‘Yes Minister’ style by overloading medical leaders with sometimes spurious tasks and disconnecting them from clinical practice. This is all compounded by a startling shortage of our colleagues willing to undertake these critical roles within our hospitals. All of this must stop. Doctors need to
“DOCTORS NEED TO RECLAIM THEIR STATURE AND SELFESTEEM, SO WE HAVE CONFIDENCE TO FILL ALL LEADERSHIP ROLES AND DO THEM WELL. ”
reclaim their stature and selfesteem, so we have confidence to fill all leadership roles and do them well. Moreover, we need to support our colleagues taking on these challenging roles to make the necessary improvements – even if this exposes a few uncomfortable home truths. This is across all departments, public and private, from the Cape to the Tweed. I’ve signed up for a second year as AMA Queensland President and I dedicate this time to increasing and empowering medical leadership (and as a flow on effect improving organisational culture and patient safety). I earnestly believe we must make progress in this regard or our profession (and patients) will suffer a gradual loss in all things that matter, and we will be increasingly exposed to attack from all quarters. No more should we endure non-medical directors and we should stand up and be clear in our reasonable view that doctors are best in these crucial jobs and support them when our medical leaders do stand up for good practice and governance. I’d like to see the Medical Superintendent/EDMS retain a minor clinical role and be truly empowered in public and private hospitals – but by the profession. Our medical leaders must do better at making our profession more cohesive, more resilient and in advocating for their doctors, not always ‘the system’ or in chasing the next dollar. I’m unperturbed by the prospect of having to exhaust myself convincing you all, that we can and must do this. Q
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Doctor Q Winter | 7
PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT REGULARS FEATURES REPORT EVENTS TOOLS
CEO’S REPORT Federal election The Federal election is not far away now and the AMA has called on the major parties to immediately reverse the Medicare indexation freeze and lift future indexation of patient rebates to levels that cover the true cost of providing high quality health services. It is an issue that promises to play a central role in the campaign. Read more on p16. The AMA is also advocating for greater certainty in public hospital funding and a genuine interest in health policy, not just fiscal policy. See the Key Issues for the 2016 Federal Election document at ama. com.au/article/key-health-issues-federalelection-2016 Creating healthy workplaces Comparisons have often been drawn between the fields of law and medicine – a natural parallel given each field’s complexity. Legal and medical professionals both work long hours and make challenging decisions on a daily basis – the results of which can often have serious impacts for patients and clients. These shared stressors contribute to one additional shared characteristic of the legal and medical fields: a heightened risk for anxiety, burnout, depression and stress. Over the last several years, AMA Queensland has been working to better support the health and wellbeing of members. In 2014, we launched our Real Hours Audit to determine how many hours junior doctors were really working, and last year we launched our Resilience on the Run program aimed at providing doctors with the resilience and coping skills necessary to thrive in the field of medicine. Additionally, at a federal level, we have been working to address concerns about bullying and harassment in the medical profession. These initiatives are critical steps in the right direction, but more must be done at the HHS level to ensure healthcare employees are working in a positive, collaborative and healthy environment. 8 | Doctor Q Winter
Tristan Jepson was a young lawyer and comedian who took his own life just before his 25th birthday. It came as an immense shock to his friends and coworkers, who had no idea about his struggle with clinical depression. His parents created the Tristan Jepson Memorial Foundation (TJMF), under which voluntary guidelines1 were developed to both improve and maintain a positive and healthy workplace environment. The guidelines are based on 13 evidencebased psychological factors that characterise a healthy workplace, including leadership, civility and respect, engagement, recognition and reward, balance and workload management. Whilst there are many frameworks around, these guidelines are evidence-based and have a very practical application. They build on a range of international and national activities, including the work of the Mental Health Commission of Canada, under the auspices of the Canadian Standards Association and the Bureau de Normalisation du Québec, and, in Australia, the Mental Health Alliance. Originally labelled for the legal profession in Australia, the TJMF is very keen for all workplaces to utilise the guidelines. Around 120 legal firms have now signed up to implement the guidelines. I strongly encourage HHSs and all medical practices to adopt the guidelines, which are adaptable to organisations of any size, location or specialty. If you require assistance in branding these guidelines for your practice, AMA Queensland is ready to assist and can put you in contact with TJMF. View the guidelines now at www.tjmf.org.au. Workplace relations team on tour In April and May, our Workplace Relations Team hosted a series of workshops in 11 locations throughout Queensland. Focused on consulting to avoid unfair dismissals, the workshop outlined the correct process for managing underperformance or dealing with difficult staff members.
The workshops were well-attended with over 300 attendees. Throughout the series, it was found that 28 clinics had a claim against them to the Fair Work Commission for unfair dismissals. Whilst not all employees were successful with their allegations, this underpins the importance of understanding the correct process when managing staff. Our Workplace Relations Team highlights how AMA can support you through a broad range of workplace issues, including managing employees, dealing with complaints, industrial awards and pay disputes. Contact our team on (07) 3872 2222. Upcoming events Winter is always a busy time for AMA Queensland, with a range of events and professional development opportunities on offer. At our upcoming Junior Doctor Conference, we will be joined by a range of inspirational speakers and professional development experts. Additionally, the conference offers doctors in training and medical students the unique opportunity to share their research and experiences with their peers in a collaborative and supportive setting. Finally, the AMA Queensland Annual Conference is fast approaching. This year we are venturing to India to explore the topic of Research – turning it into reality. With such a rich history that has made innumerable contributions to medicine, it is bound to be an unforgettable experience. Read more about our two keynote speakers on p50. If you would like to register for any of these events, please contact the AMA Queensland Events team or look out for registration information in Online News. Q http://www.tjmf.org.au/raise-the-standard/theguidelines-at-a-glance/
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Important Information: *Available to eligible customers with a Commonwealth Bank business transaction account and a linked Commonwealth Bank eligible merchant facility. ‘Same day’ includes all card sales made up to until 10pm (AEST). Third party products not included, which includes payments from Medicare and private health funds for claims processed. Everyday Settlement applies to EFTPOS and gap payments, which are treated as normal credit/debit transactions (for Commonwealth Bank account holders). Funds received by a practice for Medicare and private health funds claims are processed by the relevant organisation (Medicare or private health fund) and are processed according to their timeframes. Applicants for this offer consent to their name and merchant identification being provided to AMA Queensland to confirm their membership and eligibility for the offer. 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 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. Full fees, charges, terms and conditions are available on application. Commonwealth Bank of Australia ABN 48 123 123 124. Doctor Q Winter | 9
PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT REGULARS FEATURES REPORT EVENTS TOOLS
LEXUS OF BRISBANE lexusofbrisbane.com.au
LEXUS OF SOUTHPORT lexusofsouthport.com.au
1. 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. 2.. Eligible employees must provide such about-us/benefits for full terms and conditions. *Offer applicable to Private and ABN buyers, who are current members of AMA Queensland, on all new vehicles purchased between 1st January - 31st December 2016 and delivered 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/ between the 1st January -31st December 2016. Points paid on total net contract price of vehicles after discount but before trade-in.
10 | Doctor Q Winter
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FEATURES OF THE LEXUS CORPORATE PROGRAMME: • • • • •
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Complimentary service loan vehicles or pick-up/drop off during servicing Lexus DriveCare providing 24 hour roadside assistance Lexus Exclusive Events “Beyond by Lexus” Magazine
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Priority invitations to Lexus of Brisbane Group corporate events Dedicated Lexus of Brisbane Group representative for all enquiries Access to the Lexus of Brisbane Group’s Airport Valet Parking - collection and return service from Brisbane Airport3 Earn one Qantas Point for every dollar spent on the purchase of a new Lexus*
The Lexus of Brisbane Group looks forward to our partnership with AMA Queensland and their members. To discuss these benefits offered to you as a AMA Queensland member, phone or SMS our dedicated Lexus of Brisbane Group representative Derek Klette today. Derek Klette | Group Sales Manager derek.klette@lexusofbrisbane.com.au | 0419 723 937
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documentary evidence as Lexus or the Lexus Dealer may require to confirm entitlement to receive factory support. Terms and conditions apply. See your Lexus dealer for further details. 3. Visit http://www.lexusofbrisbane.com.au/about/ by 31st January 2017. 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. 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
Doctor Q Winter | 11
PEOPLE & EVENTS
BUILDING YOUR CAREER THROUGH MEDICAL RESEARCH
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More than 120 members came along to, or tuned in to, our research evening to hear an expert panel discuss choosing the right research project and partners, as well as tips for getting published and presenting research cogently. Speakers on the night were:
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Professor John McGrath, Director of the Queensland Centre for Mental Health Research and conjoint Professor at the Queensland Brain Institute; Professor Brett McDermott, Professor of Psychiatry, Townsville Clinical School College of Medicine and Dentistry, James Cook University; Dr Henry Tsao, Senior House Officer, Caboolture Hospital; Dr Carina Chow, Colorectal Surgeon, Mater Hospital; and
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Professor Anthony FT Brown, Senior Staff Specialist, Department of Emergency Medicine, Royal Brisbane and Women’s Hospital. A special thanks to our sponsors who make free member events like this possible: BOQ Specialist, Experien Insurance Services, MDA National, Doctors’ Health Fund and Brisbane BMW. Q
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1. Haydn Dodos and Lisa Scupham 2. Drs Hayley Man and Emily Shao 3. Christopher Uber and Douglas James 4. Kate Bastick asks a question of the panel 5. The research evening panel: Dr Henry Tsao, Professor Anthony FT Brown, AMA Queensland President Dr Chris Zappala, Professor Brett McDermott, Dr Carina Chow and Professor John McGrath.
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www.svphb.org.au Doctor Q Winter | 13
PEOPLE & EVENTS
HEALTH HUB Carrara Markets, 15 May and Cairns Esplanade, 12 March
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AMA Queensland has hosted a number of Health Hubs around Queensland so far this year, with more planned for the second half of the year. The Health Hubs are designed to promote the importance of a regular GP check-up and the importance of a patient-centred medical home as the larger picture. Q 1. Shane Power from Respiratory Services Queensland, Karen Bucholz from Diabetes Queensland, AMA Queensland Councillor Dr Sarah Coll and Vice President Bill Boyd at the Cairns Esplanade Health Hub. 2. Shane Power from Respiratory Services Queensland, AMA Queensland Councillor Dr Matt Cheng and Dr Sonu Haikerwal.
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TRANSITIONING TO PRIVATE PRACTICE Hunstanton, AMA Queensland, 14 April A panel of experts on transitioning to private practice discussed legal structuring; finance, accounting and tax considerations; along with issues to consider when employing staff and how to best mitigate risk at the recent Transitioning to Private Practice seminar.
14 | Doctor Q Winter
Thanks to our speakers from William Buck, TressCox Lawyers, BOQ Specialist Bank, Medical and General Risk Solutions (MGR) and Experien. Q
ROCKHAMPTON NETWORKING Regent Hotel, 27 April Representatives from AMA Queensland joined the Central Queensland Medical Association for an information and networking night in Rockhampton. It was a great opportunity to discuss workplace rights, rostering issues, access to leave, policies and procedures, workplace culture and issues surrounding international medical graduates. Q
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1. Rockhampton Base Hospital Director of Orthopaedics Dr Adriaan Smith, Rockhampton Base Hospital Director of Clincial Training Dr Annette Turley, AMA Queensland International Medical Graduate Representative Dr Anil Sharma, AMA Queensland Vice President Dr Bill Boyd, AMA Queensland Capricornia Representative Dr Harley Wilson and AMA Queensland Treasurer Dr Bav Manoharan with Central Queensland Medical Association Treasurer Dr Madav Nagarkar 2. Attendees at the Rockhampton Information and Networking Evening.
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MEDICAL SOCIETY DAY Representatives from university medical societies all over Queensland came to Brisbane for the Medical Society Executive Education day. This annual free program covered the essentials of legal structuring, risk, governance, accounting, disaster and media management, events management, and marketing along with advice on building resilience and enhancing wellbeing. Q Doctor Q Winter | 15
CURRENT ISSUES
Your Medicare rebate will not increase until at least 2020. The cost of running this practice will rise substantially between now and 2020. You will pay a new or higher copayment every time you visit your GP, every time you visit other medical specialists, every time you need a blood test, and every time you need an x-ray or other imaging.
$
$
$ MEDICARE REBATE
AMA and AMA Queensland are deeply concerned about the government’s plan to extend the Medicare rebate freeze from 2017 to 2020. Originally introduced by the Gillard Labor Government in their 2013 Budget, the freeze was only meant to last for a short while. However the Abbott Government later extended the freeze until 1 July 2018. The Turnbull Government’s plan means the freeze will have lasted seven years.
GP VISITS
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X-RAYS
TELL YOUR LOCAL MPs AND ELECTION CANDIDATES YOU ARE NOT HAPPY
BLOOD TESTS
Prime Minister Malcolm Turnbull has called an election for 2 July 2016 and as per usual, the health portfolio will be a key battleground in determining how Australians cast their votes. The Medicare rebate freeze promises to be front and centre.
THE GOVERNMENT HAS CUT MEDICARE AND WANTS YOU TO PAY FOR IT
SPECIALISTS
MEDICARE FREEZE
YOUR HEALTH WILL COST YOU MORE
FOR MORE INFORMATION, GO TO
ama.com.au/nomedicarefreeze AustralianMedicalAssociation
ama_media
$
#nomedicarefreeze
This decision means patients will pay more for their care, and the viability of many medical practices will be under threat as the freeze stretches out to seven years. We do not believe that this is fair to patients or to the general practice sector because it will cripple general practice and force vulnerable patients to pay more for their medical care, potentially causing them to abstain from seeking treatment and creating further costs to the health system further down the road. In late May, the Australian Labor Party announced its election commitment to reverse the Medicare rebate freeze from 1 January 2017 if they were to be elected. AMA President, Professor Brian Owler, welcomed this move. “The medical profession has been united in its strident opposition to the government’s Medicare freeze policy, and we will campaign against it until it is withdrawn,” Professor Owler said. “Labor’s announcement means that there is a real difference between the major parties on health policy. Patients are the big winners from this announcement. It is a significant vote of confidence in general practice, and a boost to the health system for the benefit of all Australians.” 16 | Doctor Q Winter
Professor Owler said that GPs have for years done their best to shelter patients from the impact of the freeze, but the budget decision to extend the freeze until 2020 will push many medical practices over the edge. While we welcome this, health is a bipartisan issue and it is essential pressure is maintained on the Federal Government to reverse the Medicare freeze. Whatever the outcome of the election, Australians need to be confident that their health is being looked after. As part of this campaign, we have developed a number of resources which will help members explain the freeze and its consequences to their patients. These include: A Medicare freeze poster which you can display in your practice. We encourage you to use this as a tool to educate patients and encourage them to voice their concerns. The AMA guide for patients on how the healthcare system funds medical care to explain to your patients how their
health care is funded and why they might have out of pocket costs for their medical care. A template letter to patients about increased medical fees to tailor your practice’s information to your patients about how the Medicare freeze will impact the fees your practice charges for its services. Information for patients on registering bank account details with Medicare to assist a transition to patient billing for practices that cannot continue to bulk bill patients as a result of the Government’s indexation freeze. You can access all these resources and more at ama.com.au/nomedicarefreeze. This election presents a golden opportunity to put an end to a measure which should never have been implemented in the first place. We, therefore, encourage all members to get behind the No Medicare Freeze campaign to end the Medicare patient rebate freeze once and for all. Q
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Doctor Q Winter | 17
FEATURES
RESIDENT HOSPITAL HEALTH CHECK SURVEY In March 2016, the AMA Queensland Council of Doctors in Training (CDT) conducted a Resident Hospital Health Check Survey with interns, junior house officers (JHOs) and senior house officers (SHOs) across Queensland. The survey domains included hospital culture, access to annual and professional development leave, education, bullying and harassment, and overtime.
Approximately 350 junior doctors responded to the survey, representing about 16 per cent of the target population. Thirty-five per cent of respondents were interns, 42 per cent were JHOs (PGY 2) and 23 per cent were SHOs. A total of 57 per cent of respondents were female. A CDT working party determined a scoring system for each of the survey domains prior to data analysis and, from that, prepared a report card, available at www.amaq.com.au.
ACCESS TO PROFESSIONAL DEVELOPMENT LEAVE (PDL) 32 per cent of all respondents applied for PDL, however this included intern-SHO levels. It is important to note that whilst Interns do not accrue PDL, but may still apply for leave for attending conferences, courses or other professional development activities by utilising part of their annual leave or by arrangements to 1. Have you applied for professional development leave (PDL)
vary their roster. From the JHO and SHO cohorts, 45 per cent applied for PDL leave, and of these, 72 per cent of recent applications were approved. We found that the majority of applicants (80 percent) give their employers at least four weeks’ notice when applying for leave.
68% NO 32% YES
2. How long in advance did you apply for PDL?
62%
Greater than six weeks
18%
Four to six weeks
14%
Two to four weeks
3%
One to two weeks
3%
Less than one week
3. What difficulties did you encounter when applying for and obtaining PDL approval?
32%
No staff to backfill in your absence
38%
Unclear Process
11%
Other
15%
Told not to apply
4%
Administrative errors
Don’t forget that your AMA Queensland membership provides you with access to confidential, assured advice on any aspect of your employment, including rosters, overtime, access to professional development leave and bullying and harassment. Call AMA Queensland on (07) 3872 2222. 18 | Doctor Q Winter
HOURS OF WORK AND OVERTIME REMUNERATION Mediocre workplace culture does feature heavily in responses and unpaid overtime, as well as reasons for not claiming legitimate overtime, is highlighted. This survey supports the findings
12%
1. On average, how many actual hours do you work per fortnight?
and recommendations in the published AMA Queensland junior doctor overtime study conducted in 2014, which highlighted the existence of a culture of non-claiming of overtime.
101+
20%
91-100
64%
77-90
females. Twenty-six per cent were interns, 44 per cent were JHOs and 30 per cent SHOs. The source of bullying was varied but included reports of bullying and harassment by senior doctors, administration staff, nursing staff as well as fellow junior doctors.
1. Have you ever experience bullying or harassment from another staff member?
2. Have you witnessed another colleague being bullied?
Never Rarely
15%
Sometimes
Did not know claiming overtime was possible
6%
Advised not to claim by administration officer
Workplace culture expectations
17%
1%
Did not believe the amount of overtime worked was worth claiming
Other
4. Do you receive 14 days notice for any changes in your roster?
48% YES 52% YES
EDUCATIONAL PROGRAMS AND ABILITY TO PURSUE CLINICAL GOALS Positively, 60 per cent of all respondents rated the teaching and training provided at their hospitals as either ‘good’ or ‘excellent’. A similar proportion
felt that their hospital considered their preferences when allocating clinical rotations, thus supporting their career goals.
Strongly agree
If you would like to discuss any aspect of the AMA Queensland CDT Resident Hospital Health Check Survey in greater detail, please email cdt@amaq.com.au and a member of the team will get back to you. We invite any interested directors of clinical training, medical education units or other interested parties, who wish to learn more about the results pertaining to their
39%
Workplace culture expectations
about it?
14%
2%
4%
54%
3. If you did Strongly disagree witness another Disagree colleague being Neither agree bullied, did you nor disagree feel there was anything you Agree could do
14%
3. If you did not claim overtime payment, what was the reason?
29%
35% 34%
Usually Always
20%
40% YES
34% YES
7% 9%
2. If you were asked to complete un-rostered overtime and submitted the hours on your timesheet for payment, how often was it paid?
It is disappointing that bullying and harassment remains an area of grave concern and danger for early career doctors. The results from this survey are worrying. Every hospital surveyed reported bullying. Sixty-four per cent of those bullied or harassed were
4%
76 or fewer
BULLYING AND HARASSMENT
18% Agree
location (and discuss possible ways of improving their conditions for prospective junior doctors), to contact us through cdt@amaq.com.au. The AMA Queensland CDT is comprised of volunteer doctor in training representatives from around the state and we look forward to working with you to improve the working conditions for our current and future doctor in training colleagues.
AMA Queensland Resident Hospital Health Check Survey Disclaimer The AMA Queensland Council of Doctors in Training Resident Hospital Health Check Survey was completed on a voluntary basis by Queensland doctors in training (interns, junior house officers and senior house officers). The purpose of this document is to assist graduating medical students as well as current interns and residents with their decision making process when deciding on which hospitals to apply for in the upcoming intern and RMO campaigns. This information is provided in good faith and should only be used as a guide and is intended to be general in nature and is made available on the understanding that the AMA Queensland and the AMA Queensland Council of Doctors in Training do not make any comment or assertion that the information provided by participants is correct, or reflects the experiences of doctors who did not participate in the survey. Before relying on the information contained in the survey results provided, users should carefully evaluate its accuracy, currency, completeness and relevance for their purposes, personal objectives and career goals, and should make their own enquiries, including consulting with the relevant Hospital and staff at the relevant Hospital. Whilst every effort has been made to ensure the accuracy of the collation of the information in this survey, AMA Queensland, its employees and the AMA Queensland Council of Doctors in Training cannot be held responsible for the information provided by participants in the survey and cannot be responsible for any loss or damage arising from any person or organisation as a result of the publication of this survey of information. AMA Queensland and the AMA Queensland Council of Doctors in Training do not take any responsibility for the outcomes published in the survey.
Doctor Q Winter | 19
PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT EVENTS TOOLS
CLEAR VISION TO PROVIDE CLARITY FOR DOCTORS AND PATIENTS
Recent news that Queensland’s waiting lists were not improving, despite a $14 billion spend on health, underlines something many AMA Queensland members – and their patients – know all too well. Being on a waiting list is like being in limbo – you know you’re somewhere, but you’re not exactly sure where that is, or how much longer you’ll be there for. While AMA Queensland members know that being put on a waiting list means being put into an outpatient urgency category, many of their patients likely wouldn’t know that. Someone put into category three, for which they can wait for a consultation for up to 365 days, may simply wonder why it’s taking so long for them to be seen by a specialist. If that patient follows up with their general practitioner about their referral, it’s just as likely that the GP will be as much in the dark about their patient’s place on the waiting list. There is simply no easy way for doctors or patients to access this information. AMA Queensland believes this needs to change. In part four of the AMA Queensland Health Vision, we have advocated for the development of a standardised online pathway for GPs and patients, which would allow them to track their position on the waiting list and the length of time to be waited. Many hospitals use real-time patient tracking data, so it shouldn’t be too difficult to provide the public with this kind of information. The development of a state-wide, standardised online pathway for GPs and patients would allow them to track their position and time on the waiting list and would help patients to make an informed choice about the type of care they access. The theme for Health Vision Part Four is about finding ways to unify the health system, which is currently riveted by divisions that have led to duplication, cost shifting and blame shifting. Unifying the health system would help to alleviate this problem, but this is easier said than done. There is a complex division of responsibility for health care services in Australia, with many types of providers and a range of funding and regulatory mechanisms. While a single-funder health system would be an obvious way to solve this problem, the reality of our health system is that such a solution would be decades away at best. Until a single funder is a reality, we believe the Queensland Government should look at ways in which it can improve connections between
20 | Doctor Q Winter
primary and secondary care. Health Hubs, which we advocated for in Health Vision Part Three, will be one way to do this, but more can be done. For this reason, Health Vision Part Four will also advocate for other solutions that can help achieve this outcome. Doing this doesn’t require monumental change. For example, under the Hospital and Health Boards Act 2011 there is already a legislative requirement for every HHS to “use its best endeavours to agree on a protocol with local primary healthcare organisations to promote cooperation between the Service and the organisations in the planning and delivery of health services.” Similarly, Primary Health Networks (PHNs) are also expected to develop collaborative working relationships with the Local Health Networks (LHNs) (or similar) within their geographic area. AMA Queensland believes these requirements could be utilised to improve connections developed as part of the Health Hub concept. Finding ways to formalise the relationship between HHSs and Health Hubs will help to improve coordination, identify gaps in service delivery to meet unmet need and prevent avoidable hospitalisations. Health Vision Part Four will be released very soon. Keep an eye on our website for more news on the Health Vision. If you have any feedback or comments on the Health Vision, please contact our Policy team via policy@amaq.com.au Q
Register today! Connecting General Practice Conference
Northern Queensland Primary Health Network would like to invite all health practitioners and their teams to attend the inaugural myPHN conference this July. This year’s theme ‘myPHN 2016: Connecting General Practice’ will focus on connecting health providers to deliver better health outcomes through general practice, Aboriginal and Torres Strait Islander medical services, allied health, pharmacy, dental and hospital and health services. Conference chair, Professor George Rubin, will lead an interactive two-day program including pre-conference workshops, a NQPHN Primary Care Providers Awards evening, and an Aboriginal and Torres Strait Islander Health Breakfast.
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Doctor Q Winter | 21
CURRENT ISSUES
PRIVATE PRACTICE AND THE AUSTRALIAN PRIVACY PRINCIPLES
IS YOUR PRACTICE’S PRIVACY POLICY COMPLIANT?
A recent assessment report by the Office of the Australian Information Commissioner (OIAC) examining the privacy policies of 40 general practices in Australia has highlighted the importance of ensuring your private practice has an effective privacy policy in place. A recent assessment report by the Office of the Australian Information Commissioner (OAIC), examining the privacy policies of 40 general practices in Australia, has highlighted the importance of AMA Queensland members ensuring they have an effective privacy policy in place, if they are involved in the management of a private practice.
how an individual may complain about a breach of the Australian Privacy Principles, or a registered APP code (if any) that binds the entity, and how the entity will deal with such a complaint;
The OAIC issued the General Practice Clinics APP 1 Privacy Policy assessment report in April 2016. The Australian Privacy Principles (APPs) are contained in the Privacy Act 1988 (Cth). APP 1 deals with the open and transparent management of personal information and requires a practice to have a clearly expressed and up-to-date privacy policy about the management of personal information.
if the entity is likely to disclose personal information to overseas recipients, the countries in which such recipients are likely to be located if it is practicable to specify those countries in the policy.
The AMA Privacy and Health Records Resource Handbook notes that APP 1 requires a practice’s privacy policy to contain the following information: the kinds of personal information that the entity collects and holds; how the entity collects and holds personal information; the purposes for which the entity collects, holds, uses and discloses personal information; how an individual may access personal information about the individual that is held by the entity and how to seek the correction of such information;
22 | Doctor Q Winter
whether the entity is likely to disclose personal information to overseas recipients; and
The report found that, despite the APP 1 requirements, the above information was not included in many of the privacy policies assessed. Dr Brian Morton, Chair of the AMA Council of General Practice, noted how critical it is for practices to be compliant with privacy legislation.“Privacy law is a very complex area and this report, which looked at a small sample of practices, is an important reminder that general practices should review and update their privacy policies on a regular basis,” Dr Morton said. If you want AMA Queensland’s Workplace Relations team to review your privacy policy or would like a copy of a recommended policy, please email workplacerelations@ amaq.com.au or phone (07) 3872 2211. Q
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Doctor Q Winter | 23
PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT FEATURES EVENTS TOOLS
THE SLIPPERY SLOPE OF HEALTH SERVICES IN COMMUNITY PHARMACIES Dr Edwin Kruys, AMA Queensland Council of General Practice member and Queensland Faculty Chair of the Royal Australian College of General Practitioners (RACGP) argues that while doctors are invariably accused of self-interest when raising concerns about pharmacy vaccination programs, there are more more important issues than business interests at stake.
New legislation in Queensland supports pharmacy-based health care services on the basis of pilots of feasibility, embellished as evidence of effectiveness. GPs are concerned and disappointed that, despite lack of independent analysis, these pilots have resulted in new legislation with little consideration given to the broader health impacts. This move is paving the way for an expansion into other pharmacybased health services, which have been successfully delivered in general practice for decades. It is also threatening the medical home model, which the federal government ostensibly supports. When doctors speak about concerns with pharmacy vaccination programs, they talk
24 | Doctor Q Winter
about evidence, quality, patient safety and fragmentation of care. However, these messages are heard as ‘self interest’. Pharmacists on the other hand talk about better access, availability and gaps in healthcare delivery due to excessive GP waiting times. Pharmacists are not heard as being self-interested, rather as providing a beneficial service for the community. Public health arguments are also intuitively compelling; to a public health advocate it doesn’t matter where vaccinations are delivered. However, these arguments need to be examined further. We have to look at the bigger picture and take into account adverse effects on our proven Australian general practice model, costs to the consumer, conflicts of interest of the pharmacy industry and issues with the Queensland vaccination trials. Proven general practice model Australia’s large network of general practitioners and their teams have been very successful in keeping Australians healthy at a low cost, compared to international standards. National surveillance data on vaccinepreventable diseases in Australia documents a remarkable success story for vaccinations delivered by general practice, which have caused extraordinary declines in child and adult morbidity, mortality and hospitalisations over the years.
“VACCINATIONS DELIVERED BY GENERAL PRACTICE HAVE CAUSED EXTRAORDINARY DECLINES IN MORBIDITY, MORTALITY AND HOSPITALISATIONS”
Major changes to our primary care model must be based on evidence and not just sound like ‘a good idea’. There is little evidence that delivering vaccinations and other health services via pharmacists will improve efficiency, safety or quality of care for patients. Although there is a convenience factor, people need to ask how commercial interests have been allowed to be placed before health benefits to the Queensland population. Issues with the trials In 2014 the Queensland Department of Health approved an application by the Queensland branches of the Pharmacy Guild Australia and the Pharmaceutical Society of Australia, which led to the start of two trials to vaccinate adults over the age of 18 at community pharmacies against influenza, dTPa (diphtheria, tetanus and whooping cough) and MMR (measles, mumps, rubella). Interestingly, no independent analysis of the trials seems to have been performed. The data that has been reported is superficial, selective and shows elements of observer bias. No analysis was undertaken to establish the clinical need for the vaccinations. No analysis was undertaken to determine what proportion of these vaccinations were high risk. The trials did not reveal evidence about the impact on vaccine-preventable disease outbreaks. There was no comparison with alternatives such as walk-in vaccination clinics in general practice. General practitioners frequently conduct opportunistic screening and preventive healthcare during consultations for vaccinations, but the impact of missed opportunities for screening and other preventative care in general practice was not looked at, and neither did the trials focus on much-needed better integration of care delivery. It seems no independent analysis was undertaken to determine whether
the standard elements of privacy, documentation or GP notification were met. Further, no mention of commercial add-on practices were monitored, for example, using vaccinations as a means to on-sell other products we know the pharmacy business model relies heavily on upselling products to consumers. The argument seems to be to improve vaccination coverage with claims of managing people ‘who have not been vaccinated’ – these claims are neither verified, nor explained; for example, are these new patients or inappropriate patients? It is a reasonable question as to why these claims have not been subject to closer scrutiny. The stakeholders’ evaluation contained leading questions, such as: “The results of the trials show that there is increased uptake of influenza vaccination among adults who have never previously been vaccinated or who were not regularly vaccinated. Do you consider this an important public health function?” This raises questions about the objectivity of the process. Conflicts of interest There is an inherent conflict of interest in pharmacists delivering general practice services including vaccinations. One of the great strengths of medication prescribing in Australia is the high degree of separation between the prescriber and the medication dispenser. This enables more objective prescribing, free of pecuniary interests and leads to better allocation of resources. This is a strong argument against moving more health services into the pharmacy environment.
“ONE OF THE GREAT STRENGTHS OF MEDICATION PRESCRIBING IN AUSTRALIA IS THE SEPARATION BETWEEN PRESCRIBER AND MEDICATION DISPENSER” The core role of pharmacy is to dispense medication safely and effectively, but the financial viability of pharmacies depends on operating successfully as small retail businesses. Concerns have been raised regarding the environment of pharmacy being more conducive to medication sales than primary care services. The pharmacy sector is seeking new ways to broaden its health services to provide new income streams, sometimes in conjunction with pharmaceutical companies with the prime purpose of profit. Commercialisation of pharmacy vaccinations has occurred overseas and here in Australia. For example, a pharmaceutical
company which produced vaccines involved in the trials, provided financial support to a pharmacy chain for their vaccination training. This illustrates the problem with delivering health services in pharmacies but this was not reported in the evaluation of the trials. If it ain’t broke… There is ample evidence that increasing general practice comprehensiveness of care is associated with decreasing costs and hospitalisations. However, each time a task is given to other providers, the effectiveness and safety of our current proven GP-model is eroded and this will ultimately have consequences for the care delivered to Australian communities. Despite concerns from doctors’ groups, the Queensland government announced in April 2016 that an amendment to the legislation now allows registered pharmacists to administer influenza vaccinations, diphtheria-tetanus-acellular pertussis vaccinations and measlesmumps-rubella vaccinations to adults.
“WE SHOULD AVOID A TRADEOFF BETWEEN OUR VALUES AND CREATING MONETARY VALUE” Pharmacists are ready to roll out more ‘enhanced pharmacy support services’ in the near future. The impact of patients presenting to pharmacies instead of general practice will result in more fragmentation of care, missed opportunities for screening and preventive health care, unnecessary and non-evidence based care, and possibly increased risk and wasted health resources. It also clashes with the innovative national medical home model. We should avoid a trade-off between our values and creating monetary value; recommendations for treatment and prescribing must only be evidencebased and should not be influenced by commercial factors. The AMA and RACGP Queensland should continue to monitor these developments, highlight the risks to policy makers and reinforce the message that we need evidence-based decision making in health care. It is dangerous to rely on short-term financial benefits at the expense of longterm, whole-of-system considerations. In the interest of all Queenslanders, decision makers should focus on strengthening general practice, not dismantling it. The RACGP remains committed to working collaboratively with both state and federal governments to develop innovative and effective models of care, and we strongly advocate for solutions that support integration, not fragmentation. Q Doctor Q Winter | 25
REPORT
NEW TEAM, BRIGHT FUTURE
CDT CHAIR Matthew Cheng CDT DEPUTY CHAIR Katherine Gridley VineshAppadurai PORTFOLIO LEADS Rural and Remote Etka Paw Jerry Abraham Alex Education and Training Zachary Tan Johnson Da Huang Communications Mila Dimitrijevic Industrial Relations Maryann Turner Events and Training Jay Gajera Emily Shao
AMA Queensland Council of Doctors in Training Chair Dr Matthew Cheng gives us an update on the three big issues for CDT right now: workplace relations, Resilience on the Run and professional development. It has been a busy start for the new AMA Queensland Council of Doctors in Training (CDT) team. Our focus has turned towards three main issues spanning across three domains affecting junior doctors. Under workplace issues we have conducted the Resident Hospital Health Check Survey, and are currently analysing the results, which will be published prior to the RMO campaign. Under junior doctor health, we expanded our successful Resilience on the Run program. Finally, under professional development our team has been working hard to deliver a relevant, insightful and highimpact Junior Doctor Conference held on 25 – 26 June. I am pleased to introduce our new team, and in particular your new hospital representatives. Each of them has demonstrated their passion and interest in representing 26 | Doctor Q Winter
you and advocating for better workplaces and health for all doctors in training. I encourage you to keep a look out and contact them if you face any issues in the workplace. Also if you are not represented at your hospital, but are keen on advocacy and would like to join the CDT as a hospital representative, please email: yourcdt@amaq.com.au. Resident Hospital Health Check You would have noticed that the Resident Hospital Health Check survey has now closed. We had an impressive 350 participants from hospitals spanning across the whole of Queensland, which was extremely encouraging and demonstrates the high level of engagement from junior doctors in affecting change to make better workplaces. Find a break down of the results on p18. Our goal is to give junior doctors information about access to leave and professional development, education quality, bullying and harassment, overtime and hours of work to help guide you when deciding which hospital to apply to. This will also give an opportunity for hospitals to recognise their strengths and weaknesses. Resilience on the Run CDT has worked hard over the past few years to produce the
HOSPITAL REPRESENTATIVES Gold Coast
Mater
Kendall Sharpe Devlin Elliott Mohammed Abdeem
Larissa Cowley
Logan Chris Maguire RBWH Alex Robinson Devlin Elliott
Rockhampton Meghan Beere Redland Hannah Bellwood Greenslopes Mila Dimitrijevic
PA
Townsville
Adam Keys Ross Smith Andrew Zammitt Lulu Zhang
Callum Smith Toowoomba
Nambour
Redcliffe
Cara Kajewski
Brook Riley
Mikaela Seymour
Cairns
Hervey Bay
Anna Mullins
Resilience on the Run program. After the success of the pilot program at Rockhampton Hospital, we are pleased to announce its expansion to Metro South hospitals. From May, Resilience on the Run programs were rolled out for interns and residents at Princess Alexandra Hospital, Logan Hospital and Queen Elizabeth II Hospital. We will be tracking the success of the program and, with the assistance of Queensland Health, plan to expand to other hospitals around Queensland. Junior Doctor Conference The AMA Queensland Junior Doctor Conference continues to grow bigger and better. The third annual conference will be held on 25-26 June at the Brisbane Convention and Entertainment Centre. The conception of the conference came from recognition by CDT that no conference in Australia was specifically targeted towards junior doctors. CDT decided to tailor a conference for junior doctors in order to inspire and equip attendees with tips to progress in their career. The conference was also designed to allow junior doctors to present their research. This year we have an amazing line up of speakers including Nobel Prize winner Peter Doherty, Australian of
Wilson Choi
the Year Fiona Wood and coauthor of Clinical Examination textbook Simon O’Connor. We also have professional development sessions on CV building and interview skills. If you haven’t already, register for the conference so you don’t miss out! I look forward to meeting you all at the Junior Doctor Conference and future CDT meetings. As always, if you have any questions or concerns, please email yourcdt@amaq.com.au Q
The AMA Career Advice Service and Resource Hub provides you with expert advice to support, guide and help navigate your medical career. The AMA’s Career Advice Service can assist you with: • Career advancement and coaching
• Addressing selection criteria
• Resume advice and model template • Global medical employment opportunity • Interview skills and tricks
For more information contact the AMA Career Adviser: Christine Brill careers@ama.com.au 02 6270 5483
ama.com.au/careers Doctor Q Winter | 27
PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT EVENTS TOOLS
QBMBA FRIEND OR FOE? The Queensland Board of the Medical Board of Australia will contribute a series of columns that aim to demystify, explain and expand upon the functions of the Board. Board Member Associate Professor David Morgan OAM explains the Board’s history and current standing.
First of all, a bit of history Up until 2008, states and territories in Australia operated in an essentially independent fashion with registration of health practitioners. At the Council of Australian Governments meeting (COAG) in that year, a proposal was adopted to establish a uniform process which would standardise the activities across our broad country. On 1 July 2010, the Health Practitioners Regulation National Law Act came into force. The national law and its goals The clearly stated goals are fivefold: Protection of public safety Facilitation of workplace mobility To assist high quality education and training The promotion of access to health services The development of flexible/ responsive work forces The Act underpins the relationship between the Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia. This is a symbiotic relationship with the Medical Board of Australia assuming primary responsibility for oversight of activities dealing with medical practitioners. AHPRA in turn provides the necessary mechanics for 28 | Doctor Q Winter
assessment, investigation, legal analysis, panel construction, health assessment reviews and submissions to the tribunal. A spanner in the works Everything appeared to be moving well following introduction of the national law until a series of complaints were made about the delay in handling notifications, the apparent inconsistency in determinations and rulings, and a sniff of leniency being adopted by the then Queensland Board in dealing with the practitioners. Reports were commissioned from Chesterman, Forrester and Hunter. A series of recommendations was made to the then Liberal-National Government in Queensland. The members of the Queensland Board of the Medical Board of Australia bore the brunt of these recommendations. Their appointments were the subject of a Show Cause notice from the Health Minister. Many resigned. Some had their appointments terminated. The Queensland Medical Interim Notifications Group (QMING) handled notification matters until the new Board was installed in January 2014.
cent of the membership was composed of medical practitioners, with the remaining half being made up of members from the community. 2. That the Chairman of the Medical Board of Queensland would be other than a medical practitioner. 3. That there would be a reorganisation of the processes adopted by AHPRA and its relationship with the Board. 4. That a regular reporting protocol would be established and maintained. But wait – there’s more! Unlike all other states and territories (with the exception of New South Wales), the reorganisation in Queensland went one step further. A bill was enacted by the Queensland Parliament creating the Office of the Health Ombudsman (OHO). The OHO began operating in July 2014.
There were many, but the following four appear to have had the greatest effect:
This installation created the Office of the Health Ombudsman as the first port of call for any complainant or any notifier dealing with registered and unregistered health practitioners in our state. The fourteen registered health practitioner Boards remained intact, as did their relationship with AHPRA.
1. That the board membership should be altered such that no more than 50 per
The primary difference meant that rather than receiving notifications directly, all
What were the key recommendations?
fourteen Boards would await a triaging process conducted by the OHO and deal with matters delegated accordingly. In medicine, the OHO retains all serious matters. Matters deemed to be not so serious are forwarded to the Medical Board via AHPRA for management. So what do we do? The Queensland Board of the Medical Board of Australia has three separate streams. They are Registration, Notification and Compliance. What’s next? I hope that this column contribution has laid bare the current landscape and whet your appetite to hear more. These separate roles of registration, notification and compliance will be expanded upon in subsequent editions. In the meantime, there is a very important concept to be grasped by the reader. The principal role of the Queensland Board of the Medical Board of Australia is for the protection of public safety. The Board is to always act as a model litigant, to refrain from any form of punitive action and to work in a collaborative and collegiate manner with all stakeholders. AMA Queensland members can be assured that their rights and interests are observed as scrupulously as all others. Q
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Doctor Q Winter | 29
PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT REGULARS FEATURES REPORT EVENTS TOOLS
WHY BECOME AN ASMOFQ UNION DELEGATE?
The Australian Salaried Medical Officers Federation Queensland (ASMOFQ) is currently working towards providing members with a greater localised response and access to a wider support network. To achieve this, they need your support. ASMOFQ is currently calling for both junior and senior doctors who are interested in acting as a union delegate for their hospital or health service district. The role of the union delegate is crucial as it provides members with a first point of contact to confidentially discuss the matter and options available to them. Union delegates will constantly be supported by the ASMOFQ industrial team. However, you may be the first point of contact for a variety of matters such as: understanding employment entitlements; raising local concerns with the ASMOFQ industrial team; supporting members to resolve matters of concern; and promoting the benefits associated with joining ASMOFQ or AMA Queensland to interested employees and at hospital inductions.
The environment today is supportive of the role union delegates play in workplace representation and resolution of matters. The Queensland Government Union Encouragement Policy acknowledges and encourages union involvement by: supporting and providing access to union delegates and officials; encouraging the establishment of consultative committees; and promoting reasonable and constructive paid leave for employees to acquire knowledge and competencies in industrial relations; If you have a few hours to spare each week, a genuine interest in gaining knowledge in relation to the employment entitlements for both junior and senior doctors in Queensland, and believe in ensuring workplace rights are upheld now and for future generations, we urge you to consider applying to become an ASMOFQ delegate. Please contact us on (07) 3872 2222 or asmofq@amaq.com.au. Q
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30 | Doctor Q Winter
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Doctor Q Winter | 31
PEOPLE & EVENTS
JILL PARKES-SMITH A DAY IN THE LIFE OF A MÉDECINS SANS FRONTIÈRES DOCTOR
Brisbane-based doctor Jill Parkes-Smith spent six months at Yida refugee camp in South Sudan working for Médecins Sans Frontières/Doctors Without Borders. In this extract from her blog she shares some of the challenges and explains why it is the most rewarding thing she has ever done. Welcome to Yida
The why
I have a three-year-old with tetanus. His face is locked in a tortured grimace and his back is held in an arched position. I have had him sedated for days, hoping he will survive. He may pull through, but we are so far from being in-the-clear and, in fact, death is a more likely outcome.
The small boy with tetanus survived and I was so incredibly happy to see him hobble out of the hospital. The road to total recovery will be a long one, but he’s alive! His grandfather was so impressed when we explained that the disease was vaccine preventable and pledged to bring all his kids and grandkids in. I was humbled by the tears that formed in his eyes and the two handed shake when he thanked me. Every day there are so many children that we see and for many of them access to even basic medical care is life saving.
It’s been just one week since I have arrived in the Yida refugee camp. This camp formed as a result of fighting in the Nuba Mountains, a contested region on the border between Sudan and South Sudan. The number of refugees here is somewhere in the order of 40,000-65,000, depending on whose figures you use and what time of the month it is. Our team is composed of eight international staff, which includes two doctors (and should usually be three). We all live in tents. Our food is basic but more than enough not to turn us to skin and bones. Both myself and the other doctor are busy. Our hospital has approximately six wards and 50 beds, however this number can increase to about 100, depending on the time of year. We are on call every third night, and second on call every other night. Frankly, we are also on call at all times, because a truck full of injured soldiers or rebels could come any time and we would have to be ready... 32 | Doctor Q Winter
Respite The extra doctor has arrived now and we are only on call every three to four nights, it is a blissful change. We now have had the luxury of sleep and, looking back, I’m frankly not sure how the other doctor and I survived. The soldiers and the rebels have also supposedly stopped fighting for the wet season. Life is looking good. Malaria season Is there anyone in this community who hasn’t had malaria? I feel as though we have seen every child in the camp and some twice or thrice during this malaria outbreak. Children seizing can be an hourly occurrence, resulting in us encouraging all the nurses to be armed with diazepam to stop seizures left, right and centre. I remember when a child seizing used to raise my anxiety
“THERE WERE SOME TEARS AND SOME SLEEPLESS NIGHTS, BUT THE CHALLENGES I FACED WERE NOTHING COMPARED TO THE CHALLENGES FACED BY THE PEOPLE” levels, now we are all used to managing two seizing children simultaneously while trying to continue our ward rounds. Malaria numbers are still increasing. We are seeing about 350 patients per day with malaria alone and we are admitting 25-30. To give an understanding of what we are experiencing, the number of simple cases of malaria is 10 times what it was at the same time last year and we are yet to reach the theoretical peak of the season. We have had over a thousand cases come through our hospital in the last calendar week. We have three doctors… we are flat out. It’s not all malaria Kala azar (otherwise known as visceral leishmaniasis) is spread by sandflies. It’s a deadly disease and one I had never seen until I came here. The treatment lasts for 17 days, with the patients enduring two injections into their muscles daily.
Copyright Yann Libessart/MSF
Watching people being cured of Kala azar is a beautiful journey. Patients stay in the hospital for a significant period, so you bond with them. And they literally look as though they are coming back from the brink of death. I had one young boy with this condition, who just left our malnutrition ward this week. It was the first time he cracked a smile and when he did it melted our hearts.
met. They shake your hand eagerly with two hands, hug you and comfort you when they are the ones that should be crying. I have things that I wish I had accomplished in my time here that I did not. I look at my hands and remember the vision of them performing compressions on the chest of a dying child. It is hard to forget. However, more often I remember the children that we worked to save and that walked out of the hospital. There were thousands and thousands. Home Taking time out of my career in Australia was one of the best decisions I ever made. I diversified my skills as a doctor, became a more compassionate and patient human and it gave me perspective. I am currently working to become a specialist. However, between now and then and certainly after I finish my specialty training, I will continue to use my medical knowledge to work with the most vulnerable people in our world and take on more opportunities with Médecins Sans Frontières. Médecins Sans Frontières is looking for paediatricians and doctors with paediatric experience to help deliver medical assistance to the people who need it most. You must be able to commit to a minimum of six months. Find out more on the MSF Australia website. www.msf.org.au/joinour-team/work-overseas/ who-we-need/paediatricians Q
Farewells I had my farewell party last night and at the staff meeting I was presented with a traditional necklace and wished well on my journey home. It’s very bittersweet leaving, but I feel a lot less guilty now that the malaria has settled right down. The Nuba are unlike any group of people I have ever Doctor Q Winter | 33
PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT EVENTS TOOLS
ON THE ROAD TO THE HOLY GRAIL OF HEALTHCARE
Dr David Rosengren, Chair of the Queensland Clinical Senate, discusses why now is the time for primary and acute care to start working together.
It’s a concept that must leave people outside of the health system questioning why it doesn’t already happen? But from inside the multi-faceted and complicated web that is our health system the idea of integrated care is a sizeable challenge. How do we get two systems, funded by different levels of government, working together, so that the experience for patients with chronic disease is better? Our patients deserve this - of this there is no doubt. There is also no doubt that Queensland clinicians and health administrators are committed to it. In October last year, delegates at the Clinical Senate’s integrated care meeting agreed on the importance of seamless integration in achieving a better experience for patients and allowing a sustainable health system. In response, Health Minister Cameron Dick announced the state’s $35 million Integrated Care Innovation Fund. The aim of the fund is “to invest in initiatives that generate new ideas for better integration of care, address fragmentation in services and achieve greater efficiency and value from health delivery systems”. There has been significant interest by healthcare organisations from across Queensland with applications received from every Queensland Hospital and Health Service (HHS) working in collaboration with their local primary healthcare networks (PHNs) and other community health providers.
34 | Doctor Q Winter
Integrated care is clearly gaining momentum in Queensland and this must be music to the ears of the more than 50 per cent of Queenslanders aged over 65 with a chronic disease. Their experience of navigating two systems that don’t work together must be frustrating to say the least. To ensure integrated care – the holy grail of healthcare – stays high on the agenda in Queensland, the Clinical Senate has put the topic back on its meeting agenda for October 2016. Bringing senior clinicians and health leaders back together will be an opportunity to revisit the outcomes of the first meeting and to focus on the finer details of what we, as clinicians and administrators, need to do to deliver on improved patient experiences and outcomes. We will again ask consumers to remind us how it feels to receive care in a fragmented system and what an integrated health system would look like to them. We look forward to hearing more about the government’s Integrated Care Innovation Fund and those successful in receiving grants. We must stay on this path to integrated care - with a rapidly ageing population the burden of disease on our health system and in our communities will rise. Now is the time for our health systems to take action so that we are better prepared to cope with this increased demand and improve the healthcare experience for patients. Q
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2016 Highlights: • GPCE & PNCE come together to form Australia’s largest primary care event! • Exciting new keynote sessions featuring the industry’s top innovators & influencers • Mental Health Skills Training – GPMHSC accredited education • NEW Active Learning Modules • Diverse range of practical skills-based sessions
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Doctor Q Winter | 35
PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT REGULARS FEATURES REPORT EVENTS TOOLS
RESEARCH FELLOWSHIP At the QIMR Berghofer and Royal Brisbane and Women’s Hospital (RBWH) haematology clinics on the Herston Hospital campus, Professor Geoff Hill and Dr Kate Markey are trailblazing a research mentoring initiative, the Queensland Health Junior Doctor Research Fellowship program.
This creative new scheme was designed to help junior doctors in Queensland, with limited research experience, advance their skills and develop their research potential under the mentorship of Queensland Health’s highly experienced Senior Clinical Research Fellows. As an early career researcher, Dr Kate Markey is ambitious and keen to pursue her desire of finding new and improved methods in treating transplant patients. “I am sure that we can develop better ways to diagnose and predict severe infection in bone marrow transplant patients and the broader group of haematology and oncology patients undergoing chemotherapy. I am trying to look beyond the traditional temperature rises and blood tests to create a diagnostic and predictive test which will measure bacterial DNA in the blood. ” “Geoff is an international leader in the field of transplant immunology, and transplant physician at the RBWH Bone Marrow Transplant Unit, which is the largest transplant unit in the country. I have been working with Geoff for many years (and completed my PhD under his supervision in 2010) but approached him about this new project work when the fellowship scheme was announced last year. Remaining under Geoff’s umbrella in the context of this fellowship was clearly the best way to ensure this fellowship is successful.” As her mentor, Professor Hill is excited saying, “this new Queensland Health fellowship scheme allows us to nurture our brightest young clinically-trained researchers, like Dr Markey.” “This scheme will confirm that Queensland can take young, talented researchers within our system and get them to nationally and internationally competitive levels. Our ultimate dream then, is for these talented researchers, who will be well placed to contribute to the global research community after their training here, will go and do that, but then be keen to return to Queensland as internationally respected practitioners.”
36 | Doctor Q Winter
than having to fit it around a fulltime clinical registrar role.” “In a practical sense, the fellowship funding has allowed me to start my own small team. Leading a team is a key step for me in establishing my career as an independent researcher.” “In the best institutes in the US, for example, people at my stage of training who are interested in pursuing a research career are able to focus on their research almost exclusively, with quite limited clinical responsibilities. This fellowship program represents a step toward that kind of system.” The mentoring role is critical in the ongoing success of the fellowship program. “By providing clinical and laboratory facilities I can ensure a productive and stimulating environment for Kate to work; that is why it is also imperative that we protect her funding and dedicated time for that research,” says Professor Hill. “One of the main issues for Kate was that after being very successful in her PhD research she immediately inherited an intense workload. She commenced junior doctor training with full-time clinical responsibilities and was therefore struggling to maintain research momentum. Consequently her international competitiveness as a researcher decreased. The Junior Doctor Research Fellowships are the ideal vehicle to encourage our researchers of the future,” he adds. Professor Hill ends philosophically saying, “my enduring legacy will be within the young people I’ve trained and mentored throughout my career, rather than any isolated research achievement.” It is very obvious that both young doctor and mentor are excited about the potential for Kate’s research to improve the care of transplant patients. But importantly for the future of Queensland and Australian research, their very successful pairing under the Junior Doctor Research Fellowship program stands as a shining example of what is possible.
Dr Markey has embraced the fellowship as an important professional opportunity to progress her medical career.
Round two for the Junior Doctor Research Fellowships will close August 2016. For further information: www.health.gov.au Q
“I am thrilled to have dedicated time for my research now, rather
Provided by Health and Medical Research Unit, Queensland Health
40
CONTINUING PROFESSIONAL DEVELOPMENT POINTS *Subject to approval
Private Practice and Medico-Legal Conference S U P P O RT I N G Q U A L I T Y H E A LT H C A R E Friday 28 - Saturday 29 October 2016 Brisbane Convention and Exhibition Centre, South Bank Whether you are starting out or already working in private practice, AMA Queensland’s Private Practice & Medico-Legal Conference has got your professional development needs covered. Offered at low-cost member rates, this conference will help you develop your knowledge base and skills to master private practice. Conference topics include: Understanding open disclosure in practice Exploring practice funding and Medicare compliance Understanding the life cycle of a medical complaint Driving patient bookings in your practice The Fair Work system and your private practice Full program and member early-bird rates now available at www.amaq.com.au Member early-bird rates are also available for practice support staff in the permanent employ of an AMA Queensland member.
Preferred Medical Indemnity Provider
QDHP
Queensland Doctors’ Health Programme
Doctor Q Winter | 37
PEOPLE & EVENTS LIFESTYLE
WHAT’S ON Third Annual Junior Doctor Conference 25 - 26 June Brisbane Convention and Exhibition Centre With the theme Looking after yourself, looking after others, AMA Queensland’s Third Annual Junior Doctor Conference features a range of inspiring speakers, medical leaders, and career and business experts to support you at this pivotal time in your career.
Private Practice and Medico-Legal Conference
AMA QUE E N SLAN D P RE SE N T S
17 - 24 SEPTEMBER 2016
S U P P O RT I N G Q U A L I T Y H E A LT H C A R E Friday 28 - Saturday 29 October 2016
Women in Medicine breakfast The key to successful relationships
Brisbane Convention and Exhibition Centre, South Bank
Annual AMA Queensland Conference
The Great Grange Challenge
Brisbane Convention and Exhibition Centre
17 – 24 September
Hunstanton, AMA Queensland
India - Delhi, Agra, Jaipur
Get your colleagues together and join us for our ever-popular networking event. Counsellor, doctor and mentor Dr Arne Rubinstein will discuss the key to successful relationships and Dr Sally Cockburn will join us as MC.
Themed Research - turning it into reality, this year’s conference will focus on navigating the challenges and complexities of the medical research process. A progressive dinner of sorts, the conference will take place in Delhi, Agra and Jaipur.
Join Phil Manser from Wine Direct as he puts Australia’s iconic red wine through its paces against the flagship shiraz from some of the country’s premier boutique wineries in a relaxed and informal environment.
Women in Medicine breakfast 31 August
38 | Doctor Q Winter
18 August
Preferred Medical Indemnity Provider
Save the date: Medico-Legal and Private Practice Conference
QDHP
Queensland Doctors’ Health Programme
28 - 29 October Brisbane Convention and Exhibition Centre Pop the Medico-Legal and Private Practice Conference dates in your diary now and stay tuned for more information in Events and Training enews.
Women in Medicine breakfast The key to successful relationships
Wednesday 31 August 2016 7 – 9am Brisbane Convention & Exhibition Centre
Doctor Q Winter | 39
PEOPLE & EVENTS
LOCAL MEDICAL ASSOCIATION ROUND UP
Stay connected with colleagues and up-to-date with the latest health news and issues affecting your local area. Don’t stand on the sidelines —join your Local Medical Association today and make a difference.
Sunshine Coast
Bundaberg
Fraser Coast Contact:
Drs Thomas Dunn and Paul Neeskens
Phone:
0409 623 009
Contact:
Jo Bourke
Contact:
Dr Daud Yunus
Phone:
(07) 5479 3979
Phone:
(07) 4152 2888
Phone: daud.yunus@gmail.com
Meetings: 28 July Speakers:
Dr Grahame Solley
25 August
Cairns Contact:
Dr Sharmila Biswas
Phone:
(07) 4036 4333
Contact:
Dr Graham McNally
Phone:
(07) 3265 3111
Web:
www.northsidelma.com
Meetings: 9 August
Ipswich and West Moreton Contact:
Dr Thomas McEniery
Phone:
(07) 3281 1177
Meetings: 18 August Psychiatry services in the Ipswich region - Dr Ankur Gupta
11 October 13 December
Mackay Contact:
Dr Bill Boyd
Phone:
0419 676 660
Central Queensland Contact:
Dr Michael Donohue
Phone:
0419 715 658
Toowoomba and Darling Downs Contact: info@tddlma.org.au Web:
Brisbane Northside
www.tddlma.org.au
Redcliffe and District Contact:
Margaret McPherson
Phone:
(07) 3121 4043
Web:
www.rdma.org.au
Meetings: 28 June
Gold Coast Phone:
0419 780 505
Dr Chris Zappala Visits LMA Meetings AMA Queensland President Dr Chris Zappala will attend a number of these meetings to meet members and hear their concerns. He will also discuss: Private health insurance reform Nurse endoscopy / role substitution
Email: info@gcma.org.au
MBS item freeze
Web:
The Queensland Medical Education and Training Institute (QMETI)
Meetings: 21 July 18 August
www.gcma.org.au
Health complaints process / OHO reform
Can’t find your local area? If your Local Medical Association does not appear or your details are incorrect, please email amaq@amaq.com.au. 40 | Doctor Q Winter
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bss@amaq.com.au Doctor Q Winter | 41
CURRENT ISSUES
RESILIENCE ON THE RUN - JUST WHAT THE DOCTOR ORDERED
Resilience on the Run – Rapid Resilience program over the next three months. AMA Queensland President Dr Chris Zappala said there’s nothing quite like the demands of working in a busy hospital.
AMA Queensland’s Council of Doctors in Training, together with Dr Ira van der Steenstraten and the AMA Queensland Membership Team, have developed a new program for Queensland hospitals aiming to help junior doctors deal with making daily life or death decisions, sleep deprivation and other workplace pressures. More than 145 junior doctors at Logan, Redlands and Princess Alexandra Hospitals are taking part in AMA Queensland’s 42 | Doctor Q Winter
“Interns and junior doctors work long, erratic hours in high pressure environments and, although they are dedicated, sometimes they need help dealing with the emotional challenges,” Dr Zappala said. “We want them to have the skills to thrive and give their patients the best possible care.” The program aims to help interns build resilience, manage relationships and deal with difficult situations. Logan Hospital intern Dr Ben Cahill said the program was useful in dealing with change. “As a young person in a new career, the stress and change in lifestyle has an impact on how you feel and how you can function,” Dr Cahill said.
“It’s important to care for yourself so you can care for your patients. This year has been a big change but it’s been very well supported. Programs like this are really valuable because they certainly didn’t exist in the past.” Metro South Health Executive Director Medical Services Dr Susan O’Dwyer said she was pleased to work with AMA Queensland to offer Resilience on the Run. “The health and safety of doctors is just as important as patient care,” Dr O’Dwyer said. “Our staff is our most valuable asset in caring for patients, so we are always keen to better support their physical and emotional wellbeing. We encourage all of our junior doctors to get involved.” Resilience on the Run was created by the AMA Queensland Council of Doctors in Training in response to a 2013 beyondblue report into the mental health of medical professionals that showed
doctors experience higher rates of psychological distress, anxiety and burnout than the general population . The pilot program, generously funded by the AMA Queensland Foundation, was trialled successfully in 2015 with 20 interns at Rockhampton Hospital. General Manager of Member Relations and Communications Holly Bretherton said the program is a demonstration of how AMA Queensland membership supports you in practice. “Resilience on the Run is just one way that AMA Queensland looks after the health and wellbeing of our members. We look forward to working with other hospitals around the state to roll the program out over the coming months. For any program enquiries, please contact Holly Bretherton on (07) 3872 2248 or email h.bretherton@amaq.com.au Q
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Doctor Q Winter | 43
PEOPLE & EVENTS LIFESTYLE
WELCOME TO OUR NEW MEMBERS INTERNS
Dr Bridgette Carr
Dr Muqtasid Hussaini
Dr Samuel Carr
Dr Anne Huynh
Dr Breanna Abraham Alex
Dr Thomas Cavaye
Dr Alison Huynh
Dr Rebekah Adams
Dr Vivian Cham
Dr Sebastian Jacob-Rogers
Dr Prasadi Adikari
Dr Daniel Charles
Dr Isawati Jawan
Dr Scott Alford
Dr Annabel Chau
Dr Justin Jin
Dr Mohamad Alshurafa
Dr Cheng-Yu Chen
Dr Lucy Jirasek
Dr Ian Anderson
Dr Kiat Cheng
Dr Bridget Johnson
Dr Alexander Ansaldo
Dr Ryan Cheng
Dr Ellinor Johnston
Dr Jillian Archard
Dr Michael Christmas
Dr Cara Kajewski
Dr Andrew Argyropoulos
Dr James Cochrane
Dr Megan Arlett
Dr Rebecca Conrick
Dr Daisy Atwell
Dr Samuel Cook
Dr Justin Azzopardi
Dr Emma Cottle
Dr Suriya Balnaves
Dr Liam Coulthard
Dr Edward Barlow
Dr Tiffany Cover
Dr Addrienne Barnes
Dr Timothy Croft
Dr Harold Baxter
Dr Thomas Crookes
Dr Meghan Beere
Dr Trent Cullinan
Dr Patrick Bekhit
Dr Shane Delisser
Dr Alastair Bell
Dr Juliana Ding
Dr Clementina Benedict
Dr Tim Diprose
Dr Alyce Black
Dr Margot Doherty
Dr Tony Blake
Dr Andrew Dow
Dr Tracey Bodetti
Dr Ash Duncan
Dr Thomas Brennan
Dr Harrison Edwards
Dr Benjamin Buffington
Dr Kate Engelke
Dr Benjamin Cahill
Dr Garbrielle Fernandez
Dr Caitlin Campbell
Dr Matthew Fielder
Dr Preston Cardelli
Dr Vivienne Fok
Dr Rebecca Carpenter
Dr Luke Franceschini Dr Jennifer Garlick
44 | Doctor Q Winter
Dr Elizabeth Garrard Dr Nicola Glasson Dr Katherine Graves Dr Hanna Grimson Dr William Guinea Dr Brook Gulhane Dr Ravini Gunawardana Dr Linda Guo Dr Mahmoud Hamzi Dr Alexandra Hand Dr Emma Hannan Dr Alexandra Hanson Dr Alexandra Hardy Dr Sally Harrison Dr Alvin He Dr Anneline Helms Dr Lucy Hempenstall Dr Yi Fei (Ruth) Heng Dr Alexander Ho Dr Lucinda Holroyd Dr Johnson Huang
Dr Kusali Kasturiarachchi Dr Justin Kathage Dr Tara Kinnane Dr Robyn Kinsey Dr Laura Koefler Dr Neil Kroeger Dr Winona Kwan Dr Brian Lai Dr Rachael Lay Dr Nicole Leather Dr Amy Leeder Dr Phoebe Lepper Dr Eveline Lim Dr Yin Lin Dr Joel Ling Dr Nyree Littler Dr Alfred Liu Dr David Liu Dr Thilini Liyanage Dr Litani Looby Dr Daniel Loui Dr Bradley Lovie
Salaried Medical Officers
Dr Jo Barkla
Dr Francisco Munoz
Dr David Freidin
Dr Geoffrey Stieler
Dr Rod Parnian Dr Julie Bradford
Dr Devlin Elliott
FEBRUARY
Dr Suresh Mahendran Dr Olayiwola Otaiku
Dr Paul Sargeant
Dr Jazlyn Read
Doctors in training
Dr Jessica Stewart
Dr Jay Gajera
Salaried medical officers
Dr Maria Corless
Dr Peter Byrnes
A/Prof Leo Hartley
Dr Kristen O’connell
Dr Wilson Choi
Dr Osama Al-Bermani
Dr Kate Douglas
Dr Madeleine Giles
Dr Peter Ratcliff
Dr Win Hein
Dr Danae Cole
Dr Lawrence Nair
Dr Jane Barry
General practitioners
Dr Kym Hickey
JANUARY Doctors in training
Dr Justin Kutzko Dr Lucy Morgan Dr Tom (Yu-Sheng) Huang Dr Carol Lim Dr Julia Taylor
Dr Guranjan Grewal
Dr Elizabeth Ardill Dr Aletia Johnson Dr Cheryl Choong Dr Peter Modlmayr
General practitioners
Dr Johan Durr
Dr Sudeer Mahadeo
Dr Aamir Siddiqui
Specialists
Dr Grant Manypeney
Dr Mal Fernando
Dr Dilum Rajapaksha
Specialists
Dr Niranjan Gaikwad
Dr Dana Moisuc Marineau
Dr Daniel Halliday
Dr Md Shahadat Hossain Dr Phillip Denman
Other
Dr Viola Nicolson Dr Brendan Miller
Dr William Sutherland
Dr Andrew Campbell-Lloyd Dr Michalis Yiallourides
Dr Rebecca Won
MARCH
Salaried medical officers
Doctors in training
Other
Dr Domink Rutz
Dr Kristy Appadoo Dr Tony Miller-Greenman Dr Kalliope Demetriou
Specialists
Dr Ruban Sankar
Dr Anthony Athanasiov
Dr Durgesh Gowda
Dr Bawani Thanapalasingam
Dr Fiona Lehane
Dr Ramesh Velu
Dr Catherine Macintosh
Dr Jennifer Brown
General practitioners
Dr Natasha Hammelswang Dr Suvi Hyytinen Dr Gurmeet Gilhotra
Dr Christian Connors
Dr Jeremy Robertson
Dr Jayant Kumar Karambhe
Dr Neeraj Khanna Dr Madanlal (Mal) Mohanlal Dr Geoff Pandy
Dr Jaykumar Patel
Dr Daniel Ly
Dr Brodie Norton
Dr Max Ryder
Dr Ernest Tee
Dr Michael Lynch
Dr Lyndall Nurzynski
Dr Shona Schadel
Dr Krishanthy Thayalan
Dr Drishti Madhok
Dr Shannon O’Beirne
Dr Jacqueline Schott
Dr Campbell Tingate
Dr Christopher Maguire
Dr Thomas O’Donohoe
Dr Shannan Searle
Dr Azhar Toodayan
Dr Gracia MalaxEtxebarria
Dr Rachel O’Neil
Dr Jiwon Seo
Dr Rory Townend
Dr Hayley Man
Dr Brendan O’Reilly
Dr Mikaela Seymour
Dr Isaac Tranter
Dr Amanda Marano
Dr Kaitlyn Palmas
Dr Ridhwan Shams
Dr Tommy Tseng
Dr Sharon Mason
Dr Soo-Ji Park
Dr Emily Shao
Dr Kristofer Ulyate
Dr Brenton McCormack
Dr Daman Pasricha
Dr Parag Sharma
Dr Renee Veinotte
Dr Tarryn Minto
Dr Giuseppe Pastore
Dr Sara Sharma
Dr Tobias Vickers
Dr Vijay Mistry
Dr Farhaan Patel
Dr Rozanne Visvalingam
Dr Anna Morgan
Dr Susan Pauli
Dr Thomas Vos
Dr Nathan Morgan
Dr Jessica Pearce
Dr Alexandra Walton
Dr James Morris
Dr Andrew Pearson
Dr Siqi Wang
Dr Thomas Mulcahy
Dr Jack Perry
Dr Michelle Ward
Dr Ramyaa Muruganandah
Dr Christian Pertudo
Dr Leigh Waters
Dr Millie Nakatsuka
Dr Meera Perumalpillai-McGarry
Dr Emily Watkins
Dr Shaleen Nath
Dr Joel Petre
Dr Kim Watkinson
Dr Ricky Nelles
Dr Hong Ji Pi
Dr Jenna Weetman
Dr Ivan Ng
Dr Shannon Picknell
Dr William Nicol
Dr David Pietsch
Dr Kathryn Noakes
Dr Laura Plant
Dr Jemma Nokes
Dr Cristobal Quitral Dr Sarah Robertson Dr Alexander Robinson Dr Nicholas Roetger Dr Pascalino Romeo Dr Harriet Ruffin Dr Jack Rush Dr Caitlin Rushby Dr Fiona Ryan Dr Marlis Ryan
Dr Jessica Sia Dr Gregory Sippel Dr Goutham Sivasuthan Dr Sarah Skalecki Dr Callum Smith Dr Jeremy So Dr Jacinta Sorensen Dr Emily Stevenson Dr Kae-Bin Su Dr Pamela Symons Dr Zachary Tan Dr Andrew Taylor
Dr Yi Wei Dr Jane Wei Dr Rachael Weir Dr Annabelle Wellham Dr Erica West Dr Ashlea White Dr Douglas Wills Dr Laura Wilson Dr Vennassa Wong Dr Victoria Woodcroft-Brown Dr Thomas Yeung Dr Lulu Zhang
Doctor Q Winter | 45
PEOPLE & EVENTS
FRANK SULLIVAN OAM MBBS FRANZCO FRACS FAAO FRCOPHTH DO (LOND) 14 February 1931 – 20 March 2016
Francis Patrick Sullivan died at the Royal Brisbane Hospital on 20 March 2016. He was 85 years old. Frank was educated at St Joseph’s College, Gregory Terrace where he was the College Captain, Swimming Captain, First Eleven Captain and the First XV Captain, a feat not repeated since. He entered the Faculty of Medicine and graduated from the University of Queensland in 1954 following in his brother, John’s footsteps. Frank did his residency at Royal Brisbane Hospital (RBH), then followed Dr Aubrey Pye’s advice to study ophthalmology and became the Eye Registrar at RBH. He then became the first Eye Registrar at Princess Alexandra Hospital (PAH) when the Eye Department transferred to PAH in 1957. In fact, he actually took the only hospital slit lamp to the PAH in his Morris Minor. Frank undertook post graduate training in England where he made lifelong friends and saw the beginnings of the ophthalmology family. 46 | Doctor Q Winter
Like many at that time, the way to study in the UK was to work your way there and back as a ship’s surgeon and to stay in college quarters. So to pursue his vocation, Frank left his family at home and studied at Moorefield’s Eye Hospital. On his return, Frank entered into the life of private practice, public hospitals and teaching and was active within the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) and the AMA. Frank was involved with RANZCO on many levels for over 50 years. At state level he was Member, Organising Committee Annual Scientific Congress, Chairman Queensland Branch Q&E Committee, Member Executive committee and Chairman – Queensland Branch. At federal level, he was the President 1988-1989, Vice President of the Royal College of Ophthalmologists (RACO) 1987-1988, Australian Representative on the International Federation of Ophthalmological Societies, Chairman
and Member Part 11 Court of Examiners, Chairman Continuing Education Committee, Qualification and Education Committee, Member Training Post Inspectorate RANZCO, Member of representative RANZCO Appeals Committee and on the Board of Ophthalmic Research Institute of Australia (ORIA). Frank was invited to speak on behalf of the Commonwealth at the formation of the Royal College of Ophthalmologists in Westminster Hall in 1989. One of Frank’s main contributions to ophthalmology was his commitment to and love of education for registrars, undergraduates, general practitioners and nurses and even in the Pacific through the International Society of Geographical Ophthalmology – particularly Nauru in 1972. Frank was involved in registrar training from the time he returned from the UK in 1959. This particular interest resulted in Frank’s appointment as a College Examiner, Chairman of the Court of
Examiners, a member of the Q & E and Chair of that committee. Frank initiated a program for registrars that included lectures, demonstrations, case presentations and trial exams using concepts and programs based on national and international experience in teaching methods and presentations. Registrar training has become a very important part of building a strong bond within the profession that is set up for life. It is something of a tradition especially in Queensland. In the early days, registrars would sometimes come for sessions on the back verandah at Frank’s home and maybe even enjoy a beer together afterwards! In 1992 Frank was invited to chair the first General Practitioners’ Symposium held in conjunction with the Annual Scientific Congress of the RANZCO. Frank demonstrated a strong commitment to the public hospital system. He was visiting specialist at the Royal Brisbane and Womens’ Princess Alexandra (PAH) and Greenslopes Hospitals. Together with Dr Brian Wilson, he established the first sub-specialty clinics for ophthalmology in Brisbane: the Glaucoma Clinic at PAH and the Retinal Vascular Unit at Greenslopes. He continued as Clinical Senior Lecturer, Department of Surgery at the University of Queensland for more than 40 years. After attending conferences and courses in the US, Frank and Dr Kevin Vandeleur introduced the first lasers into private practice in the state – again, interested in continuing education and bringing the latest technology to Queensland.
Frank was one of the first ophthalmologists to establish branch practices – Northside Eye Specialists. Today they are commonplace but in the early 60s they were non-existent. This move marked the beginning of taking ophthalmology services to the community. Frank was also one of the founding members of Terrace Eye Centre, a large ophthalmology practice which opened the way for ophthalmologists with interest in sub-specialties to work with general ophthalmologists Frank was the Chairman of the Queensland Compensation Tribunal (Q Comp) for Ophthalmology from 1991-2011, having been a member since 1967. His hospital appointments included Visiting Ophthalmologist PAH 1960-1979 and RBH 1981-2001. Frank wrote a history of ophthalmology at the RBH in 1998. For his services to RANZCO he was awarded its highest honour, the College Medal in 2010 and his services to the community in the field of ophthalmology were recognised when he was awarded the Medal of the Order of Australia (OAM) in the Australia Day Honours in 2011. Frank has always been totally committed to the AMA as the body representing the whole profession. He was a member of the AMA for 61 years. He joined as a first year resident and was an active member for the rest of his life. He regularly attended AMA Queensland conferences and chaired clinical sessions.
cross section of medical and non-medical members and participated in vigorous debates that were always interesting and sometimes confronting. He always enjoyed the education programs offered by the AMA and the opportunity to meet with colleagues from all areas of medicine. Over the last 15 years, Frank attended many of the AMA Queensland Annual Conferences in different countries in the world. He felt these trips opened his heart, his mind and his eyes to healthcare in all of the countries he visited. Frank is survived his wife Colleen and his eight children Catherine, Timothy, Louise, Johanna, Fiona, Gabrielle, Harriet and Annabel. He was grandfather to 21. As a husband and father he provided inspiration and guidance to the family. Frank and Colleen had the opportunity to support and encourage each other through their professional lives. Frank’s family extends to his wonderful circle of friends – they were very close to him and he enjoyed travelling with them, meeting together, sharing great times as well as hard times. Frank always regarded the gift of friendship as one of his most precious gifts! Drs William Glasson and Tim Sullivan Q
Frank was a member and Chair of the AMA Queensland Ethics Committee. He enjoyed working on this committee with a Doctor Q Winter | 47
PEOPLE & EVENTS
KEY SPEAKER UPDATE:
PROFESSOR FIONA WOOD AM AMA Queensland’s Council of Doctors in Training (CDT) is pleased to welcome Australian burns treatment pioneer Professor Fiona Wood as a speaker at this year’s Junior Doctor Conference. When terrorists planted three bombs around Kuta, Bali in 2002, 202 people were killed and a further 209 were injured. One bomb was inside a very busy nightclub with a thatched roof and the local hospital was unable to treat so many victims with extreme burns. Many of the victims had to be flown to specialist burn units in Perth and Darwin for treatment. Professor Fiona Wood led a team at the Royal Perth Hospital, where they treated 28 patients with burns from 2-92 per cent of their bodies, deadly infections and delayed shock. The tragedy propelled Professor Wood into the limelight and, with it, her pioneering work in burns treatment, namely spray-on skin. In 1992, the invention of cultured skin was emerging and Professor Wood began exploring tissue engineering at night with scientist Marie Stoner. Where previous techniques of skin culturing required 21 days to produce enough cells to cover major burns, the women discovered a method that reduced the period to five days. They also found that scarring was greatly reduced when replacement skin could be provided within 10 days. Professor Wood is Director of the Burns Service of Western Australia; Consultant Plastic Surgeon at Fiona Stanley Hospital (previously at Royal Perth Hospital) and Princess Margaret Hospital for Children; co-founder of the first skin cell laboratory in WA, Winthrop Professor in the School of Surgery at the University of Western Australia, and co-founder of the Fiona Wood Foundation (formerly The McComb Foundation). She was named a Member of the Order of Australia (AM) in 2003. In 2005 she won the Western Australia Citizen of the Year award for her contribution to medicine in the field of burns research. That same year her contribution to burns care was recognised through Australia’s highest 48 | Doctor Q Winter
accolade when she was named Australian of the Year for 2005 by Australian Prime Minister John Howard at a ceremony in Canberra to mark Australia Day. She is an Australian Living Treasure. Despite Professor Wood’s many accolades, she is adamant that any achievement is due to a team approach. “I could not have achieved anything without being surrounded by brilliant, caring and capable people. Every surgery takes a team, every rehabilitation process involves a team, and our research is a team effort. Everyone brings something different to the puzzle and together it makes a whole. We have Australian and international collaborations with research institutes and hospitals who share our vision, so that we can build global capacity. Of course, we can’t do any of this without the support of the community and our donors and partners – they are part of the team effort to make a difference,” she said. Professor Wood said that her interest in burns treatment came from a great curiosity about scarring, particularly the fact that scarring was not just a physical issue. “We talk a lot about improving the outcomes for burns patients, and these outcomes have to be whole-of-person or else it is a one-dimensional solution. The impact of a burn injury goes deeper than the mark it leaves on a person’s arm, or leg, or back or face. There is potential for ‘unseen’ physiological damage – for example, to the person’s organs, or muscles, which can affect mobility and cause other health issues. Then there is the emotional trauma and social health issues that need to be dealt with, and these can be highly challenging,” she said. Don’t miss Professor Fiona Wood at the Junior Doctor Conference on 25 -26 June.
Q
SATURDAY 25 - SUNDAY 26 JUNE 2016 BRISBANE CONVENTION AND EXHIBITION CENTRE Doctor Q Winter | 49
PEOPLE & EVENTS LIFESTYLE
AMA QUEENSLAND PRESENTS
17 - 24 SEPTEMBER 2016
KEY SPEAKER UPDATE:
PROFESSOR KAMESHWAR PRASAD
Professor Kameshwar Prasad is Professor and Head of the Department of Neurology at All India Institute of Medical Sciences (AIIMS), New Delhi, India. He has more than 35 years of clinical, teaching and research experience and has published more than 270 papers (more than 125 in stroke) in peer-reviewed journals of national and international repute. Professor Prasad is a member of the World Stroke Organisation Global Quality and Guidelines Working Group. He is also Editor and Reviewer of the International Cochrane Collaborative Stroke Review Group based in Edinburgh, UK. Professor Prasad started Stroke clinic in 1995 and established the Stroke unit since its inception in 2001 at AIIMS, New Delhi. He has been associated with the Indian National Programme
50 | Doctor Q Winter
for Control and Prevention of Stroke since its inception. He has been a member of the core committee, technical advisory committee and various expert groups to the national program and continues to be a member of its expert group. He is Chairman of the Scientific Advisory Board, Panel Area for Stroke Registry, Indian Council of Medical Research, and has been the Convenor of the National Stroke Management Guidelines (India). Professor Prasad coordinated the first multicentric national randomized study of the role of bone marrow-derived stem cell therapy in stroke, a first of its kind study at global level published in the American Stroke Association Journal, Stroke. He has also conducted a research trial on mobilisation of stem cells using G-CSF for acute ischemic stroke published in international journal Stroke
KEY SPEAKER UPDATE:
DR ANJALI JIAPRAKASH
Dr Anjali Jiaprakash is a PostDoctoral Research Fellow at the Australian Centre for Robotic Vision at QUT. Anjali is developing visionbased autonomous robotic technology that will allow surgeons to perform knee arthroscopy surgery faster, safer and more predictably in order to improve patient outcomes and surgeon training. Developing this technology demands highly collaborative and interdisciplinary teams from many fields, including biologists, orthopaedic surgeons, engineers and industrial designers. By working together, complex challenges can be solved. Anjali believes that research can provide real world impact through greater integration with industry. She is actively facilitating connections between scientific disciplines and the medical industry to achieve best outcomes.
Award to promote and share her enthusiasm in science, technology, engineering and mathematics (STEM) education with the wider community. She was also a finalist at the Top 5 under 40 in 2015 (a University of New South Wales and ABC Radio National initiative) that recognised Australia’s next generation of scientific thinkers. Anjali is actively embracing novel technologies to solve medical challenge. Her vision is to create a world in which robotics technology enables affordable medicine for all.
Anjali was awarded the Advance Queensland Fellowship in March 2016 to peruse her research in the field of Medical Robotics. In 2015, she won the Australian Academy of Technological Sciences and Engineering (ATSE) Young Science Ambassador
Research and Treatment. He is also coordinating a project in which the role of biomarkers in predicting stroke recovery is being studied. He has been the principal investigator of several stem cell studies in stroke model and genetics of stroke funded by Government of India. Professor Prasad has also made outstanding contributions in the field of evidence-based medicine (EBM). He has been associated with EBM since its inception 1992. He has a Master’s Degree in Health Research Methodology and Clinical Epidemiology with emphasis on EBM from the McMaster University, Canada. He has worked with and is part of the first (pioneer) international working group on EBM established at McMaster. He has authored a book, Fundamentals of Evidence-Based Medicine, which was reviewed
as the best recommended book in the field by the Journal of American Medical Association in December 2006. He was the Editor-in-Chief of Bickerstaff’s Neurological Examination in Clinical Practice, seventh edition. Professor Prasad is a Fellow of Royal College of Physicians (Edinburgh), Fellow of the National Academy of Medical
Sciences (India), and Editor of Edinburgh-based Cochrane Stroke Group. He has also received several awards and honours from national and international organisations, including the prestigious civilian honour Padmashree from the President of India. Q
Doctor Q Winter | 51
BUSINESS TOOLS
ROSS NOYE
Macquarie Private Wealth P: (07) 3233 5805 M: 0438 779 955 E: ross.noye@ macquarie.com
BIG CHANGES TO SUPER DEMAND ACTION The 2016 Federal Budget proposal represents the biggest shakeup of the superannuation rules since 2007 and is likely to have wide-ranging implications for those approaching retirement. In its current form these changes will require action by many superannuation fund members.
Lowering of the cut-in threshold for 30 per cent tax on concessional contributions:
From 1 July 2017, the threshold at which highincome earners pay additional contributions tax will decrease from $300,000 to $250,000. An additional 15 per cent tax is payable on concessional contributions to the extent the threshold is exceeded. Cap on superannuation transfer balances:
From 1 July 2017, a $1.6 million cap is proposed to apply to the amount of accumulated superannuation benefits that can be transferred to the super pension phase. It is also proposed that existing pension accounts that have a balance above the cap will need to be reduced to $1.6 million by 1 July 2017. Transition to retirement income streams:
Investment earnings on super fund assets that support a pension are currently tax free. The earnings tax exemption for assets supporting transition to retirement (TTR) income streams is proposed to be removed from 1 July 2017. We understand this measure will also apply to existing TTR income streams.
Reduced cap on Concessional Contributions:
The government has proposed that from 1 July 2017 the concessional (before-tax) contributions cap be cut from $30,000 (or $35,000 for people over the age of 49) to $25,000 per year for everyone, irrespective of age.
Tax treatment of payments from income streams: The changes raise many questions for super fund trustees and their members especially for those in or close to retirement with high account balances. The major changes to both the accumulation and pension phases of the superannuation cycle include:
Ability to catch up on before-tax super contributions:
Lifetime cap for non-concessional contributions (NCC):
Disclaimer: This information has been prepared by Macquarie Private Wealth, a division of Macquarie Equities Limited ABN 41 002 574 923 AFSL 237504. It does not take into account your objectives, financial situation or needs. Before acting on this information, you should consider whether it is appropriate to your situation.
52 | Doctor Q Winter
The government has proposed the introduction of a lifetime non-concessional contributions cap of $500,000 to include all NCC made since 2007. Please note that the $500,000 lifetime non-concessional cap was made effective from 7.30pm on 3 May 2015. All NCCs made from 2007 onwards count towards super fund members NCC cap. Removal of the work test for those aged 65 to 74 (inclusive):
From 1 July 2017, it is proposed to remove the current need to be gainfully employed for at least 40 hours in 30 consecutive days for those aged 65 to 74 (inclusive).
A tax rule that allows individuals to elect to have payments from superannuation income streams treated as lump sums for tax purposes is also proposed to be removed.
The government has proposed that from 1 July 2017 individuals with a super balance of less than $500,000 be allowed to make additional before-tax contributions where they have not reached their concessional contributions cap in previous years. Ability to nominate payments as lump sums or pension payments to be removed:
For tax purposes, you can currently elect for certain super income stream payments to be taxed as lump sums, but the government is proposing to also remove this option.
Super fund trustees and members should seek advice and plan now to take advantage of the current superannuation rules ahead of the 1 July 2017 changes.
Discover a world of investment opportunities.
Macquarie has a highly experienced team of advisers and stockbrokers who can offer tailored financial advice. Offering access to a wide range of investment opportunities, Macquarie draws on leading analysts and highly rated research* to give you access to insights and expertise that may help you achieve your financial goals. For more information or for free initial consultation, contact Ross Noye on 0438 77 99 55 or Warren Acworth on 0410 51 50 99. macquarie.com *Peter Lee Associates Review 2006, 2007, 2008, 2009, 2010, 2011, 2012. This information is provided by Macquarie Equities Limited ABN 41 002 574 923 AFSL 237504 (MEL). MEL is not an authorised deposit-taking institution for the purposes of the Banking Act (Cth) 1959, and its obligations do not represent deposits or other liabilities of Macquarie Bank Limited (MBL) ABN 46 008 583 542. MBL does not guarantee or otherwise provide assurance in respect of the obligations of MEL.
Doctor Q Winter | 53
BUSINESS TOOLS
PRIVATE HEALTH INSURANCE: WHAT’S IN THE JUNK? PETER ARONEY
AMA Queensland’s newest corporate partner, Doctors’ Health Fund, explains how junk policies are leaving patients underinsured.
Doctors’ Health Fund CEO P: 1800 226 126
E: info@doctorshealthfund. com.au The Doctors’ Health Fund is a registered private health insurer which serves the Australian medical community..
When you are discussing treatment options with a patient and they tell you they have private health insurance, do either of you know what the policy actually covers them for? The rise in low-cost ‘junk policies’ makes for a complex and confusing health insurance landscape.
paid by the healthy help cover the costs of those who need more health care. This is being eroded by the rise of cheap policies with limited cover and ultimately we run the risk of comprehensive policies becoming unaffordable.
How did we get here?
Doctors’ Health Fund argues it is possible to offer broad-based, quality cover and remain competitive without the need for junk. We believe in simplicity and transparency. There is a place for judicious use of exclusionary products relevant to life-stage, provided there is full disclosure of the member’s potential costs and access to providers.
These policies may appear attractive because of lower premiums and as a way of avoiding having to pay the Medicare Levy Surcharge; in the 2014-15 financial year, Australian Prudential Regulation Authority (APRA) data indicates that 500,000 new exclusion policies were purchased. However, they may have many services excluded or restricted and often leave the policyholder with large, unexpected out-ofpocket expenses. Hidden ‘junk’ Health care consumers are now being forced to navigate some 20,000 health cover products on the market, and more than half of the hospital policies held by Australians include some level of exclusion or restriction. Each will generally have a different mix of exclusions and restrictions, as well as benefit limitation periods. Definitions of procedures are ambiguous and differ for each fund. For example, an exclusion related to hip and knee procedures can be about reconstructions, revisions, replacements, exploratory surgery or any procedure or observation where the area is involved.
1) Australian Competition and Consumer Commission. Information and informed decision-making, 2015: accessed www.accc.gov.au/ system/files/981_Private%20 Health%20Report_2013-14_ web%20FA.pdf 2) Ley, S. ‘Half-a-million Australians downgrade private health cover’: accessed www.health.gov.au/ internet/ministers/publishing. nsf/Content/health-mediarelyr2015-ley134.htm 3) Private Health Insurance Ombudsman. Annual Report 2013-14; 43: accessed http:// www.phio.org.au/downloads/ file/PublicationItems/ PHIOAR2014.pdf 4) Australian Competition and Consumer Commission. Information and informed decision-making, 2015: accessed www.accc.gov.au/ system/files/981_Private%20 Health%20Report_2013-14_ web%20FA.pdf
54 | Doctor Q Winter
Beyond such restrictions and exclusions, many policyholders do not realise their health fund may not have a contract with their chosen hospital, pathology or radiology provider. With some policies, certain services only attract the MBS fee, rather than higher benefits available under the fund’s medical gap scheme. Consumers are surprised to learn that being covered for a service does not necessarily mean they will have no out-of-pocket expenses, and consumer complaints about bill shock are increasing. The wider impact In the longer term, not just holders of junk policies will be affected. We are concerned this race to the bottom is undermining both the public and private system. Private health insurance in Australia is built on the community rating principle, where cover is provided irrespective of health status or risk. The system relies on cross-subsidisation, where premiums
A necessary evil?
With increasing pressure from doctors, consumers and some health funds, we see regulatory reform in this area as almost certain. That said, the impact of reform is still some way off, and in the meantime, doctors are still in the position of having to help patients navigate this confusion. We have prepared a checklist (available at www. doctorshealthfund.com.au/policycheck) to help doctors and their patients understand the questions to ask and what the answers actually mean, in the hope of providing a clearer map – a small step while we wait for wider reform.
ADVANCE YOUR LEASE PAYMENTS With your final opportunity to capture maximum tax deductions for the current fiscal year ending on 30 June, making lease repayments in advance may allow you to benefit now by capturing tax deductions in the current tax year. If you are on the simplified tax system with less than $2 million in revenue, you may be entitled to make 12 months of advance payments if the lease was established within the previous 12 months, and effectively reduce your taxable income. There may be real benefits making tax deductions now, as money is generally worth more now than it will be worth in the future. For example, assume you own your practice with turnover below $2 million and an average net profit of $200,000 a year. You are paying a lease on your equipment which costs $24,000 a year (total lease of $100,000 over 5 years). By making an additional $24,000 in any financial year, you might be able to reduce your net profit for that financial year by $48,000, saving you more money in tax now. The money you save in tax may be worth more in your pocket now than if you applied the same deduction in the future. Payment structure options based on above example Year
Advanced lease repayments
Standard lease repayments
1
$48,000
$24,000
2
$24,000
$24,000
3
$24,000
$24,000
4
$24,000
$24,000
5
0
$24,000
Figures shown in the above table are for illustration purposes only and represent the approximate leasing repayments over 5 years based on finance of $100,000.
JEFF MILLER
BOQ Specialist
P: +61 7 3018 8119 E: jeff.miller@ boqspecialist.com.au
Treat yourself to some serious savings If there’s something that you want or need for your practice, now is the time to think of going on a shopping spree. Take advantage of competitive seasonal pricing and generous government tax concessions on business related assets, plus our special end of financial year offer. If you decide to finance equipment, a car, property or goodwill before 30 June 2016 you may enjoy: special prices and deals that are now in the market small business tax breaks for items under $20,000 tax and depreciation benefits at the end of the financial year up to $600 back* as part of our special end of financial year offer.
Disclaimer: The credit provider is BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 Australian credit licence no. 244616 (“BOQ Specialist”). Terms and conditions, fees and charges and lending and eligibility criteria apply. Any information is of a general nature only. We have not taken into account your objectives, financial situation, or needs when preparing it. Before acting on this information you should consider if it is appropriate for your situation. BOQ Specialist is not offering financial, tax or legal advice. You should obtain independent financial, tax and legal advice as appropriate. We reserve the right to cease offering these products at any time without notice. *The offer will be provided by way of a Universal Gift Card, which is issued by Heritage Bank Limited ABN 32 087 652 024 AFSL 240984. This offer is valid for contracts settled between 18 May and 30 June, 2016 and is not available for rollovers, escrows, overdraft (secured or unsecured) or cash management facilities (ie deposit facilities). Full document fee applies. There is only one gift card issued per contract and it is not available with any other offer. Gift cards will be issued to eligible clients at the end of the promotion period 30 June 2016; please allow up to three weeks. Gift cards are subject to availability and while stocks last. Gift cards cannot be exchanged or redeemed for cash. Gift cards will be awarded as follows: $200 for commercial contracts $30 000 and over; $400 for commercial contracts $100 000 and over; $600 for commercial contracts $250 000 and over.
Doctor Q Winter | 55
BUSINESS TOOLS
DR SARA BIRD
MDA National
Manager, Medico-legal and Advisory Services P: 1800 011 255 E: peaceofmind@ mdanational.com.au Dr Bird has worked with medical defence organisations as a claims manager and medico-legal adviser. She has particular interest in clinical risk management.
Preferred Medical Indemnity Provider
ROOT CAUSE ANALYSIS Consider this scenario: The Director of Medical Services contacts you to advise that a Root Cause Analysis (RCA) will be conducted into the unexpected death of a patient, and that you are required to attend an interview with the RCA team. This article discusses: the nature and purpose of RCAs how to proceed if you are involved in an RCA. What is Root Cause Analysis? RCA is a systematic and comprehensive methodology to analyse systems and processes of care. The aim of an RCA is to identify areas of concern that may not be immediately apparent and which may have contributed to the occurrence of an incident. It focuses on the organisation of health care, rather than the assignment of individual blame. The goal of an RCA is to find out: what happened why it happened what can be done to prevent it from happening again. RCAs have the following characteristics: The review is interdisciplinary in nature. The review is undertaken by a small team (three to five people) who are familiar with the area in which the incident occurred, but not directly involved in the incident. The analysis focuses primarily on systems and processes rather than individual performance. The analysis identifies changes that could be made in systems and processes, through either redesign or development of new processes or systems that would improve performance and reduce the risk of recurrence.
Disclaimer: This article is provided by MDA National. They recommend that you contact your indemnity provider if you need specific advice in relation to your insurance policy.
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The RCA team is required to determine the facts of what happened. In order to do so, information is gathered from a variety of sources, including interviews and/or statements from those practitioners involved in the patient’s care and any witnesses to the incident. The RCA team is not permitted to investigate the competence of an individual doctor or other health practitioner. At the conclusion of the RCA process, the RCA team must provide a written report describing
the incident, the reasons they think it occurred and any recommendations for change to practice or procedures. The final RCA Report is made available to a range of parties, including the patient and/or their family and the hospital administration. When is an RCA conducted? Generally, an RCA is performed on serious adverse clinical events. RCAs may be mandated in certain circumstances – such as patient incidents with a severity assessment rating of one (serious events which are likely to recur) and sentinel or reportable events, e.g. maternal deaths or wrong site procedures. What should you do if you are asked to participate in an RCA? You should initially review the relevant medical records and consider your direct involvement in the patient's care. If you are asked to attend an interview with the RCA team, it may be useful to prepare some notes to assist you during this discussion. Any notes should be marked as being ‘prepared for the purpose of an RCA’. You can bring a support person to the interview, if you wish to do so. If you are asked to prepare a report for the RCA team, again, this report should be clearly marked as being prepared for that purpose. If asked to participate in an RCA, we encourage you to contact your medical defence organisation. MDA National’s Medico-legal Advisory Services team provides advice and support for Members involved in an RCA. Summary points RCA is a process analysis method used to identify the factors that cause adverse events. The focus of RCA is on system change, not the assignment of individual blame. If you are asked to participate in an RCA, contact your medical defence organisation.
Doctor Q Winter | 57
PEOPLE & EVENTS LIFESTYLE BUSINESS TOOLS
REVISED REGISTRATION STANDARDS FOR 2016 KATHARINE PHILP
Tresscox Lawyers Partner
P: (07) 3004 3536 E: Katharine_Philp@ tresscox.com.au
The Medical Board of Australia (MBA) registration standards have undergone a recent review with a revised registration standard for Professional Indemnity Insurance (PII) arrangements commencing on 1 January 2016 and revised registration standards for both Continuing Professional Development (CPD) and Recency of Practice coming into effect from 1 October 2016. PII arrangements There are two substantive changes: The new standard came into effect from 1 January 2016 and all registered medical practitioners must comply with the PII registration standard other than the requirement for “appropriate retroactive cover for otherwise uncovered matters arising from prior practice undertaken in Australia”. This requirement comes into effect on 1 October 2016. From a practical point of view registered medical practitioners who comply with prior registration standards will meet the revised registration standard until 30 September 2016. Medical practitioners who do not currently have retroactive cover as part of their PII policy will need to ensure that the insurer amends the policy to include retroactive cover from 1 October 2016. The second change is that insurers no longer require Board approval. From 1 January 2016, insurers only need to be registered with the Australian Prudential Regulation Authority (APRA) and meet the minimum product standards that apply for medical indemnity insurers as defined in the Medical Indemnity (Credential Supervision and Product Standards) Act 2013 (Cth). CPD The revised CPD registration standard has not undergone significant changes. Medical practitioners with general registration i.e. who do not have specialist registration, must continue to complete a minimum of 50 hours CPD per year. Medical practitioners with specialist registration must continue to meet the requirements set out by their relevant College. For medical practitioners with provisional registration or limited registration, the standard sets out the requirements to ensure that their CPD is linked to their training position and/or supervision plan.
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The revised standard also requires international medical graduates to complete a minimum of 50 hours CPD a year. Recency of Practice In order to meet the new standard, medical practitioners must practice within their scope of practice at any time for a minimum total of: Four weeks full-time equivalent in one registration period, namely a total of 152 hours; or Twelve weeks full-time equivalent over three consecutive registration periods namely a total of 456 hours. Full-time equivalent is 38 hours per week and the maximum number of hours that can be counted per week is 38 hours. ‘Registration period’ is defined as meaning from 1 October to the following 30 September. Medical practitioners who work part-time must complete the same minimum number of hours of practice but this can be completed part time. Medical practitioners with non-practicing registration or medical practitioners who are not registered and wish to return to practice, including international medical graduates, will need to complete the following requirements. If they have two or more years clinical experience as a registered medical practitioner and are returning to practice:
After a break up to and including 12 months - there are no additional requirements that need to be met before recommencing practice;
After a break of between 12 months and up to and including 36 months - at a minimum practitioners must complete the equivalent of one year’s CPD activities relevant to their intended scope of practice;
After a break of more than 36 months practitioners are required to provide a plan for professional development and re-entry to practice for the MBA’s consideration and approval. If practitioners have less than two years clinical experience and are returning to practice and have not practiced after a break of more than 12 months they are required to commence work under supervision in a training position approved by the MBA. If changing the scope of practice, practitioners may be required to undergo additional training to ensure they are competent in the new field or scope of practice.
Look no further...TressCox Lawyers can assist you At TressCox we make it our business to know about Health and Aged Care. We can help guide you through the increasingly complex operational, legislative and policy framework. We can provide you informed legal advice on litigious, disciplinary and commercial issues at all levels. With considered legal advice we can assist you to operate a commercially viable business that complies with the health services industry’s unique and ever changing regulatory environment. We can help you with:
Employment Contracts Purchase and sale of medical practices General practice and specialist practice issues Medical indemnity claims Dispute resolution and litigation IR & Workplace Safety Regulatory investigations and proceedings Registration issues In order to keep your registration current, Tresscox has laid out the Medicare Australia investigations Business structuring and contracts recent changes to the standards for professional indemnity insurance, continuing professional development and recency of practice. Estate Planning and Wills Corporate Governance
Rachel Drew, Partner
Brisbane P. (07) 3004 3527 M. 0421 067 256 Rachel_Drew@tresscox.com.au
Bill Hickey, Partner
Brisbane P. (07) 3004 3523 M. 0421 756 502 Bill_Hickey@tresscox.com.au
www.tresscox.com.au
Robin Lonergan, Partner
Brisbane P. (07) 3004 9530 M. 0422 785 006 Robin_Lonergan@tresscox.com.au
Tony Mylne, Partner
Brisbane P. (07) 3004 3545 M. 0422 044 210 Tony_Mylne@tresscox.com.au
Katharine Philp, Partner
Brisbane P. (07) 3004 3536 M. 0409 586 785 Katharine_Philp@tresscox.com.au
Lynette Reynolds, Partner
Brisbane P. (07) 3004 3555 M. 0416 069 573 Lynette_Reynolds@tresscox.com.au
Ph: (07) 3004 3500 Doctor Q Winter | 59
PEOPLE & EVENTS LIFESTYLE BUSINESS TOOLS
THE VALUE OF INCOME PROTECTION INSURANCE CRAIG WRIGHT
Experien
Insurance Advisor P: 0488 273 399 E: craig.wright @experien.com.au Craig Wright is a life and income protection insurance specialist for Experien Insurance Services, based in Brisbane. They are the preferred life insurance partner of AMA Queensland. He focuses on the medical industry and understands the unique needs of doctors. This has helped him to negotiate enhanced products for our sector from insurers.
Craig Wright, from our preferred insurance partner, Experien Insurance Services, gives an update on the assistance they provide to those who are unfortunate to have to claim because of injury or ill health, but are fortunate to have the safety of a comprehensive insurance policy. According to the Institute of Actuaries, a person has a 60 per cent chance of being disabled for more than one month in their working life, and one in three people will be disabled for more than three months. Additionally, the Australian Housing and Urban Research Institute says that 20 per cent of mortgage defaults in Australia are due to illness and accident in a household. These are scary statistics! For most working Australians, having appropriate income protection, life insurance or trauma insurance is a necessity and not a luxury. Unfortunately many don’t have enough cover and are not using the right products. For example, people who buy insurance directly (and not via a professional adviser) may have a product with a five-year exclusion period. Also, insurers are always updating their products, and many people don’t realise that the upgraded features, payment options and pricing are not automatically extended to their existing policies. Experien ensures the right cover is put in place and paid for in the most sensible way and at the most competitive price. Most importantly, we are there at the time of any claim to act as your personal insurance concierge to ensure the claim gets paid quickly and with empathy.
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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Here are some actual stories of clients that we have helped when they needed it most. Dentist – income protection claim This unlucky dentist fell whilst travelling overseas and suffered a fractured foot. The local orthopaedic surgeon advised that she could not travel due to deep vein thrombosis and other risks, and also needed at least six weeks off work to recuperate. As she is self-employed, she relies on her income each week to cover her expenses and lifestyle costs. She was insured for $13,000 per month and Experien ensured the income protection payment claim was paid for each month she was off work or unable to work at full capacity.
Self-employed doctor – income protection claim This doctor was assaulted by an unstable patient at his practice. His injury resulted in hospitalisation and an operation. The client’s wife called Experien a few days later and the adviser comforted her and commenced the claims process. Experien went to their home when he was out of hospital and assisted him with the claim forms. The client was unfortunately unable to work for 12 weeks. The claim was paid in advance within a month replacing several months of lost income. This allowed the client time to recuperate without financial concerns. Ophthalmologist – income protection claim Experien assisted this client to obtain income protection cover. She later needed a gastric operation which required her to be off work for some time. Experien ensured the policy paid a benefit of $15,000 per month to help her pay her expenses whilst she was recovering and unable to work.
Is the cost of your Income Protection and Life insurance breaking the bank? We have access to all of the insurers in the industry, comparing policy features and prices to obtain the best Income Protection and Life insurance cover for you. We also review any existing exclusions and health loadings on your policy.
Experien is the preferred life insurance provider to AMA Queensland and one of the few national brokers that specialise in the medical sector. For a complimentary review or consultation, contact: Craig on 0488 273 399 or craig.wright@experien.com.au, or Justin on 0419 994 123 or justin.tyne@experien.com.au
Life Insurance services are provided by Experien Insurance Services Pty Ltd ABN 99 128 678 937. Experien Insurance Services Pty Ltd is a Corporate Authorised Representative (No. 320626) of ClearView Financial Advice Pty Limited ABN 89 133 593 012 AFS Licence No. 331367. General Insurance services are provided by Experien General Insurance Services Pty Ltd trading as Experien Insurance Services ABN 77 151 269 279 AFS Licence No. 430190. This information is of a general nature only and has been prepared without taking into account your particular financial needs, circumstances and objectives. While every effort has been made to ensure the accuracy of the information, it is not guaranteed. You should obtain a copy of the product disclosure statement and obtain independent professional advice before acting on the information contained in this publication.
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PEOPLE & EVENTS LIFESTYLE BUSINESS TOOLS
YEAR END TAX PLANNING – ARE YOU READY? ANGELA JEFFREY
William Buck
P: (07) 3229 5100 E: Angela.Jeffrey@ williambuck.com Angela Jeffrey is Business Advisory Director at William Buck Chartered Accountants and Advisors.
As the year marches on towards 30 June, you may begin to wonder “am I paying too much tax and is there anything I can do about it?” The process of tax planning involves a review of your overall taxation affairs, including investment structures, income and deductions, to make sure that you are taking advantage of any possible tax savings. This process is most beneficial if it is done throughout the year, but there may still be some advantages in examining your available deductions at the end of the financial year. Whether you are an employee or in business, some of the areas to consider include: Superannuation This continues to be a tax-effective way to provide for your retirement, as tax on contributions is generally limited to 15 per cent in superannuation funds. There are differing rules governing the availability of deductions, depending on whether or not you are employed, but generally, if you are under 50 years of age, you can contribute up to $30,000 per year ($35,000 if over 50) and obtain some tax benefit. For example, if you are self-employed on an income level of $250,000 per year, a $30,000 contribution into superannuation will save you approximately $9,750 in tax, (the difference between a 47.5 per cent personal marginal tax rate and the 15 per cent super fund tax rate). If you are an employer, you may be able to bring forward deductions for compulsory super contributions by making sure they are paid prior to 30 June. Superannuation – extra tax on contributions for high income earners Effective 1 July 2012, the government introduced a new tax on superannuation contributions for high income earners. This tax is known as the Division 293 Tax and applies to taxpayers who earn over $300,000 in a financial year (after making a few adjustments).
Disclaimer: The information contained in this summary is general in nature and should not be applied or relied upon without seeking additional professional advice. William Buck (QLD) has a dedicated team of superannuation and taxation experts who are happy to speak with you regarding your self managed superannuation fund or any other issues regarding superannuation you may have.
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As a result of this tax, contributions tax levied on concessional contributions made by high income earners is effectively increased from 15 to 30 per cent. The tax is levied to the taxpayer in the first instance, but the taxpayer can request that his/her super fund pay the tax on his/her behalf. The assessment notice for Division 293 Tax usually issues a few months after your personal tax return has been lodged with the Tax Office. Despite this extra tax, deductible contributions into superannuation are still considered to be highly tax effective because:
Summary points The effective tax rate applied to contributions is still lower than the highest marginal tax rate; Ongoing earnings derived by the contributions within the fund are likely to be subject to a maximum 15 per cent tax rate; and When you retire, your superannuation savings may be able to be withdrawn tax-free. Salary sacrifice arrangements If employed, salary sacrifice arrangements for either superannuation or other benefits are always worth considering, as the tax savings can be significant. As sacrifice arrangements are only valid for prospective wages, it is critical to review this option now to ensure that you obtain any potential benefit before 30 June. Interest deductions For those of you with investment-related debt, it is worthwhile to review your level of interest deductions at the end of the year. In some circumstances it may be possible to prepay interest to obtain additional tax deductions this year. Property investments - capital allowances The most popular form of tax deductions are non-cash deductions. Accelerated depreciation on income-producing buildings is one such deduction. If you own either a commercial or a residential property, obtaining a quantity surveyor report to determine the amount of additional depreciation that may be claimable in relation to the buildings is a low-cost avenue to optimise your tax position. Other opportunities There may be many other opportunities available to you, depending on your personal or business situation and may include prepaying or bringing forward business expenses. The key to successful tax planning is allowing yourself enough time to take advantage of available benefits. Hurried decisions often do not achieve the best outcome, so take the opportunity now to invest some time in your financial goals.
ARE YOU THINKING OF
BUYING OR SELLING A MEDICAL PRACTICE? WITH A DEDICATED HEALTHCARE PRACTICE, WILLIAM BUCK CAN HELP YOU BUY OR SELL YOUR PRACTICE AND MAKE THE MOST OF YOUR FINANCIAL FUTURE.
We understand that the purchase or sale of your practice is crucial to your financial situation and can help you plan and prepare to achieve the best possible outcome. William Buck is experienced in managing the purchase and sale process for medical practices, and can assist with the following: — Valuing your practice — Negotiating the sale and purchase process — Due diligence — Prepare your financial data ready for sale — Structuring the sale and maximising tax outcomes
CONTACT PAUL COPELAND FOR A CONFIDENTIAL & COMPLIMENTARY CONSULTATION OR FOR A CURRENT LIST OF MEDICAL PRACTICES FOR SALE Phone: + 61 (7) 3229 5100 Email: Paul.Copeland@williambuck.com
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PEOPLE & EVENTS LIFESTYLE BUSINESS TOOLS
CHRIS MARIANI
Medical & General Risk Solutions
Director, Medical & General Risk Solutions P: 0419 017 011
MEDICAL INDEMNITY FIND THE BEST OPTION FOR YOU
E: chris@mgrs.com.au www.mgrs.com.au Authorised Representative No. 434578
MGR A NEW NAME, SAME TEAM AMA Queensland Insurance Solutions is now Medical & General Risk Solutions (MGR). Our new name reflects what we do and where we do it - we have offices in Queensland and New South Wales with medical clients spanning from Cairns to Hobart. Though our name has been changed, our commitment to AMA Queensland members has not. Our goal remains to continue providing high-quality advice and personalised service on your risks and insurances options. With a team of qualified insurance brokers, we are able to advise on all aspects of your practice or personal insurance needs. Feel free to contact Chris Mariani or James Warwick to arrange an obligation free consultation. www.mgrs.com.au
Disclaimer: Medical and General Risk Solutions is a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, Australian Financial Services Licence No 240549, ABN 15 003 886 687. Authorised Representative No 436893. The information provided in this article is of a general nature and does not take into account your objectives, financial situation or needs. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.
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HQ: Level 2, 36 Station Road Indooroopilly QLD P: 1300 883 059 F: (07) 3871 4900 Contact an adviser: Chris Mariani P: 0419 017 011 E: chris@mgrs.com.au James Warwick P: 0402 042 116 E: James@mgrs.com.au
Policy coverage and amounts vary considerably by insurer and there is no single policy that is ‘better’ than any other policy in every respect. On top of this, your individual circumstances and needs will mean looking at policy coverage against your needs and practice risks. In addition to coverage, some other considerations include:
Quality of claims service and the philosophy of the insurer
Experience of in-house and panel legal firms History of the insurer’s ability to provide stability of pricing Does the insurer provide any discounts for getting started in private practice, loyalty, or any other discount that may be relevant Access to medico-legal advice Other benefits provided outside of the insurance policy Medical and General Risk Solutions (MGR) can find the best policy available for your needs from Avant, MDA National, MIGA, MIPS and the new insurer to the market, Tego Insurance. If you would like to review your current medical indemnity cover and practice insurances, please contact us. We have assisted many AMA Queensland members with their insurance needs.
One less thing on your to-do list Specialist risk and insurance solutions for medical practitioners and healthcare businesses. We can identify your key risks and protect you with the right insurance program, all managed by your own expert insurance adviser: • • • • • •
Medical Indemnity Practice Indemnity Management Liability Business Rooms Insurance Cyber Risks Personal Insurances
Free insurance health check
Call us on 1300 883 059
or speak directly to one of our experts: Chris Mariani 0419 017 011 chris@mgrs.com.au
James Warwick 0402 042 116 james@mgrs.com.au
www.mgrs.com.au
Medical and General Risk Solutions is a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, Australian Financial Services Licence No 240549, ABN 15 003 886 687
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LIFESTYLE
KENNETH BRANAGH THEATRE LIVE:
ROMEO AND JULIET 27 August 1pm, 28 Aug 1pm, 29 Aug 6pm and, 31 Aug 10am The Kenneth Branagh Theatre Company Live cinema season continues with a new vision of Shakespeare’s heartbreaking tale of forbidden love. Branagh and his creative team present a modern passionate version of the classic tragedy. A longstanding feud between Verona’s Montague and Capulet families brings about devastating consequences for two young lovers caught in the conflict. Reuniting the stars of his celebrated film of Cinderella, Kenneth Branagh directs Richard Madden and Lily James as Romeo and Juliet and Sir Derek Jacobi as Mercutio.
UPCOMING MOVIES*
ROBERT DEVEREUX
ANDRE RIEU
23 June
1 July 1pm, 3 July 1pm and, 7 July 10am
30 and 31 July
Me Before You Independence Day Everybody Wants Some
30 June
Soprano Sondra Radvanovsky takes on the extraordinary challenge of singing all three of Donizetti’s Tudor queens in the course of a single season, a rare feat made famous by Beverly Sills—and not attempted on a New York stage since. In this climactic opera of the trilogy, directed by Sir David McVicar, she plays Queen Elizabeth I, forced to sign the death warrant of the nobleman she loves, Roberto Devereux. Tenor Matthew Polenzani is Devereux, and mezzo-soprano Elīna Garanča and baritone Mariusz Kwiecien complete the principal quartet in the bel canto masterpiece, conducted by Donizetti specialist Maurizio Benini.
The BFG Belle and Sebastien: The Adventure Continues
7 July
Goldstone
14 July
Sing Street
21 July
Ghostbusters Star Trek: Beyond
28 July
Jason Bourne
*Please note upcoming films are subject to change
Known to millions as ‘The King of Waltz’, André Rieu is one of the world’s most popular music artists. His legendary annual Maastricht concert is the most eagerly anticipated cinema event of the year, last year setting new box office records in several countries. Set against the stunning medieval backdrop of the town square in André’s Dutch hometown, the spectacular Maastricht concert features the maestro in his element, along with his world-famous 60piece Johann Strauss Orchestra, sopranos, tenors and very special guests. André promises, and delivers, an unforgettable musical experience full of humour, fun and emotion for all ages.
WIN MOVIE TICKETS FOR TWO! Name:
Portside Wharf, Remora Road, Hamilton P: (07) 3137 6000 www.dendy.com.au
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Telephone:
Member no:
Fill out the form and fax it to (07) 3856 4727 or email competitions@amaq.com.au. Entries close 15 JULY
QUEENSLAND MUMS AND DADS REVEAL PARENTING CHALLENGES
Peer pressure, unemployment and drugs are the greatest fears Queensland parents have for their children, with a recent survey also showing that 43 per cent of Queensland kids had been bullied through name-calling/swearing, physical assault and exclusion in the past six months. Triple P Queensland Program Director Carol Markie-Dadds said more than 2,350 parents had participated in the two-week survey, revealing the hot button topics for parents raising children in 2016. “It’s no surprise parents said they struggle the most with effectively disciplining their children and keeping their own emotions, temper and stress levels under control,” Ms Markie-Dadds said. “They also reported difficulty in managing the amount of time their children spend in front of tablets, televisions, smartphones and other screens.” Ms Markie-Dadds said the survey results showed modern life was placing more demands on parents than ever. “That’s not news to GPs, because outside family members, they are often the first port of call when parents are struggling with the challenges of raising children,” she said. “That’s why it’s important GPs are aware that free, evidence-based parenting support through the Triple P – Positive Parenting Program is currently available in Queensland. “Free online, group and oneon-one support can be accessed at www.triplep-parenting.net.” GPs can refer parents and carers to these free programs or undertake free training themselves so they can deliver Triple P parenting support to their patients.
“BEST PRACTICE INDICATES THAT PSYCHOLOGICAL, ENVIRONMENTAL AND FAMILY INTERVENTIONS SHOULD, IF POSSIBLE, BE TRIALLED AND EVALUATED BEFORE INITIATING PHARMACOLOGICAL TREATMENT IN YOUNG CHILDREN (UNDER SEVEN YEARS).”
“Best practice indicates that psychological, environmental and family interventions should, if possible, be trialled and evaluated before initiating pharmacological treatment in young children (under seven years).” Free GP training Under the State Government funded rollout of free Triple P, GPs and other health professionals can get free training, resources and clinical support to deliver different levels of group and individual parenting support.
One type of training which most suits a GP practice environment is Primary Care Triple P, which equips practitioners to provide up to four 15-minute parenting consultations over a four to six-week period. Eligibility for Professional Development points can be advised by the RACGP. Ms Markie-Dadds said Triple P Online (TPOL) is proving to be a popular option for time-poor parents who wish to improve their parenting skills at their own pace. This interactive, web-based program guides parents through core parenting strategies and has been proven to reduce behaviour problems, ineffective discipline and parental stress and conflict. Studies have shown that early identification and evidence-based treatment of childhood behaviour problems can lead to significant improvements in around 50 to 60 per cent of cases. “It’s widely acknowledged that behavioural parent training programs such as Triple P are the best supported and most effective of all psychosocial interventions for addressing childhood mental health problems,” Ms MarkieDadds said. “Evidence-based interventions like Triple P can help parents promote positive child behaviour, reduce aggressive and antisocial behaviour and encourage more harmonious relationships between parents and children.” To find out more about the free training available for GPs or receive free Triple P posters and brochures, contact the project team by emailing qld@triplep.net or call (07) 3236 1212. Q
https://www.nhmrc.gov.au/_files_nhmrc/ publications/attachments/mh26_ adhd_ cpp_2012_120903.pdf Sanders, M.R., Baker, S. and Turner, K.M.T. (2012). A Randomised Controlled Trial Evaluating the Efficacy of Triple P Online with Parents of Children with Early Onset Conduct Problems. Behaviour Research & Therapy, 50 (11): 675-684. Sanders, M.R., Ralph, A., Sofronoff, K., Gardiner, P., Thompson, R., Dwyer, S. and Bidwell, K. (2008). Every Family: A population approach to reducing behavioural and emotional problems in children making the transition to school. Journal of Primary Prevention, 29: 197-222. Brestan, E.V. and Eyberg, S.M. (1998). Effective psychosocial treatments of conducteddisordered children and adolescents: 28 years, 82 studies and 5,272 kids. Journal of Clinical and Child Psychology, 27(2):180-189.
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CHECK IN TO THE ICEHOTEL Imagine having to rebuild your practice every year! That is exactly what they need to do at the Ice Hotel Jukkasjarvi, located in Swedish Lapland. Ros Bulat from AMA Travel tells us how to get the most out of your trip.
Located 200km north of the Arctic Circle, the ICEHOTEL is much more than just a hotel, it is an experience. The area has always been popular during the summer with European tourists after activities like whitewater rafting and wilderness trekking. The original structure was an igloo style, intended as an art gallery for ice sculptures. After a shortage of hotel rooms, a party of guests asked if they could stay in this igloo with their sleeping bags. It was never intended as a hotel but the idea of the ICEHOTEL was born. After first opening in 1990, every year artists are selected to reinvent this functional art exhibition into a hotel. Formed from ice harvested from the River Torne, when completed this hotel comprises of about 100 guest rooms as well as the famous ICEBAR and a small (but impressive) church. The thick walls, ceiling and floor are all made of ice. Even the beds and fittings are carved from ice. While not all of the rooms are ornately carved, no two rooms are alike. You can choose the category of room you prefer. The rooms are kept to a constant -5ᴼC, but having experienced it firsthand, it’s not as bad as it sounds. You sleep on reindeer fur in polar-tested sleeping bags and it’s a real experience. In saying that, one night is enough. The beauty is that they also offer cabin chalets so you can stay comfortable for an extra night to allow time to experience the location.
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This original ICEBAR has grown in popularity and now offers permanent locations in Stockholm and London. Regardless of which location you experience, the glasses you drink from are made entirely out of ice from the Torne River. The concept is that when you buy your first drink it includes the glass and then each drink after you keep the same glass. As it melts away from the inside, each drink is more generous than the previous. A trap for young players! I was lucky enough to experience the Aurora Borealis or Northern Lights, as they are more commonly known. It’s nothing short of spectacular. It is like watching a living breathing life form dance across the sky so clear you feel you can reach up and touch it. No photo can ever do it justice. During the day, you can learn ice sculpting or lend your hand to a little ice fishing. Dog sledding through the pristine landscape - what an experience! You can choose a guided tour or drive your own team of huskies. Don’t forget to tour on the snowmobile. This is available during the day or as a Northern Light viewing safari. Q
Ros email all or c n atio form land. 00 ore in eens 56 72 For m Travel Qu 7) 55 (0 : A F at AM 2 885 00 26 m.au P: 18 aq.co .au l@am l.com e v a r trave ld E: t r o q.w .ama www
LOVE KRUG AND SALON? … LE MESNIL IS HERE I have for years been a champagne ‘addict’ and very early in my career was lucky enough to work in the UK where I was able to quickly expand my horizons beyond Moet, Veuve and co. What I discovered is champagne offers so much more than the big brands with many boutique houses making stunning wines of complexity, richness and balance. Fast forward to now and nothing has changed. I love champagne and am thrilled to announce the arrival of Champagne Le Mesnil, a small and relatively young producer (est 1937!) from the famous village Le Mesnil.
The Le Mesnil cooperative has the benefit of scale as we suggested above. Their quality is unquestionable too, supplying Krug and Salon, for instance whose Le Mesnil offerings retail for $600 and $1,600 per bottle respectively. The net result is truly exceptional champagne at stunning prices.
What’s the big deal? Le Mesnil is the name of perhaps the best growers’ cooperative champagne house in all of Champagne. Beginning in 1937, they now draw on the resources of 553 different growers, all of whom have their vineyards in Le Mesnil Sur Oger, one of just 17 Grand Cru Vineyards (out of 318 vineyards in the region). Grand Cru is essentially the best of the best and Le Mesnil is considered by many to be the king of Champagne villages. Its chalk-rich soils and almost exclusive plantings of chardonnay result in wines with a profound minerality and piercing clarity of fruit.
We are so keen on this wine we’ve gone to Champagne ourselves and now bring it straight from the winery to Australia, no parallel importing here. Here they are… Le Mesnil Blanc de Blancs Grand Cru NV - this 100 per cent chardonnay from the exceptional Grand Cru Village of Les Mesnil-sur-Oger in the Cote des Blancs – the finest village for chardonnay in all of Champagne. The wines offer an intensity, minerality and depth of flavour which mark it as exceptional. We found citrus, fresh brioche, fresh mushroom, lemon pith, chalky elements and lightly grilled nuts and brilliant freshness and life. The palate is
mineral, intense and crisp yet creamy and precise. Le Mesnil Sublime 2007 Grand Cru - The ‘Sublime’ Grand Cru offers an exceptionally fine mousse or bead. The nose offers incredible richness and intensity, with aromas of, baked bread, cashew and citrus zest, fresh mushroom and toasty notes to finish. Typical of Le Mesnil, this offers all of the hallmark chalkiness and minerality of the Cote Des Blancs, but with more richness and creaminess than is traditional. The palate offers creaminess, brioche, grilled cashew, almonds and exceptional concentration. The finish is complex and very long indeed. Le Mesnil Prestige 2005 Grand Cru - The ‘Prestige’ Grand Cru is made without malolactic fermentation, a technique reserved for the best champagnes which have the fruit intensity to develop on lees in the bottle for many years before release. We
found concentrated green apple and blossoms, citrus oil, honey, iodine, chalkiness, yeast and bready notes derived from many years ageing on yeast in the bottle. This is potent, energized champagne, powerful, penetrating and persistent.
PHIL MANSER
Wine Direct
P: 1800 649 463 E: phil.manser@winedirect.com.au
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LIFESTYLE
ALL ABOUT YOU
RED NOSE DAY 24 June SIDS and Kids are urging Australians to help save little lives by supporting Red Nose Day on Friday 24 June. Celebrating its 28th anniversary in 2016, Red Nose Day brings much-needed attention to the work of SIDS and Kids, whose research and education programs have significantly reduced the number of sudden and unexpected deaths in infancy in Australia. Buy a red nose product and help raise money for SIDS and Kids so it can continue to provide safe sleeping education and fund vital research.
SLOW COOKED BALSAMIC GLAZE BEEF EYE ROUND ROAST Recipe from Cooking for busy mums - fast, fresh and family-friendly meals Ingredients 1kg beef eye round roast, left whole 1 onion, sliced 4 potatoes, quartered 2 carrots, cut chunky
1. Heat a fry pan on the stove or if your slow cooker sautes, set it to that function. Once hot add your onion and meat and brown the meat on all sides. While it is browning prepare your sauce and chop your vegetables.
2. In a bowl combine the stock, brown sugar, balsamic vinegar, How our school is celebrating soy sauce and garlic. Mix well to 1/2 cup brown sugar combine. 1/4 cup balsamic vinegar 3. Once the meat is brown place 1 tbs soy sauce it in the slow cooker or if in the slow cooker already set to slow 1 tbs minced garlic cook function. Date 1 cup peas 4. Add the vegetables and then Time Optional – couscous pour over the balsamic glaze and make sure the meat gets a good coating. Set to cook on 1 cup beef stock
Friday 24th June
KARATE Why not try something completely different and check out your local karate dojo? Karate could be a great option for fitness and well-being, as it increases your stamina, strength, speed and flexibility, but you also learn some self defence. It’s great for helping with focus and coordination, plus, the uniform is pretty cool.
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low for eight hours. 5. Once the eight hours is up remove the liquid and place into small saucepan. Put it over a medium heat and allow to simmer away until it reduces and thickens. Optional: leave half the liquid in the slow cooker (remove the other half and do as per step 5) then add 1 cup couscous while the slow cooker is on. It will soak up the remaining liquid. Slice the meat and serve with the vegetables/couscous and topped with the reduced balsamic glaze. Serves 4 – 6
Visit the website for more information on how to get involved:
THE SOLDIER’S CURSE
rednoseday.com.au Meg and Tom Keneally
The first in a new fast-paced, witty and gripping historical crime series. In a penal station at the edge of the known world, gentleman convict Hugh Monsarrat hungers for freedom. Identifying the killer of the Commandant’s young wife might just be his ticket to a new life...
“EVEN IF YOU’RE ON THE RIGHT TRACK, YOU’LL GET RUN OVER IF YOU JUST SIT THERE.” WILL ROGERS
WHAT’S IN A NAME? Look at all of the eponymously named diseases and clinical signs. Trousseau, Pemberton and my favourite, Chvostek (it’s just a fun word to say) have all been immortalised for the signs that I presume they discovered.
Fame. A mention in the newspaper, a sound grab on TV or maybe even the chance to say “Fellas, did you see me take that blinder in the crowd at the Big Bash last night?” It seems everyone wants their 15 minutes’ worth and doctors are certainly not immune to its seductive siren’s call.
Some blokes achieve immortality by having body bits named in their honour, like Willis with his circulatory round-a-bout and Douglas with his pouch. But I dare say the greatest glory falls on the men (and it really is always men – perhaps it is all about male egos) who have a whole disease to commemorate their medical careers. Graves, Hashimoto, Addison and Cushing. These are some of the big dogs of the eponymous medical world. A couple of things fascinate me about the eponymous world in which doctors live. Firstly, the fact that no one has put their hand up to have any of the less glamorous body parts or any of the more rancid diseases named after them. Doctors have distanced their names from the distal end of the gastrointestinal tract, no one has claimed the stench of anaerobic pus and no one has ever seemed too keen on lending a name to any sort of sexually transmitted disease. The second oddity for me is that the poor people that have suffered from some of these famous afflictions have generally been damned to historical anonymity. One would have to argue that history’s most famous patient
would have to be Joseph Merrick, the Elephant Man. His is a fascinating story that has been commemorated on stage and on the big screen with the marvellous movie starring William Hurt and Anthony Hopkins in 1980. He was born into a working class family in Leicester in 1862 and died at just 37 years old. Disability pensions and carer’s pensions were not easily procured in Victorian England, so many people with deformities found themselves earning a quid in freak shows. Joseph was one such ‘exhibit’. He soon came to the attention of Dr Frederick Treves, who was later to become the Royal Surgeon (he took Edward VII’s appendix out) and also served in the Boer war. Apparently freak shows were very popular, not just with the public, but especially with doctors. They were a great way to study exotic pathologies and congenital abnormalities. I suppose the modern equivalents of these voyeuristic circuses are the reality shows like Embarrassing Bodies where for some reason patients, who have been too embarrassed to show off their anatomy to their own doctors in the privacy of the consulting room, feel liberated enough by the chance for a dash of fame that they happily disrobe for an international television audience. Treves’ relationship with Joseph was interesting. Initially it could be argued that Joseph
was a medical oddity that Treves hoped would enhance his medical reputation. He ‘displayed’ his new star to the doctors of London Hospital and then twice more for the Pathological Society of London. As he spent more time with Joseph though, Treves discovered him to be a sensitive, courageous, intelligent and engaging personality trapped in a hideous body. The two became firm friends, as is well documented in the movie. and I dare say seeing people as being more than their collection of clinical signs (eponymous and otherwise) and diagnosis is a marvellous lesson for young doctors to learn. I reckon this movie should be an integral part of the med school curriculum. As a final note about Joseph Merrick’s story, his diagnosis is a great exercise in retrospective medicine. Treves wrote detailed notes and utilised clinical photographs. Interestingly, he did not proffer a diagnosis. It was not until 1909 that a Dr Parkes Weber suggested that Joseph had Neurofibromatosis type 1 and this remained the generally accepted diagnosis until the late 20th century when Dr Michael Cohen corrected this mistake and attributed Joseph’s deformities to Proteus Syndrome. This was named after Proteus, son of Poseidon and god of the Sea. He could change forms to avoid enemies and has also lent his name to the Proteus flower and also to one of Shakespeare’s Two Gentlemen of Verona. Q Doctor Q Winter | 71
PEOPLE & EVENTS
CHANGING QUEENSLAND CHILDREN’S LIVES THROUGH FASTTRACKED ENT SURGERY “BILLIE-ROSE WAS FALLING BEHIND AT SCHOOL AS SHE HAD TO HAVE NUMEROUS DAYS OFF DUE TO HER HEALTH ISSUES. SHE WAS SNORING, TIRED DURING THE DAY AND OFTEN HAD A BLOCKED NOSE. SINCE HAVING HER ADENOIDS REMOVED, BILLIE-ROSE HASN’T MISSED ANY SCHOOL, AND HER TEACHER HAS NOTICED SHE IS ABLE TO CONCENTRATE MORE AND IS DOING WELL WITH HER SCHOOL WORK.” 72 | Doctor Q Winter
In 2015/16, AMA Queensland Foundation helped change the lives of 36 Queensland Aboriginal and Torres Strait Islander children through fasttracked ear, nose and throat surgery. Australia’s Indigenous population has one of the highest rates of middle ear disease in the world. It is often described as a ‘silent epidemic’ as it robs Aboriginal and Torres Strait Islander children of vital opportunities to develop, learn and flourish as they are simply unable to hear. Thanks to your generous support, these 36 children are now experiencing notable improvements in hearing, as well as sleeping, breathing, behaviour and concentration. Being able to integrate better at school has made a big difference to students’ learning and general quality of life. We at the Foundation are so incredibly proud of this outcome that we want to establish fast-tracked ENT surgery as an ongoing AMA Queensland Foundation project. We know there are many more Indigenous children in rural Queensland towns who desperately need ENT surgery. These children are uncomfortable and their school work and social wellbeing is suffering as a result. Being from low socioeconomic backgrounds and remote townships, they face considerable challenges accessing timely treatment.
Following the success of the recent surgeries performed at Noosa Hospital, we are looking to expand our scope of clinics so that more children can benefit from this initiative. We want to help achieve health equality and ‘Close the Gap’ in health, early childhood and education outcomes in our lifetime. Our goal is to provide similar opportunities in clinics throughout Queensland, with Cairns and Rockhampton identified as future potential base sites. To do this, we need your help. Our partner doctors and hospitals are already supplying facilities and services at major discounts, but we still need your financial support to help with the logistics of transporting children and their caregivers to our clinics. Your tax return may not make an enormous difference to your life, but just a portion of it could completely change the future for a disadvantaged child living in rural Queensland. I urge you to please join me by giving generously. Yours sincerely,
Dr Steve Hambleton President - AMA Queensland Foundation
YES, I WANT TO HELP CHANGE THE LIVES OF DISADVANTAGED QUEENSLAND CHILDREN
YOUR GENEROSITY HAS HELPED CHANGED OUR LIVES.
Donate online at www.amaqfoundation.com.au
THANK YOU.
PERSONAL DETAILS Name:
CAN YOU OFFER MORE CHILDREN LIKE US THE SAME OPPORTUNITY TO THRIVE?
Address: Phone (H):
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SUPPORT $100
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$500
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PAYMENT DETAILS Cheque: Please make cheques payable to ‘AMA Queensland Foundation’ Credit Card:
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ACKNOWLEDGEMENT Donations are recognised in AMA Queensland Foundation publications. Please acknowledge my contribution in the name of: (30 characters max. i.e. The White Family, Mr T & Mrs S White, Sue & John White)
I would prefer my donation to remain anonymous.
OTHER Please tick I/we would like more information about leaving a bequest to the AMA Queensland Foundation.
PLEASE RETURN TO: AMA Queensland Foundation PO Box 123, Red Hill Q 4059
Photos courtesy of CheckUP
Ph: (07) 3872 2222 www.amaqfoundation.com.au ABN: 31 093 701 083
THANK YOU FOR YOUR SUPPORT! QFN-TAX-2016/DrQ
Doctor Q Winter | 73
LIFESTYLE
IN PRINT
HARRISON’S MANUAL OF MEDICINE Harrison’s Manual of Medicine is a concise, bedside resource derived from content found in Harrison’s Principles of Internal Medicine, Nineteenth Edition. Perfect for use at the point of care, the Manual presents clinical information covering key aspects of the diagnosis, clinical manifestations, and treatment of the major diseases that are likely to be encountered in medical practice.
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Presented in full color and incorporating an efficient blend of succinct text, bullet points, algorithms, and tables, Harrison’s Manual of Medicine, Nineteenth Edition covers every area of clinical medicine, including: Doctor Q has a copy of Harrison’s Manual of Medicine - Ninth Edition to give away. Fill out the form to the right and fax it to (07) 3856 4727 or email competitions@ amaq.com.au. ENTRIES CLOSE 15 JULY
Etiology and epidemiology
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Clinically relevant pathophysiology Signs and symptoms Differential diagnosis Physical and laboratory findings Therapeutics Practice guidelines Q
GIVE AWAY WINNERS DENDY WINNERS Dr Ernest Tee
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BOOK WINNERS Dr Jessica Forbes won a copy of Tintinalli’s Emergency Medicine, thanks to McGraw-Hill Education.
Don’t forget to enter in this Doctor Q edition to win. 74 | Doctor Q Winter
VR GP’s wanted for Private Billing Practice in Ashgrove, Brisbane. • • • • •
Full-time or part-time positions available Flexible working hours and days Access to existing patient base Full RN support Own consult room and parking space
• • •
For more information please contact the Practice Manager at Ashgrove West Group Practice
65% of billings or $110/hr whichever is greater Experienced, multidisciplinary, and family-friendly team Applicant need to have, or be eligible for, full registration with AHPRA
(07) 3366 3544 practicemanager@ashgrovewestgp.com.au www.ashgrovewestgp.com.au
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My Skin Cancer Centre is conveniently located only 5km from the CBD. A strong patient base ensures the tenants are heavily booked. The current location is secured for a further 2 years.
Business for Sale Sally Whittaker
Practice Manager swhittaker@westderm.com.au 0498 733 641
PSYCHIATRIST REQUIRED FOR PRIVATE PRACTICE IN CAPALABA We are looking for a Consultant Psychiatrist to join our friendly team in a well supported modern 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 excellent purpose built rooms and ample parking, is close to public transport and major shopping centres. The position has excellent potential to be both personally and financially rewarding. !
Please contact principle psychiatrist Dr Yasin by email: yasinps@outlook.com or by mobile on 0477 017 070
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Doctor Q Winter | 75
PEOPLE & ISSUES LIFESTYLE BUSINESS CURRENT REGULARS FEATURES REPORT EVENTS TOOLS
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Apply now. Visit boqspecialist.com.au/deposit or call 1300 131 141 The issuer of these products and services is BOQ Specialist - a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL no. 244616 (“BOQ Specialist�). Terms and conditions, fees, charges and eligibility criteria apply. Promotional interest rate of 3.00% p.a. for 180 days term deposits is exclusively available for new funds to bank invested in a term deposit by clients deemed by BOQ Specialist, in its sole discretion, to be engaged in the practice of medicine, dentistry and veterinary sciences. BOQ Specialist reserve the right to cease offering this interest rate at any time without notice.
76 | Doctor Q Winter