Doctor Q July 2012

JULy 2012 . Vol 79

New State President Dr Alex Markwell Exclusive: Springborg Interview

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DoctorQ JULY 2012

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DoctorQ JULY 2012

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CONTENTS

this issue Meet Dr Alex Markwell, Queensland’s new face of the AMA She is Queensland’s youngest AMA state president—and cringes when called a medicopolitician: “I can accept lobbyist; just!”...

15

FEATURE STORies 10 A meeting with the minister

MEMBER NEWS

10

34 member profile: professor roger allen

16 meet your new president-elect

51 member news

23 a neighbourly visit

REGULARS 6 FROM THE EDITOR’S DESK 8 PRESIDENT’S REPORT 9

CEO’S REPORT

2012 conference | 27 - 28 july | indooroopilly golf club

STaRTING aND wORkING IN

pRIvaTE pRacTIcE SUITABLE FOR GPS, SPEcIALISTS And PRAcTIcE MAnAGERS

accreditation

28

business

12 news in brief 25 AMA Queensland news

Current issues 18 Counting the cost of disability insurance

models & structure

independent contracting options

39 buying peace of mind for travel 41 the importance of exit provisions 42 leveraging your smsf

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JULY 2012 DoctorQ

insurance

privacy

technology

& communications

confidentiality and record management

early bird sPecial

(closes by 22 June 2012) Bring a non-member at member rates or receive early bird discount as per brochure

36

22

issues affecting

general practice

continuing professional development points *approved

practice review

Very informative conference, not only for starting up in private practice but also for existing practices. Highly Recommended. trish cuthbert - practice Manager, granite Belt Medical services

P r o u d ly s P o n s o r e d b y:

Caring for you for life

people & events 44 calendar 52 mentoring

21 pomp and practice: the national conference report

36 selling your practice

work cover

management

managing referrals

19 who’s suing who in court?

business tools

risk

workplace health & safety

53 inauguration 54 women in medicine breakfast

54

Life 45 investing 46 travel 47 wine 48 Dendy movies 49 culture

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editor’s desk

What the new (financial) year brings Heather Grant Doctor Q Editor A few weeks ago, Doctor Q was fortunate to squeeze into Health Minister Springborg’s busy schedule.

For almost an hour, he sat and talked—about his early observations of the health system and decisive early actions. He made no apology for his no-nonsense decision-making style.

As he put it, “there’s been too much stuffing around”.

And he wanted to deliver a personal message to Queensland’s medical professionals: “We value them. They

do an absolutely brilliant job...and we want to make sure that they can do their job much more easily than they have been able to do in the past.”

You’ll find excerpts of that exclusive interview on page 10. The full transcript is online at www.amaq.com.au.

July marks a new financial year, a changing of the guard in council representation and the introduction of new protocols and regulations: all captured within these pages.

Sit back and enjoy reading about the people, policies and politics of your profession! Q

Queen’s Birthday honours The man who history will remember for developing a vaccine to help prevent cervical cancer, Professor Ian Frazer, received the highest of awards in the 2012 Queen’s Birthday Honours: a Companion of the Order of Australia (AC).

AMA Queensland members to be recognised for their work were: Dr Judith Teng Wah Goh (AO), for distinguished service to gynaecological medicine, particularly in the field of fistula surgery, and to the promotion of the rights of women and children in developing countries The Honourable Dr John Herron (AO), for distinguished service to the Parliament of Australia, to international relations through diplomatic and humanitarian roles, professional medical associations, and to the community Professor Malcolm West (AM), for service to cardiovascular medicine as a clinician, researcher, academic and mentor, and to the community

through contributions to medical foundations and charities Professor John Robinson Bell (AM), for service to medicine in the field of pathology, to medical education and professional organisations, and to the community Dr Malcolm Wright (AM), for service to intensive care medicine, as a clinician, teacher and administrator, and through advanced medical training programs in developing countries Dr Don Bowley (OAM), for service to medicine through the Royal Flying Doctor Service Dr David McConnel (OAM), for service to medicine, particularly as an anaesthetist, through a range of executive and professional roles. Q The full list of Queen’s Birthday recipients can be read at http://www.gg.gov.au/res/file/2012/ honours/qb2012/Gazette%20QB12%20 (1)%20Order%20of%20Australia.pdf

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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JULY 2012 DoctorQ

Board of Directors Dr Alex Markwell President

Dr Sharmila Biswas Honorary Secretary

Dr Christian Rowan President-Elect

Dr David Alcorn Elected Member

Dr Sharon Kelly Chairperson

Dr John Cox Elected Member

Dr Chris Zappala Treasurer and Specialist Craft Group

Dr Richard Kidd Elected Member

Council Dr David Alcorn Greater Brisbane Area Dr Tom Arthur Gold Coast Area Dr Sharmila Biswas Far North Area

Dr Deborah Mills Part-Time Medical Practitioner Craft Group Dr Stephen Morrison Specialist Craft Group

Dr Kimberley Bondeson Greater Brisbane Area

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

Dr John W Cox Downs and West Area

Dr Carl O’Kane North Area

Dr Ben Duke Greater Brisbane Area

Dr Shaun Rudd General Practitioner Craft Group

Dr Larry Gahan General Practitioner Craft Group

Dr Anil Sharma Capricorn Area

Dr Noel Hayman Greater Brisbane Area

Dr Jonathon Shirley Greater Brisbane Area

Dr Sharon Kelly Specialist Craft Group

Dr Mason Stevenson General Practitioner Craft Group

Dr Richard Kidd Immediate Past President Mr Nicholas Gattas Medical Student Group

Dr Jen Williams Residents and Registrars Craft Group

AMA Queensland Secretariat Jane Schmitt Chief Executive Officer Filomena Ferlan General Manager Corporate Services Neil Mackintosh Manager - AMAQ Foundation

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

Editor: Heather Grant Graphic Designer: Erin Sticklen Advertising: Taylor Hunter 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: editor@amaq.com.au Cover photo: Courtenay Grant-Wakefield

LETTERS TO THE EDITOR

May 201 2.

Vol 78

behind the eight-ball

For Indigenous health to truly improve takes a commitment to raise healthy, well-nourished youngsters who access child health services with the same ease as their white Australian sisters and brothers.

The statistics quoted in your article ‘Snapshot of Health Shame’ (Doctor Q, May 2012) tells a sorry story of Indigenous health. Yet Closing the Gap initiatives, from my experience, are misdirected.

Well-priced fruit and vegetables and programs aimed at dealing with the chronic incidence of diabetes type 2, for example, are well and good but the fact remains Australia’s Aboriginal population is destined to be behind the eight-ball, unable to catch up to our nation’s health standards and expectations, until serious efforts are made to address the critical formative years of development in-utero through to preschool.

My study, ‘Growth characteristics of preschool Aboriginal children’, published in the Australian Journal of Paediatrics in 1979, analysed growth records of more than 500 Aboriginal children born since 1970 and living on five Aboriginal communities in

Cape York. It found significantly lower birth weight in both genders, as well as smaller head circumference, compared to British standards, and a continual downward spiral, save for a ‘catch-up’ weight period between 18 and 38 months that never quite compensated. Space does not allow me to elaborate here but the research findings were unequivocal: the small appearance for age of Aboriginal pre-schoolers was not a racial characteristic; it was due to growth failure.

As subsequent scientific studies by the likes of Nobel Prize winner Elizabeth Blackburn have revealed, risk of disease is inextricably linked to cellular makeup and early and continual stressors can manipulate a chain of circumstances that ultimately lead to susceptibility to conditions such as diabetes, cancers and other chronic preventable conditions.

Indigen

Your role in

ous-frie

closing th e gap

fracki next gong - Qld’s ld rush ?

‘Snapshot of Health Shame’

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Doctor Q, May 2012

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For Indigenous health to truly improve takes a commitment to raise healthy, well-nourished youngsters who access child health services with the same ease as their white Australian sisters and brothers. With good solid foundations, their future can be brighter.

Dr John W Cox, Paediatrician, Toowoomba

DoctorQ JULY 2012

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PRESIDENT’S REPORT

great expectations I write this column with eager anticipation— it’s the beginning of 12 months essentially dedicated to AMA Queensland and I can’t wait.

ALEX MARKWELL President, AMA Queensland Following on from Dr Richard Kidd’s term, I hope to continue his excellent track record of being approachable and engaged; a passionate advocate for the patients and doctors of Queensland. I would like to thank Richard for his mentorship and guidance during the past year, and congratulate him on a successful presidential term. I know he enjoyed his time (and wishes he had another 12 months!). Richard’s experience will be retained and put to great use as Queensland Area Representative on AMA Federal Council.

I am also very excited to be working with Dr Christian Rowan, President-Elect 20122013, whose wealth of experience, vision and energy are to our great benefit. Read his story on page 16.

I believe it is essential we re-connect with our members and potential members alike. With membership rates falling nationally, and currently holding steady in Queensland, we have an imperative to engage or our organisation will become irrelevant. In the past year, I met with members (and non-members), councillors and the board to discuss this pressing issue and a five-pronged approach was identified. To this end, I want to:

Our overarching goal: helping doctors help patients.

“Regional members will be heartened to hear I’m travelling!”

inspire our students and junior doctors through mentorship, professional development opportunities and leadership training create vibrant professional communities which foster collaboration between all doctors—doctors-in-training, specialists, GPs and medical administrators actively promote public health initiatives, improving health literacy and health education for our patients revamp our membership benefits and supports—so that members get what they need move forward on a review of our leadership structure and function which overwhelmingly indicated the need for a two-year presidential term, and use the experience of those who’ve recently served.

We must remind ourselves of our overarching goal: helping doctors help patients. When we remember this, it is easy to see how everything falls into place.

Whether you are a GP, doctor-in-training, staff specialist, VMO or student, we all have the same goal. Despite our (at times) differences, we really are all one tribe.

Re-activating local medical associations is an excellent approach for reconnecting our sometimes disenfranchised, and at times isolated, members. Dr Anil Sharma has had success in rejuvenating the Central Queensland LMA, and Dr Carl O’Kane and Dr Sharmila Biswas are in the process of re-establishing similar LMAs in Townsville and Cairns respectively. We know there are thriving LMAs that have nurtured their local professional community, and we look to them for inspiration and leadership.

Regional members will (hopefully!) be heartened to hear that I’ll be travelling in the first few months, meeting regional representatives and local members, and seeing local issues firsthand. I also favour events being held outside the ‘great southeast’: for example, the Sandford-Jackson Memorial Lecture in Townsville. Your suggestions for regional events and areas to visit are most welcome. Q

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JULY 2012 DoctorQ

ceo’S REPORT

Change, change, change AMA Queensland is in talks with the Health Minister to ensure the best outcome for Queensland doctors and patients.

JANE SCHMITT Chief Executive Officer, AMA Queensland In May, Health Minister Lawrence Springborg introduced changes to the planned health reforms to parliament.

These changes, if passed, will come into effect as this publication hits your desk or inbox on 1 July. They seek to decentralise control of health services in Queensland and increase community involvement.

Essentially, Queensland Health will split into 17 health service areas. What were known as Local Health and Hospital Networks become Hospital and Health Services. Sixteen Hospital and Health Services will operate within current district boundaries while the Children’s Health Service will provide tertiary paediatric care state-wide.

Hospital and Health Services will be run

by Hospital and Health Boards of at least five members including a chairperson. One or more members of each board must be a ‘clinician,’ although ‘clinician’ is not defined.

Boards powers explained The boards’ powers have been expanded to include: hiring and firing of staff (once accredited by the Minister). Pay and conditions will remain unchanged. owning the hospital and health service facilities and buildings (although they will need the Minister’s approval to buy, sell or lease the property).

Stemming from the boards are two new bodies.

First, Executive Committees, including the chair or deputy chair of the board and two other board members, one of whom must be a clinician, will concentrate on clinical issues and work with the chief executive.

The Executive Committee will: oversee the performance of the Hospital and Health Services help develop Medicare Local protocols and clinician and community engagement strategies help develop service plans.

The Health Minister may create ancillary boards within each Hospital and Health Service to advise the board on a particular facility, service or area of the state. These ancillary boards may, the minister says, become the basis for new, smaller, Hospital and Health Services.

New funding arrangements The new law also makes changes to the funding arrangements which will make it easier to see how much funding each hospital receives.

From 1 July, hospitals will be required to be funded by activity-based funding (ABF) where practical. Where ABF funding is not practical, hospitals may receive block funding or a mixture of block and ABF. All activity-based funding will have to be paid out of one Reserve Bank of Australia bank account and monthly reports will be made about where the money is sent.

The Commonwealth government will fund 45 per cent of the increase in the efficient price for each current service given and 45 per cent of the efficient price for each addition service (in relation to current numbers). This efficient

...seek to decentralise control of health services in Queensland and increase community involvement.

price will be determined independent of government by the Independent Hospital Pricing Authority (IHPA).

Changes to funding in Queensland Queensland Health is currently in negotiations with the IHPA to determine which services will be funded under the new system with a Commonwealth contribution and which will continue to be either funded by Queensland or bulk-billed.

AMA Queensland is in talks with the Health Minister to ensure the best outcome for Queensland doctors and patients.

Changing of the guard All of this change comes into force as we at AMA farewell Dr Richard Kidd and welcome our new President, Dr Alex Markwell, to what looks like an exciting year ahead for our membership.

I extend my personal thanks to Richard who was a tireless advocate for the profession in a year of big issues: among them, the Queensland Health payroll debacle which continued to cause much stress, disgust and disbelief; rejection of referrals across all categories to public hospital outpatient clinics; and the state election campaign. Of the latter, Richard led AMA Queensland’s long-term plan for the future of the health care system including a bold centrepiece strategy of a new leadership structure for the state’s health system made up of senior politicians, AMA Queensland medical practitioners, nurses and other clinicians actively involved in patient care. It was a strategy that grabbed the attention of our politicians, including the new Health Minister.

Richard has been a very proud, enthusiastic, willing and dedicated advocate for the profession and for patients over many years, not just during his presidency, unwilling to leave any stone unturned in an effort to put health as the top priority for Queensland. We are indebted to him. Q

DoctorQ JULY 2012

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Feature story

e

exclusiv

A meeting with the Minister

At just 21, Lawrence Springborg became the youngest person ever elected to the Queensland Parliament.

That was back in 1989. The former Opposition leader has now been given the job of sorting out Queensland Health. Minister Springborg took time out to talk with Doctor Q.

Q: You’ve had two months to analyse what’s going on in Queensland Health. Have you found any surprises?

One thing that I have observed is that various disciplines across health in the public sector, let alone the relationships with the private sector, don’t actually really understand what makes each other tick. For a system that relies upon really good interrelationships or an understanding, it’s amazing how everyone is very professional in what they do but sometimes there’s not a real appreciation of what the motivations and priorities are at an organisational level.

Q: How does that disconnect affect your ability to get them to come along with the changes you want to implement?

We’re going to have to work together to get those outcomes. Let me give you an example: some of our hospital emergency departments have really good systems from the moment a patient comes in but it’s getting consistent systems that give us identical outcomes— the best possible identical outcomes—across health care that is really important. And it has surprised me that we haven’t been able to do that.

...it’s getting consistent systems that give us the best possible outcomes across health care that is really important.

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DoctorQ JULY 2012

Q: You would be well aware of the AMA’s Seven Stitches plan. Have you had a chance to consider (a) what’s proposed and (b) look at adopting any of the recommendations?

It’s actually one of the documents that constantly sit on my desk.

One of the things that I’m intending to do when we get the boards up and going, and dealt with some of the legacy issues that have been facing this department such as health payroll, is to get to a clarity of policy development that drives Queensland Health, in consultation with the various clinical groups in Queensland and patient groups... to establish a Mental Health Commission that will provide guidance on how we expend a significant amount of money allocated to mental health; to go through Indigenous communities... to establish a group which is going to provide me with constant advice and direction around a good health policy in Queensland, providing them with the dilemmas that we constantly face in health and say ‘how should we fix it?’ My intention with that at this stage is to use the likes of the executive of the clinical senate, augmented with the clinical areas or other areas that are not apparently obvious on this executive at the moment, rather than going out and setting up a brand new Ministerial advisory council.

Q: And you’re undertaking to actually listen to that body and take its recommendations on board intact?

Absolutely and provide justification if we don’t, rather than the other way round.

Q: Given that the health budget is finite, how are you planning, practically, to reallocate money out of bureaucracy into frontline services that direct patient care?

The central office of health has already lost about 600 or 700 employees under the

previous government, so there’s been a leaning down. The introduction of hospital and health boards in Queensland are going to refocus more on frontline health service delivery and efficiency at a local level, and that’s going to of course be underpinned by activity-based funding for our bigger hospitals and that’s going to drive our efficiencies even more.

Over the next two years, under the national agreement, a devolved, decentralised model of health care in Queensland is going to allow local clinicians working as a part of a local hospital board to be able to drive those particular efficiencies more.

Q: Will there be a set number, proportion or percentage of clinicians on those boards?

I’ve made it clear to the board chairmen that we’re going to have to have solid representation when it comes to community diversity... such as governance, finance and legal but there has to be a good representation of clinical skills.

Q: Will the board members be allowed to speak publicly and openly?

The boards will be given a budget and they’ll also be funded on an activity-funding basis.

My expectation is the boards and the board chairmen will be accountable for explaining their health service decisions locally.

I have confidence in the people we have appointed as chairmen and who will be appointed as board members but the Minister always reserves the right to assist those boards by putting specialist people in to help them out. If they don’t perform, then the Minister reserves the right to remove them.

Q: Staffing is a big issue for AMA members – the shortage of GPs and medical practitioners generally, particularly where it comes to a shortage of internships for medical students. Are you looking at doing something to fix that?

We do have a very identified medical workforce shortage over the next 12 to 15 years... well over 100,000.

So it’s going to be not only the way that we graduate our doctors but the way that we train them.

We’ve also got to move towards a more permanent base for our workforce across Queensland Health because we are overly reliant on locums and that is actually distorting our workforce in many ways and causing extraordinary costs in areas where, if we could recruit peer support trained people into those environments and give them back-up, we could get a big win for efficiency and ultimately better outcomes.

Q: And so will you fully-fund more internships?

I want to; obviously with internships that’s one of the most practical ways that we can get people into doctors, into our hospitals and then address these dilemmas that we’ve got with our waiting lists and quality of care, and also the permanency of our workforce.

What we’re unashamedly doing is putting more of our focus towards frontline employment policies. Q

The full transcript of the interview with Health Minister Lawrence Springborg—including the health payroll debacle, the Children’s Hospital debate, details of his expectations of the Hospital and Health Boards and insight into his relationship with his own doctor—is online at www.amaq.com.au

DoctorQ JULY 2012

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news in brief

Digging to excellence Assistant Health Minister Dr Chris Davis, Dr Noel Hayman and Inala community elder Uncle Billy Bonner have turned the sod, marking the commencement of work on South East Queensland Centre of Excellence in Indigenous Primary Health Care, a multi-million dollar facility signed off on under the National Partnership Agreement on Closing the Gap.

Check yourself!

Specialists in public hospitals who have a right of private practice are urged to check their Medicare billing regularly. Queensland Health should provide doctors with records every month from the Practix system but it’s up to you to check their accuracy.

Your Medicare provider number uniquely identifies you and, in the event of a Medicare audit, you could be held personally liable for any misuse.

Know the rules: visit http://www.amaq.com.au/index.php?actio n=view&view=124019&pid=1488

MOCA talks continue As Doctor Q goes to print, AMA Queensland’s union partner, the Australian Salaried Medical Officers Federation of Queensland (ASMOFQ), continues to negotiate the Medical Officers Certified Agreement (MOCA).

Queensland Health insists any agreement must recognise the state’s “dire finances” and is unwilling to commit to any new funding, unless it can be offset against other costs.

ASMOFQ’s non-negotiable position is for appropriate staffing levels, sustainable staffing numbers and reasonable use of overtime based on clinical needs rather than economic climate.

ASMOFQ also maintains the need for a realistic professional development allowance for Residential Medical Officers to reflect the actual cost of courses and incorporation of the Option A right to private practice into the base salary for senior medical officers.

For more recent updates and information refer to www.asmofq. org.au or contact us at asmofq@amaq.com.au

Doctors in defence remembered LEFT: AMA Queensland’s Neil Mackintosh is proud to have served his country.

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JULY 2012 DoctorQ

Surgeon-General of the Australian Defence Force Reserves Air Vice-Mashal Dr Hugh Bartholomeusz provided a fitting reminder of the place of doctors on the battlefields when he spoke at this year’s University of Queensland Medical Society ANZAC tribute service.

The service, at the Medical School at Herston, brought to mind past medical students who had served—and died—for their country.

“In each and every one of us, commitment, courage and compassion are qualities we absolutely need to carry through,” Air Vice-Marshal Bartholomeusz, a Brisbane plastic surgeon said.

news in brief

Hospital and Health Board Chairs Announced Two medical practitioners are among 15 community leaders recently announced to return local health board decision-making to the communities they serve.

Dr Julia Leeds (Fielding), chair of the South-West Region’s Hospital and Health Board, has spent most of her medical career working in rural medicine in Charleville. She is chair of the Royal Flying Doctor Service and is on the board of Darling Downs-South West Queensland Medicare Local. Dr Leeds divides her clinical time between Charleville Hospital and Wesley Breast Clinic in Brisbane.

American honour Past state president Dr Ross Cartmill has become the first Australian inducted as an Honouree into the American Urology Association’s Brantley Scott Foundation.

The foundation, named after Dr F. Brantley Scott, a urologist who developed the inflatable penile prosthesis, fosters education and surgical standards in prosthetic surgery.

Dr Cartmill said the award was recognition fo the high quality of Australian urology, partiuclarly development of urological prosthetic surgery.

Dr Paul Alexander, who recently completed his tenure as Commander Joint Health and Surgeon-General Australian Defence Force, chairs the Metro North Hospital and Health Board.

For full details on who is chairing Queensland’s new Hospital and Health Boards, go to http://www.health.qld.gov.au/health-reform/ html/hhs-boards.

At the time of going to press, an administrator for the Torres Strait and Northern Peninsula Hospital and Health Board had yet to be appointed.

Queenslanders join the AMA Roll of Fellows Queensland’s new Assistant Minister for Health, geriatrician Dr Christopher Davis, and well-known Brisbane obstetrician Dr Gino Pecoraro were among six inductees to the AMA Roll of Fellows announced at the national AMA conference in May. Both former AMA Queensland presidents, they have fiercely advocated for improved healthcare facilities, training, standards and services.

Induction into the AMA Fellowship formally recognises outstanding contributions made, and service provided to, the AMA and the medical profession.

BELOW: Flying Officer Natasha Castree, a second year medical student and Defence Force scholarship holder, caught up with Vietnam legend, Captain Keith Payne, Australia’s last* living recipient of the imperial Victoria Cross.

Ben Roberts-Smith and Mark Donaldson are recipients of the Victoria Cross for Australia, a separate award to the ‘original’ Victoria Cross. *

ABOVE: Air Vice-Marshal Dr Hugh Bartholomeusz (centre) with Major General Dr John Pearn (far left), Capt Keith Payne and a new generation of medical doctors-in-training ready to defend Australia.

DoctorQ JULY 2012

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Feature story Feature story

our pres.

Meet Dr Alex Markwell

Queensland’s new face of the AMA Emergency physician Dr Alex Markwell has made a pledge: she will give her all to the role of AMA state president by scaling back her work commitments to just one clinic session a week.

Her undertaking casts no slight on past presidents who’ve juggled private practice and the demands of the medico-political role: it’s just her way.

“I’m lucky to be at a point in my career where I can give this role my undivided attention,” says the 33-year-old. “As president-elect, shadowing Dr Richard Kidd, I’ve seen what a tough gig this can be. And I also know that what I expect of myself cannot be done by doing anything less!”

When only one resident was rostered on the night shift to cover the entire Royal Brisbane Hospital, she went into battle again.

“It was so plainly not in the interests of patients and put young doctors at risk too,” Dr Markwell recalls.

She may be Queensland’s youngest AMA state president—and cringes when called a medico-politician: “I can accept lobbyist; just!”—but Dr Markwell lost her political naiveté years ago as a resident.

“We logged all our ward-call pages for two weeks which showed how ludicrous the work load was: how on earth could one person attend two Code Blues simultaneously and hope for an optimum outcome; impossible!”

As an intern at Royal Brisbane Hospital, Dr Markwell was riled by the unfairness of an edict denying residents the right to claim overtime “even though we still had to work it”.

By lobbying medical administration with this information, the roster changed in no time so that at least two residents were rostered on night shift.

Rather than accept the injustice, she banded with other incensed young doctors to reactivate the RBH Resident Medical Officer Society and fought for the decision to be overturned.

In speaking out, Dr Markwell soon became the junior doctor representative at state and federal levels.

“It was very obvious to me that you can complain and do nothing, and nothing will happen. Or you can take action – point out

Contact Dr Alex Markwell: a.markwell@amaq.com.au or 3872 2222

the error, show why it’s wrong and provide a solution.”

And that’s the very way she plans to operate in the next 12 months. “I see great value in preventative health campaigns.

They can help avoid so much suffering and waste. For example, when I worked with the Queensland Ambulance Service for six months, I saw firsthand what trauma could have been avoided if only seat belts were worn…

“I’m also committed to work-life balance; not as an ideal but as a reality. A rotation to Biggenden brought home just how confronting rural medicine is. Working for weeks on end and being on call 24 hours a day can be soul-destroying.

“But it’s not just in rural settings that these work practices exist. I still am horrified to see trainees and some specialists working very unsafe hours. There must be a balance to providing a service to our patients while ensuring our doctors are not at risk of injury, illness or burn-out.” Q

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Feature story

Meet your new PresidentElect

AMA Queensland President-Elect Dr Christian Rowan says now is the time for a collective medical voice to be heard, loud and clear.

s nce e i r e exp road d e bin an a b m o w al ...c r Ro m e d i c D e g i v t i n to e a l t h as h gh insi ce and nsland e . cti Q ue needs pra n i es nt i s s u s pa t i e la wel

What’s on Dr Christian Rowan’s priority list?

1 2 3 4 5 16

Quality medical training Rural medicine workforce issues Valuing and respecting senior retired doctors Pain services Addiction services

DoctorQ JULY 2012

There’s no pigeon-holing AMA Queensland’s President-Elect, Dr Christian Rowan.

He has worked as both a general practitioner and as a specialist in the fields of addiction medicine and medical administration. He has worked in public and private practice; in the city and rural Queensland. He currently juggles his clinical practice at Wesley Medical Centre and health administration, as the executive director of medical services at Brisbane’s St Andrew’s War Memorial Hospital.

These combined experiences give Dr Rowan a broad insight into medical practice and health issues in Queensland as well as patient needs.

And he’s in the co-pilot seat at just the right time, it seems.

“There is nothing more important than health to drive the economy,” Dr Rowan told Doctor Q magazine.

“I see great opportunities with a new government in Queensland for the AMA as the peak professional body to show leadership in significant times of health reforms which are coming through the system.

“Whether it’s through the AMA, the new Health and Hospital Boards or our professional colleges, doctors’ voices need to be contributing to the debate.

“There’s a window of opportunity in life when you can make a difference and for me, that’s now.”

Dr Rowan, 39, is no newcomer to medicopolitics. He’s a past president of Rural Doctors Association of Queensland and has served on the AMA Queensland Council.

Dr Rowan graduated from The University of Queensland in 1996. As a Queensland Health rural scholarship holder, he spent time in the far south-west, at St George and in the tiny border township of Mungindi. His two year payback came and went: Dr Rowan stayed, enjoying professional challenges and the social atmosphere of small-town living.

“I’m a great believer in all medical graduates gaining rural experience. It encourages independence, and a capacity to have faith in yourself as well as nurturing a continual quest for more knowledge.

“I’m also a believer in making your own destiny. My career path hasn’t followed a ‘grand plan’. But what it does demonstrate to medical students and doctors-in-training is that there is no singular ‘right route’.

Graduates who seek out opportunities can build a career that’s diverse, interesting and challenging.” Q

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DoctorQ JULY 2012

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CURRENT ISSUES

Counting the Cost of Disability Insurance Queenslanders may miss out on a scheme to ensure quality care for those disabled by catastrophic injury because the state government contends the electorate cares more about containing cost of living.

emily cotteril Policy Officer, AMA Queensland In May, Premier Campbell Newman and Treasurer Tim Nicholls poured cold water on hopes for the establishment of both a National Injuries Insurance Scheme (NIIS) and a National Disabilities Insurance Scheme (NDIS) in Queensland. The Treasurer opposed a $30 to $100 increase in annual Compulsory Third Party (CTP) insurance fees to include extra cover for catastrophic injury to all drivers, saying it was too expensive because “for most people, cost of living is the number one issue”.

This means that many with severe disabilities from catastrophic injury will continue to rely on care from the public system. The Productivity Commission has branded disability care Australia-wide as ‘underfunded, unfair, fragmented and inefficient’ with ‘little choice and no certainty.’ And Queensland may be among the worst: recent reports claim Queensland spends 30 per cent less for every person with a disability than do states like Victoria.

The NIIS and NDIS are Commonwealth Government’s solutions to the problem.

The NIIS is intended as the first step in the nationwide roll-out. Part one of the NIIS is the incorporation of no-fault cover into CTP insurance. At present in Queensland, only injured parties who can prove that someone else was at fault can be compensated for their disability; the rest must rely on public disability care.

Federal Finance Minister Bill Shorten has said he “couldn’t see the case against having... no-fault car insurance“. The Queensland Government sees differently.

It disputes the Productivity Commission’s estimate of $35, claiming the increase to CTP premiums would be at least $100. The Newman election promise to freeze family car registration for the first term further complicates the issue.

On the other hand, the scheme may also save a significant amount of money, as care would be funded from the insurance scheme; not State revenue.

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JULY 2012 DoctorQ

Confused yet? Be prepared for more of this kind of discussion—the negotiations on costings and who will pay are likely to be long-running, messy affairs. However, the political manoeuvring about the cost of the NIIS should not distract from the most important consideration: its value.

Early intervention saves money; we know that—so it’s likely an NIIS will deliver good value for money.

More important though is the amount of value an NIIS might deliver to Queensland society. This is a tricky question, a ‘value judgement’; one which we each must make based on our ethics as well as our ability to pay. Do we value $100 more than the knowledge that people with a disability and their carers will receive better care?

Do we value $100 more than the security of knowing we’d be cared for if we suffered catastrophic injury? Or do we want to spend $100 on something else?

Right now, the Queensland Government says that we’d choose the latter and are using this to justify the distribution of resources away from some of our most vulnerable.

AMA thinks, in this case, the government hasn’t got it right on values; and we don’t think they have it right on what our members value. That’s why AMA will continue to advocate for an NIIS and NDIS in Queensland.

If you would like to get involved, contact policy@amaq.com.au, visit www.everyaustraliancounts.com.au or write a letter to your state member to let them know where your values lie. Q

NIIS

Insures against catastrophic injury such as major acquired brain injuries (excluding cerebral palsy), spinal cord injuries, burns and multiple amputations A state-based scheme funded through small increases to CTP insurance, medical indemnity insurance and council rates To be in place by 2015

NDIS Covers people with significant disability from birth To be completed by 2018 Funded by state and Commonwealth governments Advocated for by AMA since 2003

Do we value $100 more than the security of knowing we’d be cared for if we suffered catastrophic injury?

Who’s suing who in court? newly released medico-legal claim statistics suggests big payouts are on the rise, particularly in public hospitals.

Andrew turner

Workplace Relations Manager, AMA Queensland

The Australian Institute of Health and Welfare’s (AIHW) recent analysis of medical indemnity litigation revealed some surprising results; foremost being that only three per cent of claims ever went all the way to court and 46 per cent of claimants dropped their actions without financial compensation.

Six per cent of claims did settle with payouts of $500,000 or more.

Public and private sector medical indemnity claims in Australia 2009-10 found 51 per cent of claims were settled prior to court in a mediation or conciliation conference.

In the year reviewed, 2,900 new medical indemnity claims were commenced and about 2,650 claims were concluded. This represented an increase in new claims made; it also saw fewer claims resolved.

What are the implications of this data for your practice?

The public sector not only attracted more claims than the private sector but public sector claims tended to take longer to resolve.

Procedure failure or post-operative complications were the most common reason for a claim followed by misdiagnosis and poor treatment management.

The most common allegation of harm was neuro-musculoskeletal and movementrelated body functions and structures.

The majority of claims related to adults (75 per cent): women were more likely to make a claim than men.

In instances where the patient was an infant, almost one-third of claims were associated with mental and nervous system effects.

Regarding the amount of compensation offered, AIHW’s report revealed that in 58 per cent of cases, the quantum of financial compensation offered was less than $10,000. In 17 per cent of cases, no compensation was made. But six per cent of claims did settle with payouts of $500,000 or more. Where compensation

was required to be exchanged, the report did not distinguish between whether it took place in a private conference prior to a trial or at a court hearing.

The length of time for the matter to come to a conclusion was also revealing: 66 per cent of claims finalised within three years of commencement whereas 14 per cent still awaited an outcome five years after their instigation.

An additional AIHW report, addressing public health claims, determined 1,620 public sector claims were commenced in 2009–10 which represented a dramatic increase from the previous years, where there were about 1,100–1,300 new claims.

What conclusion can be drawn from this information? The number of public sector medical indemnity claims which settled with compensation of $500,000 or more increased during the 2009–10 period to nine per cent (from four to eight per cent in the four years previous). Such large payouts may represent only six per cent of all claims but that trend is rising and—with the anxiety created by protracted claims— it’s a risk no medical practitioner wants to experience. While the use of non-court settlement conferences should be used, the process should be further hastened to ensure that these matters are brought to a head sooner rather than later. Q

For more information please refer to the study, “Public and private sector medical indemnity claims in Australia 2009-10” and “ Australia’s public sector medical indemnity claims 2009-10” accessible at the website www.aihw.gov.au

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CURRENT ISSUES

Pomp and practice: the national conference report a wrap-up of the recent AMA national conference.

jen williams

AMA Queensland Council of Doctors-in-Training Chair

The 2012 AMA National Conference, held in Melbourne, celebrated 50 years of our organisation, which evolved from the British Medical Association in 1962.

This year’s conference comprised a variety of keynote sessions, some core AMA business, and several smaller sessions covering topics as diverse as indigenous health and effective meeting participation.

Networking opportunities ranged from informal to black tie, with a fabulous gala dinner at the National Gallery of Victoria.

Opening addresses from Dr Christine Bennett, Dean of Medicine from the University of Notre Dame Australia, and The Honourable Jim McGinty, Chair of Health Workforce Australia, provided insight into the future for Australian doctors. Particular reference was made to the Health Workforce 2025 document, a must-read for those interested in the future of health care workers in Australia: www.hwa.gov.au/health-workforce-2025.

Health care and the environment came to the fore on day two, with fascinating orations by Climate Change Commissioner, Professor Tim Flannery, Professor Rob Adams, director of City Design for the City of Melbourne, and Carbon Reduction Institute’s managing director Rob Cawthorne. By the end of the session, most of the audience vowed to move to Melbourne, a city that has become increasingly “liveable” with outstanding city planning and significant changes to streets, parks, and buildings.

Professor the Lord Darzi of Denham, former Health Minister in the UK and Chair of Surgery at St Mary’s Hospital, London, provided a touch of aristocracy in the final keynote session, describing the British way of handling healthcare Former AMA Council of Doctors-inTraining Chair, Dr Andrew Perry, hosted a thoroughly informative workshop about effective meeting participation. Immediate

Past President of the Australian Medical Students’ Association (AMSA), Dr Rob Marshall, teamed up with Professor Geoff McColl, Deputy Dean of the University of Melbourne’s Faculty of Medicine, Dentistry and Health Services, to discuss the newlylabelled MD program that is set to spread across Australia faster than cane toads across Queensland.

Other sessions included the federal Health Minister and her shadow providing partisan viewpoints on the state of Australian healthcare, presentations on lean thinking, e-health and workplace professionalism, as well as an afternoon focussing on key areas of indigenous and mental health.

AMA Queensland’s Jane Schmitt, Carl O’Kane, Bav Manoharan, Jen Williams, Gino Pecoraro, Kirsten Price and Alex Markwell.

Kathryn Austin (NSW), Will Milford (Qld).

Dror Maor (WA), Cassandra Host (WA), Jen Williams (Qld) and Vanessa Grayson (Qld)

The Leadership Development Dinner’s guest speaker, 2011 Australian of the Year Simon McKeon, gave an account of his lifetime of leadership in the sporting arena. The photo booth ensured that the evening’s many memories would be plastered on Facebook.

Pomp, ceremony, and anecdotes from several past AMA presidents entertained the dapper crowd at the ball. Generations of doctors danced the night away, in celebration of half a century of AMA’s advocacy and membership support.

Queensland’s John Cox with Paul Bavert from Northern Territory

The 2012 AMA National Conference was an immensely successful academic and social event, with a multitude of pearls of wisdom shared. In the face of a quickly changing medical and economic landscape, perhaps the most astute advice for delegates at the conference came from F.Scott Fitzgerald, who said, “what we must decide is how we are valuable, rather than how valuable we are.”

Here’s wishing the AMA another fifty fabulous years! Q

What we must decide is how we are valuable, rather than how valuable we are.

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Feature story

Find out more about Australian Doctors International at www.adi.org.au

Helen Soi, Namatanai Hospital’s only clinical Health Extension Officer, caring for 90,000 people, treasures a copy of Common Medical Problems in the Tropics (3rd edn) by AMA member Dr Chris Schull, donated by AMAQ Foundation.

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DoctorQ JULY 2012

Feature story

A neighbourly visit Dreams can take time to be realised, as Dr Merrilee Frankish tells Doctor Q editor Heather Grant of her six month volunteer assignment with Australian Doctors International in Papua New Guinea’s remote New Ireland Province.

“As a student 30 years ago, I gained experience in PNG, Australia’s nearest and poorest neighbour. All my life’s work seems directed towards this choice. But it was a matter of timing. I completed my Masters of Public Health and Tropical Medicine, I waited for the children to leave home (my youngest is 18 and began university in Melbourne this year); I had a practice that I loved in Mareeba—and had to sell to do this—and of course, I needed my husband, Greg’s consent. I want to get through this still married!

“When he asked me ‘what is it you really want to do?’ I realised I did have the dream of working in another place of need, overseas, while I was still fit enough.

“New Ireland is home to 160,000 people yet there are just seven local doctors, all based at the provincial hospital in Kavieng which is time-consuming and costly for those in rural villages to reach; and so I spend time both in Kavieng and out on patrols,

travelling by 4WD and small overloaded, sometimes sinking, banana boats to get to the most needy.

“My role here is both clinician and teacher, helping health care workers upgrade their understanding of protocols and new treatments: ensuring the new Artemether combined therapy is implemented instead of the entrenched use of chloroquine for malaria which is rampant. Of 21 new cases presented the other day, 15 were children.

resistant. It’s as though they are expendable; left to die. This is extremely upsetting.

“What I am seeing is totally light years away from my Mareeba practice. People— particularly children—presenting late, dying from things they shouldn’t be.

“Health facilities, even the hospital, are woefully inadequate. Something as basic running water doesn’t exist; nor reliable power or working plumbing. Patients have to do their toileting outside behind bushes.

“There is an overuse of antibiotics. The use of Amoxil, which is sold in the major towns by the individual tablet for every complaint, is quite disturbing. My advice that a child does not need Amoxil after falling out of a tree and sustaining a painful arm with swelling is met with complete disbelief!

“I wanted challenge—and I’ve found it!

And what keeps me going is the gratitude of staff in remote areas to our visits, support and teaching, and seeing patients respond to treatment and recover: the big smiles all around.

“And then there are the TB cases: no apparent contact tracing, no culturing of sputum, no avenue to seek expert help for those patients who are obviously multi-drug

“I committed to six months in New Ireland and know I’ll be seeking out more challenges when I return to Queensland; challenges closer to home, most likely in Indigenous health.” Q

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We’re looking after you at Hertz Take $20 off any rental of 4 days or more*. In addition, you’ll receive your AMA discounted rate and fee waived membership to Hertz #1 Club Gold program. It all adds up to a great deal for AMA members from Hertz.

To make a booking, call Hertz on 13 30 39 or visit www.hertz.com.au and quote CDP# 283826 and PC 171835.

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8/05/12 9:39 AM

AMA Queensland NEWS

Who’s representing you on state council?

Three new faces join AMA Queensland’s council following May’s annual general meeting.

AMA Queensland Council

2012-2013

Dr Alex Markwell

President

Dr Christian Rowan President-Elect

Dr Ben Duke Greater Brisbane Area

Specialty: Psychiatry Background: A University of Newcastle graduate, Ben Duke commenced his psychiatry training in Brisbane in 2002.

Dr Duke has completed subspecialty training in consultation liaison psychiatry and holds postgraduate qualifications in health management and public health. He works in both public and private practice. This is his second stint as a Greater Brisbane representative. While training, Dr Duke was heavily involved in the trainee representative organisation serving as both Queensland and Bi-national President.

Particular interests: Dr Duke has a strong interest in medical student and junior doctor education, as well as the structural and economic aspects of our health system.

Dr Tom Arthur Gold Coast Area

Dr Richard Kidd Immediate Past President Dr Sharon Kelly Specialist Craft Group representative Dr Stephen Morrison Specialist Craft Group representative Dr Chris Zappala Specialist Craft Group representative Dr Larry Gahan General Practitioner Craft Group Dr Shaun Rudd General Practitioner Craft Group Dr Mason Stevenson General Practitioner Craft Group

Background: Tom Arthur graduated from The University of Queensland in 2009. His residency was spent in Cairns and on the Gold Coast. He is a principal house officer in surgery at the Gold Coast Hospital.

Dr Sharmila Biswas Far North Area representative

Particular interests: An ardent campaigner for adequate training and ongoing education of doctors, Dr Arthur is also a firm believer in the importance of growing the AMA as the profession’s key association, and sees his role as a councillor as part of that; encouraging greater interaction and engagement from medical practitioners in his geographic region.

Dr Anil Sharma

Dr Tom Arthur Gold Coast Area representative Capricorn Area representative

Dr John W Cox Downs and West Area representative Dr David Alcorn Greater Brisbane Area representative Dr Kimberley Bondeson Greater Brisbane Area representative

Nick Gattas Medical Student Group

Background: Nick is a third-year medical student at The University of Queensland, based at the Royal Brisbane and Wesley hospitals. He holds a Bachelor of Arts majoring in languages and has nearly completed a Graduate Certificate in Executive Leadership with the UQ School of Business. Nick is the Immediate Past Treasurer of the UQ Medical Society and Treasurer of UQMS’s charity affiliate, the Ashintosh Foundation.

Particular interests: Nick’s focus is on quality postgraduate training for all Queensland medical graduates; 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.

Two geographic area representatives remain unfilled: North Coast and Greater Brisbane regions. Nominations are sought to fill these vacancies. See page 43 for details.

Dr Jonathon Shirley Greater Brisbane Area representative Dr Noel Hayman Greater Brisbane Area representative Dr Ben Duke Greater Brisbane Area representative Dr Carl O’Kane North Area representative Dr Jennifer Williams Residents and Registrars Craft Group Dr John Murray Full Time Salaried Medical Practitioner Craft Group Dr Deborah Mills Part Time Medical Practitioner Craft Group Nicholas Gattas Medical Student Group

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Conference

Speaker profile

meet one of the speakers appearing at the annual AMA Queensland conference in madrid spain this year.

Anthony Brown Medico Legal Insurance Group

As a risk adviser, Anthony Brown is acutely aware that life can throw curve balls; and he, for one, is prepared for that. He just wishes others were.

That’s why he’s a man on a mission, out to educate AMA Queensland members about the importance of planning for the unexpected.

“Prevention is better than cure, but there are some things that cannot be avoided—or at least foreseen,” Anthony said.

About Anthony Brown Anthony Brown is a specialist insurance adviser with MLIG, AMA Queensland’s preferred insurance advisor. He has worked with doctors, securing appropriate insurance cover for their needs, for nine years. He is also a preferred advisor to members of the Australian Bar Association. Anthony is a member of the Association of Financial Advisers. He has actively supported AMA Queensland’s annual conferences since 2001.

“We can eat a well balanced diet, get adequate exercise and sleep but all those positive efforts may be for naught if our genetic makeup is predisposed otherwise.

“And then there are the unknown—accidents that can have catastrophic impacts, physically, emotionally and financially.

During his presentation in Madrid, Anthony will discuss the repercussions of certain risks that may not be preventable and what strategies you can put in place to protect you and your family financially against these risks.

He will also examine how different types of insurance such as Life, Total and Permanent Disability, Income Protection, Business Expenses and Trauma Insurance can be individually tailored to prevent a financial crisis if the unexpected happens.

Anthony will highlight why it is important for doctors to seek professional advice from an insurance specialist.

“For many clients, the hardest part is the first step: making a decision to get their financial affairs in order.” Q

“At the end of the day, we are all human. And it’s because we’re human we err about planning for tomorrow, or worst case scenarios; and it’s because of that oversight that I see too many families needlessly struggle.”

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JULY 2012 DoctorQ

Contact Details - Don Mackenzie 0409 890 056 - Tom Barr 0405 144 352

Conference

AMA QUeensland annual conference 2012

Madrid SPAIN • 23 – 29 SEPTEMBER 2012

Please contact Neil Mackintosh to request a copy of the Madrid brochure on Phone: 07 3872 2267 or email: n.mackintosh@amaq.com.au

SPONSORS DoctorQ JULY 2012

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2012 conference | 27 - 28 july | indooroopilly golf club

starting and working in

private practice SUITABLE FOR GP’S, SPEcIALISTS And PRAcTIcE MAnAGERS

testimonial from last year’s conference I’m the practice manager of a large and busy country family medical practice: we have seven GPs, six nurses and six receptionists on staff.

I’ve been the practice manager since 2009, drawing on my business degree and past experience managing a pharmacy, as well as instinct, before finding the time to attend AMA Queensland’s conference for practice managers last year.

Starting and Working in Private Practice was well put-together and presented in a way that was easy to understand and relevant.

You never stop learning in this role! I found the accountants’ presentation especially interesting. Being in a country area, we use a large accounting firm but they don’t specialise in the business of medicine, so getting their perspective was great.

Often we live such busy lives, it’s as though we live in a bubble. The opportunity to talk with others and learn from others’ experience – as well as experts – is invaluable.

Trish Cuthbert Practice Manager, Granite Belt Medical Services Stanthorpe

the fundamentals and continual development for your oWn private practice Who is it for?

What Will be covered?

This comprehensive session is designed for:

There are a variety of topics throughout each day focusing on:

• Registrars about to finish specialist training, both GP and specialist, who are considering their options in private practice

• Business mindset

• Residents and students interested in the option of private practice for their future

• Financing your business

• Other doctors, business owners and practice staff who are looking to establish their own private practice or considering working in private practice

• Business structure • Risk management • Insurances • Staffing structure and recruitment

• Those already in private practice who are looking to gain valuable information and insight into running a successful practice or improving their current practice.

• Continual development and support

The session is a two-day workshop structured to give attendees insight into private practice considerations, both as an employer and/or employee.

At morning tea, lunch, afternoon tea and after the final speaker, you will have the opportunity to talk to the exhibitors and presenters, and follow up on material and concepts covered during the day.

What information Will i be able to access?

for more information contact the Workplace relations team on (07) 3872 2216 or email j.ovnic@amaq.com.au P r o u d ly s P o n s o r e d b y:

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Caring for you for life

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AROUND THE REGIONS

Local Medical Association round up

join your lma

Stay connected with colleagues and up to date with the latest health news and issues affecting your local area. Don’t stand on the sidelines —join your Local Medical Association today and make a difference.

Sunshine Coast

bundaberg

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

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

Venue: Maroochydore Surf Club Function Room, Alexandra Parade, Cotton Tree

Phone: (07) 4152 2888 Fax: (07) 4153 3245

Time: 6.30pm for 7pm

Email: daud.yunus@gmail.com

Convenor: Jo Bourke Phone: (07) 5479 3979 Fax: (07) 5479 3995 Email: jobo@squirrel.com.au

Fraser Coast

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

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

Redcliffe & District

Address: PO Box 1347, Hervey Bay, Qld, 4655 Phone: (07) 4128 3644 Fax: (07) 4124 0660

Remaining meeting dates for 2012 24 July

29 August (AGM)

18 September

24 October

Venue: Golden Ox Restaurant, Redcliffe Time: 7pm for 7.30pm Convenor: Margaret MacPherson Phone: (07) 3409 4429

Brisbane Northside

Toowoomba For information on meeting dates, go to www.tddlma.org.au or email info@tddlma.org.au Membership of the Toowoomba and Darling Downs Local Medical Association is just $50. To join, download the application form at www.tddlma.org.au/membership.html

Remaining meeting dates for 2012 14 August

9 October

11 December

Convenor: Michael Madden Phone: (07) 3121 4032

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

Email: michael.madden@qml.com.au

A membership application form can be downloaded from our site.

For further information or to join, visit www.northsidelocalmedical.wordpress.com

Phone: (07) 5575 7054 Fax: (07) 5575 7551 Email: info@gcma.org.au

can’t find your local area?

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Gold Coast

JULY 2012 DoctorQ

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

AROUND THE REGIONS

Travels north AMA Queensland’s Drs Richard Kidd, Alex Markwell and Noel Hayman recently toured facilities and talked with

health care providers to get first-hand understand of health issues in the Torres Strait and far north. Q

The AMA team get the local perspective from Torres Mayor Napau Pedro Stephen.

Drs Richard Stone, Sharmila Biswas and Alex Markwell inspect Cairns Base Hospital emergency department’s simulation training facility.

Catching up with Apunipima Cape York Health Council team members in Cairns

Thurs day Is RIGH superin land H T: tende ospita ichard nt Dr l’s med Kidd a Tim D ical nd Noe evine w l Haym elcome an to s Queen sland’s most n orther n hosp ital.

Drs R

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AROUND THE REGIONS Dr Rosie Geraghty from Roma accepts her RDAQ Meritorious Service Award

HARD-FOUGHT campaigning by the Rural Doctors Association of Queensland (RDAQ) to restore equitable medical services across the bush has won solid support from Health Minister Lawrence Springborg who has indicated he will work closely with RDAQ to overhaul the state’s “bruised and battered health system”.

Speaking to 250 doctor delegates at the recent RDAQ annual conference, Mr Springborg announced three health reform initiatives to kickstart his promise.

The centrepiece was the establishment of a rural and remote state-wide clinical network, part of an RDAQ action plan released ahead of this year’s state election.

The roll-out of packages for rural Queensland includes the re-opening of obstetric and procedural services at Beaudesert Hospital

by July 2014, the expansion of flying obstetrics and gynaecology services (FOGS) out of Roma, and the planned re-opening of obstetric and procedural services in other regional and rural locations.

Mr Springborg said he intended a staged expansion of the Royal Flying Doctor Service FOGS contract out of Roma, from 400 flying hours to 1000 flying hours.

On hearing the news, former Scenic Rim Regional Council deputy mayor, now head of the Scenic Rim Health Taskforce, Dave Cockburn, predicted women from Beaudesert district would be “dancing in the streets”, knowing their babies could be born in their own community within two years.

Bush health reforms unveiled Photos: Ashraf Saleh

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JULY 2012 DoctorQ

AROUND THE REGIONS

New RDAQ president Dr Adam Coltzau and wife Katrina soak up the atmosphere at the RDAQ state conference dinner.

Mr Cockburn said the reinstatement of Beaudesert’s birthing unit had been a real team effort by the community and key people like local GP and obstetrician and RDAQ representative Dr Michael Rice and Associate Professor Hazel Brittain (former director of nursing at Beaudesert and now Queensland branch president of the Australian College of Midwives) for a decade, since the maternity unit’s closure in 2002.

“At its peak, Beaudesert was the busiest rural maternity unit in Queensland—it should never have been shut—but now local women will be able to have their babies in a first class hospital close to where they live,” Mr Cockburn said.

“This is a huge day for Beaudesert, the second fastest growing local government area in Queensland—and it’s a significant day for the state, because it’s a genuine sign the LNP Government is committed to getting rural health right.”

“This is a great moment for the women and families of Beaudesert who have asked for the service to be reinstated since it closed,” Ms Brittain said.

Life membership for Dr Michael Rice An honour rarely awarded within RDAQ has been presented to Beaudesert GP Dr Michael Rice.

Shane and Anita Luland with Tamara and John Hall

“The experience of the closure of maternity also meant other medical services at Beaudesert Hospital diminished over time. History shows that once you restore maternity at a hospital, other medical services also pick up.”

Dr Rice said restoration of Beaudesert’s maternity service would be a test case for safe and sustainable birthing procedures in other country towns like Chinchilla on the Darling Downs and Emerald in central Queensland where maternity services were either nonexistent or functioned “on a knife edge”.

“The 2014 timeframe is an ambitious target but it is achievable, given Queensland’s capacity to produce qualified generalist clinicians with the advanced skills to deliver babies,” he said. Q

Keynote speaker Dr Mark Loane presents a meritorious service award to Woorabinda’s Dr Mary Dunne.

At it’s peak, Beaudesert was the busiest rural maternity unit in Queensland...

Usually given to past presidents, life membership was awarded to Dr Rice for his longstanding dedication and commitment to RDAQ as the organisation’s media officer and policy writer.

“Michael has been a dedicated member for many years. He has served diligently on management committee and has been our main media officer for most of this time, effectively turning our several presidents’ ideas into impactful media releases with

ease,” said new RDAQ president Dr Adam Coltzau, from St George.

“He has also been one of the main authors of some of our key policy positions and has worked tirelessly above and beyond the call of duty. I would like to acknowledge the support and commitment of Caroline, his wife, and his family for allowing Michael to commit so much of his precious home time to our cause.”

Dr Rice gained his Bachelor of Medicine and Bachelor of

Surgery from The University of Queensland in 1988 and completed advanced training in obstetrics, intensive care, internal medicine and emergency medicine before training in general practice.

He is a GP and partner in the Beaudesert and Jimboomba Medical Centres and was a VMO GP obstetrician to the Beaudesert Hospital until its birthing service closed in 2002. Q

DoctorQ JULY 2012

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Professor Roger Allen Thoracic and sleep physician, and Bond University professor, Roger Allen, draws breath from his busy and varied private practice to reflect on his years in medicine and the men who most influenced his career choice.

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JULY 2012 DoctorQ

Q Growing up in the coastal NSW town of Ballina, salt air filled your lungs and medicine coursed through your blood, I gather.

studying medicine. We moved to London when I was nine, then to Brisbane in 1961, leaving those halcyon days behind.

I was tremendously influenced by my late father, Lucius, who was initially a country GP and his father, Kennedy, a classicist barrister.

Our home in Ballina was attached to the surgery and at times it was like growing up in an army casualty clearing station, with patients regularly overflowing into the family lounge, dying, vomiting or awaiting transport to hospital. Dinner conversations were akin to medical grand rounds, as my father reviewed the interesting “cases” of the day, or digressed to a geography or history lesson with the cutlery and upturned bowls as mountains and rivers. He too was a classicist; a polymath, eccentric and foremost, a teacher—he was a language master at two private schools before

I recorded those times in Ballina Boy: A child’s odyssey through the 1950s, capturing changes in lifestyle and medicine.

Q You used a military analogy to describe your childhood home and your consulting rooms are filled with military memorabilia.

Is there a connection?

My uncle fought in Greece and Crete and I served for many years as an army reservist. I went to East Timor with the United Nations Forces in 2000 where I ran the ICU. I still see many soldiers from Enoggera in my capacity as consultant to the Army: I very much enjoy this aspect of my work.

Photo: Destination NSW

MEMBER PROFILE

?

Did you know?

Sarcoidosis mainly affects people in their late 20s to early 40s, more commonly males.

Find out more about sarcoidosis online at www.sarcoidosis.com.au

Q Describe some of the key issues in thoracic medicine that you have encountered.

Q You also specialise in sleep disorders. Is sleep under-rated?

I have had a special interest in occupational lung diseases since the late 1970s, particularly asbestos-related diseases, and have prepared thousands of medico-legal reports over the past 20 years.

For something we spend—or should spend—one-third of our lives doing, yes! Sleep apnoea is not something that happens only to the obese. I see thin young people with this. Its symptoms overlap with depression such as dysthymia, lack of concentration, tiredness and loss of libido.

I don’t see as much asthma as I once did and that’s great: it shows general practitioners are well able to manage that condition.

But sarcoidosis remains a condition that is missed a lot because it presents with so many symptoms that appear to have nothing to do with the lungs: severe tiredness, dry mouth, skin lesions, renal impairment, uveitis, joint pains, neurological and bone marrow involvement. I did a PhD at the University of Melbourne on this condition, am on the World Association of Sarcoidosis and other Granulomatous Diseases executive and have published widely on this condition.

Left untreated, it can permanently damage organs (including the heart) yet it can be effectively treated.

Q Do you have a pet practice hate?

I do wish doctors would ensure a copy of reports accompanied radiograph images (CTs and the like). Their absence can be potentially dangerous as well as inconvenient and time-wasting. I still like the old-fashioned celluloid films compared to CD’s.

Q What can the AMA offer members?

There’s a wealth of specialist experience to be shared with doctors-in-training and general practitioners through mentoring and networking opportunities. Q

buy the book To buy Ballina Boy: Download the order form at www.ballinaboy.com/Ballina%20 boy%20-%20order%20form.pdf Fax orders to 07 3719 5177, call 07 371 9 5577 or email rogerallen@sarcoidosis.com.au

DoctorQ JULY 2012

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BUSINESS TOOLS

Selling your practice If the thought of retirement is sitting at the back of your mind you are not alone. But as more Baby Boomers’ medical practices hit the market, how can you make yours stand out? William Buck’s Julie Smith has a few ideas.

Julie Smith William Buck (07) 3229 5100 julie.smith@williambuckqld.com.au

When contemplating selling your practice, you want to get the best return. It is, after all, the culmination of years—if not a lifetime—of hard work. To do that requires a keen understanding of your asset, your potential market and the business of medical practice: key areas that are often overlooked in the sale process.

What are you selling?

When you own a medical practice, there are actually two businesses involved: 1. The medical business which is where you practice medicine and treat your patients 2. The service trust or medical centre which provides administration support and services to allow doctors to trade their medical business.

What exactly what you are selling? Are you selling the underlying infrastructure of your practice or are you offering to transfer the goodwill you have generated over a lifetime of practice?

Although both businesses are interdependent, you need to determine where the value lies. This will often depend on the size of your practice and your area of specialty. For example, in large group practices, or general practice, the service business holds the value due to its ability to attract further doctors to the business.

lead-time needed for retirement The ideal time to start planning your exit strategy is about four to five years before you want to retire. This gives you: at least two years (ideally three) of financial results showing strong trading results one year to market your practice and find an appropriate buyer one year’s transition, working in the practice after the sale.

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JULY 2012 DoctorQ

Determining what you are selling will assist in marketing your practice and identifying the right buyer.

Who are you selling to?

Understanding your buyer and their motivations can be a key ingredient for a successful sale.

Over recent years, we have seen a real shift in the dynamics of sale negotiations as businesses grapple with generational differences. As most practices for sale tend to be owned by Baby Boomers, it may be important to consider how attractive your practice would be to another generation.

Baby Boomers (those nearing retirement age) generally share the following characteristics:

financial and professional rewards; to earn their success. They may be critical of a perceived lack of work ethic in the younger generation independent and self-reliant very goal-orientated.

The sale of Baby Boomers’ practices is likely to skip a generation and be bought by those doctors categorised as Gen Y who are typically: unfazed by authority technology-proficient want a work-life balance whilst achieving their financial dreams.

From my experience in dealing with practice sales, Gen Ys rate work-life balance very highly. They will consider the impact of any purchase on their home life; not just the financial considerations.

For example, a smaller practice which may require substantial after-hours commitment from a doctor both administratively and medically may be far less attractive to a potential Gen Y doctor than a smaller investment in a larger practice which requires far less outside of work hours commitment.

Getting your practice sale-ready In order to maximise your sale price, you need to prepare your practice for sale in a systematic way: Review the current trading results of your business by benchmarking the financial performance of your practice against other medical centres. This process can help to identify areas of weaker financial performance.

Work to address these issues.

Develop a budget for the business over the next financial year with the intention of renewing this for the second year.

Have quarterly reviews of the financial performance of the business.

Implement a marketing plan for the business.

Review and formalise existing agreements with doctors.

If you are at all unsure about how best to prepare for sale, don’t hesitate to seek advice from advisors experienced in the medical industry. Q

work-centric. Baby Boomers are very hard working, happy to work long hours to achieve

DISCLAIMER: This article is intended to be general in nature and should not be relied upon by any person without seeking advice concerning their own circumstances.

DoctorQ JULY 2012

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www.amaqis.com.au

Insurance renewal time getting you down?

Let’s face it insurance is boring.

But necessary.

We know doctors have a busy schedule, and while it may be easy to renew your insurance each year without proper revision, changes may have occurred for which you may not be fully covered and premiums need competitive comparison.

For peace of mind and taking the yawn out of renewal time, contact AMA Queensland Insurance Solutions.

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

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

For more information phone: 1300 883 059

JULY 2012 DoctorQ

BUSINESS TOOLS

Buying peace of mind for travel Passport and visas organised? Check. Itinerary? Check. What about your corporate travel insurance? AMA Queensland Insurance Solutions’ Scott Stewart explains why you can’t leave town without it.

Travelling abroad—whether for work or pleasure— can be an exciting experience; but what would happen if you or one or your co-travellers became ill or injured while away from home?

International travel can quickly turn frightening if you’re not prepared for a medical emergency. A corporate travel insurance policy is an extremely flexible, yet simple, solution that covers you for worst-case scenarios.

The difference explained So why should you take a corporate travel insurance policy when you can obtain a one-off standard travel insurance policy or obtain cover through your credit card?

Firstly, a comprehensive corporate travel insurance policy will cover all directors, executives and employees of the policyholder including accompanying spouses/partners and their dependent children whilst the insured person is engaged in a journey that involves a destination, at least 100 kilometres from their listed base of operations and includes associated private or holiday travel for all directors and senior personnel as defined under the policy.

Scott Stewart AMA Queensland Insurance Solutions

Pre-existing medical conditions can be taken into account...

Corporate travel insurance policies do come with some basic requirements: You need an Australian Business Number (ABN).

The majority of travel is undertaken for ‘white collar’ business.

Trips are not expected to be more than 60 days.

You do not anticipate flying as a passenger or pilot and or operating a light aircraft/helicopter.

In addition, the ‘insured person’ is defined as someone: aged between 18 and 85 at the commencement of the policy

A quality corporate travel policy will usually also include:

in permanent full-time employment (at the policy’s commencement day).

extension of the maximum trip period of 180 days by prior arrangement a 24-hour Emergency Assistance hotline up-to-date country information, regular alerts and access to extraction services and security escorts worldwide claims settlement for serious claims.

scott.stewart@amaqis.com.au

What you need

What’s more, pre-existing medical conditions can be taken into account, which can be hard to obtain under a credit-card style of policy.

cover for events resulting from terrorist attacks

1300 883 059

an Australian resident

At AMA Queensland Insurance Solutions, we welcome the opportunity to evaluate your company’s corporate travel needs and objectives.

Based on the outcome, we would provide an obligation-free quotation on the most appropriate covers to protect your staff and family, drawing on a range of competitive options from a national buying group of leading insurers. Q

DISCLAIMER: AMA Queensland Insurance Solutions is a joint initiative of AMA Queensland and Insurance Advisernet Australia Pty Limited ABN 81 072 343 643 AFS Licence 240549. AMA Queensland Insurance Solutions is a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, Authorised Representative No: 320115. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.

DoctorQ JULY 2012

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Leave the hardwork to TressCox, giving you more time for the pleasures in life ...

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.

We connect. That’s what makes the difference.

Katharine Philp Phone 07 3004 3536 Mobile 0409 586 785 Katharine_Philp@tresscox.com.au

Leo Hopsick Phone 07 3004 3535 Mobile 0409 625 538 Leo_Hopsick@tresscox.com.au

Alex Moriarty Phone 07 3004 3533 Mobile 0459 400 500 Alex_Moriarty@tresscox.com.au

Stephen Tonge Phone 07 3004 3502 Mobile 0408 987 669 Stephen_Tonge@tresscox.com.au

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JULY 2012 DoctorQ

t w i t t e r.c o m /Tr e ssC o x linkedin.com/company/tresscox-lawyer s

BUSINESS TOOLS

The importance of exit provisions The new financial year heralds a time to consider the structure of your medical practice, advises TressCox Lawyers’ Leo Hopsick.

A very important issue for doctors to consider is whether their associateship agreement, coownership agreement or partnership agreement adequately deals with what would happen if one of the parties wanted to leave. Many doctors do not consider these issues until it is too late.

Essentially well-drafted exit provisions provide a clear constructed pathway for the party leaving a collaborative arrangement to do so without residual liabilities.

Valuation Some exit arrangements give the remaining doctors the option to buy out the practice of the doctor who is leaving. This leads to valuation issues.

There are many ways to put a dollar figure on a practice; the most common being valuations based on earnings, cash flow or assets. These methods use a variety of different indicators, such as past performance or a forecast of future income.

Leo Hopsick TressCox Lawyers, Brisbane (07) 3004 3535 leo_hopsick@tresscox.com.au

Emma Gierke Solicitor (07) 3004 3505 emma_gierke@tresscox.com.au

Without an express contractual entitlement to exit a partnership or associateship, the parties may be trapped into remaining in the practice and facing protracted negotiations.

Some valuation methods may not be appropriate in your circumstances, so it is important to ensure that you speak to your accountant about what is best for your practice. The critical issue is to agree on a method if one doctor chooses to leave the practice.

Three particular aspects must be considered: valuation, death or disability and finance.

Death or disability

The critical issue is to agree on a method if one doctor chooses to leave the practice.

Finance

Exits from practice may occur due to disability or death. Your agreement should set out what happens if one of the doctors passes away or becomes unable to practise.

Where buy out arrangements apply, consider how these buy-outs will be financed. Often, a decision to leave can be quite sudden and the remaining doctors may not be able to obtain adequate funding before the leaving doctor wants to depart.

You can consider including provisions where a partial payment is made upfront and the balance paid out over a number of months.

These are just some of the issues to consider when looking at your partnership or associateship agreement with your fellow doctors. Doctors should review their current agreements and speak to their accountant and their lawyer to ensure appropriate provisions are in place. Q

Leo Hopsick is a Corporate Partner at the TressCox Brisbane office and has extensive experience acting for doctors and owners of healthcare facilities on business and commercial matters. Leo’s experience includes business structuring, buying and selling businesses, financing and the construction of healthcare facilities.

DoctorQ JULY 2012

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BUSINESS TOOLS

Leveraging your SMSF Any medical professional who doesn’t own rooms in their own self-managed super fund (SMSF) could be missing out on a range of tax and business benefits, explains Investec’s Barry Lanesman.

Barry Lanesman Investec 1300 131 141 www.investec.com.au/medicalfinance

At Investec, we’ve always viewed the commercial property purchase of practice rooms by doctors a bit like a savings plan: what you’re really doing is locking in your rent at the purchase price. As long as the interest rate doesn’t change significantly, the repayments should stay about the same, and because you own the asset, at the end of the day it resembles a forced savings plan; hopefully with a capital growth upside.

A twist on property investment But it isn’t just disciplined savings—property is a popular and savvy investment—and it’s appeal for medical professionals is pretty clear: it is (relatively) easy to look after, requiring less expertise than equities investment and less exposure to equities’ volatility.

However, access to capital for investment has remained a traditional roadblock for many. Up until a few years ago, even though many had a pool of savings in their own self-managed super fund (SMSF), unless you had the full value of the property you wanted to purchase, that did you no good: you couldn’t borrow in super. But that’s changed. SMSFs can now take on debt.

You can even sell your rooms to your own SMSF, creating a tax-effective investment as under current legislation, there may be no capital gains tax payable on some assets that increase in value inside super.

Tax appeal The appeal of this is not just related to capital gains tax, however. Income in the SMSF is taxed at concessional rates.

While many banks will lend to SMSFs, most have a lending limit of around 63 per cent of the property’s value. Investec allows much higher gearing—up to 90 per cent for an owner-occupied commercial property—enabling those with smaller SMSF balances to consider getting into the property market.

Set up costs Of course, nothing comes for nothing. There are costs to getting a property into the fund regardless of which lender is used: among them, initial SMSF set-up costs, valuation costs, loan documentation, stamp duty and the establishment of a separate instalment trust to own the property in trust on behalf of the SMSF. However the different tax treatments of assets and investments held in a super fund environment may make this worthwhile. Q

Investec Professional Finance Pty Ltd ABN 94 110 704 464 is a subsidiary of Investec Bank (Australia) Limited ABN 55 071 292 594 (Investec Bank). This editorial includes information of a general nature only in relation to the potential commercial benefits of asset financing. Taxation is only one of the matters that taxpayers should consider in making business decisions. This editorial does not constitute taxation advice and cannot be relied upon as such. The individual circumstances of each taxpayer may affect the specific tax implications of asset financing to that taxpayer. We recommend that independent professional tax advice is sought to confirm the specific tax implications of asset financing based on the particular circumstances of each taxpayer. Investec Professional Finance is not offering financial or tax advice. All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Information is current as at February 2010.

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QUEENSLAND BRANCH OF AUSTRALIAN MEDICAL ASSOCIATION | ACN: 009 660 280 | ABN: 17 009 660 280

Election Notice 2012–2014 For election to the positions of Geographical Area Representatives on the Council of the Queensland Branch of the Australian Medical Association.

Councillor of the Queensland Branch of the Australian Medical Association 2012 - 2014 Nominations must be in writing and signed by the nominee, and two (2) nominators. All persons must be financial members of the Queensland Branch of Australian Medical Association. Any two (2) ordinary members may nominate another member provided all members belong to and are registered in the same Geographical Area.

Geographical Area Representatives required One (1) Greater Brisbane Area Representatives. Postcodes 4000 to 4199, 4300 to 4349, 4500 to 4513, 4514 to 4549 inclusive; One (1) North Coast Area Representative. Postcode: 4550 to 4601 and 4619 to 4675 inclusive.

Nomination Paper

What is required of a Councillor?

Availability to attend Council meetings five times per year, and relevant AMA Queensland events/functions such as the Presidential Inauguration Actively contribute to setting policy for the Association Actively support membership retention and growth strategies Provide a written report (template provided) for council meetings Availability to attend and contribute to AMA Queensland Committees.

Criteria for personal statements for Council Candidates for Council must submit with their nomination paper: short personal statement of no more than 250 words passport-sized head and shoulder photograph brief CV of no more than 250 words.

Nominations must be received at AMA Queensland by 5pm Monday 30 July 2012.

Nomination forms can be either faxed to (07) 3856 4727, emailed to a.turner@amaq.com.au or posted to: The Returning Officer, C/- AMA Queensland PO Box 123, Red Hill Qld 4059.

We hereby nominate_____________________________________________________________________________________________________________________________________________________(FULL NAME) as a candidate for the position of COUNCILLOR for the Geographical Area____________________________________________________________________________________________

Nominator details:

Name 1:_____________________________________________________________________

Name 2:_____________________________________________________________________

Craft/Area:__________________________________________________________________

Craft/Area:__________________________________________________________________

Telephone number:________________________________________________________

Telephone number:________________________________________________________

Residential address:_______________________________________________________

Residential address:_______________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Signature:___________________________________________________________________

Signature:___________________________________________________________________

Nominee’s details: I hereby consent to the nomination as above.

Craft/Area:_____________________________________________________________________________________________________________________________________________________________________ Date of birth:__________________________________________________________________________________________________________________________________________________________________ Telephone number: __________________________________________________________________________________________________________________________________________________________ Primary practice address:___________________________________________________________________________________________________________________________________________________ Residential address:__________________________________________________________________________________________________________________________________________________________ Signature:______________________________________________________________________________________________________________________________________________________________________ DoctorQ JULY 2012

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People EVENTS events & calendar

coming

up

1 august investing in shares: growing your wealth through shares

what’s on

6:30pm AMA Queensland, Kelvin Grove Dinner event featuring strategies and tips for managing share investments.

Suitable for beginners and intermediate-level investors.

2012 conference | 27 - 28 july | indooroopilly golf club

STaRTING aND wORkING IN

pRIvaTE pRacTIcE

Men In Medicine Breakfast 18 July Men in medicine breakfast: Looking after you 7am Moda Portside, Brisbane Networking, entertainment and inspiration, featuring a keynote presentation by former Australian rugby union captain, Phil Kearns.

SUITABLE FOR GPS, SPEcIALISTS And PRAcTIcE MAnAGERS

accreditation

business models & structure

independent contracting options

risk

workplace health & safety

work cover

management

managing referrals

practice review

2728 July privacy insurance

Starting and working in private practice conference technology

& communications

early bird sPecial

confidentiality and record management

(closes by 22 June 2012) Bring a non-member at member rates or receive early bird discount as per brochure

LAUGHTER isthe BestMEDICINE

issues affecting

general practice

continuing professional development points

Very informative conference, not only for starting up in private practice but also for existing practices. Highly Recommended.

22 Indooroopilly Golf Club, Brisbane *approved

trish cuthbert - practice Manager, granite Belt Medical services

Join other medical professionals for a series of seminars and interactive sessions exploring the challenges and opportunities relating to working in private practice.

P r o u d ly s P o n s o r e d b y:

Caring for you for life

To view the full events calendar

17 August Laughter is the best medicine dinner 6:30pm The Greek Club, South Brisbane Grab your partner and your colleagues for a fun night with Australia’s laughter specialist, Scott ‘The Doctor’ Williams.

Or to register for an event, visit amaq.com.au/events or contact Taylor Hunter on 07 3872 2269 (email: t.hunter@amaq.com.au).

financial and legal

confidence

A better financial future 25 Aug, 9am, AMA Queensland, Kelvin Grove Featuring two keynote speakers, the workshop will explore how you can review, restructure and get smarter with your finances.

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JULY 2012 DoctorQ

Women in medicine lunch 8 Sept, 10am, The Greek Club, South Brisbane Equip yourself with the financial and legal awareness needed to be successful in your career and life.

AMA Queensland annual conference 23-29 Sept, Madrid, Spain The academic focus is on preventative health strategies for the 21st century.

lifestyle

do I have enough to retire?

Doctor Q revisits respected investment adviser Ross Noye’s timeless advice on how to calculate just how much you need in under two minutes.

It’s official. We’re living longer, just ask the government actuary. Women now have an average life expectancy of 84 years and men 79 years – the reasons for the difference between the sexes I’ll leave you to ponder.

The real significance in these ever-increasing numbers is that we now need to plan for at least 20 years in retirement!

Most of us have high expectations of a ‘holiday lifestyle’ in retirement. Without a plan, that’s unlikely: financial discipline and strategic invetsment planning is needed.

One of the most asked questions by clients has always been “How much do I need to retire on?”

In my view the helplessness felt by many investors on how to get a answer to this simple question has often been the reason that little or no thought has been given to implementing an investment plan to deliver the desired retirement lifestyle: it’s just been too hard.

But it needn’t be. From my experience, “How much do I need in retirement?” is a simple question that can be answered in under two minutes.

Let’s work through an example, keeping the numbers easy so that you can focus on the process: Assume you would like an annual after-tax income of $100,000 and that this income must have the same purchasing power in 20 years time as it does today. You believe that an eight per cent per annum investment return is achievable over the longer term and that the inflation rate will remain under control at around three per cent per annum (that’s steps one to four out of the way!)

The real rate of return simply makes sure that we are always talking in today’s dollars.

To calculate your estimated long term real rate of return just subtract three per cent per annum from eight per cent per annum to get a net investment return of five per cent per annum.

We then divide your income goal by the real rate of return you discover you need

$2 million of capital invested to provide.

So there, you have your estimate of the capital you need to fund your retirement income – so now you can start developing and implementing your strategies to achieve your now clearly defined goal.

Just to summarise, if you have $2 million invested and you achieve an after-tax and after-inflation return of five per cent per annum it will provide you with an annual income of $100,000 forever, while also maintaining your $2 million capital base.

Obviously, if you don’t care whether you spend your capital you will need less.

Remember to add back the three per cent inflation figure to arrive at your pre-tax, preinflation investment hurdle rate of return you require to hit your income target. The first thing you should notice is that your hurdle rate is bigger than the cash rate – so investing the money in cash will not give you the return you need. One way to make this easier is to reduce the tax you pay – and that’s easier than you think.

If you are aiming for double the retirement income above you will need twice the capital invested.

Over the last 27 years, I have found that the main reason most people struggle with their retirement planning is that they did not take the time to work out what they are aiming for. So take the two minutes, it really could change your life. Q

Step

1

Assume you are retiring today.

Step

Guesstimate the annual retirement income you would like from today.

Step

Guesstimate what you believe is an achievable longterm investment return.

Step

Guesstimate what you think the long-term annual inflation rate might be.

Step

Subtract answer to step four from answer to step three to get your afterinflation after-tax investment return.

Step

Divide your desired annual income by your estimated Real Rate of Return ie your answer to step five.

2 3

4

5

6

The main reason most people struggle with their retirement planning is that they did not take the time to work out what they are aiming for.

DoctorQ JULY 2012

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lifestyle

o t h t r No

Alaska!

The great outdoors is what Alaska is famous for, with no end to the photo opportunities in America’s land of the midnight sun, says AMA Travel’s Ros Bulat.

getting there Fly via Seattle to get to Anchorage or take the Qantas BrisbaneLos-AngelesVancouver route, a popular cruise departure port.

Right now it’s summer in Alaska, and that means cruise season.

From June to September, cruises ships, ranging from intimate groups of 20 to liners carrying as many as 2000 travelers, navigate their way through the Inside Passage and its rich tapestry of rivers, fjords, waterfalls, tidal pools and expansive straits. Along the way, the network of waterways provides access to kilometres of pristine coastline, glaciers and vast populations of porpoises, whales, sea birds, seals, sea lions, otters and eagles.

Inside Passage welcomes more than 600,000 visitors a year but there’s nothing ‘standard’ about the experience. For those who seek ‘interactive’ holidays, the smaller ships may be preferred: they can get much closer to the shoreline and offer sea kayaking and wilderness excursions, straight from the back of the ship. But while they do have onboard activities and lectures, they do not offer the same “full” cruise ship experience of some of the larger liners.

From Vancouver, British Columbia, one and two week itineraries include stops at various ports of call where passengers spend the day taking optional land-based tours such as flight seeing, fishing, gold panning, hiking, and touring Alaskan Native cultural attractions.

After cruising, Denali National Park is the next most popular destination for travelers.

Experience the wilderness from the comfort of your panoramic train window as you head north from Anchorage. Q

Alaska’s capital, Juneau, is invariably part of a cruise ship’s itinerary—be it at the start, end or midway—as it is the gateway to many of the amazing south-central attractions such as Glacier Bay National Park and Admiralty Island.

You can’t talk about Alaska without picturing a 400 kilo bear catching a salmon that is leaping upstream to spawn: catch the sight first-hand near Kodiak or Admiralty Island. It’s here that you also take time to relax, try a little fly-fishing … and just quietly, there’s plenty of amazing food, wine and spa facilities to keep the non-fishing types happy!

Alaska do Call Ro esn’t stop th ere… s or Ste ph AMA T ravel Q anie at ueensla nd.

PHON E: 180 0 262 8 FAX: (0 85 7) 5556 7200 EMAIL : travel@ amaq.c om.au WEB: www.a maq.w orldtra vel.com .au

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JULY 2012 DoctorQ Photographs courtesy Alaska Travel Industry Association: Chris McLennan, Brian Adams, Robin Hood.

lifestyle

Matt Wallace Wine Direct 1800 649 463 matt.wallace@winedirect.com.au

Un bicchiere di vino Vermentino, per favore

Photo: South Australian Tourism Commission

Italian favourite worth bottling downunder A sunny winter’s weekend in Queensland calls for a drop that echoes the warm Mediterranean, says Wine Direct’s Matt Wallace, offering a white Italian varietal to our tastebuds.

Winemakers in Sardinia and Liguria have known and grown Vermentino for eons, creating excellent flavour with low alcohol and good acidity if picked early.

A relative newcomer to Australia, Vermentino is ideally suited to warm regions and hot vintages and Chalk Hill, Oliver’s Taranga and 919 Wines have produced some exceptional examples.

Corrina Wright, winemaker at Oliver’s Taranga in South Australia’s McLaren Vale,

shortlisted Vermentino as a white variety with which she could produce a wine of equal quality to her formidable reds: she pictured easy drinking and very food-friendly, with an accent on lime, lemon blossom, sea spray, herbal, minerality and bright acidity.

Something too that could withstand withering heat (days of 50 degree heat not unknown in her part of the world; conditions that send Shiraz and other traditional vines flat and dropping fruit). “Winemaking with Vermentino is about preservation of fruit,

you don’t need to do much to it,” she told me.

This both confirms its suitability to warmer climes and gives the nod to the fact that Vermentino offers a fairly simple proposition to the end consumer. While styles will vary, they still fit within a fairly narrow and finite spectrum. There is not the risk of picking up a bottle, expecting crisp fruit and good acid and getting something layered, unctuous and oak aged.

That said, Jenny and Eric Semmler from 919 Wines in the Barossa produce an oak aged Vermentino. Theirs is partially barrel fermented but only in old oak. This primarily imparts textural rather than flavour characters, a gentle step to the left of taut and crisp, toward medium bodied and creamy. It is different from Oliver’s Taranga and Chalk Hill’s wines yet recognisably varietal. “Vermentino offers the opportunity to work with, rather against, climate and in so doing produce consistently, rather than occasionally, exceptional wines,’ says Jenny Semmler.

Chalk Hill, also in McLaren Vale, sought an aromatic variety suited to a warm climate which would work well with food and produce consistently high quality wines.

I suspect they might be on the right path given that their inaugural Vermentino from 2011 has been awarded two trophies. Q

DoctorQ JULY 2012

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DENDY MOVIES

MET OPERA - WAGNER’S THE RING CYCLE

ENCORE SEASON

Dendy Portside Cinemas continues to screen your favourite operas on the big screen Die Walküre (15 July), Siegfried (29 July), Götterdämmerung (5 August), Le Comte Ory (2 September), Lucia di Lammermoor (16 September) and Don Giovanni (30 September).

Enjoy a sumptuous array of canapés and refreshments at interval at no extra charge.

Hysteria Opens: 12 July Cast: Maggie Gyllenhaal, Hugh Dancy An offbeat, very amusing romantic comedy, Hysteria is set in 1880, and follows Mortimer Granville (Dancy), a young disillusioned doctor working for another whose treatment of the female malaise ‘hysteria’ requires intimate manual relief. Hysteria presents love with a twist and shows that in desperation, man’s inventiveness truly comes to the fore.

ore for m isit info vom.au

WINTER WONDERLAND

.c dendy

CLASSIC FILMS CONTINUE Dendy Portside hosts a wonderland of classic films to wile away the winter months, including: TO KILL A MOCKINGBIRD

RAYMONDA

The Sapphires

22 July 1pm & 26 July 11am

Opens 9 August

DR ZHIVAGO

16 July

IT’S A WONDERFUL LIFE

23 July

CALAMITY JANE

30 July

Cast: State Academic Bolshoi Theatre of Russia Director:Yuri Grigorovich

Cast: Chris O’Dowd, Deborah Mailman,

THE AFRICAN QUEEN

6 August

Jessica Mauboy, Shari Sebbens

MEET ME IN ST LOUIS

13 August

The last ‘grand ballet’ of the 19th century, Raymonda is considered symbolic of a key period for classical ballet. It portrays a lover’s dream turned nightmare, and the horror of realising the nightmare has become reality.

It’s 1968 and four young talented Aboriginal women learn about love, friendship and war when their all-girl group, The Sapphires, entertain US troops in Vietnam. This film earned a standing ovation at the 2012 Cannes Film Festival and is tipped to be a sleeper hit in the US.

BEN HUR

20 August

This new choreographic version from Yuri Grigorovich dates back from 2003.

All films screen on a Monday at 10am and 6pm.

For full details visit: http://www.dendy. com.au/Promotion/Winter-WonderlandA-Season-Of-Classic-Films-In-Portside

WIN MOVIE TICKETS FOR TWO Name: Postal address: Portside Wharf, Remora Road, Hamilton Ph: (07) 3137 6000 www.dendy.com.au 48

9 July

JULY 2012 DoctorQ

Phone:

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

CULTURE

Das Rheingold by The Hamburg State Opera with The Hamburg Philharmonic Orchestra 23-25 August, Concert Hall, QPAC Das Rheingold is the first in Richard Wagner’s epic Der Ring des Nibelungen (The Ring) a towering example of 19th century Germany’s artistic legacy, comprising four separate operas. Celebrated Australian and Hamburg Philharmonic musical director Simone Young conducts the Hamburg State Opera and Philharmonic Orchestra’s concert performance.

A Midsummer Night’s Dream

by The Hamburg Ballet

30 August-5 September, Playhouse, QPAC

Vienna Boys Choir

The Hamburg Ballet’s ravishing version of Shakespeare’s classic tale of magic, mistaken identity and lovers’ quarrels is one of choreographer John Neumeier’s most joyous creations. A rare combination of inspired concepts, exquisite, haunting choreography and broad comedy, A Midsummer Night’s Dream features music from Mendelssohn, Hungarian Gyorgy Ligeti and familiar street tunes played on a barrel organ. The music will be performed

by Queensland Symphony Orchestra under the baton of The Hamburg Ballet’s resident conductor, Brisbane-born Simon Hewett.

9 September and 12 October, Concert Hall, QPAC The Vienna Boys Choir returns to Australia for a very special national tour, including the premiere of a new work by composer Elena Kats-Chernin. For more than 500 years the Vienna Boys Choir (or Wiener Sängerknaben) has been an enduring symbol of Europe, working with composers such as Fux, Salieri, Haydn and Bruckner and conductors such as Claudio Abbado, Leonard Bernstein, Nikolaus Harnoncourt and Sir George Solti.

ore for M ion mat infor m.au co qpac.

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Terrain

by Bangarra Dance Theatre 3-7 October, Playhouse, QPAC Internationally acclaimed Bangarra Dance Theatre presents a fusion of contemporary dance and storytelling commissioned by artistic director Stephen Page. Described as a hymn to country, Terrain transports us to Lake Eyre, the place of Australia’s inland sea: one of the few untouched natural waterways in the world. Bangarra artists explore the innate connection of Indigenous people to country and how the landscape is a second skin.

Name:

WIN DOUBLE PASSES TO Bangarra

Postal address:

Phone:

FAX BACK TO (07) 3856 4727 or email editor@amaq.com.au by 31 July DoctorQ JULY 2012

49

IN PRINT

Bigger or Better?

Australia’s Population Debate What is the link between population and economic growth? What are the environmental impacts of population growth? Are we really an ageing society; and is that a matter of concern? Are ‘boat people’ and refugees generally a significant component of our migrant intake?

How can we influence Australia’s future population?

Doctor Q has a copy of Bigger or Better? Australia’s Population Debate to give away.

Simply fill out your details in block letters on the form and fax it to (07) 3856 4727 or email editor@amaq.com.au.

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JULY 2012 DoctorQ

win this book!

Entries close 31 July.

competition winners

Professor Ian Lowe takes to the soapbox for a lunchtime discussion about population growth at Melbourne’s Wheeler Centre on 26 July. Details at http:// wheelercentre.com/calendar/ event/bigger-or-betteraustralia-s-populationdebate

These questions and more are answered by pre-eminent scientist and commentator Professor Ian Lowe as he analyses this political hot potato and presents the complex issues around population growth in an accessible manner, encouraging informed discussion.

Bigger or Better? Australia’s population debate is published by University of Queensland Press and retails for $34.95. Q

Name: Postal Address:

Telephone:

DENDY WINNERS

QPAC winners

Book WINNER

Double pass winners

Dr Ros Seeney, Dr Wendy Christie and Dr Tram Nguyen won double passes to enjoy legendary Australian pianist David Helfgott perform at QPAC, for one night only, on 29 August.

Dr Paul Paterson won the coveted Brukner and Khan’s Clinical Sports Medicine 4e, published by McGraw-Hill Australia and retailing at $189.95

1. Wendy Bourke 2. Joshua Lawson 3. Peta Margie 4. Marjorie Busby 5. Leonie Todhunter 6. Raffaela Lawson 7. Jonathon Cafferky 8. Noel Saines 9. Alison Mccoll 10. Kevin Lee See

MEMBER NEWS

2012 Member benefits online

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

The 2012 AMA Queensland Member Benefits Guide is now available online. Check it out and ensure you know all the services, support and great benefits you get as part of your membership.

April

www.amaq.com.au/memberbenefits For further details about member benefits, please contact the membership team on (07) 3872 2222 Q

AMA Membership team

win

i am a member...

AMA Queensland recently launched our I am a member campaign to celebrate the many reasons why doctors choose to become and remain members of their professional association. Check out our I am a member campaign on our website www.amaq.com.au Q

free

Add to our I am a member hip campaign by emailing members membership@amaq.com.au outlining your reason for joining and staying a member of AMA for your chance to win free membership subscription in 2013.

mbaq The Medical Benevolent Association of Queensland is a charitable organisation with the objective of assisting members of the profession in times of need. MBAQ offers limited financial assistance to assist medical practitioners in times of crises (conditions apply). Q

doctors in training

For further information, please visit: www.mbaqld.com.au or email mbaq@amaq.com.au

Dr Charles Blair Dr Melissa Fox Dr Robert Hughes Dr Chris Garwood Dr Tungamirai Batiya Dr Suresh Munugani Dr Joshua Hann Dr Jehan-Hari Joethy Dr Jaswinder Kathuria

General Practitioners Dr Rizwan Akhter Dr Riazal Ali Dr James Kang Dr Alun Parry Dr Stephanie ShawBinns Dr Mark E Weller

Specialist Practitioners Dr Gregory Amos A/Prof David Coman Dr Paul Jeffrey Conaghan

Dr James H Earnshaw Dr Jon-Paul Khoo Dr Ian C Reddie

part-time Practitioners Dr Jeanette F Tait Dr Andrew Butler Dr Edward Wims Dr Andrea McGlade

salaried practitioners Dr Sugeet Bajeva Dr Francois Du Toit Dr Alan Ruben Dr Denise Thomas Dr Luke Waldrip Dr John Wilson

Joint Practitioners Dr Paul A Chapman Dr Rajan Narula Dr Laddy Narula Dr Margot Bosanquet

Virtual practice management, IT and secretarial support  Virtual Secretarial Services  IT Infrastructure & Software  Practice Management Advice  Medical Billing Services  Bookkeeping and BAS  Compliance and risk management

www.vmo.net.au info@vmo.net.au Call one of our qualified consultants today 1300 VMO-AMA AD_MAR2012.indd 1

725 145 18/3/12 2:26:20 DoctorQ JULY PM 2012

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People & EVENTS

Shared experience Dennis Hall from Direct Dialogue passed on essential tips for instant connections when he attended a recent AMA Queensland mentoring event.

Med-Connect participants—firstyear medical students and doctor members of AMA Queensland— also had a chance to mix and match experiences and hear from those who’ve gone before: Dr Bav Manoharan (mentee) and Dr Shaun Rudd (mentor).

Kylie Beem, Dr Shaun Rudd and Lesley Leong

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JULY 2012 DoctorQ

This year 270 students and doctors took part in Med-Connect, providing students with the unique opportunity to learn and receive support from their mentors, and doctors the opportunity to give back to the profession.

Defence Force Recruitment, a generous supporter of MedConnect over the past couple of years, was also in force. Q

ABOVE: Direct Dialogues’ Dennis Hall passes on tricks of the trade for networking.

Dr Reggie Ba Pe with Bonnie Kwor

Defence’s Capt Andrew Crowe with Dr Shaun Rudd, Kristin Giannasca, Dr Alex Markwell and Dr Bav Manohanan

People & EVENTS

A regal

Affair

About 200 people frocked up at Brisbane’s Tattersall’s Club for a night both solemn in its ceremony and joyful : the 2012 President’s inauguration. Q

President-Elect Christian Rowan in procession

Alex Markwell with husband Anthony Allen

Legends: Dr Humphry Cramond and Professor Tess Cramond

Joan Lawrence, John Cox, Lena Fleming and Kim Bulwinkel

Award Winners AMA Memorial Prize Dr Michael Tuppin

Richard Kidd congratulates Professor John Pearn on receiving the President’s Award

William Nathanial Robertson Prize Dr Marlow Coates Harold Plant Memorial Prize Dr Annette-Sarah Swift John Bostock Prize in Psychiatry Mr Goran Mitric, Ms Clare Applegarth

Robyn Kastrissios and Eleanor Chew

Gino Pecoraro and Christopher Price

Lilian Cooper Prize Dr Matthew Devine, Dr Michael Tuppin

AMA Medal of Achievement James Cook University Ms Stephanie Ferguson AMA Award of Distinction Mrs Anne Chater Citation of the Branch Dr Chester Wilson President’s Award Professor John Pearn AMA Roll of Fellows Dr Chris David, Dr Gino Pecoraro

DoctorQ JULY 2012

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People & EVENTS

High Notes: Highlights of Bettina Arndt’s career in sex include not just having her own talk-back radio show and being banned for two years from live television and radio but becoming the person that everyone came to for advice about sex.

Bettina’s glorious morning Renown sex therapist and social commentator Bettina Arndt entertained and enlightened guests at the annual Women in Medicine breakfast on 6 June in Brisbane.

The international columnist and author of the Sex Diaries and What Men Want – In Bed had guests laughing all morning with her amusing and insightful anecdotes about the changing nature of relationships between men and women.

54 54

JULY JULY2012 2012 DoctorQ DoctorQ

The breadth of medical professions represented on the day was a superb affirmation of AMA Queensland’s vision to be a vital hub for the medical community in which to share ideas and develop business networks.

Special thanks to the event sponsors for their support of women in medicine: AMAQIS, TressCox Lawyers, William Buck and Doctors’ Health Fund. Q

CLASSIFIEDS

Professor RogeR Allen Professor Roger Allen is a highly regarded and widely published respiratory and sleep physician practicing at The Wesley Medical Centre, Auchenflower, Brisbane.

Professor Allen has special expertise in sarcoidosis and medicolegal reporting in asbestos and other occupational diseases and is renowned for his meticulous work.

To make a referral or for further information on Prof. Allen’s medical services visit: www.sarcoidosis.com.au or www.sleephealth.com.au For appointments ring: 07 3719 5577 Fax 07 3719 5177 or email receptionrka@internode.on.net

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SESSIONAL ROOMS - CLEVELAND Cleveland House Visiting Specialist Centre (CHVSC) is centrally located in Bloomfield St, Cleveland with easy access for your patients. Our experienced and committed staff will ensure that your Bayside regional or sessional practice location operates smoothly as an extension of your main rooms. Various sessions currently available. One consulting room available on a permanent basis.

Please phone 0422 496 430 to discuss or email kristine.malone@bigpond.com for further information.

Dr Brian Wilson-BoyD (07) 3371 9000 | www.ent-surgeon.com.au Dr Wilson-Boyd is an Ear, Nose and Throat, Head and Neck Surgeon consulting and operating at the Wesley Hospital and North West Brisbane Private Hospital.

Dr Wilson-Boyd is always available for queries from his patients, their family and their doctors. He aims to provide his patients and their referring General Practitioners with comprehensive solutions within a mutually acceptable time frame.

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has medical finance specialists on call?

Queensland finance specialists L-R Jeff Miller, Angela Warren, Simon Moore, Bill Dale, Michael Foley, John Evans, Todd O’Reilly, Alan Coughlan, Pat Salter, Sam Baxter

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