JULY 2013 . VOL 85
AMA Queensland Membership Magazine
HEALTH VISION PRESSURE POINTS MEET OUR NEW PRESIDENT AND COUNCIL
THE FUTURE IN OUR HANDS
FREE TO AMA QUEENSLAND MEMBERS
DoctorQ JULY 2013
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THIS ISSUE DR CHRISTIAN ROWAN MEET THE MAN WHO WILL REPRESENT AMA QUEENSLAND AND LEAD OUR NEW COUNCIL THROUGH THE CHALLENGES AND OPPORTUNITIES OVER THE NEXT 12 MONTHS
20 NEW PRESIDENT-ELECT: DR SHAUN RUDD 22 NEW AMA QUEENSLAND BOARD AND COUNCIL
Current issues 26 HEALTH VISION: OUR ADVOCACY ACTION PLAN 28 FAIR WORK ACT CHANGES
30 AMA QUEENSLAND WEBSITE 2.0
32 MEMBERSHIP IS LIKE HERD IMMUNITY 34 FOUNDATION NEWS
It’s a unique opportunity to continue to drive innovation, improve clinical services, encourage collaboration and drive reengagement with clinicians.
48 CONFERENCE UPDATE
52 WHAT HAPPENS WHEN...? 54 REVIEWING CONTRACT ARRANGEMENTS 56 BREACHING DUTY OF CARE ALONE IS NOT ENOUGH 58 BUYING PROPERTY
people & events 10 PRESIDENTIAL INAUGURATION
12 COCKTAILS WITH BERNARD SALT
FROM THE EDITOR’S DESK
37 RDAQ CONFERENCE
40 EVENTS CALENDAR 45 OBITUARY: DR FRANK JOHNSON
16 LETTERS TO THE
46 OBITUARY: DR ADRIAN GROESSLER
36 LOCAL MEDICAL ASSOCIATION ROUND UP
44 MEMBER NEWS
59 TRAVEL 62 MOTORING 63 ALL ABOUT YOU
64 MOVIES 65 ON STAGE 66 IN PRINT
DoctorQ JULY 2013
FROM THE EDITOR’S DESK BOARD OF DIRECTORS
MICHELLE FORD RUSS Doctor Q Editor Things are looking a bit different here at AMA Queensland: we’ve sworn in a whole new President, President-Elect, Board and Council and gone live on a fresh new website. I sat down with Dr Christian Rowan and Dr Shaun Rudd last month to find out what they’re about and they’re in for a busy 12 months! Read more on p18. Find out more about our new website on p30 and visit www. amaq.com.au. Five pressure points that you’ve asked us to target in our advocacy work have been outlined on p26. It’s all part of our advocacy action plan within our Health Vision. Join the conversation on the blog at amaqhealthvision.com.au or at the engagement forums planned for July and August so far. We’ve got some lovely social photos from the Presidential Inauguration and Cocktails with Bernard Salt too
(p10 and 12), while Dr Vanessa Grayson has written a great column likening membership to herd immunity (p32). With a Federal election looming and some worrying policies being volleyed about, it’s certainly a timely to discuss strength in numbers. We’ve also listened to your feedback and we’ve now included a new feature in the magazine: case studies from MDA National. They’ve kindly given us a case study that focuses on whether you need to report deaths to the coroner and some guidelines if you are faced with that decision. Don’t forget our giveaways in this edition: movie tickets, books and theatre tickets. We’re also keen to hear your feedback on All About You, our new social page. Email me at editor@amaq. com.au and let me know. Q
Dr Christian Rowan President
Dr David Alcorn Honorary Secretary
Dr Shaun Rudd President-Elect
Dr Alex Markwell Elected Member
Dr Sharon Kelly Chairperson
Dr John Hall Elected Member
Dr Chris Zappala Treasurer
Dr Richard Kidd Elected Member
COUNCIL Dr Tom Arthur Gold Coast Area
Dr Kelly Macgroarty Specialist Craft Group
Dr Sharmila Biswas Far North Area
Dr Bav Manoharan Greater Brisbane Area
Dr Kimberley Bondeson Greater Brisbane Area
Dr Dilip Dhupelia Part-Time Medical Practitioner Craft Group
Dr Bill Boyd Capricorn Area Dr Ben Duke Greater Brisbane Area Dr Larry Gahan General Practitioner Craft Group Dr Noel Hayman Greater Brisbane Area Dr Sharon Kelly Specialist Craft Group Mr Nicholas Gattas Medical Student Group
OBITUARIES AMA Queensland sadly wishes to advise that the following members recently passed away: Professor Robert MACLENNAN Specialist Internal Medicine Late of Mount Glorious Member for 58 years
Dr Colin Howard WALKER General Practitioner Late of Woree Member for 21 years
Dr Robert LEA (Robin) Specialist Psychiatry Late of Speers Point Member for 62 years
Dr Grahame Frank DIXON General Practitioner Late of Durack Member for 61 years
Dr Frank Louis JOHNSON Specialist Rehabilitation Medicine Late of Runaway Bay Member for 58 years
Dr Vanessa Grayson Residents and Registrars Craft Group Dr Wayne Herdy North Coast Area
Dr John F. Murray Full -Time Salaried Medical Practitioner Craft Group Dr Carl O’Kane North Area Mr Callum Potts Medical Student Observer Dr Shaun Rudd General Practitioner Craft Group Dr Jonathon Shirley Greater Brisbane Area Dr Mason Stevenson General Practitioner Craft Group
AMA QUEENSLAND SECRETARIAT Jane Schmitt Chief Executive Officer Filomena Ferlan General Manager Corporate Services Colleen Harper Manager - AMA Queensland Foundation
Holly Bretherton General Manager Member Relations and Communications Andrew Turner Manager - Member Services
Editor: Michelle Ford Russ Graphic Designer: Erin Sticklen
Disclaimer – All material in Doctor Q remains the copyright of AMA Queensland and may not be reproduced or transmitted in any form without permission. While every care is taken to provide accurate information in this publication, the material within Doctor Q is for general information and guidance only and is not intended as advice. Readers are advised to make their own enquiries and/or seek professional advice as to the accuracy of the content of such articles and/or their applicability to any particular circumstances. AMA Queensland, its servants and agents exclude, to the maximum extent permitted by law, any liability which may arise as a result of the use of the material in Doctor Q.
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Journalist: Barbara Ferres Advertising: Louise Glynn Doctor Q is published by AMA Queensland Contact Phone: (07) 3872 2222 Postal Address: PO Box 123, Red Hill QLD 4059 Print Post Approved PP490927/00049 Email: email@example.com
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FIRST UP, FEDERAL ELECTION IN HIS VERY FIRST PRESIDENT’S REPORT, DR CHRISTIAN ROWAN LOOKS TO THE LOOMING FEDERAL ELECTION, WHERE QUITE A FEW CONCERNING ISSUES ARE ARISING WHICH COULD HOLD SERIOUS CONSEQUENCES FOR THE PROFESSION.
DR CHRISTIAN ROWAN President, AMA Queensland FEDERAL TAX CAP ON SELFEDUCATION EXPENSES AMA Queensland is backing the campaign being led by our Federal colleagues to strongly protest the Federal Government’s intention to introduce a cap on the tax deduction for work-related self-education expenses at $2,000 per person from 1 July 2014. AMA has launched a dedicated website www.doctors4health.com.au where members can add their voice to the fight and lobby local MPs to ensure this decision is reversed prior to the Federal election on 14 September.
FEDERAL ELECTION As the Federal election draws closer, AMA will be actively campaigning for additional General Practice support. We will be highlighting issues affecting GPs such as the lack of Medicare Benefits Schedule item indexation, changes to the Practice Incentives Program impacting on after hours GP services and the rollout of eHealth initiatives.
As the Federal election draws closer, AMA will be actively campaigning for additional General Practice support. to the Health Minister who will oversee the appointed Ombudsman and take responsibility for managing all health complaints in Queensland.
Nurses Federation for private practice nurses in NSW, Victoria and Tasmania, to bargain collectively with their respective employers.
While AMA Queensland supports the development of a new health complaints system, the Bill, as currently drafted, lacks the safeguards of transparency, independence and significantly undervalues the role of clinicians in the complaints processes.
This was a win for all doctors in private practice who are already struggling to meet the ever-increasing costs of running a business; hopefully this case sets a precedent that will discourage similar orders from being lodged here in Queensland in the future.
Although we acknowledge and support the Minister’s policy intent, AMA Queensland has serious concerns that the Bill in its current form will not lead to a fair and efficient complaints process that is accountable to the community.
I would like to conclude by thanking all of those involved in last month’s Presidential Inauguration; it was a great event and an opportunity to celebrate some of the most inspirational members of our profession.
QUEENSLAND HEALTH OMBUDSMAN BILL 2013
FAIR WORK COMMISSION DECISION ON ANF APPLICATION
If passed in its current form the Queensland Health Ombudsman Bill 2013 will grant unprecedented powers
This week AMA welcomed the decision by the Fair Work Commission (FWC) to refuse an application by the Australian
Despite the many challenges we will encounter over the next year, I am extremely honoured to hold the position of AMA Queensland President and I look forward to working with you over the coming months. Q
“AMA Queensland believes that the current Bill before parliament has significant flaws and the Association has grave concerns about the Bill’s impact on good clinical practice.” You can read more on more on page 9. 6
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DoctorQ JULY 2013
STRAIGHT TO WORK FOR OUR NEW TEAM WITH THE FESTIVITIES OF ELECTIONS AND INAUGURATION NOW OVER, IT IS TIME TO TACKLE THE NEXT ROUND OF CHALLENGES FACING THE MEDICAL PROFESSION AS TURBULENT TIMES FOR THE HEALTHCARE PROFESSION CONTINUE.
JANE SCHMITT Chief Executive Officer, AMA Queensland AMA Queensland was delighted to welcome Dr Christian Rowan as our 2013 - 2014 President and Dr Shaun Rudd as Presidentelect at our Presidential Inauguration on 14 June (see page 10 for the full story). We also congratulate our new Councillors and welcome back those that are returning to another year in their representative roles (a full list is provided page 22). Key issues confronting AMA Queensland and our members right now include:
HEALTH OMBUDSMAN BILL 2013 QUEENSLAND AMA Queensland opposes to the Bill in its current form and is working with the Health Minister to reach a compromise that supports a transparent and accountable system with greater clinical decisionmaking at its heart. The Bill, if passed, will abolish the Health Quality and Complaints Commission and replace it with a Health Ombudsman who will oversee all health complaints in Queensland. Although we acknowledge and support the Minister’s policy intent, and in fact AMA Queensland has strongly advocated for an effective and independent health complaints system that is accountable to the community, the Bill in its current for does not achieve this (see page 9 for more information).
FEDERAL GOVERNMENT TAX CAP ON EDUCATION EXPENSES The Federal Government plans to introduce a cap on the tax deduction for work-related self-education expenses at $2,000 per person from 1 July 2014. AMA, at all levels, is opposing this poorly considered policy which will inhibit the ability of people to improve their skills and knowledge. The $2000 cap will apply to tuition fees, registration fees, textbooks and journals, computers, student union fees, accommodation, running expenses and travel. We will continue to lobby the Federal Government to rethink this decision which has dire consequences
JULY 2013 DoctorQ
for any professional looking to enhance their educational experience.
MEDICARE LOCALS I recently met with the Chairs and CEOs of the 11 Queensland Medicare Locals to discuss key issues affecting primary health care service provision, coordination and delivery. The meeting was an excellent opportunity to begin to identify ways in which we can work collaboratively to improve outcomes for doctors and their patients.
The Federal Government plans to introduce a cap on the tax deduction for work-related self-education expenses at $2,000 per person from 1 July 2014. AMA, at all levels, is opposing this poorly considered policy...
AUDITOR-GENERAL REVIEW OF RIGHT OF PRIVATE PRACTICE BILLING The Queensland Auditor-General’s Review of the Right of Private Practice Billing Processes is expected to be handed down during July. AMA Queensland and our partner union ASMOFQ are working closely to ensure members are kept updated and made aware of their rights and responsibilities for any action that follows as a consequence of the review.
AMA QUEENSLAND’S HEALTH VISION In the last issue of Doctor Q we unveiled AMA Queensland’s Health Vision which provides a robust framework for health services delivery in Queensland. We need your input to ensure that it meets the needs of ALL doctors in Queensland, please visit www.amaqhealthvision.com for information or to get involved. As always, I thank you for your ongoing support of AMA Queensland and invite you to enjoy this jam-packed issue of Doctor Q – and I hope to see you at one of our many upcoming member events! Q
AMA Queensland was delighted to welcome Dr Christian Rowan as our 2013-2014 President and Dr Shaun Rudd as our President-Elect.
AMA Queensland NEWS
AMA QUEENSLAND OPPOSES HEALTH OMBUDSMAN BILL IN CURRENT FORM On 4 June 2013, the Health Minister introduced the Health Ombudsman Bill 2013 into Parliament. This Bill, if passed, will abolish the Health Quality and Complaints Commission and replace it with a Health Ombudsman who will oversee all health complaints here in Queensland. Under the Bill, the Health Ombudsman will continue to report to the Health Minister who is provided with wide ranging powers to direct and compel information from his employee (the ‘Health Ombudsman’).
AMA Queensland has many concerns regarding this change. Although we strongly advocate for an effective health complaints system that will improve our health system and provide for a fair, efficient and transparent complaints process that is accountable to the community, AMA Queensland believes that the Bill in its current form will not achieve this outcome.
AMA Queensland has made a submission to the Queensland Parliament’s Health and Community Services Committee Inquiry into the Bill. View it at www.amaq.com.au.
Independence from government and transparency of decision-making are essential to regain public and clinician confidence in Queensland’s health system – the Bill does not achieve this. The expertise and experience of senior medical practitioners is essential in order to appropriately assess the conduct and performance of medical practitioners using a solid evidence-base and benchmarking – the Bill does not achieve this. The Health Ombudsman must be in a position to fearlessly address systemic issues including, but extending beyond, complaints about individual practitioners – the Bill does not achieve this. Complaints matters, particularly where restrictions are placed on medical practice, should be dealt with in a timely way – the Bill does not guarantee this. Q
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DoctorQ JULY 2013
People & EVENTS
Awards AMA Queensland Citation of the Branch Dr Thomas McEniery Dr Vedella (Del) M. Hinckley
AMA Queensland Award of Distinction Mrs Lois Wilson AMA Memorial Prize Daniel Schuster William Nathaniel Robertson Medal Katrina Clark Harold Plant Memorial Prize Timothy Amos John Bostock Prize in Psychiatry Dylan Barnes Lilian Cooper Prize
GUESTS DECKED OUT IN BLACK-TIE ENJOYED THE PRESIDENT INAUGURATION AT THE STAMFORD PLAZA TO SEE DR CHRISTIAN ROWAN TAKE THE REINS.
Daniel Schuster AMA Queensland Medal of Achievement – James Cook University Oliver Hayes AMA Queensland Child Health Prize – Bond University Farah Zaman AMA Queensland Children’s Health Prize – Griffith University Anabelle Lindley President’s Award Dr Noel Hayman
ABOVE LEFT: AMA Queensland Vice Presidents - Back row: Dr Charles Roe AM and Dr John Lee. Front row: Prof Joan Lawrence AM, Professor Tess Cramond AO OBE OStJ and Dr Humphry Cramond MBE OAM. ABOVE RIGHT: Health Minister Lawrence Springborg with President Dr Christian Rowan MIDDLE LEFT: New President Dr Christian Rowan MIDDLE RIGHT: Dr Vanessa Grayson and Dr Will Milford BELOW: Attending members of the 2012-2013 AMA Queensland Council
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People & EVENTS
BERNARD SALT MORE THAN 120 AMA MEMBERS AND GUESTS GATHERED AT THE VICTORIA PARK GOLF CLUB ON THURSDAY 30 MAY FOR COCKTAILS WITH ONE OF AUSTRALIA’S RENOWNED DEMOGRAPHERS BERNARD SALT.
Bernard Salt is an author, business advisor and regular columnist for The Australian who rose to prominence with the release of his first book The Big Shift in which he predicted a rise in the demand for coastal lifestyle and he has also authored recent books The Big Picture, The Big Tilt and The Man Drought. At our event, Bernard outlined key demographic trends in Queensland and the trends that will impact the medical profession over the coming decades. Q
Tracey de Angelis, Sabina Ali and Simon James
Dr Cheryl McNally and Dr Graham McNally with John Gower (centre)
Immediate Past-President Dr Alex Markwell, CEO Jane Schmitt and Bernard Salt
ABOVE: (From left) Ross Noye (Macquarie), Paul Copeland (William Buck), Jeff Miller (Investec), President Dr Christian Rowan and Mark O’Flynn (Macquarie).
A special thank you to our sponsors: 12
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AMA Queensland NEWS
ABOVE: AMA Queensland Councillor Dr Dilip Dhupelia (left) and President Dr Christian Rowan with Dr Marsh Godsall (centre).
MACKAY MEET AND GREET The AMA Queensland team, including President Dr Christian Rowan, Immediate Past President Dr Alex Markwell and Member Relations General Manager Holly Bretherton visited Mackay 6 – 9 June. The team hosted a member and non-member networking function at Mackay Artspace, sponsored the Mackay Hospital Grand Rounds lunch and represented AMA Queensland at the RDAQ Conference at the Mackay Convention Centre over the weekend. President Dr Christian Rowan said “The Mackay regional trip was a great opportunity to engage with our local members,
non-members and students. It is important for us as an Association to discuss the issues our members are facing at a local level at this pivotal time for health in Queensland. I was pleased to provide our members in Mackay with a timely pre-election update on our regional advocacy initiatives, including our Vision for Health in Queensland and our advocacy for those issues relevant to General Practice. We also welcomed our new Councillor representing Capricornia, Dr Bill Boyd, at our Mackay member and nonmember networking function and we look forward to working with him closely over the coming months.” Q
ABOVE: Jerry Abraham, Stephy Zhang, Dr Amy Nelson and Immediate Past President Dr Alex Markwell.
ABOVE: President Dr Christian Rowan, RDAQ President Dr Adam Coltzau and Immediate Past President Dr Alex Markwell at the RDAQ Conference.
DR HAMBLETON TO SERVE THIRD TERM Kedron GP Dr Steve Hambleton was elected unopposed to serve a third term as AMA President. AMA Vice President, Professor Geoffrey Dobb, the Director of Critical Care at Royal Perth Hospital, was also elected unopposed to serve a third term in his role. Canberra ophthalmologist, Dr Iain Dunlop, was elected Chairman of Council, and Dr 14
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Elizabeth Feeney, an anaesthetist from NSW, was elected Treasurer. AMA NSW President, Dr Brian Owler, and AMA Victoria President, Dr Steve Parnis, were elected to fill the remaining AMA Executive positions. Dr Hambleton served as AMA Queensland President in 2005-2006. Q
AMA Queensland NEWS
QUEEN’S BIRTHDAY HONOURS LIST Congratulations to the following members who were honoured on the Queen’s birthday. Dr Peter Woodruff AM was appointed a Member of the Order of Australia for significant service to medicine, particularly in the field of vascular surgery and through contributions to healthcare standards. Dr Woodruff has been a member for 30 years.
UQMS ANZAC TRIBUTE SERVICE AMA Queensland staff were pleased to attend The University of Queensland Medical Society’s 2013 ANZAC Tribute Service. Hosted by the society and Major General John Pearn AO RFD (Retd), the service include a student address
from UQMS President Claire Mohr and the Keynote Address was provided by Lieutenant Colonel Peter Nasveld, who spoke about the untrained medical officers who supported medical staff in WWI and II. Q
Professor Peter Leggat was appointed a Member of the Order of Australia for significant service to medicine as a specialist in the fields of tropical and travel medicine. Professor Leggat has been an AMA member for 25 years. Q
How the MBAQ can help you The Association provides financial assistance to help medical practitioners through crises. If you find yourself in a financial crisis, then make contact with the MBAQ to receive the application forms for assistance.
How you can help the MBAQ You may contribute to the Medical Benevolent Association of Queensland in several ways: • By becoming a member of the Association: Subscriptions - Ordinary Annual membership $30 p/a - Life membership $50 one sum • By making a tax-deductible donation to the Association. • By making a bequest in your Will. • By naming the Association as the beneficiary where there is a surplus following functions such as Year Reunions or LMA Dinners.
Tragedy is unpredictable and may strike at any age in the life of a medical practitioner... More Information Further information can be found on the MBAQ website at www.MBAQ.org.au. All donations are tax deductible.
Donate or subscribe today!
Medical Benevolent Association
of Queensland DoctorQ JULY 2013
letters to the editor
PRIVATISATION: MORE BUCK FOR SELECT FEW Feature story
Thank you for your interview with Minister Springborg and raising the issue of privatisation of healthcare in Queensland.
ATION: PRIVAEETNSIS LAND’S HEALTH WHAT QU SAY MINISTER HAD TO
It is a great forum to hear out the Minister and I particularly welcome the comments by Andrew Turner a few pages earlier, pointing out some of the risks inherent in privatisation and introducing individual contracts.
practice for delivering and the most efficient the – that we’re getting understanding of our health care services Q. What’s your OF – is RELEASE our dollar in delivering for privatisation THE maximum value for business rationale FOLLOWING is a ARE IN BETTER HEALTHC is it because there BLUEPRINT FOR free public health services. this about cost or AMA QUEENSLAND ion that means you dysfunct QUEENSLAND MANY service public research, training, the TED US WITH Q. What about hospitals to achieve MEMBERS CONTAC can’t get public PROPOSED ent - how do you ? developm ABOUT professional in private hospitals CONCERNS TOOK efficiencies you see provider is giving OF SERVICES. WE ensure that a private PRIVATISATION THE ion of all of those QUESTIONS TO SOME OF YOUR those opportunities? CE I think it’s a combinat HEALTH, LAWREN public hospitals have to MINISTER FOR UP things; some of our things that need HERE’S A WRAP to drive down They are all the SPRINGBORG, AND innovative in trying very been d because that’s a TO SAY... true there’s been be properly considere OF WHAT HE HAD be very costs. It’s certainly sector, that we need to public thing the one in d the t culture that’s permeate the most significan but clear about. That’s line service delivery n. innovatio not only in front require to that “we’re the public challenge that’s going block also organisationally, of that, we’ve got subject to the sorts Notwithstanding e sector so we’re not where we quarantin actually funded components imperatives that set normal financial for training, that’s amounts of money own home or business on in exist in someone’s very high expectati a parallel got a in We’ve live aside. don’t somewhere”. We ts with our Hospital this is public money our service agreemen an universe, because that training is and Health Services sure that we’re getting we have to make we actually do. that what of money part t public the importan maximum dollar for by a hospital funded we spend. We’re talking about all continuing to provide the public sector a lot of talk about ities Q. There’s been training opportun Coast University of the services and privatising the Sunshine training hospital would hospitals or service a big public sector no-one pays Hospital, what other assessing to what it would be and that’s currently do, you we are provisions about making sure anything for it. It’s the taxpayer for go out to tender? value get the most efficient that, with ahead of ourselves that we actually do because the more I don’t want to get I’ve deliver more quality University Hospital. means that we can the Sunshine Coast in their Coast. clinicians Sunshine senior the health services for met with a group of was all explained what it various areas and ent have a set very comfortable. Q. Does the Governm about and they were decisions about timetable for making to Coast that’s been done of the Sunshine the privatisation I commend the work where ? areas; we all know University Hospital date in a range of open in health, this is an are as we curves cost the through as quickly are in there, they’re We’re pushing it that I’d like to process now, KPMG saying . been clinicians I’ve can. with those possibly going to be engaging about where we’re no decision has a very clear picture open, have very be to It’s going make going early next year. I want out of it is to been made. What practice best possible sure we’ve got the
There do not seem to be many other facts brought forward by the AMA regarding the potential risks and downsides of privatisation in this feature story:
The “Sunshine Coast University talk” has some hard and salient facts that have been omitted in this piece: Ramsay Medical, one of the biggest private health providers in Australia, is currently in the bidding for the running of the attached hospital and happens to have been the biggest single donor to the Liberal party last year: Paul Ramsay Holdings donated $505,000 to the Liberal Party, while related entity Ramsay Health Care donated $100,000 to the Liberals.1
healthcare or hospitals outlined or trialled in this country. Can we trust promises about future arrangements by a politician and the private sector that is driven my maximising returns for its investors? Education means reallocating some of the lucrative profits without direct benefit to the shareholder - is that likely to happen without strict regulation and control when even in the public sector it is hard to maintain?
3. The abuse of the Medicare billing by bulk billing practices
with extra-short consultation times undoubtedly resulting in poor quality health-care as well as squandering of health dollars has just recently been reported all overt Australia. It has also been reported to be predominantly found in ‘large corporations’, ie companies that invest in medicine for maximum profit without necessary personal attachment to the cause, project or patient. Pharmaceutical industries are regularly overcharging the public and the Australian state due to lack of stricter regulation of the ‘private market’.2
4. Already private hospitals are ‘cherry-picking’ the lucrative
interventions and procedures, leaving the costly and labour intensive patients and cases to the public sector. Letting the public sector lose all lucrative interventions due to waiting lists and then claiming that private which does rarely ever look after massive trauma, complex elderly, the disabled and chronic conditions, cancer or ICU patients is ‘more efficient’ is comparing apples with pears.
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2012 DoctorQ 2013 MARCH MAY DoctorQ
far there are no figures available for hospital performance that indicate that private hospitals are doing better than public hospitals in Queensland. To the contrary there was some reluctance of private hospitals to make their figures public. All that in spite of the massive funding gap and sometimes double cost between the private compared to the public hospitals.
6. Charging of beyond Medicare rebates by many doctors
is already putting a strain on low-income Australians potentially reducing the uptake of critical preventive or curative consultations. Privatisation is unlikely to reduce that phenomenon, to the contrary, especially in the country where profits are reduced and needs are increased.
The idea of outsourcing the profitable aspects of medicine to the private sector while maintaining the labour and costintensive ones in the public hand is hardly likely to give us more health for our buck - only more buck for some health providers. The visual graphic of ever increasing gold coin staples underlying your privatisation feature seems to indicate a very lucrative and golden future ahead of us. While privatisation is undoubtedly very lucrative for some and can deliver high quality care for the ones who can afford it, it is unlikely to deliver better healthcare for all or indeed bring substantial amounts of money back into the health system. After all it is driven by the incentive to maximise profits not health. I hope the AMA keeps up the discussion about health privatisation and offers further insights and facts in the next edition. Kind regards, Dr Ulf Steinvorth
g the delivery of talking about privatisin and the concerns of services such as EDs existing core clinical Q. How do you alleviate public comes to some support worried that the wards but when it doctors who are of got to. When we’ve be sidelined in favour clinical services, we’ve sector is going to sure we have to make s? got business units, the private provider talking about private We’re best efficient. the they’re n is to deliver to run sector assisting us My principal obligatio and not-for-profit in Queensland for nd hospitals in Queensla possible health services some of our new I think our Hospital value for that. possibly the best value for money. best the doing and getting Boards have been clinicians. and Health Service This is not about sidelining getting more mature a good job, they’re of stakeholders engagement process, widely with a variety consult I around the clinician nd, as well as other in a more collegiate including AMA Queensla [and] they’re working we their d groups. Although services within unions and intereste way to integrate ves we that’s a good thing. different perspecti frequently share districts and I think purpose on a broad are also share a common of our great ideas We’re finding some I want range of issues. Q from clinicians. coming forward s of objective the an alignment between nd Health, that’s clinicians and Queensla in this. Our objective the important thing [it’s] patient care, how is better quality delivers it is probably delivered or who tion – it’s about not the biggest considera it the best way. making sure we deliver widely, tion more Q. Will there be consulta the privatisation issue? particularly around nd we need to understa Absolutely. I think how very interested in privatisation. We are on might be able to take the private sector ilities, that’s why some of our responsib not contestability. We’re we’re looking at
2. To my knowledge there is no credible training in private
possible practice we’ve got the best of it is to make sure “What I want out g our health care services.” practice for deliverin and the most efficient
THIS IS HOW THE MINISTER EXPLAINS PRIVATISATION – WHAT DO YOU THINK? Please send your feedback to membership@ amaq.com.au
2013 MAY 2012 MARCH DoctorQ DoctorQ
letters to the editor
PRIVATISATION REPEATING PAST MISTAKES The article in the latest issue of Doctor Q concerning the interview with the Minister for Health demonstrates the idealogues have taken over in the state government. I worked in the NSW Health Department during the Greiner years and they had the same idea that the private sector can better run not only the health system but other services as well. They brought in managers from the private sector to head many departments. All were failures. In health the Minister Ron Phillips gave the new hospital at Mount Druitt to a Catholic order to run and decided to let the private sector build and run the new Port Macquarie hospital. The Mount Druitt hospital was returned to public management as soon as the contract expired at the wish of the Catholic order. The cost of the Port Macquarie contract turned out to be much higher than if it had been built and run by the state government as government borrowings are cheaper than private borrowings
and the return on profit margin further pushed the cost up. In later years Minister Phillips said that they would never do that experiment again. Queensland will repeat the same mistakes and alienate not only the health workers but the public as well. The private system can control the inputs by only providing certain services but the public system has little control over inputs and has to be responsible for everyone who presents requesting treatment whether it be at that point or transferred to a larger treatment centre. Dr Peter Stanley
Have your say! Email your thoughts to firstname.lastname@example.org and join the conversation.
DoctorQ JULY 2013
DR CHRISTIAN ROWAN DRUG AND ALCOHOL SERVICES. CLOSING THE GAP. RURAL HEALTH. SENIOR DOCTORS. MEDICAL TRAINING AND CAPACITY. NEW AMA QUEENSLAND PRESIDENT DR CHRISTIAN ROWAN HAS A NUMBER OF ISSUES IN HIS SIGHTS TO TACKLE OVER THE COMING YEAR. There is always the right time for stepping up to a leadership role. For Dr Rowan, heath reform has made now that time.
information technology enable and augment good clinical care and allow providers to connect with doctors on the ground.
“It’s a unique opportunity to continue to drive innovation, improve clinical services, encourage collaboration and drive re-engagement with clinicians. I’m obviously passionate about clinical leadership, so there’s an opportunity to contribute there,” said Dr Rowan.
We will continue to assist with strategies to address geographic maldistribution of the medical workforce. We need to get more general practitioners and rural generalists and specialists into rural and regional Queensland, by looking at incentivised ways to encourage the health workforce to live and work in those communities: geographic isolation, continuing professional development for people once they’re out there, housing, spousal employment, children’s education and so forth,” he said.
Dr Rowan is also looking forward to leading a team of experienced councillors to set some long-term goals and consolidate AMA Queensland’s Health Vision. “There’s a good team of councillors on the current AMA Queensland Council with a lot of knowledge, skills and expertise in relation to general practice, indigenous health, regional specialist services and it’s always a positive, because the President comes in for one year and they make their contribution, but there’s a whole team of people behind that: not only councillors and the Board but the AMA Queensland Secretariat as well. “Sustainability is about having a cohesive agenda, which is why we’ve developed the Health Vision at AMA Queensland. It’s very important from the perspective that’s its clearly articulating our vision and guiding values and our principles as an organisation and what we hope to achieve as far as health outcomes are concerned for the health system both publicly and privately. Having worked in many varied areas of medicine, Dr Rowan will bring significant experience to the table. “I’ve had experience in working in both general practice and primary care, in rural and regional environments. I’ve also worked as a specialist in tertiary hospitals but also have formal qualifications in medical administration, which has allowed me to see the continuum of patient care from general practice all the way through to secondary hospital, tertiary practice and multi-disciplinary collaboration with a variety of health professionals.” Dr Rowan completed all of his general practice and rural medicine training via the Remote Vocational Training Scheme and he has worked in rural and regional Queensland for ten years before completing his addiction medicine and medical administration specialist qualifications. “We need to continue to champion strategies to improve access and availability of direct health service provision. Telehealth and
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“I’m very passionate about leading Closing the Gap initiatives in relation to Indigenous health, from my experience in regional and rural environments, that’s very important. “As an addiction medicine specialist, I have strong views about what needs to be done in relation to alcohol and drug services. Substance dependency is a significant health, social and economic burden, not only for those individuals and their families affected, but for communities as well,” he said. Despite the recent passing of AMA Queensland’s Retired Doctors Working Party Chair Dr Frank Johnson, Dr Rowan is adamant to continue the fight. “We should better recognise, respect and value senior members of our profession and I will continue to address practice categories for retired doctors. The Limited Registration Occasional Practice category had worked well in Queensland and I believe it should continue as a category nationally,” he said. Over the next 12 months and beyond, medical education and training capacity for interns as well as prevocational and vocational positions is one the biggest challenges ahead. “From a community perspective, we need to get these people through to provide services and so it’s in everyone’s interests that we all work constructively together to maximise training opportunities in the public and private sectors and in general practice and hospital settings. The last thing we want is lack of training opportunities to be the barrier to getting students from medical school to when they can independently practice.”
We need to have productivity and efficiency and there needs to be value for money, but not at the expense of good clinical care and good clinical outcomes.
THE BLUEPRINT FOR BETTER HEALTHCARE “I think we have to acknowledge that in the Blueprint for Better Healthcare there were some positive initiatives: the public reporting of clinical and system outcome measures; some of the transparency and accountability measures; the telehealth initiatives and expanded training capacity and enhanced service provision. “However, I have concerns about other elements in the Blueprint, particularly industrial reform and moves to potentially privatise services such as medical imaging and pathology. My strong view is that any privatisation as a result of contestability really requires robust, transparent and rigorous checks and balances as well as ongoing performance monitoring. We need to be very mindful and watch that very carefully. “We need to have productivity and efficiency and there needs to be value for money, but not at the expense of good clinical care and good clinical outcomes. “For all of that to occur, we continue to emphasise that good processes, good clinical engagement and allowing clinical leadership to flourish is critically important to having a safe, effective and sustainable health system. FEDERAL ELECTION One of the first big campaigns for Dr Rowan is the Federal election in September. “We will be working closely with the Federal AMA on those issues pertinent to general practice, such as inadequate MBS item indexation, GP super clinics and changes to Practice Incentive Payments, particularly affecting the viability of after-hours GP service provision. So AMA Queensland is going to be highlighting those issues relevant to general practice,” he said. Members can contact Dr Christian Rowan on (07) 3872 2222 or email@example.com. Q
A member of the Australasian Professional Society on Alcohol and Other Drugs
Director of Medical Services at St Andrew’s War Memorial Hospital
A Visiting Medical Officer to the St Andrew’s War Memorial Hospital Multidisciplinary Pain Service and to the Wesley Rehabilitation Centre’s Pain and Back Rehabilitation Programs
An Addiction Medicine Specialist and Medical Director of Addiction Sciences Queensland An Associate Professor at Griffith University’s School of Medicine
His clinical interests include
prescription drug dependency, opioid substitution therapy and co-morbidity pertaining to pain conditions and substance disorders
Remote Medicine, Medical Administration and General Practice
Senior Lecturer with the University of Queensland’s Centre for Clinical Research
A Masters in Diplomacy and Trade from Monash University in foreign affairs, public policy, health diplomacy, and trade
Holds a number of clinical and administrative fellowships in Addiction Medicine, Rural and
President of the Rural Doctors Association of Queensland from 2006-2007
Deputy Chief Medical Officer, Clinical Ethics and Research for Uniting Care Health
DoctorQ JULY 2013
DR SHAUN RUDD AMA QUEENSLAND’S NEW PRESIDENT-ELECT, HERVEY BAY GP DR SHAUN RUDD SEES HIS FUTURE ROLE CLEARLY: TO LOOK AFTER MEMBERS AND ALLOW THEM TO GET BACK TO THE BUSINESS OF PROVIDING THE BEST POSSIBLE CARE FOR THEIR PATIENTS.
First on the agenda for Dr Rudd is working with President Dr Christian Rowan to fight the new $2,000 a year cap on tax deductions for work-related self-education expenses. Many members are concerned the cap will restrict their continuing professional development to less than the bare minimum required by AHPRA. “The tax grab by the Federal Government on educational costs is of great concern and an ongoing part of the hidden agenda to control, manipulate and dumb down our great profession. We do not want mediocrity, we want excellence!” Dr Rudd sees training the increasing number of new medical students and doctors as the biggest challenge the medical profession has faced for many years. “Who’s going to take them on? Will they have jobs at the end of the day? There are not nearly enough doctors involved in teaching,” he said. “I believe we need to better connect the primary and hospital care sectors, so that there’s better communication as patients enter and exit the hospital system. We need to encourage hospitals to transfer the care of their patients back to their GP as soon as possible,” he said.
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Changes to senior doctor Awards as outlined in the Blueprint for Better Healthcare in Queensland will surely be one the first issues for our new Board to get their teeth into. “Industrially, the muted contracts for our public hospital doctors issue is well and truly front and centre,” said Dr Rudd. “I am also very concerned with the ongoing high bulk billing rates in General Practice which requires addressing. Quite simply, it’s selling us short and everyone knows a practice that purely bulk bills will not be in business for long. A free service will never be appreciated and it’s desperately oversubscribed. It should exist for patients on a case-by-case basis who truly can’t afford treatment,” he said. AMA Queensland is in good hands with Dr Rudd in the three year term of President, President-Elect and Immediate Past President. “I have put my hand up to be President for a number of reasons. I believe we need to recruit and retain significantly more members. I will have a guiding principal and that is to do all I can to protect and improve the profession, our members, my colleagues.” Q
DR RUDD BIO
Dr Shaun Rudd graduated from Queens University Belfast in 1978. Following a number of years working in the public hospital system in Northern Ireland, he completed General Practice Vocational Training. The training included a year of General Practice in the small township of Bramhall Lane just outside Manchester, England. In 1987, Dr Rudd emigrated to Australia where he worked for the first 11 years as a GP in Casterton, a small country town in the western districts of Victoria. Almost 15 years ago, he moved to Hervey Bay in sunny Queensland where he does three clinical days a week and works as a General Practice Liaison Officer, liaising between the Primary Care and Hospital Care Sector the other two days. Dr Rudd served has served on the AMA Queensland Council for eight years and has served on numerous committees for International Medical Graduates, general practice and public health. He has also chaired a Public Hospital Board and been a member of a Private Hospital Board. Outside medicine his main interest is playing and watching team sports with a little bit of fishing thrown in. He is a passionate, proud, paid up member of the Hawthorn Football Club and still plays Masters Football in the Queensland Masters League, representing Queensland in the Veterans Team (over 55s) in interstate football.
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DoctorQ JULY 2013
AMA QUEENSLAND 2013- 2014
RESPONSIBLE FOR DETERMINING QUESTIONS AND MATTERS OF POLICY FOR THE ASSOCIATION, MAKING BY-LAWS ABOUT ETHICAL CONSIDERATIONS (INCLUDING HANDLING COMPLAINTS RELATED TO THE PROFESSION), AND MAKING RECOMMENDATIONS TO THE BOARD OF DIRECTORS ABOUT REPRESENTING THE ASSOCIATION ON ALL MATTER OF POLICY WITH GOVERNMENT OR OTHER STAKEHOLDERS, THE AMA QUEENSLAND COUNCILLORS FOR 2013 - 2014 ARE:
DR CHRISTIAN ROWAN
DR SHAUN RUDD
DR ALEX MARKWELL
MBBS (UQ) FRACGP FARGP FACRRM FRACMA FAChAM (RACP)
MBBCH BAO (Belfast)
BSc, MBBS (Hons 1) FACEM MAICD
Immediate Past President
Specialty: General Practice
Specialty: Emergency Medicine
Dr Rudd has been practising as a GP for 26 years and is currently based in Hervey Bay. He enjoys all areas of General Practice and has been a representative on AMA Queensland Branch Council for the past eight years. He has also served as the AMA Queensland Honorary Secretary from 2007-2008; Chair of the AMA Queensland International Medical Graduates Committee and Chair of the General Practice Liaison Officer State Committee.
Dr Markwell is an emergency physician working in Brisbane. She has an interest in medical education, pre-hospital trauma care, and doctors’ health.
Specialty: Addiction Medicine Dr Rowan is a graduate of the University of Queensland. He has completed Fellowships with the Royal Australasian College of Physicians’ Chapter of Addiction Medicine, the Royal Australian College of General Practitioners, the Australian College of Rural and Remote Medicine and the Royal Australian College of Medical Administrators. He is employed in both public and private practice, has an appointment with Griffith University and is the Executive Director of Medical Services at St Andrew’s War Memorial Hospital in Brisbane. “My intention is to ensure the independence and integrity of the medical profession. I believe in representing the interests of all patients both urban and rural and the medical staff who care for them.”
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“To represent and serve the members of our association, to continue to build a strong membership and financial base that provides us with a powerful lobbying platform.”
“The AMA is the voice of our profession. We must continue to engage with our members, re-connect with our potential members, and improve our relationship with other colleagues to enable us to advocate effectively for our patients. We will be required to respond to challenges, but we must continue to strengthen and progress our association and be proactive in promoting our patients’ health.”
Additionally councillors have an internal role to assist the Member Relations Department, along with other Departments within the Secretariat, including welcoming new AMA Queensland members
DR DAVID ALCORN
DR TOM ARTHUR
DR SHARMILA BISWAS
MBBS (UQ) LLB( Hons) LLM FRANZCP SJD (QUT) MBA (Uni Melb) FRACMA AMP (Harvard)
BSc MBBS GradDipAppAnat
Gold Coast Area Representative
Far North Area Representative
Specialty: Principal House Officer with an interest in surgery
Specialty: General Practice
Greater Brisbane Area Representative Specialty: Psychiatry and Medical Administration “I am passionate about consumer collaboration and driving system-wide improvements in safety, effectiveness, access and efficiency for consumers and their families, informed by the integrity, research and wisdom of the medical profession. I am committed to our association’s mission of helping doctors to help patients.”
“I have a strong interest in the adequate training and ongoing education of doctors, with a focus on pre-vocational education and technical skills. I’m a firm believer in the importance of AMA to the medical profession, and see my role as councillor to encourage greater interaction and engagement from the medical practitioners in my region.”
“My intention as a Branch Councillor is to support and maintain the integrity of the profession, maintain standards and advocate for the delivery of services to patients using best practice in all areas. My primary interest is to raise the profile of the regions.”
DR KIMBERLEY BONDESON
DR BILL BOYD
DR DILIP DHUPELIA
BSc (Hons) MBBS FRACGP DAME
MBChB (Dundee) FRACOG FRANZCOG
Greater Brisbane Area Representative
Capricorn Area Representative
LRCPS (Ire) Dip Obst ACOG FRACGP FARGP FAICD
Specialty: General Practice, Aviation Medicine
Specialty: Obstetrics and Gynaecology
Part Time Medical Practitioner Craft Group
“My intention is to represent the doctors in the Greater Brisbane Area”.
“In my previous time on Council my CV includes a year as Honorary Secretary, a year as Chairman and two years as Chairman of the State Conference. I am delighted to have the opportunity to take part in the many and varied activities of AMA Queensland on behalf of our members.”
I’m a firm believer in the importance of AMA to the medical profession, and see my role as councillor to encourage greater interaction and engagement from the medical practitioners in my region.
Specialty: General Practice “Having had extensive medical experience in both the public and private sectors, as well as within the Federal and State Government sectors, I have a good grasp of health improvement strategies within the national health reform environment in areas such as integration of primary and secondary services and ensuring holistic care within a seamless patient journey. I look forward to working within a wide ranging team and hopefully add value to the fine work already being performed in representation, leadership and advocacy.”
DoctorQ JULY 2013
DR BEN DUKE
DR NOEL HAYMAN
DR WAYNE HERDY
DR LARRY GAHAN
BMed FRANZCP MHA MPH
BSc App MBBS (UQ) MPH(UQ) FAFPHM (RACP) FRACGP
MBBS (UQ), BA (Hons) (UQ), Ll B (QUT), Ll M (QUT), FACLM 1995
Greater Brisbane Area Representative
Greater Brisbane Area Representative
Specialty: Psychiatry “I have a strong interest in medical student and junior doctor education, as well as the structural and economic aspects of our health system.”
North Coast Area Representative
Specialty: Public Health and General Practice “Indigenous health: I believe we can do so much better in this area if we all work together. I would love to see more Indigenous students studying medicine – if I can do it, anyone can.”
Specialty: General Practice “I aim to represent the views of my constituents to Council; to promote patient safety especially by diminishing role substitution and developing task delegation; and to assure the future of young graduates by promoting best education and best career prospects.”
I aim to assist the AMA to do what it does best, providing advocacy and guidance to the appropriate governments and agencies.
General Practitioner Craft Group Specialty: General Practice “I believe doctors need an organisation to provide a balanced engagement in the health service network with health reform, primary health care, local hospital services, Medicare issues and patient issues prioritised. I aim to assist the AMA to do what it does best, providing advocacy and guidance to the appropriate governments and agencies. We need appropriate balance between the Local Hospital Network, Medicare Local and Aged Care Services.”
MR NICK GATTAS
DR VANESSA GRAYSON
DR JOHN HALL
DR SHARON KELLY
Medical Student Group Representative
MBBS (Hons), FRACS
Residents and Registrars Craft Group
Downs and West Area Representative
Specialist Craft Group
Specialty: Resident Medical Officer – Future Emergency Medicine Trainee
Specialty: Rural Procedural Medicine and General Practice
“My focus is on quality post-graduate training for all Queensland medical graduates, both international and domestic; building stronger ties between medical students and junior doctors to strengthen the continuum of medical education, training and representation; and improving AMA Queensland’s engagement of medical students.”
JULY 2013 DoctorQ
“As Chair of the Council of Doctors in Training, I hope to bring a voice to the DiTs in our state. Through our hospital representatives and publication The Rounds, I hope to improve the understanding of our members on the issues that is impacting on their working conditions and future training opportunities. I look forward to ensuring that the Queensland DiTs are well represented within AMA Queensland.”
“I hope to help advise council on issues affecting rural Queenslander’s health and their health care teams. I will highlight important issues including the strengthening of the rural healthcare workforce, access to essential healthcare for rural Queenslanders, including quality primary care, emergency services, inpatient care and maternity services, and strengthening access to specialty services.”
Specialty: ENT Surgery “As a specialist practicing in both public and private sectors I am well placed to advocate for a wide variety of specialists and particularly, for visiting medical officers, without whom public hospitals could not run. The doctors in these hospitals have recently experienced unprecedented changes in funding and administration. On behalf of AMA Queensland I will continue to advocate for these doctors and the vital services they provide for patients.”
DR RICHARD KIDD
DR BAV MANOHARAN
DR JOHN MURRAY
BHB MBChB Dip Obs FAMA
DR KELLY MACGROARTY
MBBS (UQ) FFARACS
General Practitioner Craft Group
MBBS (UQ) FRACS FAOA
Specialty: General Practice
Specialist Craft Group
Greater Brisbane Area Representative
Full Time Salaried Medical Practitioner Craft Group
Specialty: Resident Medical Officer with an interest in general surgery
Specialty: Salaried Anaesthetist
“I intend to work for doctors to be free and safe to practise and teach medicine to the highest standards and thereby promote patient and community good health.”
Specialty: Orthopaedic Surgery “As an AMA Queensland Council member, I will focus on assisting the President to improve relationships between general practice and the surgical disciplines. I would like to help improve access to hospital services for all patients, in particular, prompt specialist review and treatment. I will also endeavour to strengthen our commitment for training opportunities in the surgical specialities for the next generation of doctors.”
“I will focus on representing my colleagues at both the CDT and Branch Council level. We need to work to improve the quality of and fair access to training and education in both the prevocational and vocational arenas, including, ensuring training is affordable to trainee doctors, and that working conditions and awards are protected and enforced. We need to ensure fair and transparent processes for allocation of both prevocational and vocational positions.”
“To see that the issues impacting on full time salaried staff in Queensland hospitals continue to receive the same prominence in AMA Queensland deliberations as those matters impacting on GPs and VMOs.”
DR CARL O’KANE MBBS, BSc (Med) FACEM, MCLinEd North Area Representative Specialty: Emergency Medicine “It is an honour to serve as the AMA representative for Far North Queensland. Given the challenges facing public health care, I hope to assist members working in this sphere and develop new clinical opportunities between the public and private sectors.”
DR JONATHAN SHIRLEY
DR MASON STEVENSON
DR CHRISTOPHER ZAPPALA
MBBS (UQ) FANZCA
Greater Brisbane Area Representative
General Practitioner Craft Group
MD MHM MBBS (Hons) FRACP AMusA GCAE
Specialty: General Practitice
Specialist Craft Group
Specialty: Anaesthetist “As an anaesthetist I observe the patients’ clinical experience across a wide range of specialties and also the interaction between them. My concern for the future of health care at both state and federal levels centre around sustainable clinical service delivery for patients and the ongoing education and training needs of junior doctors across the board. As a member of council, I will take an active role in ensuring the highest quality and professional standards for our colleagues.”
“I will continue to be an AMA Queensland resource and spokesperson on the Sunshine Coast.”
Specialty: Thoracic and Sleep Physician “I’m interested in re-establishing the central importance of the member focus of our organisation and I want AMA Queensland to be a pro-active and positive participant in health reform.”
As a member of council, I will take an active role in ensuring the highest quality and professional standards for our colleagues. DoctorQ JULY 2013
AMA QUEENSLAND’S HEALTH VISION
OUR ADVOCACY ACTION PLAN
THE DELIVERY OF THE STATE BUDGET WAS A TIMELY REMINDER OF THE PRESSURE THAT THE HEALTH SYSTEM IN QUEENSLAND IS UNDER AT THE MOMENT.
As governments struggle to reconcile strained budgets with good health care and electoral success, medical leadership will be crucial in ensuring the values of compassion, trust and knowledge remain central in the health care system.
like AMA Queensland to take action on. Reform will be needed in these areas to future-proof the profession and the Queensland Health system. We’ve invited leading clinicians and thinkers to explore these issues on our blog at amaqhealthvision.com, but Doctor Q is getting a preview this month.
That’s why AMA Queensland is developing a Health Vision to guide our advocacy to government. Over the next month we will be continuing to ask Queensland doctors about their vision for the health system and the action they would like AMA Queensland to take on their behalf.
Join the conversation by emailing us at firstname.lastname@example.org, calling (07) 3872 2222, coming to one of our events in Brisbane and Townsville or visiting the blog at amaqhealthvision.com. Q
Members have told us that there are five key areas or ‘pressure points’ on the health system that they would
1 END-OF-LIFE CARE End-of-life care is a topic doctors often raise with AMA Queensland; they are concerned that patients experience difficulties accessing palliative pathways and that the ‘treat as default’ model is not serving patients well. The ABS says that by 2025 it is expected that almost 20 per cent of the Australian population will be 65 or over. By 2056, it will be one in four. 70-75 per cent of people express the desire to be cared for, and die at home – yet most will die in inpatient facilities across the country. Queensland has a comparatively low palliative care separation rate across both public and private hospitals (16.7 per 10,000 persons). NSW recorded the highest rates (24.9) followed closely by Victoria (24.7). The lowest palliative care separation rate was recorded in public hospitals in Western Australia (5.7 per 10,000 persons) – as they use more home-based care.
JULY 2013 DoctorQ
2 WORKFORCE AND TRAINING The health workforce in Queensland is facing the joint challenges of a flood of medical graduates from the states three medical universities who are struggling to find training places and a shortage of doctors and other health workers in rural and regional areas. The challenge in the years ahead will be to provide training for junior doctors so that there enough doctors to serve all Queenslanders. Numbers of medical graduates have increased from 1,195 in 2000 to 2,380 in 2009, an increase of 99.2 per cent. This increase has not been matched by an increase in training places. In 2011, major cities had 433 doctors per 100,000. Outer regional areas had only 247. Lower numbers of medical practitioners combined with long distances between health services means that access to medical care is significantly reduced in regional and rural areas.
3 PUBLIC HEALTH AND REVERSING GENERATIONAL DISADVANTAGE Growing health inequality, unhealthy lifestyles – especially for children – and an ageing population are increasing problems which jeopardise the ability of our health care system to provide adequate care to Queenslanders. Dramatically increased rates of heart disease, diabetes, kidney disease, obesity, asthma, anxiety and depression, and other chronic diseases now affect a large proportion of Australians. Recent cuts to public health spending have highlighted the need for further advocacy and action in this important area. In 2012, more than half (57 per cent) of the adult population in Queensland were overweight or obese (2.2 million people) – with the rate of obesity in disadvantaged areas double those recorded in advantaged areas. 26.6 per cent of Queensland children are considered overweight or obese. 7.3 per cent of 14–19 year olds smoked daily in 2010.
4 CREATING A UNIFIED HEALTH SYSTEM Cost-shifting and poor communications between the primary care sector and the acute hospital setting has become par for the course of the Australian health system. As health budgets come under pressure, cost-shifting between governments is a tempting option – but does not serve patients. This system is not serving patients as well as it could. The National Health and Hospitals Reform Commission said in 2009 that “inconsistent and unequal access to appropriate services and health outcomes is causing many Australians unnecessary suffering”. And while National Health Reform has gone some way to improving the situation – more can be done.
There are considerable inequalities in health outcomes within the population. This is particularly the case for Indigenous Queenslanders whose life expectancy at birth is significantly lower than their non-Indigenous counterparts (10.3 years less for males and 8.9 years less for females.)
5 REPRIORITISING CARE IN RESPONSE TO CHANGING DEMAND In 2012-13 the Queensland Government spent around a quarter of the state budget on health – and this amount is set to increase dramatically if changes are not made to service priorities. The age dependency ratio in Australia was last reported at 20.33 older dependents (>65) to 100 working age people (1563) in 2011. This ratio has grown by 1.36 per cent in the past ten years, most of this increase taking place in the last five. As the population ages, there will be fewer productive workers to support the health care of a growing proportion of older retirees. In light of these challenges, health funding must be viewed strategically, and medical leadership and evidence-based care will be crucial to reprioritising funding in a fair and effecting manner.
DoctorQ JULY 2013
FWA CHANGES TARGET ROSTERS, BULLYING AND FLEXIBLE HOURS IN EARLY JUNE, THE FEDERAL GOVERNMENT SUCCESSFULLY INTRODUCED CHANGES TO THE FAIR WORK ACT 2009. THE CHANGES ARE LIKELY TO AFFECT YOUR WORKPLACE.
Workplace Relations Manager, AMA Queensland
From 1 January 2014, the ability for employees to lodge a claim for workplace bullying will be expanded with the workplace umpire able to intervene and stop any inappropriate workplace conduct. Bullying, discrimination and harassment has now been defined as ‘repeated, unreasonable behaviour directed towards a worker or a group of workers that creates a risk to health and safety’. This definition of ‘worker’ importantly includes contractors as well as employees. Under the changes, if an employee is alleging they are the victim of workplace bullying they will be able to lodge a complaint to the Fair Work Commission, whose powers will be expanded to make orders to halt the conduct. Fines of up to $33,000 can be made where an employer fails to implement the changes ordered by the Commission. Crucially, an employee cannot make a complaint where they are being managed for under performance, if an employer can demonstrate they took reasonable management action. However, an employer will be required to keep meticulous file notes of the performance management and ensure they adhere to the appropriate process.
DID YOU KNOW?
Secondly, flexible work arrangement categories have been expanded. Previously only employees with children under schooling age or parents with a child with a disability were able to make a
JULY 2013 DoctorQ
The changes have also meant better defined guidelines as to what constitutes a ‘reasonable request’ for flexible working arrangements. request. Under the changes, the following employees can now request flexible work arrangements: employees with school age children, mature-age employees , employees faced with family violence, or employees providing personal assistance to a member of their immediate household who is experiencing family violence.
To ensure that your workplace is compliant with your workplace health and safety requirements, regular ongoing training is recommended. AMA Queensland provides workplace training on employer’s responsibilities in managing workplace bullying, discrimination and harassment. For more information on workplace requirements, please visit www.amaq.com.au or call us on (07) 3872 2222.
The changes have also meant better defined guidelines as to what constitutes a ‘reasonable request’ for flexible working arrangements. Changes to the Awards now mean it is compulsory for employers to consult with staff when developing, amending and/or changing rosters. While there would not need to be an agreement with the employee to introduce the roster change, the employer would still need to engage with the employee, either individually or collectively. Q
ANNOUNCEMENT / EXPRESSIONS OF INTEREST
North Mackay Private Hospital (Previously known as the Pioneer Valley Hospital)
OPENING EARLY 2014 34 beds will be licensed for Rehabilitation and General Medicine. Sleep Study facilities are also available. We will have a range of Allied health staff working at the North Mackay Private. Expressions of interest are called for Gerontologists, Rehabilitation Medical Specialists and General Practitioners to practice in the Facility. Expressions of interest will also be accepted for Allied Health Personnel. Consulting suites accommodating small or large practices are also available for lease.
For further information, please contact: Mrs Fleur Harmsworth Director of Nursing, North Mackay Private 57 Norris Road, NORTH MACKAY QLD Phone: 0409 348 870 Email: fleur.harmsworth@ northmackayprivate.com.au
Brand new category outlining AMA Queenslandâ€™s advocacy on your behalf Links to submissions such as Health Ombudsman Bill
Member testimonials/feature images
Latest AMA Federal RSS feeds Completely overhauled classifieds section
The latest actions within the Health Vision
Ability to host video
Up-to-the-minute AMA Queensland news and updates
Brief sitemap overview
MEMBERSHIP Clear benefits of membership in each category Ability to pay membership fees and manage your membership
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AMA QUEENSLAND NEW
THE AMA QUEENSLAND WEBSITE NOW FEATURES A WHOLE NEW LOOK-ANDFEEL WITH A CRISP, MODERN DESIGN, CLEAR AND INTERACTIVE DROP-DOWN MENUS AND UPDATED CONTENT.
The purpose of the website refresh was to improve the quality of experience and accessability of information for existing and prospective members.
The main feature of the new website is the homepage, dominated by an eye-catching rotational banner of photographs and quotes from real-life AMA Queensland members who volunteered to take part in the project.
EVENTS CALENDAR Ability to view events individually or per month Clear contact details and registration forms to attend
The engagement of real members, as opposed to purchasing stock images, gives the website an important authenticity for doctors looking to connect with their professional association. The personalised images and testimonials help to tell the story of just who our members really are, and why they are a part of AMA Queensland. Other exciting features of the website are the new menu options which include Advocacy, Media and a significantly improved calendar. The website refresh has been a labour of love for many members of the AMA Queensland Secretariat who have worked for over a year to finalise the updated content and design. We would like to thank everyone who was involved in bringing the website to life, both AMA Queensland Secretariat staff and our members. Over the coming months we plan to develop a broader social media presence, underpinned by a clear strategy to ensure we are meeting the diverse communication needs of all our members. Members can currently follow AMA Queensland on Twitter, Facebook, Wordpress and coming soon, LinkedIn. We appreciate member feedback and suggestions so please check out amaq.com. au and let us know what you think.
NAVIGATION Drop down secondary navigation on every page Easily locate and sections and pages within a category
For further information on our website or other social media platforms, please contact email@example.com or call (07) 3872 2222. Q
DoctorQ JULY 2013
MEMBERSHIP IS LIKE HERD IMMUNITY IT’S NOT ENOUGH TO RELY ON ALL YOUR COLLEAGUES BECOMING MEMBERS: HERD IMMUNITY NEEDS NUMBERS.
DR VANESSA GRAYSON
Chair, Council of Doctors in Training
I have developed a love for documentaries over the last six months after having downloaded ABC iView and SBS on demand. Once again, I find myself drawing inspiration from one of these documentaries for yet another article. This time there are no cute animals, no breathtaking landscapes and certainly no soothing voiceover from David Attenborough. Jabbed is an Australian made documentary that examines the history of vaccination and reemergence of preventable conditions as parents across the world are skipping their children’s shots to avoid vaccine reactions. Australia has a robust childhood vaccination program. Whenever I see a child in the emergency department, one of the questions I always ask is “Are your child’s vaccinations up to date?” In my personal experience, reassuringly the answer is more than often “yes”.
If we can increase our DiT membership base, the louder our voice, the more power we have to influence policy and affect change. “Is your membership up to date?” The response I often hear is, “No. What’s the point in being a member?” Gone are the days when people would join the AMA just to be a part of their professional organisation. We live in a consumerist society where people want instant bang for their buck. Given that some DiTs pay a small fortune in courses, college memberships and exam fees, it is no surprise they are hesitant to sign up to any extra expenses.
However, it is difficult to ignore the reported reappearance of childhood diseases such as, measles, mumps and whooping cough. The reliance on herd immunity has resulted in decreasing vaccination rates and a resurgence of disease even in adult populations.
The AMA is best known for its history and advocacy work. The President, Council and Secretariat relies on a number of colleagues volunteering their personal time to attend meetings and functions to improve working conditions, rights within the workplace and protect the interest of patients. The difficulty with this work is it takes time to reap rewards and the benefits are often not immediately obvious.
Interestingly, as I have become more involved with the AMA Queensland, I find myself asking colleagues a similar question
To make matters more difficult, the advocacy work AMA conducts is on behalf of the entire medical profession,
JULY 2013 DoctorQ
irrespective of whether doctors are members or not. So why should you pay money to be a member of the AMA, if you get the benefits of their representation for free? The answer is simple – herd immunity. The more people we have as members of the AMA, the stronger we are as an association. This is particularly true for our DiT population. We represent the largest numbers of doctors but have proportionally the smallest number of members. If we can increase our DiT membership base, the louder our voice, the more power we have to influence policy and affect change. Most importantly, the better the protection we can offer our members. In the wake of the intern and RMO campaigns, ongoing overtime issues and now the $2,000 self-education tax cap, there has never been a more important time to be a part of the AMA. So I leave with one last question, “Is your membership up to date?” Q
DoctorQ JULY 2013
DR MARKWELL: NEW FOUNDATION AMBASSADOR
IMMEDIATE PAST PRESIDENT DR ALEX MARKWELL TALKS WITH AMA QUEENSLAND FOUNDATION ABOUT HER NEW POSITION AS FOUNDATION AMBASSADOR AND THE FUTURE OF THE FOUNDATION.
Q Congratulations on your new role as an AMA Queensland Foundation Ambassador. Why did you decide to take it on? Before my term as AMA Queensland President 2012-13, I didn’t fully appreciate the role of the Foundation or how it worked. This changed when I became a director of the Foundation and I learned about the many projects the Foundation supports. For example, the JCU Medical Student Bursary is a Foundation program which supports medical students who are committed to pursuing a career in rural medicine. As a Foundation Ambassador, I hope to inform doctors about what the Foundation does and how they can support it. Q What’s so different about the AMA Queensland Foundation? The Foundation supports projects based on individual need, not just by disease or geography. It has the flexibility to support causes and make a real difference, just like the specialised bus that was donated to Red Hill Special School earlier this year.
There are many worthwhile health-related charities, I also donate to MSF, Red Kite, and Fred Hollows Foundation, but the AMA Queensland Foundation is unique in that it harnesses the generosity and spirit of the medical community. Q How can members get involved in the Foundation? I love that members can not only help through donations, but also nominate projects they would like to support. This allows the Foundation to make a real difference in areas that our members are passionate about. However, you don’t need to be an AMA member to support the Foundation; anyone can support doctors doing good! Q Are there any other ways to support the Foundation? Bequests, while a sensitive topic, allow donors to be an important part of the Foundation’s future. They allow donors to make a significant and long-term contribution which will give the Foundation
greater financial security, allowing us to commit to long-term and substantial projects. Q Can a donor decide how the bequest is used? Leaving a bequest to the Foundation is a special type of gift that can be designated generally or according to the donor’s wishes, which I think is important as it allows the donor and their family to have some say in where and how the funds are distributed. Bequests and donations can be made anonymously or acknowledged depending on the donor’s wishes. This collaborative approach allows donors to work with the Foundation to ensure the arrangement meets the needs of all parties. Q
For further details... On the AMA Queensland Foundation or to have a discreet chat about possibly leaving a bequest, please contact Colleen Harper, Foundation Manager, (07) 3872 2204 or firstname.lastname@example.org
RED HILL SPECIAL SCHOOL’S BUS GOES WILD Kids from the Red Hill Special School embarked on a three-day camp recently, where they spent a day at the Currumbin Sanctuary. The camp was made possible by a very special bus donated by AMA Queensland Foundation and our partner Sullivan Nicolaides Pathology. James enjoyed getting up close to a possum and for Hannah it was stroking a snake. Adania was completely captivated by the lorikeets and couldn’t help but giggle when she hugged a koala. Q 34
JULY 2013 DoctorQ
QUEENSLAND X-RAY SUPPORTING DOCTORS DOING GOOD Queensland X-Ray is proud to be continuing its support of the vital work the AMAQ Foundation undertake each year. As long term sponsors, we’ve seen the Foundation develop into the success it is today. Queensland X-Ray and the Foundation share many common aims including a commitment to providing much needed support to those for whom the public health system isn’t able to provide for. As an organisation dedicated to continuous improvement through education, our association with the AMAQ Foundation is only natural. Queensland X-Ray has provided support via the James Cook University Medical Student Bursaries. The bursaries offer financial support to medical students
with a genuine interest is supporting rural and indigenous communities; helping these young doctors remain within the communities they’re working and therefore gaining more experience. Our association with the AMAQ Foundation has spanned over ten years. During 2013, we’ve asked that our donation is specifically put towards supporting Indigenous communities. Q
DOCTORS DOING GOOD
Do you have a project which needs financial assistance? Contact Colleen Harper, Foundation Manager: Phone: (07) 3872 2204 Email: email@example.com Website: www.amaqfoundation.com.au
As doctors we see people in genuine need falling through cracks in the system. Sometimes, no matter how much we do individually, it is not enough. Collectively, through the Foundation, we can make a meaningful difference. Being a nimble charity, we can direct funds to where they are most needed; often to places overlooked by others. Dr Steve Hambleton, Foundation President
88 L’Estrange Terrace, Kelvin Grove Qld 4059 P: (07) 3872 2222 E: firstname.lastname@example.org www.amaqfoundation.com.au
Doctors doing good. DoctorQ JULY 2013
AROUND THE REGIONS
LOCAL MEDICAL ASSOCIATION ROUND UP
JOIN YOUR LMA
STAY CONNECTED WITH COLLEAGUES AND UP TO DATE WITH THE LATEST HEALTH NEWS AND ISSUES AFFECTING YOUR LOCAL AREA. DON’T STAND ON THE SIDELINES —JOIN YOUR LOCAL MEDICAL ASSOCIATION TODAY AND MAKE A DIFFERENCE.
BRISBANE NORTHSIDE Next meeting: 13 August
Next meeting: 25 July
For information on meeting dates and membership contact Cairns LMA President Dr Sharmila Biswas.
Venue: Maroochydore Surf Club
Phone: (07) 4036 4333
Monthly dinner meetings are generally held on the fourth Thursday of each month.
Convenor: Jo Bourke Phone: (07) 5479 3979 Fax: (07) 5479 3995
For information on meeting dates and membership contact Townsville LMA President Dr Carl O’Kane.
For further information or to join visit www.sclma.com.au
Phone: (07) 4433 1111
Convenor: Dr Graham McNally Phone: (07) 3265 3111 For further information or to join, visit www. northsidelocalmedical.wordpress.com
REDCLIFFE & DISTRICT Next meeting: 31 July and 27 August Venue: Golden Ox Restaurant, Redcliffe Time: 7pm for 7.30pm
Convenor: Margaret MacPherson
Next meeting: 18 July and 15 August
For information on meeting dates go to www. gcma.org.au or email email@example.com
For information on meeting dates and membership contact Central Queensland LMA Secretariat Dr Harley Wilson.
A membership form can be downloaded from our site.
Phone: 0419 277 611
Phone: (07) 3121 4043
TOOWOOMBA & DARLING DOWNS
For further information, go to www.tddlma. org.au or email firstname.lastname@example.org
For information on meeting dates and how to join, contact Bundaberg LMA President, Dr Daud Yunus.
Membership to the Toowoomba and Darling Downs LMA is just $50. To join, download an application form at www.tddlma.org. au/membership.html
Phone: (07) 5575 7054 Fax: (07) 5575 7551
For information on meeting dates and how to join, contact Fraser Coast LMA President, Dr Shaun Rudd.
Phone: (07) 4152 2888 Fax: (07) 4153 3245 Email: email@example.com
Phone: (07) 4128 3644 Fax: (07) 4124 0660
CAN’T FIND YOUR LOCAL AREA?
July 2013 DoctorQ
If your Local Medical Association does not appear above or your details are incorrect, please email firstname.lastname@example.org with corrections, contact details, how to join, web address, dates for upcoming meetings and who to contact for further information.
AROUND THE REGIONS
RURAL DOCTORS ASSOCIATION QUEENSLAND CONFERENCE More than 180 rural doctors met in Mackay for the Rural Doctors Association of Queensland 2013 Conference: Digging Deep: Living and working on the land. Rural Doctors Association of Australia President Dr Sheilagh Cronin was awarded life membership, while new AMA Queensland Councillor Dr John Hall was awarded Legend of the Bush, a rare honour bestowed on members who have provided longstanding service to the organisation and its ethos of providing first class advocacy for rural doctors to improve health outcomes in the bush. Health Minister Lawrence Springborg, President Dr Christian Rowan, a past RDAQ President 2006-2007 and Immediate Past President Dr Alex Markwell also attended. Q
LEFT: Dr John Hall is awarded Legend of the Bush by outgoing President Dr Adam Coltzau
MIDDLE: Dr Adam Coltzau and Minister Springborg talk to media at RDAQ 2013
RIGHT: Dr Sue Masel – incoming RDAQ President – closes RDAQ 2013
Photography credit: Dr Ashraf Saleh
DoctorQ JULY 2013
GROWING YOUR PRIVATE PRACTICE CONFERENCE 2013 | 19 - 20 JULY | VICTORIA PARK, HERSTON Suitable for GPs, Specialists and Practice Managers This conference program will equip delegates with the skills and knowledge to build and grow their private practices. Based on delegate feedback, the program has been refreshed and now offers two concurrent streams â€“ a fundamentals stream for those looking to move into private practice and an advanced stream, designed for those who wish to grow and improve the efficiency of their current practice.
PROGRAM DAY 1
Fundamentals Stream (Ballroom)
FRIDAY 19 JULY
Advanced Stream (Alabaster Room)
SATURDAY 20 JULY
8.30am - 8.50am
9.00am - 9.15am
8.50am - 9.00am
9.15am - 10.00am
9.00am - 9.45am
The Business of Management Chris Whitecross, Arrowdynamics
Medicare Benefits Schedule & Practice Incentives Program Dr Kandasamy, Medicare
9.45am - 10.00am
10.00am - 10.45am
Setting up Your Business Structure Lynette Reynolds, TressCox eHealth and Telemedicine Andrew Turner, AMA Queensland
10.45am - 11.30am
12.15pm - 1.00pm
1.00pm - 1.45pm
Accreditation Kirsten Dyer, AGPAL Medical Marketing that Builds Reputation and Value Jason Borody, Vividus Record Management and Privacy Katharine Philp, TressCox Wining Your Favourite Cases Online Jason Borody, Vividus
2.30pm - 3.15pm
How to Deal with Difficult Clients and Colleagues While Keeping Your Professional Cool Dr Anne Purcell
3.15pm - 3.25pm
Getting Value from Your Business Advisors Paul Copeland, William Buck
3.25pm - 4.00pm
Healthscope Afternoon Tea
10.15am - 11.00am
Financial Strategies for Private Practice Simon Moore, Investec Specialist Bank Financial Health Check for Your Practice Paul Copeland, William Buck
11.00am - 11.45am
Practice Location and Design Ian Shapland, Elite Fitout Solutions Innovative Practice Adam Kostanski, Ozdoc
1.45pm - 2.30pm
10.00am - 10.15am
Financial Foundations- Getting it Right from the Start Julie Smith, William Buck Sustainability and Your Practice Dane Muldoon, The Solar Guys
11.30am - 12.15pm
Understanding Health Professional Online Services (HPOS) and Electronic Medicare Claiming Representative, Medicare
Risky Business in Cyberspace Allyson Alker, MDA National Writing Policies and Procedures for Your Practice Andrew Turner, AMA Queensland
11.45am - 12.30pm
Medico Legal Implications for Private Practice Andrew Turner, AMA Queensland WorkCover and Protecting Your Staff Melanie Stojanovic, WorkCover
12.30pm - 1.15pm
1.15pm - 2.00pm
How to Employ and Manage Staff George Sotiris, AMA Queensland Insurance and Risk Mitigation in Private Practice Chris Mariani, AMA Queensland Insurance Solutions
2.00pm - 2.45pm
Crucial Tips for Success Colleen Sullivan, AAPM
2.45pm - 3.30pm
Afternoon Tea and Networking
REGISTRATION FORM GROWING YOUR PRIVATE PRACTICE | CONFERENCE 2013 | VICTORIA PARK, HERSTON
PLEASE RETURN COMPLETED FORM TO: Member Services Postal: PO Box 123, Red Hill, QLD, 4059 Email: email@example.com Fax: 07 3872 2280 Phone: 07 3872 2205
THIS ACTIVITY HAS BEEN APPROVED BY THE RACGP QI & CPD PROGRAM Total 20 Category 2 points
PARTICIPANT DETAILS PARTICIPANT 1
QI & CPD Ref No:
QI & CPD Ref No:
AMA Queensland No:
AMA Queensland No:
Special Dietary Requirements:
Special Dietary Requirements:
Invoice address: Phone:
REGISTRATION FEES Member Price
Friday and Saturday
AMA QUEENSLAND MANUALS AT A SPECIAL PRICE Discounted price $230.38 each (full price $392.00)
or all three for $587.47 (full price $999.60)
Morning tea, lunch, afternoon tea throughout
WORK HEALTH & SAFETY MANUAL
Program booklet and speaker notes On-site parking
One hour FREE Members Services consultation
EMPLOYEE POLICY & PROCEDURE MANUAL
PAYMENT DETAILS I enclose a cheque for $
(payable to AMA Queensland)
Direct deposit for $
Credit card number:
Bank of Queensland BSB: 124 084 Account: 10 032 949 * Please quote member number and practice name within transfer description.
Cardholder Name: Expiry date:
Direct deposit details are:
PRIVACY INFORMATION: AMA Queenslandâ€™s primary purpose of collecting personal information on this form is to process your purchase. In providing your details you consent to your personal details being used in the manner indicated. ABN: 17 009 660 280
events calendar People & EVENTS
WOMEN IN MEDICINE BREAKFAST
JULY WORKPLACE RELATIONS TRAINING Member seminar
A training workshop focusing on how to manage difficult situations, with issues such as how to conduct workplace investigations, and outline what your medico-legal and workplace risks are when managing difficult patients.
GROWING YOUR PRIVATE PRACTICE
Victoria Park, Herston
Hunstanton, AMA Queensland
A two-day workshop giving insight into private practice considerations. Topics will focus on business mindset and structure, finance, risk management, insurances, staffing structure, and recruitment.
AMA QUEENSLAND CONFERENCE 22 - 28 September Santiago, Chile Set in the beautiful city of Santiago, the capital of Chile, the theme for the 2013 AMA Queensland Conference is Health worldwide - challenges and future directions. What role does Australia play in the global arena? JULY 2013 DoctorQ
Women face relentless pressure to ‘combat the signs of ageing’. In an age and culture of media obsession our special guest presenter Wendy Harmer will explore growing older with grace.
19 - 20 JULY
TO VIEW THE FULL EVENTS CALENDAR
Victoria Park Golf Club, Brisbane
Covering the new Queensland Health complaints process and the Health Ombudsman role this event also includes medico-legal case updates and sessions planned from the Office of the Adult Guardian and Coroner.
Or to register for an event, visit amaq.com.au/events or contact Louise Glynn on (07) 3872 2269 (email:firstname.lastname@example.org).
BANCROFT ORATION Wednesday 27 November Victoria Park, Brisbane Professor David Paterson from the University of Queensland Centre for Clinical Research will present on Small bugs – big problem: tackling antibiotic CLAIMER resistance.
In Medicine Women
Growing older with grace? AMA QUEENSLAND ANNUAL BREAKFAST WEDNESDAY 31 JULY, 7:00AM
BALLROOM, VICTORIA PARK GOLF COMPLEX, HERSTON AMPLE FREE ONSITE PARKING
Now more than ever, women face relentless pressure to ‘combat the signs of ageing’ – both in their personal lives and careers, as if ageing is a disease or disorder. In an age and culture of media obsession with youth, our special guest presenter Wendy Harmer will explore growing older with grace, good humour and shared wisdom discussing: Her own experiences in the media and as a ‘later life’ mother The importance of older role models and mentors for our Gen Y and Gen Z children, grandchildren, sisters and colleagues – in the face of increasing pressures arising from the use of social media The cornerstones of diet, exercise, positive self talk and acceptance to embrace growing older Where does plastic surgery fit in the discussion on ‘ageing gracefully’?
Ticket price: $70 $80 $65
AMA Queensland Member
Wendy Harmer is one of Australia’s best-known humorists. As a stand-up comedian she performed her onewoman shows at the Melbourne, Edinburgh, Montreal and Glasgow Mayfest Comedy Festivals, in London’s West End and the Sydney Theatre Company. Wendy enjoyed huge popularity leading Sydney radio station 2Day FM’s toprating Breakfast Show for 11 years and winning 84 of the 88 ratings surveys for that period. A former political journalist, Wendy is the author of eight books for adults including her best- selling novel Farewell my Ovaries, Love and Punishment and Nagging for Beginners, a how-to guide for women. Her latest novel Friends Like These was published in April 2011, and her first teen novel I Lost my Mobile at the Mall was published in November 2009. Wendy’s children’s book series about Pearlie the park fairy have sold more than 700,000 copies in Australia and internationally since the first title Pearlie in the Park was published in 2003.
(also available to staff working in a member practice)
Non-member Medical students and DiTs
For further details Phone 07 3872 2222 or Email email@example.com
(Must be an AMA Queensland member)
$650 Member table of 10 (inc. GST) $750 Non Member table of 10 (inc. GST) PROUDLY SPONSORED BY:
CONGRATULATIONS to the following doctors who are now elected members of AMA Queensland.
DOCTORS IN TRAINING
DOCTORS IN TRAINING
Dr Talia Giovenco
Dr Gabrielle Edney
Dr Michael Khoury
Dr Michael Chou
Dr Amy Chahal
Dr Matthew Harwood
Dr Nick Chiang
Dr Megan Appleton
Dr Bahram Boghraty
Dr Satish Kharia
Dr Yoska Lindsay
Dr Georgina Cameron
Dr Nicole Brown
Dr Tahir Shah
Dr Geeth Weerasooriya
Dr Campbell Ramage
Dr Brendan Hill
Dr Roderick McMurray
Dr Carolina Van Den Boogaard
Dr Elena How
Dr Christopher Power
Dr Sarah Cavanagh
Dr Christopher Thomas
Dr Mthuthuzeli Sobantu
Dr Nirosha Jayawardena
Dr Sachin Verma
Dr Abhiramee Raviraj
Dr Dan Caines
Dr Michael Berkley
Dr Clare Costello
GENERAL PRACTITIONERS Dr Antonino Capulong Dr Rob Millar Dr Lourduswamy Chinnapp Dr Antonella Sanna Dr Bruce Jones Dr Rajeev Chhaya Dr Bhavana Chhaya
PRIVATE SPECIALISTS Dr Scott Stirling Dr Akshay Mishra Dr William Alexander Dr Richard Nankervis Dr Emma Hothersall Dr Elizabeth R Webster Dr John SM Evans
PART-TIME PRACTITIONERS Dr Gary Phelps Dr Ibolya Szucs
Dr Kanchuka Gunaratna Dr Gihan Piyatunge
GENERAL PRACTITIONERS Dr Liam Rath
sland AMA Queen
The Membership and Workplace Relations team will shortly commence with some member practice visits from July, to canvass local needs and issues and provide an overview of how our services can support you in practice. Would you like to catch up with us over lunch? Contact the membership team at firstname.lastname@example.org or phone (07) 3872 2222 to arrange a visit. Q
JOIN US FOR LUNCH!
Dr Oliver Gunson Dr Shuaib Saood Dr Mehdi Zahedpur Dr John Sutherland Dr Sian Sutherland
PRIVATE SPECIALISTS Dr Sunthra Shanmuga Dr Jonathan Kapul Dr Tara Marsh Dr Mandeep Mathur Dr Bimal Sood
PLANNING AHEAD Following the success of the recent free member seminars, Road-Map to Retirement and Expert Evidence, as well as our keynote events with the Health Minister and renowned demographer Bernard Salt, the events team are starting to plan our 2014 events calendar. We invite your suggestions on topics and speakers that you would like to see in the program - send your ideas to Holly Bretherton, General Manager – Membership email@example.com or call (07) 3872 22478. Q
INAUGURAL MEDICO-LEGAL CONFERENCE
SAVE THE DATE
SATURDAY 26 OCTOBER AMA Queensland is pleased to announce our inaugural Medico-Legal Conference at Hunstanton, on Saturday 26 October. This value-for-money event (special member registration rates apply) will cover the new Queensland H ealth complaints process and the role of the Minister-appointed Health Ombudsman. The program will also include
the latest medico-legal case updates, along with sessions planned from the Office of the Adult Guardian and Coroner. Places for this program are strictly limited, register your interest by emailing Holly Bretherton, General Manager - Membership firstname.lastname@example.org. Q
Dr Rochelle Phipps Dr Yvette Tan
Dr Christopher Johansson Dr James Jarman Dr Humsha Naidoo
JULY 2013 DoctorQ
The 2013 Member Benefits Booklet is available on our refreshed AMA Queensland website, under the ‘Membership’ tab. Check out our comprehensive suite of member benefits: new, free member events, expert advice through our Workplace Relations team, quality services and special offers from our exclusive corporate partners, along with practical and informative resources and publications. Q
Dr Ramin Kousary
2013 MEMBER BENEFITS BOOKLET
2013 DIRECTORY OF MEMBERS
Please find a list of corrections for the 2013 Directory of Members on page 67. Please take note of these changes and amend your Directory accordingly. Q
ASSOCIATE PROFESSOR FRANK LOUIS JOHNSON BSc MBBS FRACP FACRM It is with great sadness I report the death of Frank Johnson, one of the Gold Coastâ€™s original doctors and first specialist. He died of a stroke on Wednesday 8 May, 2013 at the Gold Coast Hospital surrounded by his family. He was 83, but most of us found this hard to believe. His funeral service at Allambie was attended by many of his colleagues from the Gold Coast and Brisbane and was packed with friends and even past patients.
Associate Professor Frank Louis Johnson 22 February 1930 - 8 May 2013 AMA member for 58 years
He originally qualified in medicine in 1955, spent a year at Sydney Hospital and three years at Royal Melbourne. He returned to the coast to join a group practice with Boyd Bouvier and George Freeman. In 1966 he decided to go to the UK to specialise (spending two years in Manchester Royal Infirmary and Buxton Hospitals) before moving to Rancho Los Amigos in California in 1968 working as a rheumatologist and rehabilitation physician. He returned to Australia in 1969 and established rheumatology at RBH. He was one of the three original rheumatologists to practice in Queensland, serving both the rheumatology and the general community with dedication and distinction for many years. He set up the paediatric rheumatology clinic with Ray Tiernan at Royal Childrens Hospital. He later set up the rheumatology and rehab services at the Gold Coast Hospital when he moved back to the Gold Coast. He was instrumental in establishing the Arthritis Foundation of Queensland and sat on its board as well as serving terms as both vice-president and president. He served on the Australian Rheumatology Association (ARA) board and held offices of president and vice-president. He was also president of ARA (Queensland). In 2006 he was awarded the ARA Distinguished Services Medal.
He headed up the AMA subcommittee of Retired Doctors lobbying for changes to the Federal regulations which came in with National Registration...
He sat on the Australian Council for Rehabilitation of the Disabled (ACROD) board and served terms as Vice President and also Chairman of the medical committee. He was active in many charitable roles, the Endeavour Foundation and House With No Steps being just two. I joined Frank in partnership in Southport in 1985 and he generously passed the VMO post at the hospital on to me while he looked after Rehabilitation. We had an incredibly productive and enjoyable 11 years and going solo afterwards was never quite the same. We kept in close touch through shared interests. After retirement from private practice in 1995 he continued to do the rehabilitation work until 1999. In 2005 he was appointed Associate Professor at Bond University where he taught for many years. He headed up the AMA subcommittee of Retired Doctors lobbying for changes to the Federal regulations which came in with National Registration, and there are still issues unresolved for all of us on the cusp of retirement. He was a member for 58 years. Frank was always larger than life, cheerful and incredibly energetic, passionate about the issues he took on and always a friend. He will be greatly missed by his colleagues, and our great sympathies go to Eleanor his wife of more than 50 years, his daughters Fran, Libby, Karen, and Margie and their extended families. Contributed by Dr Julien de Jager. Q
DoctorQ JULY 2013
DR ADRIAN JOHN GROESSLER MBBS FRACP
Dr Adrian Groessler was born in Geraldton, Western Australia, the eldest of five children to John and Jean Groessler (nee Cooper). In 1955 he joined the National Service at Swanbourne, and graduated with an MBBS from the University of Western Australia while serving as a lieutenant with the Royal Australian Army Medical Corps (RAAMC). While an intern at Fremantle hospital, Dr Groessler married Susan Jacqueline Olney in 1961 marking the beginning of a whirlwind life of travel and adventure-and became a medical officer with Western Command (WA) with promotion to Captain. In 1964 he served as a medical officer with British Military Hospitals Kinrara and Terendak, Malaysia, during ‘Confrontation’. He was attached for six months as RMO to the 7th Field Squadron, Royal Australian Engineers, at Kuamut - a remote and inhospitable jungle location in Sabah, Borneo. The Army PR team reported that locals paddled frail canoes, rode ponies and buffalos and tramped miles on foot to be treated in Dr Groessler’s makeshift clinic in Kuamut Village. A year later he served at the British Military Hospital in Singapore where he attended to the families of Australian, British, New Zealand, Gurkha, Malay and Singaporean soldiers. In 1966, after serving as assistant Paediatrician (and Captain) with the British Military Hospital, Singapore, Dr Groessler and his wife and three young daughters sailed to the UK where he served as Senior House Officer at the Kent and Canterbury
Hospital, and where his fourth daughter was born. Dr Groessler reported in the British Medical Journal (Dec 1966) a timely decision to trial diazepam to treat a hop farmer for moderately severe tetanus after previous treatment failed. He later served as a medical registrar at Whittington Hospital, London. Dr Groessler and family returned to Melbourne in 1968 where he served in Medical Administration, Army Headquarters and was admitted membership to both the Royal College of Physicians (London) and the Royal Australian College of Physicians. He then served in Vietnam in 1969 as a major with the 1st Australian Field Hospital (the ‘Vampires’) where he heard news of the birth of his first son. Another son followed in 1971 in Papua New Guinea while Dr Groessler served as Director of Health Services, and lieutenant colonel (PNG Command). In Port Moresby he found time to build a boat christened ‘Ratahi’ which later provided regular weekend adventures for the Groessler family to Pulau Ubin, Singapore. At the ANZUK hospital in Singapore, Dr Groessler was a specialist Physician in general medicine and Paediatrics. Returning to Australia in 1974, Dr Groessler was admitted as a fellow to the Royal Australian College of Physicians. The family settled in Brisbane where he served consecutive positions with the 1st Military Hospital, Yeronga: as commanding officer and physician then as Director of Medical Services with promotion to Colonel.
JULY 2013 DoctorQ
DR ADRIAN GROESSLER
LEFT: While serving with the Royal Australiam Army Medical Corps, Dr Groessler provided medical checks on locals in Borneo, Singapore and Papua New Guinea.
Dr Adrian John Groessler 2 December 1937 – 5 April 2013 AMA member for 8 years
In 1977, Dr Groessler left the regular army following his appointment as Medical Superintendent of the Royal Children’s Hospital Brisbane. With a growing family he moved to central Queensland in 1982 following his appointment as Medical Superintendent and Consultant Physician, Mackay Base Hospital. In 1998 Dr Groessler became a member of the Royal Australian College of Medical Administrators and over the next 20 years served several executive appointments with Mackay Base Hospital and Rockhampton Base Hospital. He also served executive positions with King Fahd Military Hospital, Saudi Arabia, which satisfied his penchant for travel and adventure. In 2006, Dr Groessler found his future interest in clinical training as the senior staff physician and director of clinical training, Mackay Base Hospital. However, in 2008 Dr Groessler began to develop symptoms of Facial Onset Sensory and Motor Neuronpathy and retired mid2009. It was also belatedly revealed that he had advanced cancer of the appendix. Sadly he passed away on 5 April 2013 from pneumonia and was farewelled in a private ceremony with close friends and family. Dr Groessler is remembered as a loving husband, brother, father and grandfather, a great and caring friend with formidable wit and intellect. He was highly regarded as an accomplished physician, academic and teacher with an enduring philosophy of ‘Question everything, and consider carefully the answers’, ad pondus omnium. Contributed by Dr Groessler’s daughter, Anthea Leggett. Q
This case study has been published with the permission of MDA National
DUTY TO REPORT TO THE CORONER IN A NEW SERIES FOR DOCTOR Q, MDA NATIONAL BRING YOU SOME CASE STUDIES TO PONDER. WHAT WOULD YOU DO IN THE CASE BELOW? DO YOU THINK YOU NEED TO REPORT THE FOLLOWING DEATH TO THE CORONER?
The 57 year old patient presented with a severe headache. Her GP diagnosed a migraine and prescribed analgesia. The patient returned to see a locum in the practice a few days later with ongoing headache. Her BP was noted to be mildly elevated and the GP recommended the patient return to see her usual GP a few days later.
Medical practitioners are responsible for reporting a large proportion of deaths to the coroner and it is important that all medical practitioners are aware of their legal obligation to report certain deaths.
Two days later, the patient was taken by ambulance to the local hospital with an increasingly severe headache. She was seen by a resident medical officer who thought the patient was exhibiting ‘drug seeking’ behaviour. She was discharged a few hours after her initial assessment. The following day, the patient was taken back to the same hospital by ambulance. About 15 minutes after arriving in Emergency Department (ED), the patient’s Glasgow Coma Scale went from 15 to 5. The patient was transferred to the intensive care unit of a tertiary hospital where an urgent CT scan revealed a significant subarachnoid haemorrhage, secondary to a ruptured aneurysm. Neurosurgical opinion was sought but, in view of the patient’s poor neurological condition, it was felt that operative intervention would be futile and the patient died a couple of hours later.
In Australia, there is a legal requirement for doctors to report ‘reportable’ deaths to the coroner. These may include deaths where the cause or nature of the death is: unknown unnatural or violent unexpected suspicious the result of an accident or injury during or resulting from an anaesthetic occurred in care, custody or as a result of a police operation health-related procedure or health care related However, each state and territory of Australia has its own unique coronial legislation and the criteria for reportable deaths vary slightly between jurisdictions. Legislative changes to the Queensland Coroners Act, introduced in November 2009, require all ‘health care related’ deaths to be reported to the coroner. A death is reportable under this category if:
1. The health care caused or contributed to the death, or a failure to provide health care caused or contributed to the death AND
2. Death was an unexpected outcome of the health care being provided.
NOTE: The patient’s death would be reportable because failure to provide health care contributed to the death (failure to take adequate history, or investigate or refer during the first three presentations).
Death is considered to be an unexpected outcome if, before the health care was provided, an independent professional peer would not have expected the person to die. The Office of the State Coroner Queensland has provided the following guidance: Would the person have died at about the same time without the health care? Did the death result directly from an underlying disease or injury? Was the health care carried out with all reasonable care and skill? With regard to the death being an unexpected outcome, the professional peer should be qualified in the relevant area of health care and be aware of relevant matters including: The person’s known state of health before the health care was provided; The clinically accepted range of risk associated with the health care. To determine whether the death was the unexpected outcome of the health care, the medical practitioner should ask the following questions: Before the health care was provided, was the person’s condition such that death was foreseen as more likely than not to occur? Was the person told that death was foreseen as more likely than not to occur? Was the decision to provide the health care reasonable given the person’s condition including their quality of life if the health care wasn’t provided? If the answer is ‘no’ to any of the above, the death is reportable. If the answer is ‘yes’ to all the above, the death is not reportable1. Q
1 Information for Health Professionals. Office of the State Coroner Queensland, 2009. Accessed at http://www.courts.qld.gov.au/Coroners_Court/OSC-fs-InfoForHealthProfessionals.pdf 2 Charles A, Ranson D, Bohensky M, Ibrahim J. Under-reporting of deaths to the coroner by doctors: a retrospective review of deaths in two hospitals in Melbourne, Australia. Int J Qual DoctorQ JULY 2013 Health Care 2007; 19(4): 232-236.
AMA QUEENSLAND ANNUAL CONFERENCE COORDINATOR NEIL MACKINTOSH IS HARD AT WORK LOCKING IN SPEAKERS AND TAKING REGISTRATIONS. HE GIVES US AN UPDATE ON SOME THE SPEAKERS WEâ€™LL HEAR FROM IN SANTIAGO.
ANTHONY BROWN MLIG
Anthony Brown, specialist insurance adviser with MLIG, will address delegates at the 2013 AMA Queensland Annual Conference in Santiago. During his presentation, Anthony will discuss some of the recent changes in the superannuation environment and how this can affect insurance policies held within superannuation. He will address some of the advantages and disadvantages of insurance held within superannuation. Anthony will highlight why it is important for doctors to seek professional advice from an insurance specialist to ensure their insurance structure is adequate and leaves no surprises at claim time. As a Senior Adviser with 10 years experience in the insurance field, Anthony has developed an extensive understanding of the needs of doctors in private practice and also those in the public sector. Anthony
is eminently qualified to offer insurance advice and planning to medical practitioners and discuss some of the potential risks that could prohibit their ability to generate an income and therefore limit their capacity to financially provide for themselves and any dependants. Anthony has spoken on similar matters at several seminars including the AMA Queensland Conference 2011 and 2012, Australian Bar Association Advice and Advocacy Courses held yearly throughout Australia, the Bar Association of Queensland Annual Conference in 2010 and GP Seminars in 2010. MLIG is an active member of the Association of Financial Advisers (AFA), an AMA Queensland preferred insurance adviser and has been an active supporter of every Annual Conference since inception in 2001. MLIG is also the preferred adviser to members of the Australian Bar Association.
Tim Kane Australian Ambassador to Chile
CONFERENCE SPEAKERS Addressing guests in Santiago will also be the following speakers. There will also be a health reforms panel discussion, debates, an open forum and business, management and medico-legal sessions.
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Tim Kane will discuss Australiaâ€™s relations with Chile, where priorities include regional security, the environment, illegal fishing and whaling. Both countries are major agricultural exporters and continue to push for agricultural trade liberalisation. Australians greatly boosted tourist numbers to Santiago when direct flights commenced in 2011.
Dr Jillann Farmer United Nations Medical Director, Medical Services Division Dr Farmer was appointed Medical Director in 2012 and her role supports United Nations personnel around the globe. She will present on healthcare for a global workforce and explain more about the UN Humanitarian program.
Dr Victoria Brazil Emergency Physician and Medical educator Dr Brazil works in clinical emergency medicine with special interests in medical simulation, workplace based assessment and public policy issues in medical education and the workforce. She will present on medical education in the 21st Century.
Dr Mark Wenitong Apunipima Cape York Health Council Dr Wenitong is a past president and founder of the Australian Indigenous Doctors Association and is heavily involved in clinical and policy work with the aim of improving Aboriginal and Torres Strait Islander health outcomes in Australia. Dr Wenitong will discuss chronic disease within the Aboriginal and Torres Strait Islander population.
AMA QUEENSLAND ANNUAL CONFERENCE 22 - 28 SEPTEMBER 2013
“Health worldwide - challenges and future directions”
Download a brochure from the events calendar at www.amaq.com.au
Doctors, Practice Managers, Registered Nurses and other industry professionals from throughout Australia are welcome to attend. Keynote speakers of world renown will be presenting and CPD points will be awarded.
To find out more about this conference or to register please contact Neil Mackintosh Phone: (07) 3872 2222 or Email: email@example.com
Associate Professor Noel Hayman Indigenous health expert Associate Professor Noel Hayman will explain how the Inala Indigenous Health Service went from a practice serving 12 patients to over 8,000 by 2012, with 1,500 doctor consultations each month by implementing simple research findings and community consultation.
Dr Rod Thelander Australian Doctors for Africa medical team Western Australian GP Dr Rod Thelander will talk about his work with Australian Doctors for Africa, who provide financial and health investment of overseas medical teams, services and assistance to effect significant change in health care and well-being in Madagascar, Somalia and Ethiopia.
Dr David Cronin Otorhinolaryngologist A Senior Lecturer at Griffith University Medical School and an Ear, Nose and Throat Specialist on the Gold Coast, Dr David Cronin will discuss Indigenous eye disease in rural and remote Queensland and the Northern Territory.
Professor Ignacio Sanchez MD Rector, Catholic University, Chile Professor Sanchez, from Chile’s top University’s Medical School, will discuss regional health challenges and future directions for the Chilean population.
Dr Wayne Herdy Lieutenant-Colonel, Army Reserve As a Lieutenant-Colonel in Australia’s Army Reserve, Dr Herdy will discuss international relief operations in Banda Aceh, one of the areas hardest hit by the 2004 earthquake and tsunami.
Dr Christian Rowan AMA Queensland President As a Fellow with the Australian College of Rural and Remote Medicine and a Past President of Rural Doctors Association Queensland, Dr Rowan will reflect on vocational training to general practitioners in remote areas, who would otherwise have difficulty accessing training.
DoctorQ JULY 2013
INVESTING OFFSHORE: HAVE YOU CONSIDERED REPOSITIONING YOUR PORTFOLIO? INTERNATIONAL INVESTING CAN EXPAND THE OPPORTUNITIES AVAILABLE TO INVESTORS WHO WISH TO BUILD A DIVERSIFIED PORTFOLIO ACROSS INDUSTRIES, SECTORS AND COMPANIES THAT ARE NOT AVAILABLE IN AUSTRALIA. ROSS NOYE EXPLAINS HOW.
Ross Noye Macquarie Private Wealth
With the US recovery gaining momentum, the US Federal Reserve has announced it will be reducing its quantitative easing (QE) strategy to aid the recovery. With the end of the mining boom and a faltering Australian economy, this announcement received a quick reaction from overseas investors with a sell-down of local shares and a sharp drop in the Australian dollar. A lower dollar benefits businesses with overseas earnings because they translate into higher earnings when they are reported in Australian dollar terms. As a result, some investors may like to review their portfolios and re-position them to potentially benefit from this new dynamic which looks like it still has further to play out. Importantly, many of these same companies will have high operational leverage after spending recent years with the high Australian dollar reducing costs and increasing productivity in order to stay competitive. The falling dollar will help them reap the rewards of this hard work. Australian and international investors have benefitted from the surge in the share prices of those companies paying high dividend yields, share buy-backs and an increase in dividend payout ratios, with bank shares up strongly in the 12-months to the end of April 2013. Diversification across asset classes, industries and economies has proven even more important
in the post-GFC years. An example is the relative performance of the Australian market up around 52 per cent from the GFC lows, while the US market is up more than 122 per cent as I write (source: Iress). There are more than 2,000 entities listed on the Australian Securities Exchange (ASX), but overall, the Australian sharemarket is highly concentrated with a large representation in the financial services and resources sectors. In fact, the financial services sector accounts for 32 per cent of the market, while the resources sector represents 31 per cent. Surprisingly, one stock alone accounts for approximately 10 per cent of the entire Australian sharemarket.
(07) 3233 5805 0438 779 955 firstname.lastname@example.org Ross Noye is a stockbroker and financial advisor at Macquarie who specialises in investment and retirement planning.
International investment provides an avenue to enable better management of the level of risk in a portfolio by spreading exposure across different asset types and economies. International investing can expand the opportunities available to investors who wish to build a diversified portfolio across industries, sectors and companies that are not available in Australia. Certain sectors, such as healthcare and information technology, are under-represented in the Australian market and provide very limited choice for investors. Other sectors, such as aerospace, automobiles, and microchip technology, may not even be available domestically. However, most Australian investors tend to focus their investment portfolios on domestic securities and miss the benefits of this diversification. With the falling Australian dollar these benefits become more pronounced. While the current environment may bring opportunities, investors should be aware there can be a number of risks involved in investing internationally besides the usual market risks, including currency risk and sovereign risk. Investors should consider the impact of currency changes on international assets and should consider seeking advice before making investment decisions Q
DISCLAIMER: This information has been prepared by Macquarie Equities Limited ABN 41 002 574 923 (“MEL”) participant of Australian Securities Exchange Group, Australian financial services licence No. 237504, No 1, Shelley St, Sydney NSW 2000, and does not take into account your objectives, financial situation or needs. Before acting on this information, you should consider whether it is appropriate to your situation. We recommend that you obtain financial, legal and taxation advice before making any financial investment decision. Members of the Macquarie Group or their associates, officers or employees (“Macquarie”) may have interests in the financial products referred to in this advice by acting in various roles including as investment banker, underwriter or dealer, holder of principal positions, broker, lender or adviser. MEL is not an authorised deposit-taking institution for the purposes of the Banking Act 1959 (Cth), and MEL’s obligations do not represent deposits or other liabilities of Macquarie Bank Limited ABN 46 008 583 542. Macquarie Bank Limited does not guarantee or otherwise provide assurance in respect of the obligations of MEL.
DoctorQ JULY 2013
WHAT HAPPENS WHEN… ? THE TEAM AT AMA QUEENSLAND INSURANCE SOLUTIONS ARE EAGER TO ANSWER YOUR INSURANCE QUESTIONS. HERE’S ONE PUT FORWARD TO THEM RECENTLY BY A PRACTICE MANAGER, BUT IT’S A SCENARIO THAT EQUALLY IMPACTS CONTRACTED DOCTORS OR THOSE RENTING ROOMS.
Chris Mariani AMA Queensland Insurance Solutions 1300 883 059 email@example.com Chris Mariani is a medical indemnity specialist at AMA Queensland Insurance Solutions.
XYZ Practice Pty Ltd is a medical centre. Most of their doctors ‘rent rooms’ from them. XYZ Practice Pty Ltd has Public Liability and Medical Indemnity insurance (covering the practice entity and employed staff). Dr Betty is one of the doctors renting rooms. She also holds her own medical indemnity and public liability insurances, as per the room rental contract. The practice owners asked us; What happens if Dr Betty does a procedure, and the patient obtains an infection from an instrument that was not sterilised properly by my employed practice nurse. In this
Should the practice be unable to pay their 80 per cent - Dr Betty would become legally liable to pay the whole claim.
instance, XYZ Practice Pty Ltd is negligent for not properly sterilising the instruments. Does my current insurances cover such scenarios? The practice’s medical indemnity policy will respond to cover the nurse as well the as the practice’s ‘vicarious liability’. But while it appears clear the nurse was responsible, the patient’s lawyer may try to join Dr Betty to the claim. The following table outlines some potential allegations that may be made and how the various insurances should respond:
THE LAWYER MIGHT ALLEGE
Dr Betty had a non-delegable duty to check the instruments before she used them.
Dr Betty should notify her medical indemnity insurer who will manage the allegation against her. The insurer may try to defend the claim (where it is a defensible claim) or negotiate their portion of liability. Using the scenario where the matter goes to judgement and the Judge finds Dr Betty 20 per cent liable, then her insurer should cover her 20 per cent.
The Practice Entity
The practice is ‘vicariously’ liable for the negligent action of the employed nurse because it failed to have appropriate procedures in place.
The practice should notify its medical indemnity insurer who will manage the claim for both the nurse and the practice. If the practice is found the remaining 80 per cent liable then the insurer would pay the 80 per cent.
(or the directors of the entity)
The nurse who failed to sterilise the equipment
The nurse is directly liable as it was their error.
THE ‘SCATTERGUN’ APPROACH – WHY ALL THREE MAY BE NAMED IN THE CLAIM? ‘Joint and several liability’ applies to personal injury claims in Australia. Essentially, if each of the parties in the table are found to have any liability (even one per cent) then they are each jointly and severally liable for the whole claim. In the scenario, Dr Betty’s proportion is deemed to be 20 per cent. Should the practice be unable to pay their 80 per cent - Dr Betty would become legally liable to pay the whole claim. This whole amount should then be covered by Dr Betty’s
medical indemnity policy - as her policy should provide cover for ‘amounts you become legally liable to pay as compensation for civil liability…in respect of claims made against you’. In the case of Dr Betty, the patient’s lawyers expect she holds a $20 million medical indemnity policy (as required by registration) so while she was not the one that caused the initial error – they will try to get her ‘on the hook’. The joint and several liability laws can leave Dr Betty ‘holding the baby’. Q
DISCLAIMER: AMA Queensland Insurance Solutions is a trading name of KSLR Pty Ltd, a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, AFSL 240549. Corporate Authorised Representative No: 366807. The information provided in this article is of a general nature and does not take into account your objectives, financial situation or needs. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.
JULY 2013 DoctorQ
Complimentary insurance health check with your Associationâ€™s Insurance Advisors
Make sure you are fully covered at the right price We know doctors have a busy schedule, and while it may be easy to renew your insurance each year without proper revision, changes may have occurred for which you may not be fully covered and premiums need competitive comparison.
For peace of mind and an insurance healthy practice, contact AMA Queensland Insurance Solutions on 1300 883 059.
All insurance needs covered for all members through AMA Queensland Insurance Solutions.
DoctorQ JULY 2013
REVIEWING CONTRACT ARRANGEMENTS THE AIM OF CONTRACTING ARRANGEMENTS IS TO SHIFT THE ADMINISTRATIVE BURDEN AND INCREASINGLY LEGISLATIVE BURDEN AWAY FROM HIRING EMPLOYEES. WILLIAM BUCK’S JULIE SMITH EXPLAINS HOW RECENT CHANGES TO THE LOCUM MODEL MAKE IT A LESS ATTRACTIVE OPTION WHEN CONTRACTING DOCTORS. Julie Smith William Buck (07) 3229 5100 firstname.lastname@example.org
Julie Smith is Tax Services Director at William Buck Chartered Accountants and Advisors.
A recent full Federal Court decision in ACE Insurance Limited v Trifunovski & ors  FCAFC 3 (“the ACE Insurance Case”) increases the likelihood that contracting arrangements under a locum model will be subject to statutory leave entitlements, regardless of the agreement in place with the medical centre and contracting doctor. This is especially the case where the contracting doctor trades in an individual capacity. There are two common methods under which a contracting arrangement is put in place. OPTION 1 – THE DOCTORS IN PRACTICE MODEL Under this common model, the doctor appoints the medical centre as their agent and pays a fee which includes GST. The medical centre collects patient fees and disburses them. As the doctor is paying a fee to the medical centre for services and at no time is engaged by the medical centre to perform work for it, there is no opportunity for a deemed employer/employee relationship.
OPTION 2 – LOCUM MODEL Historically this model was popular because it was easy to understand and slightly easier to document when it came to the service agreement. Under this model the doctor contracts their services to the medical centre for an agreed rate or percentage of patient fees generated. As the doctor is contracting with an entity, and not the end patient for their services, they are required to charge GST for this service. From a cash flow perspective, the medical centre collects all patient fees and then determines the payment due to the doctor, adds GST and then makes the payment. There are a number of issues with regards to the Locum Model which have made it increasingly unpopular. Where the doctor is contracting as an individual, the payments under this model will most likely be subject to: inclusion in any Workers Compensation premium assessments; subject to the superannuation guarantee; where the practice is large enough, State Payroll Tax, even if the contractor is operating through a company or trust. In addition, another possible outcome of this case is that the practice may have PAYG withholding obligations in relation to the contractors.
There are a number of issues with regards to the Locum Model which have made it increasingly unpopular.
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Where the locum contracting agreement is between the medical centre and the doctor directly (even if the doctor operates through a trust or company), we believe there is some risk the medical centre will also have a Superannuation Guarantee obligation with respect to that doctor. If you are currently utilising a locum arrangement, the upside is that the change to a doctor in Practice Model is relatively easy to implement. The adoption of an updated service agreement and the some minor changes to your bookkeeping in relation to the recording of income and service fees will ensure any audit activity in this area does not impact on your practice. Q
DISCLAIMER: The information contained in this summary is general in nature and should not be applied or relied upon without seeking additional professional advice. William Buck has a dedicated team of superannuation and taxation experts who are happy to speak with you regarding yourself managed super fund or any other issues regarding superannuation you may have.
Knowledge Beyond Numbers
Here at William Buck, we pride ourselves on having extensive knowledge of the medical industry, beyond just the numbers. Medical practitioners and leaders of health and aged care organisations face a unique challenge; running an efficient and successful business while offering the best quality of care for their patients. Businesses in this sector are grappling with the competing demands of operational efficiency, regulatory changes, increased pressure on profitably, stakeholder expectations, new technologies and competition for funding. You need a partner who understands these unique industry issues and can help you through the financial, business and personal wealth implications. William Buck is that partner.
CHARTERED ACCOUNTANTS & ADVISORS
BREACHING DUTY OF CARE ALONE IS NOT ENOUGH TRESSCOX PARTNER KATHARINE PHILP EXPLAINS HOW A RECENT HIGH COURT CASE, WALLACE VS KAM1, FOUND THAT BREACHING DUTY OF CARE ALONE IS NOT ENOUGH TO OBTAIN COMPENSATION, WHICH COULD IMPACT DOCTORS AND ‘INFORMED CONSENT’. Katharine Philp Partner (07) 3004 3536 Katharine_Philp@tresscox.com.au Katharine Philp is a Partner at TressCox Lawyers and is highly regarded for her Health Law and Medical Negligence expertise.
More than 20 years ago the High Court of Australia handed down its decision in Rogers v Whitaker2, in which it held that a medical practitioner had a duty to warn a patient of material risks of a procedure in addition to exercising reasonable care in the provision of treatment. A material risk is a risk to which a reasonable person in the patient’s position would attach significance. In the case of Rogers v Whitaker Mrs Whitaker was blind in one eye, having suffered a penetrating injury in her childhood. As an adult she sought Dr Roger’s advice about an elective procedure on her damaged eye. She was also very anxious not to lose her sight in her good eye. Dr Rogers recommended surgery but did not warn of a 1 in 14,000 risk of sympathetic ophthalmia, which risk was sadly realised when the procedure was performed (without any technical negligence). As is well known to many Ophthalmologists, the High Court found that Dr Rogers had a duty to warn of this material risk and he was required to compensate Mrs Whitaker for her injury of total blindness. Since the advent of Rogers v Whitaker doctors have become alive to the process of providing warnings of risks of procedures which has become known as ‘informed consent’.
...they are not generally regarded as responsible for all the consequences of that course of action but only for the consequences of the information being wrong.
On 8 May 2013 the High Court of Australia handed down a unanimous decision which considered a doctor’s duty to warn and the issue of causation; ultimately finding in favour of the doctor, in this case a neurosurgeon. TressCox Lawyers represented Dr Andrew Kam who operated on Mr Wallace’s lumbar spine. Like all procedures this procedure carried inherent risks. The first, least serious, risk was that of bilateral femoral neurapraxia (temporary local damage to the nerves in the thighs). The more serious risk was a 1 in 20 chance of permanent and catastrophic paralysis. These risks bore no relationship to each other. The procedure was unsuccessful and the risk of neuropraxia was realised resulting in Mr Wallace suffering significant pain for some time. He did not suffer from paralysis as a result of the surgery. Mr Wallace claimed that he had not been warned of either risk and had he been warned of either risk he would not have chosen to undergo the surgery and therefore would not have suffered the injury of neuropraxia.
The claim was dismissed at trial. Justice Harrison of the Supreme Court of NSW found that although Dr Kam negligently failed to warn Mr Wallace of the risk of neurapraxia, he also found that Mr Wallace would have chosen to undergo the surgical procedure even if warned of the risk of neurapraxia. He concluded that Dr Kam’s negligent failure to warn was not a necessary condition of the occurrence of the neurapraxia. Mr Wallace appealed to the Court of Appeal which also found in favour of Dr Kam and then ultimately to the High Court. The High Court stated in its decision that even if a person who is required to provide a warning negligently fails to do so, they are not generally regarded as responsible for all the consequences of that course of action but only for the consequences of the information being wrong. The example used to explain this principle was that of a mountaineer who is negligently advised by a doctor that his knee is fit to make a difficult climb, which he would not have undertaken if properly advised, being injured in an avalanche. In that instance the mountaineer’s injury was a result of engaging in mountaineering, not a result of the negligent advice about his knee. The argument that had the proper advice being given he would not have been on the mountain in the first place does not give the mountaineer a cause of action against his doctor. The decision of Wallace v Kam reinforces the principle that it is not enough for a plaintiff to prove a breach of duty of care. Even when a duty to provide reasonable treatment or advice is breached by a doctor, a plaintiff also has to prove a causative connection with any alleged injury in order to obtain compensation. Q
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1 Wallace v Kam (2013) HCA 19 Rogers v Whitaker (1992) 175 CLR 479
“We are well connected to the health industry, so we offer a deep understanding of the issues.”
TressCox has over 100 years experience representing Medical Practitioners in various areas of Health Law. Our Health Services Group is one of the largest and most experienced in Australia. We are well connected to the health industry, its peak bodies and key professionals, so we offer a deep understanding of the issues. When professional, ethical and commercial issues compete, our legal advice is sensitive to every nuance and reality for one particular reason: our health team has specialist expertise gained through long term relationships with the industry. • • • • •
Asset Protection Trusts Property transfers to related parties Conveyancing Leasing Employment arrangements
www.tresscox.com.au Phone: 07 3004 3500
• Acquisition of medical practices • Property syndicates • Deceased estate, Will and succession planning • Structuring of medical practices twitt e r.c om/ Tres s C o x linkedin.com/company/tresscox-lawyer s
WITH INTEREST RATES REASONABLY LOW AND RENTAL YIELDS IN CAPITAL CITIES QUITE HIGH, THERE ARE A LOT OF PEOPLE INTERESTED IN INVESTING IN PROPERTY RIGHT NOW. ALTHOUGH MANY MEDICAL AND DENTAL PROFESSIONALS DON’T SEE THEMSELVES AS PROPERTY INVESTORS, A LOT OF THEM END UP THAT WAY, SAYS INVESTEC’S TREVOR ROBERTSON.
Trevor Robertson Investec 1300 131 141 www.investec.com.au/medicalfinance Investec offer a range of financial products and services specifically tailored to the medical sector. Trevor Robertson is the Head of Residential Lending.
The Brisbane market is picking up,” says Trevor. “The valuations are coming in more in line with client expectations now. Around the inner-ring, places like Paddington and Bulimba, which are your blue chip areas where you’ve seen the growth previously. We’re starting to recover and rental prices haven’t dropped off.” However for the Gold Coast and Sunshine Coast markets, property values have fallen. “Most of the activity we’re seeing is within Brisbane,” adds Trevor Robertson. Where this becomes attractive for medical professionals, he adds, is because of the types of financial products available to them through Investec. “As a general rule—keeping in mind that each medical professional is different—we go out of our way to lend 100 per cent for owner occupier with no Lenders Mortgage Insurance,” he explains. “If someone is looking to invest in multiple properties, it may be more likely 95 per cent, perhaps dropping to around 90 per cent with a third or fourth property. We’re seeing people re-entering the property market because of low interest rates,” he says. “There’s a lot of demand as a result and agents are putting pressure on people to exchange. That’s the case for many people on fixed incomes entering the market.”
There’s always a chance you could lose money, so taking the advice of an accountant, lawyer and financial planner is a good idea... 58
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Where a potential danger lies, he adds, is in those groups targeting professionals and encouraging them to gear up to build a property portfolio. “There are a lot of planners out there who advise our clients to gear up to invest, but if they own properties they can’t rent out, they could put themselves in a vulnerable financial situation.” Owning an investment property is usually a long-term investment. It’s important you can ride through the financial lows so that you are still there to reap the rewards when the market goes through an upward cycle. “When you’re working out how much you can afford to borrow to buy an investment property, it’s tempting to try to maximise your borrowing against the purchase price to make the most of tax advantages. However, there are risks associated with borrowing 95 per cent or 100 per cent of the purchase price, for example, if the market drops or interest rates rise you could find yourself with a loan you can’t afford to repay, and a property you can’t afford to sell. “There’s always a chance you could lose money, so taking the advice of an accountant, lawyer and financial planner is a good idea before investing in anything,” says Trevor Robertson. Depending on whether you’re planning to invest in a property or rent out your existing property, you may want to investigate different sorts of loans, too. Interest only loans can be useful for investment properties if you still have a loan against your principal residence. During an interest-only period, you only pay back the interest that your loan incurs, so any spare cash flow can be used to reduce your home loan debt which, unlike the interest on an investment property loan, is not tax deductible. If you’re investing in your own rooms, that’s a different story altogether. For medical and dental clients, Investec offer up to 100 per cent for owneroccupied premises. It’s just another example of Investec’s extensive experience in working with medical and dental professionals, explains Investec’s Andre Karney: “As specialists in that area we are able to do things which the general financiers are unable to do. We’ve been doing it for 20-odd years, so we know this market in a deeper way than anyone else.” Q
lifestyle “I caught the travel bug when travelling to Europe with my family during high school, and still haven’t found a cure for it. I hope I never will!”
Meet LINDA HIGGINS ROS BULAT IS PLEASED TO WELCOME AND INTRODUCE LINDA HIGGINS, WORLD TRAVEL PROFESSIONALS’ NEW AMA TRAVEL QUEENSLAND SPECIALIST.
“I caught the travel bug when travelling to Europe with my family during high school, and still haven’t found a cure for it. I hope I never will!” After completing a Travel Agent qualification, my first position in travel was with an agency in Balmain. That was a great start, offering a variety of experience, from pension concession rail tickets to first class travel. There was never a dull moment with such a diverse clientele. After 17 years I decided it was time for a change and started working for a company specialising in conference/group travel. I used my extensive leisure experience to offer delegates extensions – pre and post conference. During my six years I was able to extend me experience by also working in their corporate division. Since moving to Queensland nine years ago I have come full circle and found my way home to re-join the World Travel Professionals team. I look forward to putting
my passion for travel along with World Travel Professionals excellence in delivery into action. My favourite holiday – how do you choose? Is it the destination or an experience shared with loved ones .... or even people you meet along the way! Snow skiing, cruising, London, Salzburg, Epernay, Ho Chi Minh, camping in the Canadian Rockies, Barramundi fishing in the Northern Territory, horse riding in Kosciusko National Park...... was it my last holiday .. or will it be my next holiday? On my last holiday I was very lucky to travel with friends I have known since primary school. We were heading ... north to Alaska! “We started with a few nights in Anchorage as a base where we drove up to Denali National Park. We flew over Mt McKinley from Talkeetna (a bit of trivia – this is the town that Northern Exposure was based on) and my first glacier landing was something very special. “Later we caught a flight to Cordova to stay at a fishing lodge, what a fabulous place. My friend caught a 10kg halibut, but unfortunately I caught the one that John
West rejects. I consoled myself with the breathtaking scenery and spectacular walks in the area. We followed this by travelling to Kenai Peninsula and a few nights near Seward: great salmon bakes, meeting the locals and champagne by the river with Kenai Mountains as a backdrop - can it get any better. Yes it can! With a cruise to Vancouver through Glacier National Park and the Inside Passage. Picture this: sitting on your balcony, beautiful sunny day, watching the glaciers, drinking champagne. Alaska really was an experience and I look forward to filling those interested in about it more.” Q
For mo re inform Linda a ation c all or e t AMA mail Ro Travel s and Queen sland. PHON
E: 1800 262 885 FAX: (0 7) 5556 7200 EMAIL travel@: amaq.c om.au WEB: www.a maq.w orldtra vel.com .au
DoctorQ JULY 2013
BIODYNAMIC WINE WHAT’S ALL THE FUSS ABOUT? WINE DIRECT’S PHIL MANSER EXPLAINS THE GROWING DEMAND FOR ORGANIC WINE AND WHY AUSTRALIAN VINEYARDS ARE RISING TO THE OCCASION.
As a wine merchant of many years I have frequently encountered requests for organic wine which has often had me turning to a compendium with a very short list of producers. Of course these days that list is running into several pages which is great for those of us sensitive to the 21st century. I’m happy to say we’ve moved on from the days of expensive preservative free wines with an unpleasant premium attached. Of course the French vigneron looks on and says ‘what’s the big deal? We’ve done this for centuries’… So what is biodynamic wine all about? In simple terms it’s just plain old fashioned farming, using what nature has provided to nourish the soil and manage the seasonal adversities. Some of this includes using what the nearby cattle have provided to fertilise the soil, composting, mulching and letting a variety of cover crops grow between the rows allowing a diverse range of fauna to operate in balance.
One such exponent of biodynamic farming is Paxton Vineyards (McLaren vale) who now proudly wear the mantle of ‘Certified Biodynamic’ as deemed by the National Association for Sustainable Agriculture Australia. Biodynamism employs an overlaying philosophy that comes from the teachings of the Austrian philosopher Rudolf Steiner. His is a holistic approach to agriculture which Paxton employ to ‘help wines catch the climate and soil’. In practical terms, biodynamic agriculture focuses on having healthy, alive, nutrient rich soils and a well balanced environment. For example, one of the main biodynamic preparations Paxton use is called preparation 50. It is produced by burying organic manure in a cow horn, digging it up in spring, adding water and spraying it over the vineyard... natural pest control. Paxton boast a diverse array of wines ranging from a delicate 2013 Pinot Gris to the very imposing and ink-like Quandong Farm Shiraz. Both wines display pristine fruit character and offer amazing value for money. Kalleske (Barossa Valley) are
In simple terms it’s just plain old fashioned farming, using what nature has provided to nourish the soil and manage the seasonal adversities. 60
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another biodynamic producer whose wines continue to earn plaudits from around the wine world and again, offer superb value for money, Clarrys Red Blend immediately comes to mind, vibrant fruit and firm structure. Q
Phil Manser Wine Direct 1800 649 463 email@example.com
Introducing QXRWeb Simple, convenient, secure access to all your radiology needs in one place with single sign-on QXRWeb Images Secure access to images and reports side by side via Inteleviewer or Inteleconnect QXRWeb Reports Secure access to radiology reports via Webster QXRWeb Appointments Real time confirmed appointments without picking up the phone
QXRWeb E-Education Online Continuing Medical Education (CME) materials tracked for verification with your professional body QXRWeb Profile Update your details or change your password
You can access QXRWeb today if you have an existing QXRWeb Images account â€“ simply use your existing username and password at www.qxrweb.com.au. Call Doctor Direct on 1800 77 99 77 to set up an account.
DoctorQ JULY 2013
The Gallardo is the most popular model that Lamborghini has ever produced.
LAMBORGHINI Track day
AS THEY SAY “SOMEBODY’S GOTTA DO IT”, SO WHEN DR LARRY GAHAN WAS OFFERED A SELECTION OF LAMBORGHINIS TO TEST DRIVE AT THE PERFORMANCE DRIVING CENTRE AT NORWELL, WE DIDN’T HAVE TO TWIST HIS ARM!
The combination of a Lambo and a race track is the ultimate dream gig for any petrol head. It would have been such a waste to drive the range of Lamborghini Gallardos on the road only. From their origins in tractors, the Lamborghini company has forged a long history of premium sports car engineering and race track success, so it was only fitting to sample these beautiful beasts appropriately. Lamborghini Gallardo models provided were the 550-2 (550hp 2WD) and the 560-4 (560hp 4WD), ranging from $400,000-$500,000. With 1,380kg to haul, the power to weight ratios are not too far removed from V8 Supercar status. In metric parlance the Gallardo’s V10 is good for 405 or 412 Kw with 540Nm of torque, allowing 0-100kph of 3.7 seconds. As Valentino Balboni, the legendary Lamborghini advisor and test driver for over forty years stated “a Lamborghini must always combine the presence of a race car with the reliability of an old friend”. The V10 is the ultra reliable 5.2 litre motor shared with Audi. It doesn’t require the frequent expensive ‘engine out’ cam belt servicing at 20,000km intervals that earlier Ferraris demand. Service costs are in the realm of $1,400pa
Thanks to Brisbane Lamborghini of 632 Wickham St, Fortitude Valley, Brisbane. 62
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until the $4,000/40,000km/4-year service. This is more in the upper luxury bracket than the Supercar bracket. The Gallardo was quiet and placid while ambling out to the track, and with the features of GPS, reversing camera, park sensors and Bluetooth, this vehicle would be very forgiving in real life use, considering its track based alter ego. Once we’re let loose on the circuit it comes to life, and the ferocity promised by the raging bull emblem is unleashed. The mechanical symphony provided by the V10 technological tour de force is amplified by the race bred exhaust system. The butterfly valves open above 3,500rpm, allowing maximum torque, enhanced throttle response, and especially the glorious exhaust note. You can dial in the setting you want to adjust the mood of the car, from normal to sport to Corsa (full race mode), and the smile gets wider the further you go up the dial. The E gear transmission can be operated manually, full automatic, or any combination between using steering wheel mounted paddles. There is no clutch, another saving in maintenance costs, and the E gear changes up and down faster than humanly possible.
When braking heavily the E gear enhances retardation with auto downshifting complete with ‘blipping’ of throttle between changes accompanied by a fantastic exhaust cackle that puts other manufacturer’s attempts at this in the shade. The orchestra of mechanical noises combined with protesting tyres ensured that not one driver even thought to turn on the upmarket sound system in the cars. While the 560-4 all wheel drive version is more refined, more controlled, and more capable, my personal favourite was the 5502. The experience of driving an example of arguably the world’s most uncompromising sports car brand on the ragged edge, steering by throttle in beautiful sweeping slides in convoy with Paul Stokell, Australia’s premier Lamborghini racer, was an experience that will live with me forever.
The Gallardo’s 550-2 (2WD) was not really meant to be a regular model. A prototype was in fact built for Balboni in 2008, answering his desire for a more thrilling, more tactile and responsive version of the Gallardo. Lamborghini was impressed and approved a one off build of 250 Valentino Balboni editions, which also featured a unique white and gold painted stripe down the centre of the car. They were so popular that the 550-2 is now a regular build model and has contributed to the Gallardo being the most popular model that Lamborghini has ever produced. Q
all about you APP SNAP International Movie Database Settle the argument on who that dark haired bloke from that movie was last night with the IMDb app. Settle those spousal arguments in a few clicks with International Movie Database (IMDb) app. The free app has information on over two million TV shows and movies and over four million actors, directors and crew members. It also includes user and critic reviews, as well as movie quotes, goofs and trivia. Q
“We’re having a big meeting tomorrow to kick off our Employee Wellness Campaign. Who’s in charge of bringing the soda and donuts?”
BOOK CLUB LOOKING FOR A NEW BOOK TO READ?
Join us in reading a variety of books for the chance to win a copy of next edition’s book club book. Send your feedback to firstname.lastname@example.org. Q
POLENTA CAKE WITH CITRUS ZEST
THE IMMORTAL LIFE OF HENRIETTA LACKS REBECCA SKLOOT Her name was Henrietta Lacks, but scientists know her as HeLa. She was a poor Southern tobacco farmer, yet her cells—taken without her knowledge—became one of the most important tools in medicine. The first “immortal” human cells grown in culture were vital for medical research and development. Henrietta’s story tells of a dark history of bio-ethics and informed consent.
THE LOST PILOT: A MEMOIR
JEFFREY PAPAROA HOLMAN In 1945, a Japanese kamikaze pilot plunges his divebomber at the Royal Navy’s HMS Illustrious. Petty Officer W. T. Holman sees him coming – he has seconds to live. Firing from the ship blows the plane off course; its bomb explodes beside the ship in a shocking near miss. Later in life, Holman’s son begins to ask questions: Why did his father live and that pilot die? Who was the pilot and did he have any family? Lost Pilot is a historical memoir about the persistence of grief in the wake of war’s faceless cruelties.
2 cups rice milk fortified with calcium/B12 1 cup whole grain cornmeal/polenta ½ cup light coconut milk ½ cup chopped raw almonds Diabete s friendly ½ cup raisins/sultanas ¼ cup honey 1 tablespoon finely grated lemon zest ⅓ cup lemon juice 1½ teaspoons pumpkin pie spice/mixed spice 1 teaspoon vanilla extract
METHOD 1. Bring rice milk to a boil in a medium saucepan. Stirring constantly with whisk, add cornmeal gradually in a thin stream. Reduce heat to medium, and whisk for 5 minutes or until very thick. 2. Reduce heat to low and add remaining ingredients, stirring well after each addition. 3. Press into a 9-inch/23-centimeter round cake tin and smooth top. 4. Cool in the fridge until chilled through. 5. Garnish with chopped nuts, lemon zest and mixed spice, and serve chilled. Q © Recipe and image kindly provided by Sanitarium Health & Wellbeing Company DISCLAIMER: The above recipe meets the nutrition criteria set by Australian Diabetes Council. However, the opinions expressed on www.sanitarium.com. au do not necessarily reflect the views of Australian Diabetes Council.
DoctorQ JULY 2013
COMING FILMS 4 July
The Lone Ranger Wikileaks – We Steal Secrets
Wolverine Bling Ring
Now You See Me
15 August Paranoia 29 August Red 2 (see main image)
CLASSIC FILMS 29 July
The Quiet Man (1952) 10am and 7pm
ORE FOR M ISIT V INFO OM.AU
26 August Sunset Boulevard (1950) 10am and 7pm
DENDY CLUB MEMBERS SCREENINGS
GREAT ART ON SCREEN
All tickets are just $8! Book early – these screenings sell out! A new series of cinema events that brings the world’s greatest art exhibitions to the screen.
Only God Forgives 10 July at 6.30pm A Bangkok-based drug kingpin (Ryan Gosling) goes on a mission of revenge when his brother is found dead. Voted #1 at Sydney Film Festival.
NATIONAL THEATRE LIVE AT DENDY CINEMAS
MUNCH 150 13 July, 10am | 14 July, 1pm This year, all of Norway celebrates the 150th anniversary of the birth of Edvard Munch (1863 – 1944), one of the towering figures of modern art. Munch 150, co-hosted by the National Museum and the Munch Museum (both in Oslo), is already being hailed as a “once-in-alifetime show”.
Kick Ass 2 19 August at 6.30pm After Kick-Ass’ insane bravery inspires a new wave of self-made masked crusaders, led by the badass Colonel Stars and Stripes (Jim Carrey), our hero joins them on patrol.
6 - 7 July, 1pm | 10 July, 10am | 11 July, 6pm Helen Mirren reprises her Academy Award winning role as Queen Elizabeth II in the highlyanticipated West End production.
CORPORATE EVENTS & GROUP BOOKINGS
For sixty years Elizabeth II has met each of her twelve Prime Ministers in a weekly audience at Buckingham Palace – a meeting like no other in British public life – it is private. Both parties have an unspoken agreement never to repeat what is said. Not even to their spouses.
We love hosting corporate film nights and group bookings at Dendy. Hosting a corporate screening event is a great way to thank clients or staff – or perhaps you have a favourite charity that you would like to raise some money for? We have a functions pack and cinema package to suit all requirements. Contact Events & Publicity Manager Jenny Sonter on email@example.com for a free quote.
WIN MOVIE TICKETS FOR TWO Name: Postal address: Portside Wharf, Remora Road, Hamilton Ph: (07) 3137 6000 www.dendy.com.au 64
JULY 2013 DoctorQ
FAX BACK TO (07) 3856 4727 or email firstname.lastname@example.org by 30 June
lifestyle lifestyle ORE FOR M ION MAT INFOR M.AU CO QPAC. 246 OR 136
QUEENSLAND MUSIC FESTIVAL’S TAKE 6 13 July, Concert Hall, QPAC With ten Grammys to their name, Take 6 is the quintessential a capella group and model for vocal genius. Six virtuosic voices unite in crystal clear harmony against a backdrop of syncopated rhythms, innovative arrangements and funky grooves that bubble into an intoxicating brew of gospel, jazz, R&B and pop.
GEORGE BENSON LIVE IN CONCERT 22 August, Concert Hall, QPAC Described as one of the greatest guitarists in jazz history and an amazingly versatile musician, George Benson has earned an impeccable reputation as one of music’s most enterprising and engaging stars. With a career that spans five decades, more than 35 albums and ten Grammy Awards, George Benson has used his jazz roots as the foundation for an engaging mix of pop and R&B.
THE COMPLETE WORKS OF WILLIAM SHAKESPEARE (ABRIDGED)
11 – 13 July, Playhouse, QPAC Sydney Dance Company and the Australian Chamber Orchestra join forces for an exhilarating new performance featuring the music of JeanPhilippe Rameau.
From 21 September, Cremorne Theatre, QPAC
A bold, speedy, irreverent romp through all 37 of Shakespeare’s plays in just 99 minutes. Without the language barriers or the period hurdles, this piece aims to out-Python Monty!
Artistic Directors Rafael Bonachela (SDC) and Richard Tognetti (ACO) bring Rameau’s impassioned Baroque ballet and opera music roaring into the 21st century in their stunning collaboration Project Rameau. Fusing refined Baroque music with explosive contemporary dance, Project Rameau’s premiere season played to packed theatres and critical acclaim.
WIN DOUBLE PASSES TO PROJECT RAMEAU
Three brave actors brazenly blend the best of the brilliant Bard with the scrapings from the bottom of the absurdity barrel in this farcical feast of inspired lunacy. A side-splitting roller coaster ride and probably the fastest, funniest Hamlet you’re ever likely to see.
Name: Postal address:
FAX BACK TO (07) 3856 4727 or email email@example.com by 30 June DoctorQ JULY 2013
HEALTH PROMOTION STRATEGIES AND METHODS THIRD EDITION
Well-known health promotion expert, Professor Garry Egger, leads an experienced, Australian-based author team on the third edition of his essential guide to developing practical and effective health programs. Aimed at the health promotion student, Health Promotion Strategies and Methods, 3e is a practical guide to developing health promotion strategies.
Doctor Q has a copy of Health Promotion Strategies and Methonds 3e to give away. Simply fill out your details in block letters on the form and fax it to (07) 3856 4727 or email firstname.lastname@example.org.
CHECK FOR YOUR NAME!
JULY 2013 DoctorQ
Entries close 3o June 2013
This title takes a balanced approach to health promotion, by considering not only the individual, but also group dynamics, as well as population and community approaches. With an increasingly overweight population and the impact of social media as a key communication channel, this new edition of the book
considers key issues and methodologies in getting key messages through. Clearly structured, with real-life case studies throughout each chapter, this book delivers the latest research and health practice in an accessible and meaningful way to assist students and junior practitioners in planning and implementing their health promotions. Published by McGraw-Hill, Health Promotion Strategies and Methods retails for $57.95. Q McGraw-Hill Education is offering Doctor Q readers 15% OFF Health Promotion Strategies and Methods, 3e Promo Code: DRQ13 www.mcgraw-hill.com.au/medical
WIN THIS BOOK! Name: Postal Address: Telephone:
DOUBLE PASS WINNERS
Dr Mitesh Gandhi, Dr Alison McColl and Dr Wendy Bourke won double passes to Queensland Theatre Companyâ€™s Mother Courage and Her Children.
Dr Tara Parsons won a copy of The Good Doctor: What Patients Want, from Auckland University Press.
1. Dr Melissa Leung 2. Dr Karen Chan 3. Dr Peta Margrie 4. Dr Christopher Que Hee 5. Dr Jai Raj 6. Dr Lisa Erzetich 7. Dr Nigel Dore 8. Dr Michael Williams 9. Dr WE Ryan 10. Dr Caron Forde
To the right is a list of AMA Queensland members who were unfortunately omitted from or had errors in the initial 2013 Directory of Members. Please take note of these changes and amend your Directory accordingly. If you have any further questions regarding the Directory of Members, please contact the Membership team on (07) 3872 2222 or email email@example.com
ENT Head & Neck Surgery Error: The below members were incorrectly listed in the specialty of endocrinology. AGNEW, JULIENNE M F Silverton Place 101 Wickham Terrace BRISBANE QLD 4000 P: 07 3832 1244 F: 07 3839 0876 A/H: 07 3261 9570 Pager: 1300 555 555 Ext: 93130 SI: Paediatrics, Rhinology, Head & Neck Surgery ALLEN, LINDSAY H M Mater Medical Centre Level 3 Suite 7 Mater Private Hospital 21-37 Fulham Road PIMLICO QLD 4812 P: 07 4725 1333 F: 07 4725 2538 M: 0407 727 460 E: firstname.lastname@example.org SI: Paediatric ENT ALLISON, PAUL M Pacific Private Clinic Suite 5 123 Nerang Street SOUTHPORT QLD 4215 P: 07 5532 6755 F: 07 5532 5644 M: 0414 326 755 E: email@example.com ALTMANN, CAMERON M Cameron Altmann Surgical Suite 6 Level 3 Mater Medical Centre 21-35 Fulham Road PIMLICO QLD 4812 P: 07 4728 9886 F: 07 4728 6380 A/H: 07 4728 9886 SI: Paediatric ENT, Head and Neck Skin Cancer, Sinus Surgery, Parotidectomy, Medico-Legal
ANNING, FRANK W M Silverton Place Suite 56 101 Wickham Terrace BRISBANE QLD 4000 P: 07 3832 3422 F: 07 3832 3328 E: firstname.lastname@example.org SI: Sinus Disease & Surgery, Medico-Legal, Snoring North West Medical Centre 125 Flockton Street EVERTON PARK QLD 4053 P: 07 3832 3422
Pager: 1300 555 555 Ext: 53737 E: email@example.com SI: AIDS/HIV Medicine, Oncological Infection Plastic and Reconstructive Surgery Error: No longer at Noosa Junction address
Violet Street REDCLIFFE QLD4020 P: 07 3832 3422
MCDERMANT, GREG M Kawana Private Hospital Suite 10 5 Innovation Parkway BIRTINYA QLD 4575 P: 07 5438 8399 F: 07 5438 8299 Pager: 1300 555 555 Ext: 852 SI: Breast Surgery, Cosmetic Surgery, Plastic & Reconstructive Surgery
Strathpine Specialist Centre 32 Dixon Street STRATHPINE QLD 4500 P: 07 3832 2422
Error: Omitted from listing VARGEHSE, RAPHAEL M Ipswich Hospital Chelmsford Avenue IPSWICH QLD 4305 P: 07 3810 1140 F: 07 3810 1592
Infectious Diseases Error: Omitted from listing GEORGHIOU, PAUL R M Wesley Medical Centre Unit 25 Level 2 40 Chasely Street AUCHENFLOWER QLD 4066 P: 07 3870 5080 F: 07 3870 4611 M: 0413 430 510 A/H: 07 3830 5600
Error: Incorrect phone and fax number, email address and website listed â€“ NEW PRACTICE WHITE, MELISSA F Suite 2 52 Burnett Street BUDERIM QLD 4558 P: 07 5456 4278 F: 07 5450 1045 E: admin@melissawhitegastro. com.au W: www.melissawhitegastro. com.au
125 Flockton Street Everton Park QLD 4053 P: 07 3353 3100 F: 07 3353 4130 E: firstname.lastname@example.org Orthopaedic Surgery Error: Incorrect email address listed PRICE, JAMES M Halberstater House 39 Fulham Road, Pimlico TOWNSVILLE QLD 4812 P: 07 4728 8500 F: 07 4728 8455 E: reception@drjamesprice. com.au Psychiatry Error: Incorrect email address listed Duke, Benjamin J M Connolly Clinic Belmont Private Hospital 1220 Creek Road CARINA QLD 4152 P: 07 3055 9357 F: 07 3843 5384 M: 0458 408 255 E: ben.duke@healthecare. com.au SI: Psychiatry, Medico-Legal Suite 58 Silverton Place 101 Wickham Terrace SPRING HILL QLD 4000 P: 07 3832 6027 F: 07 3831 3404
Obstetrics and Gynaecology Error: Incorrect email address listed SHEAHAN, TERRY M North West Medical Centre
DoctorQ JULY 2013
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The July 2013 edition of AMA Queensland's flagship publication