SEPTEMBER 2013 . VOL 86
AMA Queensland Membership Magazine
AUSTRALIA DECIDES MEDICO-LEGAL CONFERENCE REGISTER NOW RoPP UPDATE FREE TO AMA QUEENSLAND MEMBERS
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THIS ISSUE SE 7 PT
AUSTRALIA DECIDES 2013 WE’VE COMPARED AMA’S KEY PRIORITIES AGAINST ELECTION PROMISES MADE SO FAR TO HELP YOU DECIDE WHO’S BEST FOR HEALTHCARE.
FEATURE STORies 26 MATER UNVEILS NEW HOSPITAL PLANS
people & events 10 WOMEN IN MEDICINE
12 Q&A WITH TONY JONES 14 GROWING YOUR PRIVATE PRACTICE
22 PSYCHOLOGICAL INJURY AND THE WORKPLACE
16 AMSA NATIONAL CONVENTION 2013
34 EVENTS CALENDAR 40 MEMBER PROFILE: DR ENNO TAEMETS
24 RIGHT OF PRIVATE PRACTICE REVIEW 28 FOUNDATION NEWS
32 MAINTAINING A LOG BOOK
Just remember, sleep is better than sex – so get as much as you can.
42 LOOK NO FURTHER FOR BUSINESS SUPPORT 44 STRATEGIES FOR SUCCESS 45 INTERNATIONAL INVESTMENT: A MORE CONFIDENT U.S. IS GOOD FOR INVESTORS 46 WHAT HAPPENS WHEN...? 48 RESTRUCTURING TO REDUCE TAX - FACT OR FICTION?
50 EMAILER’S REGRET 53 TRAVEL VALUE WITH INVESTEC CREDIT CARDS
FROM THE EDITOR’S DESK
30 LOCAL MEDICAL ASSOCIATION ROUND UP 38 MEMBER NEWS
54 WINE 55 TRAVEL 57 MOTORING 59 ALL ABOUT YOU
60 MOVIES 61 ON STAGE 62 IN PRINT
DoctorQ SEPTEMBER 2013
FROM THE EDITOR’S DESK MICHELLE FORD RUSS Doctor Q Editor Comedian John Oliver did a hilarious send up of our Aussie elections to an American audience incredulous that our campaign period for this election will only last four weeks. “Four weeks? That’s like three iPhones from now!” While heaven help us if we ever follow the American system, four weeks is little time to assess who is the best party to lead the country. Then again, more time would probably not make it easier to sort through the white noise and get down to who is planning to do what for healthcare. AMA brought out the Key Health Issues for the Federal Election 2013 as the campaign began and we’ve done our best to check the AMA priorities against the campaign promises. Have a look on page 20. Our Workplace Relations Manager Andrew Turner has given us feedback from the Right of Private Practice Auditor’s Review on page 24 and our new Workplace Relations Advisor Luke Donaldson has given us an insight into psychological injury in the workplace, which just happens to be his thesis topic (page 22).
We’ve had some great events recently, with both Women in Medicine and Growing your Private Practice very well received. Check out the photos on p10 and page 14. We’ve also got the Bancroft Oration coming up with David Paterson, Professor of Medicine at UQ’s Centre for Clinical Research on the quite disturbing topic of Small bugs, big problems: tackling antibiotic resistance. We’re very excited to welcome Dr Karl Kruszelnicki as our special guest for our inaugural AMA Queensland Doctors in Training and Student Awards on 25 October. Three award winners will be announced on the night and given a $1,000 cash prize: a Junior Medical Officer, a Registrar and a student. Come along for a glamorous evening with cocktails, canapés and a chance to celebrate our younger doctors and students. Q
THE GREAT GRANGE CHALLENGE Six wines decanted and displayed for tasting with prices from $55 to $650 - could you pick which one was the Grange? Find out more on page 54.
BOARD OF DIRECTORS Dr Christian Rowan President
Dr David Alcorn Honorary Secretary
Dr Shaun Rudd President-Elect
Dr Alex Markwell Elected Member
Dr Sharon Kelly Chairperson
Dr John Hall Elected Member
Dr Chris Zappala Treasurer
Dr Richard Kidd Elected Member
COUNCIL Dr Tom Arthur Gold Coast Area
Dr Kelly Macgroarty Specialist Craft Group
Dr Sharmila Biswas Far North Area
Dr Bav Manoharan Greater Brisbane Area
Dr Kimberley Bondeson Greater Brisbane Area
Dr Dilip Dhupelia Part-Time Medical Practitioner Craft Group
Dr Bill Boyd Capricorn Area Dr Ben Duke Greater Brisbane Area Dr Larry Gahan General Practitioner Craft Group Dr Noel Hayman Greater Brisbane Area Dr Sharon Kelly Specialist Craft Group Mr Nicholas Gattas Medical Student Group Dr Vanessa Grayson Residents and Registrars Craft Group Dr Wayne Herdy North Coast Area
OBITUARIES AMA Queensland sadly wishes to advise that the following member recently passed away: Dr Kevin Patrick EVERDING General Practitioner Late of Sunnybank Member for 40 years
Dr John F. Murray Full -Time Salaried Medical Practitioner Craft Group Dr Carl O’Kane North Area Mr Callum Potts Medical Student Observer Dr Shaun Rudd General Practitioner Craft Group Dr Jonathon Shirley Greater Brisbane Area Dr Mason Stevenson General Practitioner Craft Group
AMA QUEENSLAND SECRETARIAT Jane Schmitt Chief Executive Officer Filomena Ferlan General Manager Corporate Services Colleen Harper Manager - AMA Queensland Foundation
Holly Bretherton General Manager Member Relations and Communications Andrew Turner Manager - Member Services
Editor: Michelle Ford Russ Graphic Designer: Erin Sticklen Disclaimer – All material in Doctor Q remains the copyright of AMA Queensland and may not be reproduced or transmitted in any form without permission. While every care is taken to provide accurate information in this publication, the material within Doctor Q is for general information and guidance only and is not intended as advice. Readers are advised to make their own enquiries and/or seek professional advice as to the accuracy of the content of such articles and/or their applicability to any particular circumstances. AMA Queensland, its servants and agents exclude, to the maximum extent permitted by law, any liability which may arise as a result of the use of the material in Doctor Q.
SEPTEMBER 2013 DoctorQ
Journalist: Barbara Ferres Advertising: Louise Glynn Doctor Q is published by AMA Queensland Contact Phone: (07) 3872 2222 Postal Address: PO Box 123, Red Hill QLD 4059 Print Post Approved PP490927/00049 Email: email@example.com
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TACKLING THE BIG ISSUES
THE PAST FEW MONTHS HAVE CERTAINLY BEEN BUSY ONES, WITH A RANGE OF IMPORTANT PUBLIC HEALTH AND INDUSTRIAL ISSUES DEMANDING URGENT ACTION AND ATTENTION. BINGE DRINKING, SEXUAL HEALTH, RIGHT OF PRIVATE PRACTICE ARRANGEMENTS, HEALTH COMPLAINTS AND THE CURRENT FEDERAL ELECTION ARE ALL HIGH ON THE AGENDA.
DR CHRISTIAN ROWAN President, AMA Queensland DISCUSSIONS CONTINUE FOLLOWING AUDITOR-GENERAL’S REPORT INTO ROPP Following the July release of the AuditorGeneral’s report into Right of Private Practice (RoPP) arrangements in the public health system, AMA Queensland and our partner Union ASMOFQ have continued to vigorously represent members in ongoing discussions with the Minister, DirectorGeneral and Deputy Director-General of Queensland Health. We support system improvements that will deliver more streamlined and transparent billing process and will work closely with the Government to ensure all changes are reasonable, equitable and well-communicated. We expect the Auditor-General to release a further report during November.
Almost one in ten Australians over the age of 14 drinks at levels considered risky to long term health.
profession. The Bill was passed on the 20 August without changes. AMA Queensland will continue to lobby the government to ensure the development of an independent, efficient and fair health complaints system.
TACKLING QUEENSLAND’S BINGE DRINKING CULTURE Following the release of some alarming statistics by the Foundation for Alcohol Research and Education about binge drinking, AMA Queensland partnered with national charity Hello Sunday Morning to encourage Queenslanders to rethink their drinking habits. The research found that almost one in ten Australians over the age of 14 drinks at levels considered risky to long term health. This shocking statistic prompted me to take on the personal challenge of ‘giving up grog’ for three months to try and highlight our dangerous drinking culture. From street violence to brain and liver damage, binge drinking takes an enormous toll on our community. Doctors and hospital staff deal with the physical and emotional fallout of binge drinking every day, as a doctor and proud Queenslander, I am declaring it time to change. Read more on page 59.
CUTBACKS TO BIALA SEXUAL HEALTH SERVICES It is our understanding that the Metro North Hospital and Health Service plans to reduce staffing at Biala House from 46
positions to 16 positions. Such a drastic reduction in service capacity would have catastrophic consequences for many vulnerable people in our community. Queensland Health’s expectation that GPs will pick up the slack is unfair and unrealistic. In a press statement we called on the State Government to consider the long-term ramifications of reducing Biala’s service to skeleton staffing levels. It is our grave fear that cutting back services at Biala won’t reduce the costs of providing sexual health care; it will just make it somebody else’s problem. Without swift government intervention, the entire community will carry the significant human and financial burden of this illconsidered plan.
TOWNSVILLE TOUR To finish on a high note, I was pleased to meet with members and local health care providers in Townsville on 7 August as part of our Health Vision program. It is always a privilege to be welcomed by local clinicians who offer valuable insight into the unique health needs and challenges of their communities. I look forward to meeting with more members throughout the year as I travel to Central and Far North Queensland. As always, I thank you for your ongoing membership and support of AMA Queensland as we work together to create better outcomes for doctors and their patients. Q
PARTNERING WITH MDA NATIONAL TO VOICE CONCERNS OVER HEALTH OMBUDSMAN BILL 2013 I was pleased to join MDA National President A/Professor Julian Rait to voice our concerns over the proposed Health Ombudsman Bill 2013 which grants unprecedented power to the Health Minister and allows for the ‘naming and shaming’ of doctors. AMA Queensland and MDA National issued a joint statement on behalf of members highlighting the concerns of our members and the 6
SEPTEMBER 2013 DoctorQ
MDA President A/Professor Julian Rait speaks with Dr Christian Rowan about concerns with the Health Ombudsman Bill 2013.
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DoctorQ SEPTEMBER 2013
A VIEW TO THE FUTURE WHILE AUSTRALIANS HEAD TO THE POLLS ON 7 SEPTEMBER, AMA QUEENSLAND IS WORKING WITH MEMBERS TO CREATE A VISION FOR HEALTH THAT WILL LAST FOR THIS PRIME MINISTER’S TERM AND BEYOND.
JANE SCHMITT Chief Executive Officer, AMA Queensland As we go to print with this issue of Doctor Q, the Federal election will only be a few days away. In what is tipped to be another tight result for both major parties, there are several key issues that the AMA will continue to highlight, regardless of the outcome. In expectation of the poll announcement, AMA Queensland was pleased to partner with our state and federal colleagues to launch the AMA Key Health Issues for the Federal Election document. We’ve done our best to check campaign promises against our priorities on page 20.
TAX CAP ON SELF-FUNDED EDUCATION EXPENSES One of the most critical issues for our members, and indeed all professionals, is the proposed tax-cap of $2,000 on self-funded education expenses. This illconceived policy was due take effect from 1 July 2014 but thanks to intense lobbying by AMA and a coalition of high level supporters (including the Federal Opposition and Green parties) this has been delayed until 2015 and sent back to the drawing board for further consideration. While this is still not an ideal outcome, we are pleased to see common-sense prevail and will continue to advocate on behalf of members to ‘scrap the cap’.
The Engagement Forums formed a crucial part of our consultation process and offered members the opportunity to share their views, suggestions and concerns. AMA QUEENSLAND’S HEALTH VISION I was delighted to meet with members at our Health Vision Engagement Forum in Townsville on 7 August. This followed a highly successful session in Brisbane on 26 July which tackled several key policy issues including end-of-life care and workforce planning. It was inspiring to see the passion and committment members brought on both occasions which led to robust and spirited discussions about the future of healthcare in Queensland. The AMA Queensland Health Vision was unveiled earlier this year and outlines our five year policy framework. The Engagement Forums formed a crucial part of our consultation process and offered members the opportunity to share their views, suggestions and concerns face-to-face. Anyone still wishing to contribute their feedback can visit our Health Vision Blog via our website at amaq.com.au or email firstname.lastname@example.org.
EVENT UPDATE We continue to build on a successful year of events with the annual Growing Your Private Conference and Women in Medicine breakfast both taking place in July. The new program for Growing Your Private Practice proved extremely popular with a capacity crowd of GPs and practice managers attending both days of the conference. Our Women in Medicine presenter this year was author and comedian, Wendy Harmer, who covered the topic ‘Growing older with grace?’ with humour, honesty and candour. Feedback from both events was excellent with high praise for the professional organisation and quality of the experience – a great result for all involved! See pages 10 and 14 for photographs from these events. Up next, we have the inaugural AMA Queensland Doctors in Training and Student Awards and celebration of junior doctors evening featuring special guest ‘Dr Karl’ on 25 October. This is an exciting opportunity to acknowledge the contribution of the newest members of the medical profession and offer some encouragement as they progress into their careers. Turn to page 39 for more information on how to nominate or register for the Awards or ceremony. Please enjoy this exciting issue of Doctor Q and I thank you for your ongoing support of AMA Queensland. Q
I was delighted to meet with members at our Health Vision Engagement Forum in Townsville on 7 August. It was inspiring to see the passion and commitment of members. 8
SEPTEMBER 2013 DoctorQ
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AMA QUEENSLAND’S ANNUAL BREAKFAST
Women in Medicine MORE THAN 140 GUESTS BRAVED THE EARLY MORNING TO JOIN SPECIAL GUEST, COMEDIAN AND AUTHOR WENDY HARMER FOR THE ANNUAL AMA QUEENSLAND WOMEN IN MEDICINE BREAKFAST HELD AT VICTORIA PARK GOLF COMPLEX ON WEDNESDAY 31 JULY. The topic this year was ‘Growing older with grace?’ as women experience increasing pressure to ‘combat ageing’ and maintain relevance in a youth-obsessed culture. Wendy tackled serious issues such as body image, self-esteem, cosmetic surgery and bullying in a warm, witty and wildly entertaining presentation that had the audience in stitches. Her number one beauty tip for looking instantly younger - “Install a light dimmer switch - works every time!”
The morning was hosted by AMA Queensland CEO Jane Schmitt and President Dr Christian Rowan, who although largely outnumbered by members of the fairer sex, said he found the morning very “educational!” A number of great prizes were also awarded thanks to the generosity of our corporate sponsors and partners. Q
WITH THANKS TO OUR SPONSORS
ABOVE: Carla Azzi and Issabella Sugani from Doctors Health Fund, Wendy Harmer, Jane Schmitt and Dr Christian Rowan Julie Buchanan, Summer Williams and Janice Marshall
ABOVE: Angela Lindner, Julie Smith from William Buck, Wendy Harmer, Jane Schmitt and Dr Christian Rowan
Victoria Brazil and Katina Breeze ABOVE: Jane Schmitt, Leah King (Lexus), Wendy Harmer, Katelyn Hay (Lexus) and Dr Christian Rowan
Margaret Roache and Amanda Stein
BACK ROW: Fiona Dalzell, Liz Boge, Robyn Smith, and Catherine Duffy FRONT ROW: Dinah Blunt, Jennifer Green and Catherine Rees
Wendy’s number one beauty tip for looking instantly younger: “Install a light dimmer switch works every time!” Cherise Holt and Michaela Lee
Susan Walsh, Helen Whelan and Mary Mahoney
People & EVENTS
Q&A WITH TONY JONES TWO HUNDRED QUEENSLAND MEDICAL PROFESSIONALS GATHERED AT BRISBANE’S HILTON HOTEL TO WITNESS THE ABC’S TONY JONES IN FULL FLIGHT AT A MEDICAL Q&A: THRASHING OUT THE BIG ISSUES IN PRIMARY HEALTH CARE.
The unique Q&A forum for doctors, hosted by UnitingCare Health hospitals, The Wesley Hospital and St Andrew’s War Memorial Hospital, debated key challenges facing the Queensland health sector. Hot topics on the night included eHealth initiatives, funding new medicines and technology, increased use of nurse practitioners, privatisation of public hospitals and GP super clinics. The Brisbane Q&A event was the second in the series of GP professional development events hosted by the Wesley and St Andrew’s. It included a day program for GPs, followed by a dinner and the Q&A in the evening. The first event in the series was a hypothetical with Geoffrey Robertson QC. Q
Cheryle Royle, Dr Kirsten Price, Dr Christopher Price and Dr Margaret Cotter
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SEPTEMBER 2013 DoctorQ
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DoctorQ SEPTEMBER 2013
People & EVENTS
GROWING YOUR PRIVATE PRACTICE
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More than 100 practice managers and doctors attended the fifth private practice conference in July to hear the latest on all aspects of practice management. Based on participant feedback, the AMA Queensland team introduced two streams this year to cover fundamental and advanced topics. Attendees heard presentations on setting up business structure, practice location and design and marketing tips that creates reputation and value. They also heard about risky business in cyberspace,
how to employ and manage staff and cruicial tips for success. The conference participants feedback said they felt informed and motivated with comments also left on the high quality of the presenters. Q
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People & EVENTS
AMSA NATIONAL CONVENTION 2013 QUESTIONABLY THE WORLD’S LARGEST STUDENT-RUN CONFERENCE, THE AUSTRALIAN MEDICAL STUDENTS ASSOCIATION NATIONAL CONVENTION ON THE GOLD COAST WAS A HEADY MIX OF POLITICS, DEBATE, EDUCATION, WORLD RECORDS AND FUN. AMSA PRESIDENT BEN VENESS GIVES US THE LOW DOWN.
BENJAMIN VENESS President, Australian Medical Students’ Association (AMSA) The controversy over the fifth and latest, edition of the Diagnostic and Statistical Manual of Mental Disorders was unmissable. Absent from the public debate however, was an acute and distinct affective illness that uniquely plagues Australian medical students each winter-time, yet is nowhere to be found within the Manual’s 992 pages. In 2011, South Australian medical student Timothy C. Coppafeel and a rather oddlynamed psychiatry registrar called Rooster drafted a seven-page submission to the American Psychiatric Association titled, ‘Post-convention depression[PCD]: a novel Axis I mood-spectrum psychiatric disorder’. “PCD is a novel Axis I psychiatric disorder. It affects approximately five per cent of Australian medical students from July to December annually, and more than 75 per cent of those attending the obligatory precipitating AMSA National Convention,” they wrote. “The features of this disorder are disillusionment with normal social activity, and concern regarding looming medical examinations. Auxiliary symptoms may include depression, anhedonia, difficulty concentrating, hypersomnia and lassitude. “In extreme cases deferral ideation may exist and remains a risk. PCD overlaps with organic medical conditions, especially in its early phases.”
In extreme cases deferral ideation may exist and remains a risk... A student called Emily, who attended this year’s National Convention on the Gold Coast, appears to meet criteria. A support group has formed on Facebook and Emily volunteers: “Suffering some true ‘CD - Lying in bed in pyjamas at 3pm, haven’t left my house in two days, bags not yet unpacked, spending hours looking at convention photos and videos, all while bus chants are cycling continuously in my head. Thank goodness I’m on holidays until next week!”
Mental health was a prominent topic through the week, with a plenary delivered by BeyondBlue director Dr Michael Bonning and a very well-received lecture by motivational speaker Glen Gerreyn. Professor Michael Kidd AM (also a BeyondBlue director) opened the Convention, having returned recently from Prague where he assumed the position of President of the World Organisation of Family Doctors (WONCA).
AMSA set at least two records with Convention this year. We’ve searched high and low, and cannot find a larger student-run conference anywhere else in the world. This year’s Convention attracted 1,350 delegates from across Australia and New Zealand for the full week, with over 1,800 attending for at least part of the extravaganza. The amazing team behind this year’s event was led by Peter Neeskens, a final year student at The University of Queensland.
Beloved Convention regular and media personality, Dr Sally Cockburn returned to speak and chair a panel that also included AMA Queensland’s Immediate Past President, Dr Alex Markwell. GP author Dr Nick Earls was the final speaker to entertain and inspire the audience of students from every year of medical school. Friday afternoon was taken up with an ‘Australia’s Brainiest Med Student’ game show; a keynote speaker debate featuring AMSA’s hilarious Vice-President (external), Richard Arnold; the grand final of the weeklong debating competition; and a closing ceremony that included the obligatory ‘Hawaii 5-0’ AMSA dance.
But the great beauty of AMSA’s National Convention is that its not all fun and games. While the social program is famed and phenomenal, so too, is the academic program.
Superheroes from the University of NSW team getting assessed in the Emergency Medical Challenge.
So, doctors, please bear with us as we adjust into normal society again, recovering slowly but surely from our PCD. It wouldn’t be the best convention in the world if it didn’t affect us so. Until next year, Rangers. Can’t wait to see you all again at Radelaide 2014! Q
SEPTEMBER 2013 DoctorQ
Additionally, we smashed the World Record for spooning, where one person wraps their arms around another in the manner of spoons bundled together – a common form of affection. 1,108 medical students spooned for five minutes with over 20 invigilators ensuring that all the students were spooning appropriately.
AMA Queensland NEWS
COUNCIL PROFILES ON WEBSITE
A full background and intention statement for each AMA Queensland Council member is now available on the website. Read more about the people who will represent you over the next 12 months. Dr Tom Arthur and Dr Bavahuna Manoharan’s specialities were incorrectly listed in last month’s Doctor Q: Dr Arthur is a Prinicipal House Officer with an interest in surgery and Dr Manoharan is a Resident Medical Officer with an interest in general surgery. Q
PLIBERSEK AND ROWAN PRAISE INDIGENOUS HEALTH SUCCESS President Dr Christian Rowan was pleased to join Federal Health Minister Tanya Plibersek for a visit to the Moreton Aboriginal and Torres Strait Islander Community Health Service (MATSICHS) at Morayfield last month. The visit was to highlight the efforts of the Institute of Urban Indigenous Health (IUIH) which represents a partnership between the Aboriginal and Torres Strait Islander Community Health Service, Kalwun Health Service, Yulu-Burri-Ba Aboriginal Corporation for Community Health and the Kambu Medical Centre. The IUIH is regarded as a centre of excellence and aims to support the effective implementation of COAG’s Closing the Gap initiatives and allocation of funding. It helps to coordinate indigenous health services in the South East Queensland Region and focuses on promoting partnerships and integration with other mainstream health services.
SEPTEMBER 2013 DoctorQ
“The IUIH’s Deadly Choices Campaign has been extremely successful in promoting awareness and educating the Aboriginal and Torres Strait Islander communities about the risks associated with chronic disease, particularly those caused by smoking, poor nutrition and lack of physical activity.” “Health Minister Plibersek and I were delighted to be invited by the IUIH to meet with some of their dedicated health workers and community leaders. We were given the opportunity to talk about ‘Closing the Gap’ initiatives with those who work at the frontline of indigenous primary health care.” “The success of the IUIH is a terrific example of what can be achieved when the Aboriginal and Torres Strait Islander communities are actively engaged in decision-making processes to ensure outcomes reflect their unique health and cultural needs,” said Dr Rowan Q
CAREER PROFILES GO LIVE Need career inspiration? The Doctors in Training Profile section of the AMA Careers Advisory Service website outlines the career pathways and life experiences of some of our doctors in training through personal accounts of their journey to date. These profiles may provoke a new way to look at your own career pathway and offer encouragement for the years to come. They also highlight that it’s common to sometimes feel overwhelmed, struggling with a work/life balance or still trying to figure out which direction to take. To find out more please visit careers.ama. com.au/dit-profiles. Q
INTERESTED IN SHARING YOUR OWN JOURNEY? Please contact your AMA Careers Consultant via email at firstname.lastname@example.org or the hotline 1300 884 196.
DoctorQ SEPTEMBER 2013
AUSTRALIA DECIDES 2013
IN THE COUNTDOWN TO FEDERAL ELECTION 2013, THE MAJOR CONTENDERS ALL SEEM TO BE PLAYING A DIFFERENT GAME WHEN IT COMES TO THE FUTURE OF OUR NATION’S HEALTH. LABOR SAYS THEY’RE PREPARED TO ‘SPLASH SOME CASH’ FOR SPECIFIC CAUSES, THE COALITION WANTS TO ‘TIGHTEN OUR BELTS’ AND THE GREENS ARE KEEN TO TAKE ACTION ON MBS INDEXATION AND ASYLUM SEEKER HEALTH.
This is a critical time for healthcare across Australia as decisions made now will affect all of our communities for the foreseeable future, some holding implications for generations to come. The AMA has outlined its policy priorities in Key Health Issues for Federal Election 2013, and is actively lobbying the candidates to make sure health is at the forefront of their campaigns. Please note these are the campaign policies announced before 21 August, when Doctor Q went to print. The Coalition are expected to make announcements on their health policy on 27 August. This article also does not include all health policies, but those in line with AMA’s Key Health Issues for the Federal Election 2013.
MENTAL HEALTH LABOR: has pledged to invest in prevention and youth mental health, with 50 additional Headspace mental health services being rolled out and a ‘virtual clinic’. Suicide funding is now at $304 million over five years. COALITION: plans to “support better mental health services with Early Psychosis Prevention and Intervention Centres (EPPICs); boosting of basic and applied research into mental health; new Headspace (National Youth Mental Health Foundation) sites; better employment opportunities to those with serious mental health problems and boosting outside services that job agencies can provide to clients with mental health issues. 20 20
SEPTEMBER 2013 DoctorQ JULY 2013 DoctorQ
KEY ISSUE #1
KEY ISSUE #2
AFFORDABLE MEDICAL SERVICES
APPROPRIATE HEALTH CARE FOR ASYLUM SEEKERS
Medicare rebates frozen until mid-2014 to save $664 million Medicare Extended General Safety Net Threshold from $1221 to $2,000 to save $105 million Phase out tax offset for medical expenses to save $964 million AMA SAYS “In 1984-85, Medicare rebates covered 90.3 per cent of medical fees. In 2011-12, Medicare rebates covered 78.5 per cent of medical fees. The decision by the Government to delay MBS indexation by eight months will further increase the gap between patients’ Medicare rebates and medical fees. There will be a compounding effect forever more.” In 2013, patients whose medical gaps exceed $1221.90 will receive extra Medicare benefits to help them with medical gaps for the rest of the year. In 2015, patients won’t get this extra support until their medical gaps total $2,000.” WHAT’S ON OFFER? GREENS: Have promised to reverse the Federal Government’s $664 million decision to delay indexation of MBS rebates until mid-2014 in a move that AMA President Dr Steve Hambleton said showed “health policy leadership”.
AMA SAYS “The next Government must establish a truly independent medical panel to oversee, and report regularly on, the health services that are available to asylum seekers in immigration detention facilities, both onshore and offshore. The AMA wants humanity restored to an otherwise inhumane approach to asylum seekers. The Panel would inspect the available health services, and detainee access to them, and report quarterly to the Parliament, the Prime Minister, and relevant Ministers.” WHAT’S ON OFFER? GREENS: Promise to establish an independent medical panel to monitor the health of asylum seekers held in detention which has long been the call of the AMA, demanding the establishment of an Independent Health Advisory Panel comprising medical and mental health experts. Under this proposal, the Panel would be invested with authority to inspect offshore immigration detention centres and personnel, and report to Parliament twice a year. LABOR AND THE COALITION: Both parties have signaled their intention to pursue the current agenda of redirecting asylum seekers for processing offshore.
In 1984-85, Medicare rebates covered 90.3 per cent of medical fees. In 2011-12, Medicare rebates covered 78.5 per cent of medical fees.
KEY ISSUE #3
KEY ISSUE #4
KEY ISSUE #5
CONTINUING TO IMPROVE INDIGENOUS HEALTH
SCRAP THE CAP
AMA SAYS To attract and retain a medical workforce with the right skill set for rural practice, the next Government must: provide a dedicated quality training pathway with the right skill mix to ensure GPs are adequately trained to work in rural areas, and by developing and implementing a new funding program to support and encourage more ‘generalist’ training; provide financial incentives to ensure competitive remuneration for rural doctors, as outlined at https://ama.com.au/node/4136; extend the MBS video consultation items to GP consultations for remote Indigenous Australians, aged care residents, people with mobility problems, and rural people who live some distance from GPs. This will considerably improve access to medical care for these groups and improve health outcomes; replace the Australian Standard Geographical Classification and the Districts of Workforce Shortage (DWS) system with a more comprehensive model that provides a more accurate picture of workforce conditions for administering relocation payments, and providing incentive and retention payments; and improve Bonded Medical Places Scheme by providing more flexibility for graduates to allow them to complete return of service obligations in any rural area, not just a DWS. WHAT’S ON OFFER? GREENS: Promise to invest over $1 billion in rural health, with significant Federal funding for rural and regional hospitals. Approximately $200 million would go towards rural infrastructure grants to keep more clinics open longer, and $20 million for health services to provide training in rural areas. LABOR: Labor plans to implement a $8 million package to fund 60 intern places in regional and rural hospitals.
PRIVATE HEALTH INSURANCE LABOR: has removed the rebate on Lifetime Health Cover loading and introduced means testing on the 30 per cent rebate on premiums. COALITION: pledges to restore the rebate on Lifetime Health Cover loading.
AMA SAYS “The next Government must commit to a new COAG National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes for another five years from 2013, with at least the same level of funding as allocated in 2008. The focus of this Agreement should be: improved infrastructure capacity for primary health care in the Aboriginal Community Controlled service sector; development of a network of Centres of Excellence in Aboriginal and Torres Strait Islander Health across Australia; and ensuring a healthy early start in life for Aboriginal and Torres Strait Islander children, particularly those susceptible to risk factors and stressors that can determine poor outcomes later in life.” WHAT’S ON OFFER? LABOR: Seem set to continue their ‘Closing the Gap’ agenda by announcing three new targets; improving community safety, access for Indigenous people with a disability and increasing Indigenous participation in higher and further education. They have also committed to additional support for Indigenous people to drive positive change in their communities.
AMA SAYS ‘Scrap the Cap’ has been a major campaign, led by the AMA, in collaboration with many other peak and professional bodies, to overturn this short-sighted and ill-advised policy that sought penalise people for selfimprovement and education. “The next Government must reverse the decision to cap tax deductions for workrelated self-education expenses. This will ensure doctors continue to improve their medical knowledge and skills through their training years and with professional development throughout their careers.” WHAT’S ON OFFER? LABOR: Following a mass outcry from doctors and other professionals, have deferred the implementation of the tax until mid-2015. COALITION AND GREENS: Both supported the position of AMA and more than 60 other professional organisations, business groups and education providers in condemning the proposed tax.
Mo ha st dis s on bee turbin n a tac ssis no gly, t dis tin kle cu here g suc h chron doct ssio COALITION: Have pledged to establish dep as ic d ors n dia ressi hype isea to a Prime Minister’s Indigenous Advisory s v rte b rel etes e n es, Council to ensure that indigenous programs ate , c dis sion a rth d di hol ord , achieve “real, positive change in the Th ritis, sorde ester er, e o lives of Aboriginal people”. The Prime wit AMA oesop rs, ch lr h Minister’s Indigenous Advisory Council will h o chr estim age nic by on al at include indigenous and non-indigenous dis i wo GPs e a c d es rkl oa nd m iseas that c ase a Australians with a broad range of skills d. e a n Wh a s kes is ring d as including experience in the public ich m f thm o u 7 e o r po ve s S sector, business acumen, and ne t oft patie a. con epte r pa nt m thi en a strong understanding of rd cri front ber, rty w do s tic n e of indigenous culture. tho al h d by they ins the e t ir acc se in ealth AMA will he e o effi unta pos issue on t cont lectio i i s Au cient ble f tions . It hese, nue n on or i str he s a im nd to b de of alia alt ns. h sy liver pow port oth e a e in e ste Q m f g a r are nt th r, saf a or t m the e, be fair ade ne a n fit of a d ll
DoctorQ SEPTEMBER DoctorQ JULY 2013 2013
PSYCHOLOGICAL INJURY AND THE WORKPLACE
ARE YOUR STAFF SUFFERING STRESS, ANXIETY OR DEPRESSION AS A RESULT OF THEIR EMPLOYMENT CONDITIONS? IT’S UP TO MANAGERS TO TAKE REASONABLE CARE TO REMOVE THEIR EMPLOYEES OR CONTRACTORS FROM HARM.
Workplace Relations Advisor, AMA Queensland
Psychological injury in the workplace refers to injuries across the ‘mental’ spectrum such as stress, anxiety and depression. Claims for psychological injury need to be a direct result of the employment conditions, so where the employment is a significant contributory factor to the injury. These injuries often fall under both Workplace Health and Safety and Workers’ Compensation legislation. Stated under section 32(5) of Queensland’s Workers’ Compensation and Rehabilitation Act 2003 ‘psychological injuries are not deemed injuries where reasonable management action (RMA) applies’. The legislation does not provide a strict definition of psychological injury which can make mental injuries difficult to define and quantify. Employers face a challenging task of identifying and accounting for the risks and hazards that may result in psychological injury. Common risks can include bullying and harassment, level of workload, lack of recognition and reward, workplace change and role clarity. ‘Reasonable management action’ is defined as ‘actions a reasonable person would do or how a reasonable person would respond or react under similar circumstances’. Management action must ensure a reasonable process is conducted in a fair and equitable manner, addressing particular work related matters, disputes and issue resolution.
Common examples of RMA include, but are not limited to, action to demote, transfer, discipline, redeploy or retrench and decisions not to award, promote, transfer, reclassify, and approve leave of absence or benefit. Employers should beware that where reasonable action is not taken, or RMA exacerbates an existing or pre-existing injury, they may be subject to a breach in compensation and health and safety legislation. In the recent case of Swan v Monash Law Book Co-operative (Legibook) the Supreme Court of Victoria awarded almost $600,000 to an employee who developed severe psychological disorders from an ‘established pattern of workplace bullying’ by her manager. The case is an illustration of a trend where damages are being pursued for bullying claims, alleging ‘serious injuries’ under workers’ compensation laws.
SEPTEMBER 2013 DoctorQ
We are delighted to announce a new addition to our 2013 Events Calendar with the inaugural AMA Queensland Medico-Legal Conference in October. CPD points have been applied for through RACGP and RACMA. The two-day program will look at critical medico-legal issues affecting the delivery of healthcare in Queensland including: An overview of Queensland’s new health complaints management process Case studies presented by the Coroner and key outcomes to improve patient safety and quality in health care A greater awareness of the risks with the rise of e-health
These cases use a breach in health and safety where the employer failed to take reasonable care and reasonable steps to remove an employee from harm.
The latest research on doctors’ legal knowledge on end of life care/ capacity issues
Employers must take a broad perspective on risk, and not rely on an employee’s assertion that they can cope with the behaviour and that the employer should not just ‘sit on it at this stage and take comments on notice’. Q
View the full program on page 36.
Psychological injury is not deemed an injury where Reasonable Management Action (RMA) can be established.
Common risks can include bullying and harassment, level of workload, lack of recognition and reward, workplace change and role clarity. 22
INAUGURAL MEDICO-LEGAL CONFERENCE
An overview of the latest legal case updates in relation to medical negligence.
DoctorQ SEPTEMBER 2013
RIGHT OF PRIVATE PRACTICE REVIEW IN LATE 2012 THE HEALTH MINISTER ANNOUNCED THAT RIGHT OF PRIVATE PRACTICE (ROPP) WOULD BE SUBJECT TO AN INDEPENDENT REVIEW BY THE QUEENSLAND AUDIT OFFICE. THIS REVIEW WAS WARRANTED TO DETERMINE WHETHER PURPORTED ALLEGATIONS OF FRAUD, MISMANAGEMENT AND MALADMINISTRATION COULD BE SUBSTANTIATED.
Workplace Relations Manager, AMA Queensland
Throughout 2013, it was emphasised that the audit is not an investigation of individuals, but a review of the scheme’s probity and propriety, to assess its compliance with relevant legislation, regulations, objectives and contractual undertakings. There are two parts to the auditor-general’s report; firstly a review of the scheme’s administration, and secondly, addressing the billing procedures by individual practitioners. Importantly, Australian Salaried Medical Officers’ Federation Queensland (ASMOFQ) and AMA Queensland does not condone fraudulent activity and supports appropriate action being taken against anyone proven to be committing a criminal offence; however no evidence has been provided to demonstrate any illegal activity. COST NEUTRALITY Far from being cost neutral, the scheme has cost the public health system at least $804 million over the last decade. The actual cost is higher than this because Queensland Health continues to subsidise the facility charges and administration fees that should be charged to those SMOs in retention and revenue sharing models. However, the report fails to account for revenue from: Bed Day fees from insurers; Prosthesis sales; Pharmaceuticals on the PBS and Diagnostics fees other than in Options R and P.
QUEENSLAND HEALTH’S RESPONSE
Option A is the largest contributor to the shortfall, generating cumulative deficits over the nine years to 30 June 2012 of
$725.69 million; from inception Option A has failed to be self-sufficient. The primary reasons for the shortfalls are the cumulative percentage increases in the allowance rates paid to SMOs since its introduction in 1992, and the extension of the scheme in early 2006 to SMOs who were either unable, or had a limited ability, to generate revenue. The report found that the revenue generated by most Option A SMOs have been significantly less than the allowances they are paid. With its inception in 1992, the objective of the scheme was around recruitment and retention which was never going to achieve cost neutrality. Its goals were to attract and retain SMOs; contribute additional revenue for hospitals; use Option A to capture more private patients in a cost neutral manner and to incentivise full time staff specialists. The report goes on to find the system itself is at fault, with the SMOs participating in the scheme having lost sight of (or never had sight of), the objective of cost neutrality, which the report states was one of the two primary justifications for the scheme’s introduction. SYSTEM ANALYSIS The audit office concluded that there is significant confusion and misinformation about this objectives of these arrangements. Furthermore, the belief and attitude of administrators and SMOs alike is that the Option A arrangement, today and in the past, has always been about salary supplementation to achieve the second objective of recruitment and retention.
Since this report was released, Health Minister Lawrence Springborg released a broadcast to clarify the government’s position on the Right of Private Practice review. View the broadcast at www.amaq.com.au AMA Queensland is pleased the Government has clarified their position, and in doing so, acknowledged the concerns put forward on behalf of our salaried members. We will continue to work closely with Queensland Health to ensure any new arrangements are consultative and well-communicated. We encourage any members with concerns about their individual circumstances to contact our Workplace Relations team on (07) 3872 2222.
SEPTEMBER 2013 DoctorQ
The report states that this secondary goal has been achieved—there are more SMOs in the public health system per head of population, and in proportion to other medical staff than before. This is of little use as it is not known number how many SMOs are required in Queensland Health or their recruitment targets. As the report concludes, “it is clear that the concept of cost neutrality is now a foreign consideration to all involved. This is typified by the experience in 2011–12 when almost half of those SMOs on Option A allowances generated no private practice revenue”. However, the current state should not be a reflection of SMOs. While they are bound contractually to participate in private practice arrangements and generate revenue, the system has failed to articulate a clear understanding of their responsibilities as SMOs with a right of private practice. The administration of rostering practices and internal processes also work against the ability of administrators, particularly the Directors of Medical Services (DMS), to monitor and oversight the scheme and its operation effectively. Queensland Health is now considering how to adopt this report while awaiting the second part of the report which is expected in November. As information comes to light, ASMOFQ will keep you informed of developments and seek your comments. Q
THE NEXT EXCITING PHASE IN THE DEVELOPMENT OF SPRINGFIELD CENTRAL
MATER UNVEILS NEW HOSPITAL PLANS MATER HEALTH SERVICES RECENTLY ANNOUNCED ITS PLANS TO BUILD MATER PRIVATE HOSPITAL SPRINGFIELD AT HEALTH CITY SPRINGFIELD CENTRAL.
The 80-bed, $85 million hospital will offer a combination of inpatient, day and chemotherapy beds and will be supported by Australian Government funding of $21.4 million for the cancer care centre. Mater has a master plan for the hospital precinct of Health City which incorporates a number of expansion stages designed to meet the growing demands of the region. Stage one works are due to start in August this year and be complete by the end of 2015 with further stages planned for future roll out. “Mater Private Hospital Springfield will provide a range of medical and surgical services that are relevant to the Springfield community,” said Mater Health Services CEO Dr John O’Donnell.
“The hospital will be a truly innovative, unique and contemporary model including latest use of digital technologies for providing health care needs to the growing region. “The framework of services provided by Mater, its partners and other third parties, will be responsive to the community’s health need and will provide accountable, holistic care that promotes wellness, prevention of illness in addition to exceptional acute and sub-acute care and treatment.” The seven level, 10,000m2 facility will include theatre space, inpatient wards, a day surgery unit and a cancer care centre, initially with a linear accelerator and 15 medical oncology treatment bays, to be further developed in a partnership between Mater and Radiation Oncology Queensland. Mater will work closely with Springfield Land Corporation (SLC) in relation to the Master Planning and governance of Health City, Springfield Central. Chairman of Springfield Land Corporation Maha Sinnathamby said he was excited the company’s five year relationship with Mater Health Services has now resulted in this hospital project and looks forward to continuing the partnership with Mater Health Services.
“Mater Private Hospital Springfield will provide the landmark building for Health City Springfield Central and mark the start of a 52 hectare master health and wellness precinct that will be unique to the country providing all forms of co-ordinated health facilities and services such as research and development, education and training, allied health, retirement and aged care with appropriate hotel and visitors accommodation. “Approximately 8.7 hectares of Health City Springfield Central is earmarked for primary health and acute hospital type development with pre-planning approval obtained for up to 1,200 hospital beds.” Ipswich Mayor Paul Pisasale also welcomed the development. “This is tremendous news. It is the next exciting phase in the development of Springfield Central. “In February a new Mater Health Centre opened at nearby Brookwater with services including specialists, pathology and a pharmacy. “Mater Health has again reaffirmed its commitment to the Ipswich region with the unveiling of plans for a new private hospital in the proposed Health City precinct of Springfield Central. “When completed, current and future residents in the area will have a range of high quality health services on their doorstep,” Cr Pisasale said. Q
y Health Cit Central Springfield rt of sta marks the re master a 52 hecta wellness health and precinct. 26
JULY 2013 DoctorQ
*Text and image reproduced with permission from Mater Health Services
FOR SALE OR LEASE 121 Wickham Terrace (Ballow Chambers) Entire lower ground floor – historic Ballow Chambers • 250m2 approximately • One carpark
• Multi story carpark adjoining • 14 consulting rooms
CONTACT: George Koukides P: 3840 5922 M: 0412 872 786 E: email@example.com
How the MBAQ can help you The Association provides financial assistance to help medical practitioners through crises. If you find yourself in a financial crisis, then make contact with the MBAQ to receive the application forms for assistance.
How you can help the MBAQ You may contribute to the Medical Benevolent Association of Queensland in several ways: • By becoming a member of the Association: Subscriptions - Ordinary Annual membership $30 p/a - Life membership $50 one sum • By making a tax-deductible donation to the Association. • By making a bequest in your Will. • By naming the Association as the beneficiary where there is a surplus following functions such as Year Reunions or LMA Dinners.
Tragedy is unpredictable and may strike at any age in the life of a medical practitioner... More Information Further information can be found on the MBAQ website at www.MBAQ.org.au. All donations are tax deductible.
Donate or subscribe today!
Medical Benevolent Association
of Queensland DoctorQ SEPTEMBER 2013
BACK ON THE HORSE MANY DOCTOR Q READERS MIGHT REMEMBER CHELSEA HIGGINS, A YOUNG HORSE RIDER WHO SUFFERED A DIFFUSED BRAIN INJURY AFTER BEING CRUSHED BY HER HORSE IN 2010. CHELSEA’S REHAB INCLUDED CONSISTENT USE OF ONE OF FOUR SPECIAL iPADS DONATED BY THE AMA QUEENSLAND FOUNDATION, THANKS TO THE DR STAN AND MAUREEN DUKE FOUNDATION. NOW, CHELSEA IS BACK ON THE HORSE AND CLOCKING UP THE AWARDS.
The AMA Queensland Foundation team first met Chelsea when they donated money to the Royal Children’s Hospital for iPads and software for paediatric rehabilitation. After her fall, Chelsea spent nine days in a coma before returning to Brisbane for an intensive six months of rehabilitation at the Royal Children’s Hospital. She was trying to regain her ability to speak and was unable to write as she was totally paralysed on her right side.
iPADS IN PAEDIATRIC REHAB The iPads can be used with a wide range of software to assist in learning, literacy and social skills. The Paediatric Rehabilitation department at the Royal Children’s Hospital use over 300 iPads for rehabilitation in their multi-disciplinary clinics, which are held four times a week and assist hundreds of children. The iPads are used for in-patients and are also taken home or sent to children as part of the outreach program. The touch facility of the iPad is invaluable in enabling access, as many patients do not have the motor skills or physical ability to hold a pencil or use a regular keyboard or mouse. The iPad is also very effective in distracting children when hospital staff are required to do a medical examination or procedure. AMA Queensland Foundation would like to thank the Stan and Maureen Duke Trust for making this and many other generous donations to Royal Children’s Hospital possible. 28
SEPTEMBER 2013 DoctorQ
Chelsea has used the iPad for occupational, speech, and music therapies, and praises the strong role it played in her recovery. She says the long-term benefits are obvious and while she still has some trouble writing, she’s a whizz when it comes to using her smart phone or a computer.
Even though Chelsea’s fall has resulted in permanent damage, she lives an extraordinary life. In 2012 alone, Chelsea received the Queensland Para Equestrian of the Year award, the Queensland Women in Sport ‘Rising Star’ Award, and was the third Qualifier for the 2012 London Olympics, just to name a few. On top of a heavy training schedule, Chelsea is planning to undertake a Diploma of Business in July and is on track to represent Australia at the 2016 Paralympics in Rio de Janeiro. Q
Doctors doing good This is just one example of how AMA Queensland Foundation supports doctors doing good. To see more success stories or to donate please visit our website: www.amaqfoundation.com.au
WILLIAM BUCK SUPPORTS FOUNDATION William Buck have a strong connection to the medical industry. We have been working with medical professionals for many years and are proud to support a charity which is close to our clients’ hearts. The AMA Queensland Foundation are fantastic supporters of rural healthcare and medical research and are true to their charter of ‘doctors doing good’. Previously, William Buck have directly supported the AMA Queensland Foundation in providing a donation to Muscular Dystrophy Queensland. This donation allowed Muscular Dystrophy Queensland to purchase a a new Hi-Lo bed for a two-year-old in Mackay which made a huge difference to her and her family.
Additionally, William Buck have also provided a scholarship to a James Cook University student, Preston Cardelli, who is particularly interested in working in rural and remote medicine in Far Northern Australia and working within Indigenous communities. William Buck look forward to continuing their support of the AMA Queensland Foundation and being involved in their fantastic projects. Q
END OF YEAR TAX APPEAL
The Noye family
AMA QUEENSLAND FOUNDATION DIRECTOR ROSS NOYE EXPLAINS HIS REASONS FOR PLEDGING A BEQUEST TO THE FOUNDATION.
Over the 15 years of working closely with AMA Queensland and serving on the Foundation board I have met many remarkable people dedicated to improving the health and well being of their patients and their community, and made lots of great friends. What is even more remarkable to me is just how inclusive the Association is in its advocacy for members and non-members alike. It really is an organisation with doctors doing good at its very heart.
We discussed this as a family and agreed that words will never be enough, so we decided to make our thank you more tangible by making a bequest to the Foundation on behalf of all those doctors and nurses...
Our familyâ€™s link with the profession became even stronger when our son Nick decided he wanted to do medicine, which was wonderful news. It was just four months later that life threw one of those tricky curved balls that can literally hit you for a six. Nick was diagnosed with a tumour in one of his thoracic vertebrae the day before he was to fly overseas to study for six months as part of his commerce degree at the University of Queensland. It was a tough period for Nick and our family, but made so much easier because of the support and kindness from so many friends and colleagues from the AMA and the hospital. It was nothing short of amazing, and Mandy, Sarah and Paul, Nick and I will be eternally grateful. We discussed this as a family and agreed that words will never be enough, so we decided to make our thank you more tangible by making a bequest to the AMA Queensland Foundation on behalf of all those doctors, nurses and AMA staff who were so kind and supportive to us during that tough time.
2013 End of Year Tax Appeal raised an incredible $36,580. Thank you to all 103 donors who helped to smash the $25,000 target (and double the funds raised in the 2012 appeal). All funds will go towards continuing to support financially disadvantaged medical students at James Cook University who are keen to continue to pursue careers in rural and regional Queensland. Q
For further details... On the AMA Queensland Foundation or to have a discreet chat about possibly leaving a bequest please contact us below:
DOCTORS DOING GOOD
Do you have a project which needs financial assistance? Contact Colleen Harper, Foundation Manager: Phone: (07) 3872 2204 Email: firstname.lastname@example.org Website: www.amaqfoundation.com.au
The good news? Nick had the operation, lost a rib and a vertebra, gained some titanium, finished his commerce degree, is in second year med at Griffith on the Gold Coast, and enjoying it immensely. To all those who provided the skills expertise, support and kindness during that time â€“ thank you. Our bequest is for you. Q DoctorQ SEPTEMBER 2013
AROUND THE REGIONS
LOCAL MEDICAL ASSOCIATION ROUND UP
JOIN YOUR LMA
STAY CONNECTED WITH COLLEAGUES AND UP TO DATE WITH THE LATEST HEALTH NEWS AND ISSUES AFFECTING YOUR LOCAL AREA. DON’T STAND ON THE SIDELINES —JOIN YOUR LOCAL MEDICAL ASSOCIATION TODAY AND MAKE A DIFFERENCE.
SUNSHINE COAST Monthly dinner meetings are generally held on the fourth Thursday of each month. Next meeting: 26 September and 24 October Venue: Maroochydore Surf Club
For information on meeting dates and membership contact Cairns LMA President Dr Sharmila Biswas.
Next meeting: 8 October
Phone: (07) 4036 4333
Convenor: Jo Bourke Phone: (07) 5479 3979 Fax: (07) 5479 3995 Email: email@example.com For further information or to join visit www.sclma.com.au
Convenor: Dr Graham McNally Phone: (07) 3265 3111 For further information or to join, visit www. northsidelocalmedical.wordpress.com
TOWNSVILLE For information on meeting dates and membership contact Townsville LMA President Dr Carl O’Kane. Phone: (07) 4433 1111
REDCLIFFE & DISTRICT Next meeting: 18 September and 29 October Venue: Golden Ox Restaurant, Redcliffe Time: 7pm for 7.30pm
GOLD COAST Next meeting: 19 September and 17 October For information on meeting dates go to www. gcma.org.au or email firstname.lastname@example.org
CENTRAL QUEENSLAND For information on meeting dates and membership contact Central Queensland LMA Secretariat Dr Harley Wilson. Phone: 0419 277 611
A membership form can be downloaded from our site.
Phone: (07) 5575 7054
Fax: (07) 5575 7551 Email: email@example.com
FRASER COAST For information on meeting dates and how to join, contact Fraser Coast LMA President, Dr Shaun Rudd.
For information on meeting dates and how to join, contact Bundaberg LMA President, Dr Daud Yunus.
Convenor: Margaret MacPherson Phone: (07) 3121 4043
TOOWOOMBA & DARLING DOWNS For further information, go to www.tddlma. org.au or email firstname.lastname@example.org Membership to the Toowoomba and Darling Downs LMA is just $50. To join, download an application form at www.tddlma.org. au/membership.html
Phone: (07) 4152 2888 Fax: (07) 4153 3245 Email: email@example.com
Phone: (07) 4128 3644 Fax: (07) 4124 0660
CAN’T FIND YOUR LOCAL AREA?
July 2013 DoctorQ
If your Local Medical Association does not appear above or your details are incorrect, please email firstname.lastname@example.org with corrections, contact details, how to join, web address, dates for upcoming meetings and who to contact for further information.
AROUND THE REGIONS BELOW: AMA Queensland President Dr Christian Rowan, GCMA President Dr Gary Swift and AMA President Dr Steve Hambleton
AMA VISITS GOLD COAST MEMBERS AMA President Dr Steve Hambleton and AMA Queensland President Dr Christian Rowan spoke at the Gold Coast Medical Association (GCMA) in July. GCMA President Dr Gary Swift said local GPs and specialists were given an update on AMA issues in federal and state arenas. “Particular concerns were expressed about issues such as the cap on tax deductibility of self education expenses and the prospect of a potentially flawed and dangerous system managed by a Health Ombudsman. LEFT TO RIGHT: Dr Michael Slancar (HOCA), AMA Federal President Dr Steve Hambleton, HOCA representatives Rhonda Hughes and Teena Pisarev, AMA Queensland President Dr Christian Rowan and GCMA President Dr Gary Swift
“Concerns were expressed about local issues affecting our region pertaining to health boards and administrators. Members were reassured at the level of surveillance and involvement of the AMA at federal and state levels,” said Dr Swift. Q
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19/07/13 1:30 PM DoctorQ SEPTEMBER 2013
MAINTAINING A LOG BOOK AS AN ASPIRING PROCEDURALIST, DR BAVAHUNA MANOHARAN HAS ALWAYS BELIEVED IN KEEPING A LOG BOOK OF CASES (SURGERIES AND MINOR PROCEDURES); A PRACTICE THAT IS COMMONPLACE AMONGST A LOT OF JUNIOR DOCTORS AND MEDICAL STUDENTS. HE RECENTLY HAD A CHAT WITH A MEDICAL LAWYER ABOUT THE ETHICS AND RISKS OF ELECTRONICALLY STORED PATIENT INFORMATION.
DR BAVAHUNA MANOHARAN Councillor, AMA Queensland
Whilst certain vocational trainees might have some form of formal audit/logbook requirement and have college mandated mechanisms for maintaining a logbook, pre-vocational doctors and med students are often left to figure it out for themselves. After some thought and friendly advice from the professionals, we came up with a short list of considerations and recommendations for any junior doctor or student who is thinking about maintaining a log book. THE LOG BOOK As we usually maintain a logbook for self-improvement, assessment and audit reasons (for our benefit) rather than any clinical requirement (for patient benefit), there is a greater onus on us to protect patient confidentiality and privacy and to minimise any potential risk to patients in this process. What information are you recording? Is it absolutely necessary? It is also vital to determine, preferably before starting a logbook, who else will have access to this information, currently and into the future, and the reasons for their access.
Ensuring any electronic document is password protected and stored on a secure, virus free system that is only accessible to authorised individuals would be the bare minimum. As a junior doctor, I would be reticent to record any details like patient address, comorbidities, operation details beyond the name/type of the procedure, or any other details that may potentially expose the patient’s identity. Definite no-nos would be things like patient contact details, clinical photographs or photos/copies of medical imaging. HOW TO STORE IT While electronic records are more convenient and easier to update, they also carry increased risk of potential breaches by way of unauthorised access. Ensuring you have securely stored this information is vital, especially if it is being kept on private computers or stored outside the hospital.
The simplest and probably the safest option in terms of preserving patient privacy log book would be one with a list of procedures with dates and your role. If you are trying to measure the gender-mix and age demographics of your patients; recording gender and age (not date of birth) would be reasonable as it would be difficult to identify patients based on this alone. If you were doing any further investigations and needed to re-identify patients, you could record the patient hospital URN number, but it does mean anyone with relevant access to hospital systems could identify the patient, but this is safer than recording patient names or initials.
DISCLAIMER: This article is aimed at medical students and junior medical staff, rather than vocational trainees who might have specific or mandatory logbook and audit needs as part of their college requirements. Also, this is not legal advice, I am not a lawyer. For further information contact your friendly MDO.
SEPTEMBER 2013 DoctorQ
Ensuring any electronic document is password protected and stored on a secure, virus free system that is only accessible to authorised individuals would be the bare minimum. The test you should apply is if your logbook was ‘stolen’ and the data inappropriately accessed, what harm would be suffered by patients? If patients are potentially identifiable, unauthorised dissemination of the information in your log book could result in a breach of their privacy, and lead to a complaint or claim being made against you. Q
People & EVENTS
DR KARL TO HEADLINE JUNIOR DOCTOR AWARDS
AUSTRALIA’S SUPERSTAR-OF-SCIENCE AND CERTIFIED ‘LIVING TREASURE’, DR KARL KRUSZELNICKI WILL HELP CELEBRATE AMA QUEENSLAND’S INAUGURAL JUNIOR DOCTOR AWARDS ON 25 OCTOBER. BARB FERRES HAD THE CHANCE TO PICK HIS BRAIN.
Q Dr Karl, your amazing career has seen you travel the world and excel in the areas of medicine, science and media. Do you think diversity is an important element to a fulfilling career?
Q What advice would you offer junior doctors just getting started in their medical careers? All the advice given in the book by Samuel Shem, House of God
Diversity is essential. The way that our current careers are practised is continually changing. So we all need a very varied ‘mental toolbox’ to adapt. But, don’t forget that career also means to travel rapidly downhill, out of control …
Ask every patient “What line of work are you in?”, and then listen and ask until you understand their jobs. This will give you more empathy with your patients, and one day, you will make a brilliant diagnosis based on this knowledge.
Q When you first began practicing medicine, what were you most excited to try? And most scared of doing?
Q As junior doctors routinely deal with stressful situations - do you have any tips for keeping a cool head and sense of humour?
1.5 billion people have a neurological complaint of some sort. The predictions are, that with the ‘ageing’ population, half the population will have Alzheimer’s Disease by 2100. We need to understand the Blood-Brain Barrier more (as 95 per cent of our drugs will not pass across it).
Excited? Trying to liberate each of my patients from what was holding them back. Scared? Making decisions without enough information. Q Growing up, did you dream of being a doctor, a television star or an astronaut? Or something entirely different? I haven’t finished growing up. If I had $80.01 million, I would pay the $80 million taxi fare to the Russians to get up to the International Space Station.
Don’t forget that career also means to travel rapidly downhill, out of control...
Just remember, sleep is better than sex – so get as much as you can. This will give you a clearer head. But, as Frank Zappa said, “you can’t have too much sex or vegetables”.
Q What do you think is the biggest health challenge that will confront the next generation of doctors? Lack of respect from a jaded public
Climate change will bring massive health costs Poverty has so many effects it can count as a disease. Q
Q I’m sure you have many, but can you name one seriously weird science fact about the human body? (something unlikely to be found in medical textbooks!) Your body generates more power/volume and more power/mass than the Sun. Sometimes, chemistry can overcome nuclear. Q Scientifically speaking, are people more motivated by passion, duty or curiosity? What drives you? A sense of awe and wonder at the mighty Universe around us. There is so much to know. It was only 15 years ago that we discovered the missing 69 per cent of the Universe (Dark Energy).
AMA Queensland invites you to dress up for a fantastic night celebrating the achievements of our doctors in training and students at the inaugural AMA Queensland Doctors in Training and Student Awards, on Friday 25 October. This exciting event will highlight the contribution of the medical profession’s rising stars and feature an entertaining address from Australia’s ‘superstar of science’ Dr Karl Kruszelnicki.
NOMINATE NOW AT AMAQ.COM.AU
Dr Karl holds degrees in mathematics, biomedical engineering, medicine and surgery and has studied astrophysics, computer science, and philosophy DoctorQ SEPTEMBER 2013
MEDICO LEGAL CONFERENCE
22 - 28 SEPTEMBER
CELEBRATING JUNIOR DOCTORS
Victoria Park, Herston
Get dressed up, have a cocktail and enjoy guest speaker Dr Karl Kruszelnicki while we celebrate the achievements of our junior house officers, residents, registrars and students at the inaugural AMA Queensland Doctors in Training and Student Awards.
AN iPAD MINI
TO VIEW THE FULL EVENTS CALENDAR
Covering the new Queensland Health complaints process and the Health Ombudsman role, this event also includes medico-legal case updates and sessions planned from the Office of the Adult Guardian and Coroner.
AMA QUEENSLAND CONFERENCE
Spanning six days and set in the beautiful city of Santiago, the capital of Chile, the theme for the 2013 annual AMA Queensland Conference is - Health worldwide - challenges and future directions. What role does Australia play in the global arena?
Hunstanton, AMA Queensland
27 NOVEMBER BANCROFT ORATION
Victoria Park, Herston
Antibiotics may be one of the miracles of modern medicine, however, their resistance is an escalating problem. Prof David Paterson from the University of Queensland Centre for Clinical Research will present on Small bugs – big problem: tackling antibiotic resistance.
Or to register for an event, visit amaq.com.au/events or contact Louise Glynn on (07) 3872 2269 (email:email@example.com).
HELP US PLAN GREAT MEMBER EVENTS FOR 2014 With our refreshed events program for 2013 well in progress, including our new Medico-Legal Conference, we want to hear your ideas on professional development and social programs that would best suit your needs in 2014.
A link to the 2014 Events Planning Survey is available on the website and we invite you to submit your ideas on topics and speakers for 2014 and your feedback on the 2013 program.
Members who complete the survey by 13 September will go in the draw to win an iPad Mini!
SEPTEMBER 2013 DoctorQ
People & EVENTS
2013 BANCROFT ORATION SMALL BUGS - BIG PROBLEMS: TACKLING ANTIBIOTIC RESISTANCE 27 NOV, 6.30 – 8.30PM VICTORIA PARK GOLF CLUB
Antibiotics have been regarded one of the miracles of modern medicine. However, antibiotic resistance is an escalating problem of global significance. Indeed, the Chief Health Officer of the United Kingdom recently rated antibiotic resistance as much a threat to modern society as terrorism and climate change. This lecture will examine the origins of antibiotic resistance and provide a pathway forward for today’s clinicians in their treatment of infection. David Paterson is a Professor of Medicine at The University of Queensland Centre for Clinical Research (UQCCR) as well as Consultant Infectious Diseases Physician, Consultant Microbiologist and Medical Advisor for the Centre for Healthcare
Related Infection Surveillance Prevention (CHRISP).
Professor Paterson’s clinical work, research and teaching has been honoured and recognised internationally. He received both his medical degree and PhD from The University of Queensland. In 2007, Professor Paterson returned to Brisbane after spending ten years at The University of Pittsburgh School of Medicine, one of the leading academic medical institutions in The United States. His work at The University of Pittsburgh Medical Centre included appointments as Chief of Transplant Infectious Diseases and Director of the Antibiotic Management Program. In 2000 he was one of two recipients of the prestigious American Society for Microbiology (ASM) Merck Irving Sigal
Memorial Award for significant research in microbiology and infectious diseases. He received the 2008 Frank Fenner Award for Advanced Research in Infectious Diseases by the Australasian Society for Infectious Diseases (ASID) and in 2009 he was the winner of a Queensland Health Senior Clinical Research Fellowship. His research interest includes study of the molecular and clinical epidemiology of infections with antibiotic resistant organisms. The focus of this work is the translation of knowledge into optimal prevention and treatment of these infections. Professor Paterson has received research funding from the Centers for Disease Control and Prevention (CDC) and the National Health and Medical Research Council (NHMRC). Q
Introducing QXRWeb Simple, convenient, secure access to all your radiology needs in one place with single sign-on QXRWeb Images Secure access to images and reports side by side via Inteleviewer or Inteleconnect QXRWeb Reports Secure access to radiology reports via Webster QXRWeb Appointments Real time confirmed appointments without picking up the phone
QXRWeb E-Education Online Continuing Medical Education (CME) materials tracked for verification with your professional body QXRWeb Profile Update your details or change your password
You can access QXRWeb today if you have an existing QXRWeb Images account – simply use your existing username and password at www.qxrweb.com.au. Call Doctor Direct on 1800 77 99 77 to set up an account. DoctorQ SEPTEMBER 2013
medico-legal conference 26 oct
The AMA Queensland Medico-Legal Conference has been designed and developed in conjunction with the AMA Queensland Ethics and Medico-Legal Committee.
The program will equip delegates with: A timely understanding of how the new health complaints management process in Queensland will work. The key findings in health care related cases as presented by the Deputy Coroner, Christine Clements and what can be learned and implemented in practice to improve patient safety and quality in health care. A greater awareness of the risks with the rise of e-health, tablet computing and social media in practice and how they can be better navigated.
Register for this event at
The latest research from QUT’s Faculty of Law on doctors’ legal knowledge on end of life care/capacity issues, where the gaps in this knowledge lie and how they can be addressed.
An overview of the latest legal case updates in relation to medical negligence and key take-aways for the profession. Knowledge on the key risks in general practice and how these can be minimised through correct procedures and protocols along with insurance.
Hunstanton, AMA Queensland 88 L’Estrange Terrace, Kelvin Grove
RACGP Accreditation for an Active Learning Module (Category 1, 40 points) has been applied for. Upon approval by RACGP, GP delegates will be advised of points available and further details including pre-disposing and reinforcing activities.
Registration price (inc GST)
For any enquiries about accreditation in the meantime, please email Holly Bretherton, General Manager, Member Relations firstname.lastname@example.org
Doctor in Training Rate (Years 1 – 5)
Member Early-Bird Rate Available until Friday 20 September
Member Standard Rate
RACMA Accreditation Accreditation through the Royal Australasian College of Medical Administrators has been applied for. Upon approval by RACMA, delegates will be advised of points available. For any enquiries about accreditation in the meantime, please email Holly Bretherton, General Manager, Member Relations email@example.com.
Solicitors and Barristers CPD points PROUDLY SPONSORED BY:
Solicitors can claim one point per hour for attending this conference, as long as the content is relevant to your area of practice and level of expertise (please contact the Queensland Law Society for further information on Solicitors’ CPD). Barristers please note that CPD points have been approved by the Bar Association of Queensland as follows: 1 CPD point per hour of attendance 3 CPD points per hour of presentation or pro rata Strand- non-allocated Accreditation code: AMAQ131026
SEPTEMBER 2013 DoctorQ
program 9.00am - 9.05am
Introduction by the Chair
Katharine Philp Partner, TressCox Lawyers
9.05am - 9.10am
Dr Christian Rowan President, AMA Queensland
9.10am - 9.50am
The Anatomy of the New Health Complaints System in Queensland
12.30pm - 1.30pm LUNCH 1.30pm - 2.10pm
Social Media, e-Records and Patient Privacy in Healthcare: Emergent Risks in the Digital Age
From the introduction of e-health to use of social media by doctors privately and and rise of tablet computing, the increasing use in technology is opening up a raft of new medico-legal risks in medicine, particularly in relation to patient privacy and consent. Join Deb Jackson, Claims and Advisory Counsel at MDA National for a discussion on emerging risky scenarios and how to manage these in practice.
Checks and balances in place to ensure a fair and transparent system
Deb Jackson Claims and Advisory Counsel, MDA
Dr Michael Cleary Deputy Director General, Health
2.10pm - 2.45pm
Medico-Legal Case Digest
Barrister Dr Donna Callaghan of the Queensland Bar will present a concise medico-legal case digest, focussing on cases of note from the last 12 months, including the obesity case from NSW (that has been recently overturned on appeal). Dr Callaghan was a medical practitioner and anaesthetic registrar before working as Claims Manager/State claims manager at what is now Avant, qualifying in law and then working as a solicitor/senior associate for six years. She was called to the Bar in 2009 and about half her practice is in the area of health law.
Dr Donna Callaghan Barrister, Queensland Bar
2.45pm - 3.15pm
3.15pm - 3.45pm
Practical Case Studies - Risk Mitigation in Practice
Medical indemnity expert Chris Mariani of AMA Queensland Insurance Solutions will explore common and emerging medical and business risks in medical practice and how to mitigate and manage these risks through the right insurance program. Stepping through some practical case studies, Chris will outline:
The role and powers of the Health Ombudsman How will the complaints process be managed? Right of appeal available for doctors who have a complaint made against them
Services and Clinical Innovation Division, Department of Health
9.50am - 10.30am
Panel Discussion and Response
Dr Christian Rowan President, AMA Queensland; Dr Michael Cleary Deputy Director General, Health
Services and Clinical Innovation Division, Department of Health; Dr Russell Stitz Chair, Health Quality and Complaints Commission; Prof. Ian Gough General Surgeon, The Wesley Hospital; Deb Jackson Claims & Advisory Counsel, MDA National
10.30am - 11.00am MORNING TEA 11.00am - 11.30am Using Mortality Data and Findings to Improve Safety and Quality in Healthcare
While only a small proportion of deaths investigated proceed to a coronial enquiry, when it appears medical treatment may have been better or different, key learnings from the findings are vital to share with the profession. Using de-identified case studies, this session will explore key findings in coronial enquiries and how they can be implemented in practice.
11.30am - 11.45am Questions You Always Wanted to Ask the Coroner But Were Afraid to Ask!
This will be an interactive Q&A session. You may submit your question/s pre-conference or ask them from the floor.
Christine Clements Deputy State Coroner, Office of
Implementing your own risk management framework in order to better identify your risks in practice. An explanation of the insurances the ‘average’ private practice should hold to protect their assets and liabilities - from medical indemnity, public liability, property, business interruption, management liability and others.
11.45am - 12.15pm Legal Issues Around Capacity for Withholding and Withdrawing Life Sustaining Treatment
Doctors working in emergency medicine, oncology, renal medicine, geriatric medicine and palliative medicine are regularly involved in medical decisions about end of life care for adults who lack capacity. Professors Ben White and Lindy Willmott will present the findings of their three-year research project which considered doctors’ knowledge of the law on withholding and withdrawing treatment. They will discuss the differences in knowledge they identified and how these gaps can be addressed in practice.
12.15pm - 12.30pm Interactive session to allow participants to pose their questions and difficulties faced in this domain.
Professor Ben White Director, Health Law Research
Centre, Faculty of Law, Queensland University of Technology
Professor Lindy Willmott Director, Health Law Research Centre, Faculty of Law, Queensland University of Technology
Medical indemnity for you and your practice entity, legislation and government support schemes and how they protect and support you – an exploration of relevant case studies.
Chris Mariani Advisor, AMA Queensland Insurance Solutions
3.45pm – 3.55pm
Conference Wrap up and Closing Remarks
Our Chair, Katharine Philp, will sum up our key learnings from the day.
Katharine Philp Partner, TressCox Lawyers
3.55pm – 4.00pm
to download a registration form visit the events calendar at amaq.com.au
DoctorQ SEPTEMBER 2013
CONGRATULATIONS to the following doctors who are now elected members of AMA Queensland.
JUNE DOCTORS IN TRAINING
Dr Qaasim Dollie Dr Mostafa Seleem Dr Helen Mar Fan Dr Khadija Khatry Dr Bilesha Jayawardena Dr Karyn Charles Dr Margot Cooper Dr Rajiv Sharma Dr Shanan Buitendag Dr Jonathan Ong D Sushil Kumar Dr James Maxwell Dr Jessica Eltherington Dr Nathalie Worth Dr Travis Auty Dr Timothy Chan Dr Joseph De Luca Dr Mary-Anne Xia Dr Alborz Jahangiri Dr Stefan Antoniou Dr Elizabeth Anderson Mr Luke Conway Dr Altaf Latif
Dr Shashank Desai Dr Jason Scott Dr Louisa Crowther Dr John Reilly Dr Christopher Jelliffe Dr Madhumati Chatterji Dr Hendrik Viljoen Dr Elizabeth Mills Dr Cristina Pop Dr Kellee Slater Dr Harish Kumar Dr James Askew Dr Shamsul Islam
GENERAL PRACTITIONERS Dr Simone Page Dr Farshid Soheilifar Dr Jawaid Yaqub Dr Neil Jensen Dr Len Redoblado Dr Nam Tran Dr Casey Wadwell Dr Pee Chan Dr Harpreet Sawhney Dr Xiaowen Luo Dr Qing Hui Lin Dr Yasser Zeidan Dr Scott Horsburgh Dr Ian Wong Dr Carol Portmann
PRIVATE SPECIALISTS Dr David YH Chung Dr Jay Iyer Dr Sam Scherman Dr Victor Chen Dr David Taylor Dr Emile Touma Dr Kiam-Khiang Lim Dr Michael Hatzifotis Dr Van Nguyen Dr Arman Sabet Dr Daniel Carroll Dr David Paterson
PART-TIME PRACTITIONERS Dr Nikola Ognyenovits Dr Bruce Burrow Dr Narelle Fagermo Dr Judith Martin
MATERNITY LEAVE Dr Clarice Lantai
JULY DOCTORS IN TRAINING Dr Malcom Forbes Dr Gemma Robertson Dr Kimberly Ulett Dr Ivana Fernando Dr Makula Kiyingi Dr Sofia Padhy Dr Ravinder Gornall Dr Ijenikhoumwen Wellington Dr Ryan Wellington
GENERAL PRACTITIONERS Dr Jan Alton Dr Russell J Hunter
PART-TIME PRACTITIONERS Dr Marissa Daniels Dr Joshephine Laurie Dr Nirmala Sugnanam Dr Ashwani Garg Dr Carolyn Radford Dr Sodabeh Abazari Dr Caroline Hughes Dr Michelle Davis
SALARIED PRACTITIONERS Dr Christine Gentner Dr Donald R Cameron Dr Keat L Choong Dr Uyen Tran Dr Christien Schwindack Dr Fawaz Mufti Dr Mark Edwards Dr Tjeerd Tijhof Dr John Doneley Dr Manoj Bhatt Dr Parag Nalavade Dr Ewan Wright
SEPTEMBER 2013 DoctorQ
CALLING ALL OUR CENTRAL QUEENSLAND MEMBERS WE’RE VISITING IN OCTOBER! AMA Queensland President Dr Christian Rowan and Manager of Workplace Relations Andrew Turner, will be visiting Gladstone, Rockhampton and Emerald from 21 –24 October. They will be hosting member dinners and hospital lunches and visiting practices in locations throughout Central Queensland. Would you like to meet with them? Contact us to arrange a time.
DISCOUNT ON YOUR FEE!
Stay tuned via email for further details coming to members in these areas or visit the events calendar on the website (www.amaq.com.au) for more information on the upcoming tour. Q
A FRIEND Did you know that if you refer a colleague to join AMA Queensland, you will receive a 25 per cent discount off your 2014 membership? With further change in the wings for health in Queensland, we’re working hard to support our members on the issues that count, ensuring the new health complaints reform process is fair and equitable and that the proposed $2,000 cap on professional development is scrapped for good. Our robust Health Vision outlines AMA Queensland’s five year plan for Health in Queensland, so there is no better time to join our strong and vital member organisation.
UPDATE YOUR DETAILS Just a reminder to update us should you change employment or locality, so we can ensure your member communications will reach you, and we can tailor services and information most relevant to you. Please let us know if you have changed your: General practice information – including contact address, phone number, fax, email and mobile Discipline – e.g. General Practice; Salaried Medical Officer Employment status – Private; Public; VMO Practising status – Student; Full-time; Part-time; Retired Q
Forward any referrals by contacting us and your 25 per cent discount will be automatically applied to your 2014 membership subscription. Q
DIRECTORY OF MEMBERS
The production of the AMA Queensland 2014 Directory of Members will commence shortly and a verification form will be sent to you via email, confirming your address details for the Directory. We also invite practices to advertise in the Directory and competitive member advertising rates are on offer. Contact AMA Queensland membership team: Phone: (07) 3872 2222 Email: firstname.lastname@example.org
CELEBRATING THE BRIGHT FUTURE OF MEDICINE WITH DR KARL KRUSZELNICKI Date:
Friday 25 October, 6.30pm
Venue: Ballroom,Victoria Park, Herston Price:
$45 $60 $70 $85
Student Members Doctor in Training members Members Non-members
Dress code: Cocktail or evening attire
AMA Queensland Council of Doctors in Training invites you to dress up for a fantastic night celebrating the achievements of our doctors in training and on Friday 25 October. This exciting new event will highlight the contribution of the medical profession’s rising stars and feature an entertaining address from Australia’s ‘superstar of science’ Dr Karl Kruszelnicki. Don’t miss this fabulous networking and socialising opportunity - junior doctors, student members and senior doctors are all invited to dress up for a fabulous night of celebration, canapés and cocktails set against the glittering Brisbane skyline.
KNOW AN OUTSTANDING JUNIOR DOCTOR OR INTERN? NOMINATIONS ARE NOW OPEN UNTIL FRIDAY 30 SEPTEMBER
To download a nomination and/or registration form, visit the AMA Queensland website: www. amaq.com.au For any enquiries, please contact Holly Bretherton, General Manager of Membership on (07) 3872 2248 or email h.bretherton@ amaq.com.au
We invite you to nominate junior doctors or students with one or more of the following: Junior doctors and students who demonstrate excellent clinical and academic skills respectively Have undertaken volunteer or community work Provide support to their professional colleagues Consistently demonstrate the AMA Queensland values of compassion, trust and knowledge in their professional lives and in the community.
DoctorQ SEPTEMBER 2013
AFFECTIONATELY REFERRED TO AS DR T BY COUNTLESS QUEENSLAND WOMEN GRATEFUL FOR HIS HELP AT THE MOST DIFFICULT TIME IN THEIR LIVES, BRISBANE PSYCHIATRIST DR ENNO TAEMETS ESTABLISHED THE BRISBANE CENTRE FOR POST NATAL DISORDERS (BCPND) IN 1991.
Dr Enno Taemets
After a presentation to a postnatal support group in Brisbane in 1991, Dr Taemets became acutely aware of the lack of facilities and specialised services for sufferers of postnatal disorders in Queensland. Quite simply, there was nowhere a woman could receive treatment and continue caring for her baby. “Following this meeting, I approached the Belmont Private Hospital CEO and following discussions with the Director of Nursing, a few beds were set aside at the end of a corridor with the express purpose of developing a perinatal unit. The unit was able to attract some very dedicated and keen staff and all in all, staff turnover in the unit is very low,” said Dr Taemets. “It is very demanding and intensive work, to not only look after new mums who are going through a very difficult time, but also to assist those new mums in managing their newborn babies.”
Many mothers need help in coming to understand the pathway of a transition from a person with a career, to now being a mother. 40
SEPTEMBER SEPTEMBER 2013 2013 DoctorQ
COGNITIVE THERAPY AND PARENTING “We were very lucky to engage Mary Williams who was working in the cognitive therapy unit at the Belmont Private Hospital. We asked Mary to devise a program specifically designed for mothers, based on cognitive therapy principles. She developed a program that has evolved over the last 22 years from cognitive therapy, through to schema focused therapy and as such it is very highly structured. It is highly regarded, particularly by those who have gone through the program,” he said. During the last 22 years, the team has added a Triple P and Circle of Security program to the course and the unit now is a standalone facility with ten inpatient beds, a comprehensive day program, a telephone support link for past patients and a call-in centre for new mothers wishing to seek help. The unit is operational seven days a week, 24 hours a day. “I think it attests to the dedication of the staff who work in the unit that more than two decades on, the unit is not only still operating, but has grown to a very high
standard, delivering an excellent service. I recall going to perinatal conferences both nationally and internationally in the 1990s and seeing their programs and what we were offering in the unit was well and truly at the forefront of what was being offered elsewhere. “Unfortunately the opportunity for research has not been very high and so the work that was done in the early years has gone unpublished. Nonetheless, the unit and its staff are very proud to have the knowledge that our early work showed great foresight and is still very sound today. WORKING WITH MUMS AND BUBS “Working with post natal mothers is very rewarding, but I find most new mothers who do want to get well not only for themselves, but also for their babies and families so they are a very motivated group. “There is an increasing awareness of the importance of a new mother’s relationship with her husband/partner, her own parents and parents in law, with her other children and particularly the new baby. “There is now increasing emphasis in incorporating infant attachment theories in addition to the biological treatments mentioned. Other psychological interventions include relationship therapy, trauma therapy for those mums who have had early childhood trauma, or trauma in labour and reassurance. In addition, many mothers need help in coming to understand the pathway of a transition from a person with a career, to now being a mother. Treatment can be multifaceted and very rewarding when you see the mother becoming more confident and self assured. “One of the reasons that working with new mothers drew my attention was a very tragic case that occurred whilst I was training to be a psychiatrist. A young, vivacious mother was treated for postnatal depression in the hospital system and she seemed very well upon discharge. Sadly within a few weeks she suicided. It left a lasting memory with me because of the woman’s age, the fact that she was a new mother. She had left her
It is imperative to be mindful that the new mother is making the appropriate adjustments and is not struggling and spiraling down with her mood and anxiety... husband, baby and another child behind. As we have come to learn, some post natal disorders are very mercurial, I’m particularly referring to the psychoses, and without treatment, things can turn quite disastrous very quickly.” RECOGNISING POST NATAL DISORDERS Postnatal disorders are more common than you might expect, with as many as 25 per cent of women suffering some form of depressive or anxiety disorder in the post natal period not all need biological treatments. “It is imperative to be mindful that the new mother is making the appropriate adjustments and is not struggling and spiraling down with her mood and anxiety,” said Dr Taemets. “For any new mother, there are a couple of hallmarks to enquire about, such as previous psychiatric history, or a family history of a psychiatric disorder. “These should heighten the awareness to the possibility of a perinatal disorder. Furthermore, it is important to ask about matters relating to their sleep, appetite and how they are managing in their relationship with their partner and also any other children if they are present.
themselves as being a mother, to be mindful of how they are managing feeding the baby, settling the baby and of course of the robustness of her support network. “Try to gain an understanding of the depth of any negative mood swings the mother may be experiencing and be aware of any negative perceptions she may be having about herself as these may be indicative of a depressive mood state,” he said. Postnatal blues generally occur between days three to ten, so if there is a persistence of agitation, anxiety, depressive mood state or tearfulness beyond day ten, it is important to monitor the mother carefully. Also if the post natal blues period is very severe it may indicate the situation is more complex than first thought. AMA MEMBERSHIP “I am a member of AMA Queensland as it provides doctors with a body that can be approached about matters relating to their practice or support of the profession. It also offers other advantages and helps identification with being a medical practitioner,” he said. Q
“It is important to ask about tearfulness, feelings of guilt; that is how they consider
DoctorQ SEPTEMBER SEPTEMBER 2013 2013
LOOK NO FURTHER FOR BUSINESS SUPPORT AMA QUEENSLAND BUSINESS SUPPORT SERVICES (BSS) HAS BEEN OPERATING SINCE 1996 AND CAN ASSIST WITH SERVICES SUCH AS ADMINISTRATIVE SUPPORT, EVENT MANAGEMENT, BOOKKEEPING SERVICES AND MARKETING/PROMOTION OF YOUR ORGANISATION. BSS’ FINANCE OFFICER MATT WHITE ANSWERS SOME FAQS ABOUT BUSINESS SUPPORT. Matt White Finance Officer (07) 3872 2218 email@example.com Matt White is a Finance Officer with AMA Queensland Business Support Services, who can provide professional and confidential financial services for your organisation.
I am the President of a committee and am having difficulty finding the extra time or resources to organise and prepare for meetings, communicate effectively with our members and simply require general administrative support. Can you assist?
All I need is assistance with bookkeeping. Is this possible?
We can increase your resources without employing extra staff and you only pay for the services you require. This frees up your time to focus on what you do best and gives you the confidence knowing that your organisation’s needs are being met. We are professional, friendly and flexible!
We offer bookkeeping services to many different organisations in the health industry, from GP and Specialist practices to community and medical associations. We are experts in the delivery of payroll services (including superannuation, PAYG and payroll tax), creditors, debtors, bank reconciliations, provision of monthly financial reports and completion and lodgement of business activity statements. We communicate with your tax accountants to ensure services are performed efficiently, this reduces double handling and saves you money.
I need to organise small meetings and sometimes large event or conferences throughout the year. Can you help me?
I am on a small committee and only have a few meetings a year, can you assist?
Yes, we offer meeting rooms catering for smaller meetings/functions/workshops including catering, technical support on-site and can assist you with all aspects of your event or meeting preparation. For larger meetings we can liaise with your professional conference organiser to ensure a seamless event.
Absolutely, we can tailor our services to meet your committee’s needs. Contact us to discuss your needs.
I am involved in a membership organisation and frequently need graphic design assistance and would like to increase our web and social media presence for our members, what can you suggest?
I am involved in a larger association that requires variable levels of support throughout the year and at this stage we are unwilling to employ a new staff member. What would you recommend?
From our experience, members require frequent and effective communication from their member organisation. We can coordinate graphic design services and provide website assistance including social media and newsletters.
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SEPTEMBER 2013 DoctorQ
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Since May 2010 when we began with AMA Queensland Business Support we have been overwhelming pleased with the prompt, accurate and reliable service provided to us. The professional service provided has eased the workload of individual Committee members and improved our funding and event management – all at a more competitive price than we had previously been paying. Dr Nicole Fairweather, ASA Queensland Chair
STRATEGIES FOR SUCCESS Jason Borody
MEDICAL PRACTICES DEPEND HEAVILY UPON REFERRALS FROM COLLEAGUES AND WORD OF MOUTH. WHILE THESE ARE VALUABLE, VIVIDUS MARKETING DIRECTOR JASON BORODY EXPLAINS THAT WITHOUT A SOLID MARKETING STRATEGY, REFERRALS ARE NOT ENOUGH TO KEEP A PRACTICE PROFITABLE IN TODAY’S COMPETITIVE ENVIRONMENT.
Director (07) 3282 2233 firstname.lastname@example.org Vividus specialises in healthcare marketing for hospitals, medical centres, GP and specialist practices, and healthcare businesses.
The Vividus team work to increase community awareness of your business and help you build patient lists via local-area marketing, professional websites, online marketing, satisfaction surveys and referral-based marketing. To develop a marketing plan that will attract patients, improve patient experience and build reputation, visit www.vividus.com.au or call (07) 3282 2233.
SEPTEMBER 2013 DoctorQ
THE REALITY OF THE ONLINE COMMUNITY Studies show that 80 per cent of Australians use the internet to research health care. Internet users range from teenagers to the over 65s. In fact, internet usage among the more profitable 55-64 year old age category is over 60 per cent. What does that mean? It means that medical practitioners who are not prepared to meet their patients online, must be prepared to lose their patients. Your online marketing plan has quickly become a critical component of your broader marketing strategy. BENEFITS OF A SOLID HEALTH MARKETING STRATEGY By utilising their online presence correctly, health care professionals are able to: Increase practice awareness Open lines of communication between existing and potential patients/referrers Establish themselves as an authority in their location and field of specialty
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ted appear disjoin g planning can tation. Havin pu re damaged t en pm lo ve and lead to de for content an pl e ar er op e a pr Thes les funnels’. nt creates ‘sa swering patie an r fo ds ho et to your preemptive m em th g in d direct questions an e. tic prac of success. One measure your e to lin on et rg an Fo s of citing benefit ery part ev the most ex at th is ting plan health marke your strategy e. Whether bl ra s, su ea is m website page s, og l media, bl l ia er at m includes socia ur yo articles –all ed until fin PR, or online re er th ei red and can be monito ed with new sful, or replac es cc su e ar they ity. effective activ
To do list audience and research Define your target questions. By
and their needs, perceptions, to them instead te wri can you , this doing about their age, nk Thi of simply for them. nicate with each concerns, how they commu gate online. gre con y other, and where the ls. This might require Set achievable goa and consultation some market research competition and the for rks wo into what also survey uld what doesn’t. You sho s regarding tion cep per rrer refe patient and issues. are lthc hea your practice and local platforms and tools to Integrate a mix of Only by providing market your practice. platform will you ied var a r information ove rse audience. If be able to reach a truly dive es like yours, ctic pra for rch your targets sea ine optimisation then invest in search eng medical forums ask y the If . (SEO) marketing est in a community or social media sites, inv stions and post que wer ans professional to e’s behalf. comments on your practic
Patients (and consumers generally) operate very differently than they did a few years ago. Rapid increases in the use of search engines like Google mean that health providers need to be savvier in the way they legitimise themselves through online directories, wikis, blogs, forums, and comments on Facebook or Twitter. Building your online presence in a systematic fashion that both informs and guides, will build reputation and ultimately get people talking positively about your practice. Engaging with your target audience and providing useful information whenever requested builds trust in your practice and awareness of your capabilities. Ultimately, readers will come to know and trust you before they walk in your door. Successful medical practices need to effectively utilise online marketing through professional planning, implementing, measuring, and tweaking. The internet is always changing and your practice needs to keep pace. Q
INTERNATIONAL INVESTMENT: A MORE CONFIDENT US IS GOOD FOR INVESTORS WITH THE US SLOWLY BUT SURELY MOVING OUT OF THE GLOBAL FINANCIAL CRISIS, THEIR GROWING CONFIDENCE IS GOOD NEWS FOR LOCAL INVESTORS. MACQUARIE’S ROSS NOYE EXPLAINS.
Ross Noye Macquarie Private Wealth
The US equity market has performed very well in 2013 and is up 12.6 per cent in the six months to 30 June, adding to its outperformance over most other major markets in the past few years – and for good reason. The economy appears to be nearing the point it can stand on its own two feet following years of stubbornly slow growth after the 2008/09 financial crisis. While not robust, the footing does appear strong enough to have the US Federal Reserve entertaining the removal of very loose monetary policy. The labour market has improved, bringing unemployment down to 7.6 per cent, thanks to monthly non-farm payroll gains averaging 202,000 this year. The housing market continues to improve and, most importantly for the equity markets, this is translating into the highest level of confidence since before the 2008 bear market. Much of the good news in the US is in the home. For the second straight month, home prices in all 20 major markets increased, a feat not accomplished since prior to the housing crisis that started in 2006. This is translating into more employment in the form of construction jobs, an improving sense of wealth for home owners and, of course, more construction activity. All of these factors are good for the economy. This has helped propel the National Association of Home Builders sentiment index to its highest level since 2005. With that comes improving activity, which bodes well for the continued recovery in this important industry.
The one key ingredient that has been missing for much of the past few years is confidence. The lack of confidence has magnified the impact of external shocks such as the European crisis, fiscal cliff, geopolitical unrest and the markets’ reaction to soft economic data.
(07) 3233 5805 0438 779 955 email@example.com Ross Noye is a stockbroker and financial advisor at Macquarie who specialises in investment and retirement planning.
When confidence is lacking, markets can be downright cruel to investors when any bad news surfaces. It also affects the market multiple or risk premium. One could argue the strong performance of defensive sectors over the past year is evidence of people wanting to invest in US equities but still taking a cautious toe-dipping approach. The good news is confidence is returning. US consumer confidence has risen to a level not seen since January 2008. The US equity market remains our preferred global equity market given valuations, the recovery in housing and rising energy production. The removal of quantitative easing (QE) may cause added volatility but we believe improving fundamentals will begin to outweigh the negative impact of change in monetary policy. With the US economy a major driver of global growth and the US consumer the main driver of US economic growth a more confident US consumer and stronger US economy is good for all investors. Investors should be selective about their exposure to the US economy and seek advice on investment choice and implementation. Q
12 % $US85 BILLION .6
US EQUITY MARKET HAS PERFORMED VERY WELL IN FOR THE 6 MONTHS TO JUNE 30 2013
PER MONTH BEING SPENT ON MORTGAGE & TREASURY BONDS
183,000 JOBS PER MONTH FOR THE PAST TWO YEARS (AVERAGE)
The good news is confidence is returning. US consumer confidence has risen to a level not seen since January 2008.
DISCLAIMER: This information has been prepared by Macquarie Equities Limited ABN 41 002 574 923 (“MEL”) participant of Australian Securities Exchange Group, Australian financial services licence No. 237504, No 1, Shelley St, Sydney NSW 2000, and does not take into account your objectives, financial situation or needs. Before acting on this information, you should consider whether it is appropriate to your situation. We recommend that you obtain financial, legal and taxation advice before making any financial investment decision. Members of the Macquarie Group or their associates, officers or employees (“Macquarie”) may have interests in the financial products referred to in this advice by acting in various roles including as investment banker, underwriter or dealer, holder of principal positions, broker, lender or adviser. MEL is not an authorised deposit-taking institution for the purposes of the Banking Act 1959 (Cth), and MEL’s obligations do not represent deposits or other liabilities of Macquarie Bank Limited ABN 46 008 583 542. Macquarie Bank Limited does not guarantee or otherwise provide assurance in respect of the obligations of MEL.
DoctorQ SEPTEMBER 2013
WHAT HAPPENS WHEN... Chris Mariani AMA Queensland Insurance Solutions 1300 883 059 firstname.lastname@example.org Chris Mariani is a medical indemnity specialist at AMA Queensland Insurance Solutions.
THE TEAM AT AMA QUEENSLAND INSURANCE SOLUTIONS ARE EAGER TO ANSWER YOUR INSURANCE QUESTIONS. LAST MONTH THEY LOOKED AT A SCENARIO WHERE AN EMPLOYED NURSE FAILED TO STERILISE MEDICAL EQUIPMENT USED BY A DOCTOR RENTING ROOMS FROM THE PRACTICE. THIS MONTH THEY LOOK AT ANOTHER COMMON ISSUE – THAT OF RISK AND INSURANCE ISSUES TO BE AWARE OF IN INDEPENDENT SERVICE CONTRACTS.
SUMMARY OF SCENARIO We regularly review contracts for AMA Queensland Insurance Solutions clients. XYZ Practice Pty Ltd is a medical centre. The doctors are engaged as independent contractors with formal written contracts in place. The contracts contain the following clauses:
1. The doctor to hold medical indemnity and public liability insurances
2. A ‘contractual indemnity’ clause requiring the doctor to indemnify the practice for any liability incurred by the practice ‘howsoever caused’. The above are common in many contracts and the two key issues we regularly see are:
WHAT IS THE DIFFERENCE BETWEEN PUBLIC LIABILITY AND MEDICAL INDEMNITY? Many clients ask us this - essentially, medical indemnity covers the doctor’s (or practices) ‘professional activities’ – meaning a claim alleging medical negligence (i.e. a failure to diagnose, negligent surgery, etc). Public liability by contrast covers ‘non-professional’ claims, such as a visitor slipping in the waiting room, or tripping over the contracted doctor’s medical bag.
1. While contracted doctors understand they
The only thing worse than paying insurance premiums - is to pay the premiums and then find you’re not covered in the event of a claim.
need medical indemnity (as it is compulsory under medical registration), many fail to realise they will also need public liability insurance.
2. Almost all insurance policies contain a ‘contractual indemnity’ exclusion. This effectively means your policy will not cover a claim where you become liable solely due to the existence of the contract. An example of a typical contractual liability exclusion “The insurer is not liable… for any liability the insured assumed by contract, waiver, guarantee or warranty, unless liability would have attached in the absence of such contract…” So how to fix the above issues? PUBLIC LIABILITY
DISCLAIMER: AMA Queensland Insurance Solutions is a trading name of KSLR Pty Ltd, a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, AFSL 240549. Corporate Authorised Representative No: 366807. The information provided in this article is of a general nature and does not take into account your objectives, financial situation or needs. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.
SEPTEMBER 2013 DoctorQ
The doctors could individually purchase a $10 million public liability policy for around $450 each. In our client’s case, the doctors were all long-term contractors working solely in the practice. We negotiated with the practice’s insurer to extend the practice public liability to include the seven contracted doctors – at a total cost of less than $500, much more cost effective than each doctor buying their own policy.
CONTRACTUAL INDEMNITY In discussions with the practice their intent was ‘the doctor should pay for their mistakes and we should pay for ours’. This is what we recommend on the basis that both parties are insured so in the event of a claim where both are joined, each lodges a claim with their insurer and the insurers fight over ‘apportionment of liability’. But the existence of the contract as currently drafted, changes the practice’s intent. Using a claim example where the contracted doctor and the practice nurse are equally negligent causing both to be sued by a patient. Under the ‘common law’ position the practice (as employer of the nurse) is 50 per cent responsible and the contracted doctor 50 per cent responsible. However the contract changes the common law position and the doctor is now required to pay 100 per cent of the claim. The doctor lodges his claim with his insurer, and the insurer applies the exclusion, meaning the doctor is only covered for half of their liability. Q
Insurance renewal time getting you down? Letâ€™s face it insurance is boring. But necessary. We know doctors have a busy schedule, and while it may be easy to renew your insurance each year without proper revision, changes may have occurred for which you may not be fully covered and premiums need competitive comparison. For peace of mind and taking the yawn out of renewal time, contact AMA Queensland Insurance Solutions.
All insurance needs covered for all members through AMA Queensland Insurance Solutions.
AMA Qu eenslan d Insuran ce Solution Your Ins s urance Speciali sts
For more information phone: 1300 883 059
RESTRUCTURING TO REDUCE TAX – FACT OR FICTION? IF IT SOUNDS TOO GOOD TO BE TRUE, IT USUALLY IS. IN A TAX SETTING, ‘TOO GOOD TO BE TRUE’ COULD LAND YOU IN HOT WATER. JULIE SMITH BUSTS SOME MYTHS.
Julie Smith William Buck (07) 3229 5100
One of the most common questions we are asked is “How can I structure my affairs to reduce tax”? When considering a restructure in order to reduce your tax it is important that you carefully consider how the restructure will be viewed by the Australian Tax Office.
I can set up a company and pay tax at 30 per cent on all of my income
This is not permitted in accordance with ATO rulings, which state that all of the profit of a medical practitioner’s company must be paid to the doctor by way of wages or super
I can set up a trust and split the profits with my spouse
The ATO would consider this to be tax avoidance and would attract the anti-avoidance penalty provisions of the Income Tax Assessment Act
I can pay myself a reduced salary and give the rest to my family
This is also considered to be income splitting, as the practitioner is not paying themselves on commercial terms
Julie Smith is Tax Services Director at William Buck Chartered Accountants and Advisors.
William Buck have experience in restructuring for medical practitioners and ensuring the structure is tailored to suit their needs .
A simple method to assess whether your arrangement may be at risk is to consider the level of your personal remuneration, the income you record in your personal tax return. Ask yourself, “If I was working for someone else, would I be working for them for this level of remuneration?” If the answer is no, then you could be at risk. Over the years, a number of tax rulings have been issued by the ATO, providing guidance in relation to the legislation and various case judgments on the issue of income splitting. When considering the application of tax laws to a particular circumstance, we believe consideration should be given to all available ATO rulings, court decisions and other interpretative advice rather than relying on one particular ruling. These tax rulings can be summarised into the following important points: Where a practice can afford it, equity principals (owners that derive income from the practice) should be remunerated with a market rate salary regardless of the business structure in place. Where a practitioner is paid a salary which is significantly lower than market rate and the overall result of the tax payable for the group is significantly less than would otherwise be payable if the structure did not exist, then the implementation of that structure may be viewed as being undertaken for the purposes of avoiding tax.
SEPTEMBER 2013 DoctorQ
We also note the following factors that the ATO will consider when determining whether a business is undertaking income splitting activities: Are the salaries paid to the equity principals commensurate with skills exercised or services provided to the practice? What is the reason for implementing the structure in the first place? Are the business profits being paid to lower taxed family members or related entities, and not the equity principals that provided the services? Are the profits of the business entities or related interposed entities being accumulated for distribution to individuals other than those who generated the income? Has there been a change in activities performed by the individual prior to incorporation/ restructure? The application of overly aggressive structures can lead to substantial penalties and interest for underpaid tax. In addition, the costs of defending a particular position, such legal fees, may be substantial. William Buck have experience in restructuring for medical practitioners and ensuring that the structure is tailored to suit their specific needs and is compliant with ATO rules. If you have concerns in relation to the effectiveness of your practice’s structure with regard to the above issues, you should speak to your accountant or contact our office. Q
We have practice buyers
If you are looking to sell your medical practice â€“ we currently have a number of buyers actively looking to purchase. Whether you are a general practice or a specialist practice looking to create a group practice arrangement, we have doctors interested in becoming involved
DoctorQ SEPTEMBER 2013
CHARTERED ACCOUNTANTS & ADVISORS
EMAILER’S REGRET FEW THINGS IN LIFE ARE AS CERTAIN AS DEATH AND TAXES, BUT ONE THING DOES COME CLOSE - IF YOU SEND AN EMAIL IN ANGER, CHANCES ARE YOU ARE GOING TO REGRET IT. RACHEL DREW AND EDMUND BURKE FROM TRESSCOX LAWYERS SHOW US ONE SUCH CASE TO PONDER BEFORE YOU HIT THE SEND BUTTON.
Rachel Drew Partner (07) 3004 3527 Rachel_Drew@tresscox.com.au Rachel Drew specialises in providing advice to employers and human resources professionals in relation to employee management and entitlements at TressCox Lawyers.
Anaesthetist Dr Mark Colson may agree after an angry email he ‘penned’ contributed to a long and uncomfortable legal battle that could have been avoided. Dr Colson was sacked from his 14 year position at Geelong Hospital for misconduct. The saga began when an incidence of alleged double billing was queried and he was invited to a meeting to discuss the issue. He responded with an email that was distributed to his peers in the hospital. The five-page diatribe dated 23 March went to 42 specialists in his department. Some choice quotes include “the tolerance of dissent and a range of views, or even personality types, is the hallmark of a good democracy”. He wrote that dissent was not welcome in his department and democracy was clearly not his director’s “preferred political system”. He signed off with a particularly cutting critic of the culinary practices of his place of employment, while implying that the decision to fire him had already been made: “If this is the case, I am sure ‘normal practice’ in such situations would include a last meal. Could I please request grated carrot and mayonnaise sandwiches, preferably prepared about four hours prior to the meeting. Nobody does these quite like Barwon Health.” He was sacked.
He wrote that dissent was not welcome in his department and democracy was clearly not his director’s “preferred political system”.
SEPTEMBER 2013 DoctorQ
At the Fair Work Commission hearing, Commissioner Roe rejected Barwon Health’s argument about the allegations of double billing, but found that his email could have been a valid reason for him to lose his job. However, Commission Roe felt that the decision to terminate the employment was unjustly harsh. As to remedy, the Commissioner was satisfied that there was a sufficient level of cooperation for a proper working relationship to resume and he ordered that Dr Colson be reappointed to the position in which he was employed immediately before the dismissal. Barwon Hospital, presumably with the critique of their carrot and mayonnaise sandwiches still smarting, sought leave to appeal the decision and the Full Bench decided that it was in the public interest to grant Barwon Health’s application for permission to appeal.
The main issue on appeal was whether or not Dr Colson had been ‘unfairly dismissed.’ This issue required a finding to be made as to whether or not the dismissal was harsh, unjust or unreasonable. The central issue in dispute was whether there was a ‘valid reason’ for Dr Colson’s dismissal, within the meaning of s.387(a) of the Fair Work Act 2009. The Commissioner found that parts of the email contained unwarranted personal attacks on managers and that the distribution of these comments throughout the Department constituted misconduct and provided a valid reason for termination. “The writing and dissemination of the letter of 23 March 2012 constitutes misconduct and provides a valid reason for the termination of Dr Colson’s employment. But given the context, in particular our finding that Dr Colson did not engage in fraud or submit the 4 March claims dishonestly, combined with the fact that the letter was written in the heat of the moment we are not persuaded that Dr Colson’s conduct should be characterised as serious and wilful misconduct justifying termination without notice. It does however constitute a valid reason for dismissal.” On this occasion the Full Bench remitted the issue of remedy to Deputy President Gostencnik for determination and that decision has not yet been published but the principle is clear. Even if an employee is dismissed for a valid reason, the Commission can still decide that the decision to terminate without notice is unjustly harsh. In this instance, the long years of service, the value of the work being performed and the damage to the doctor’s reputation were all relevant. So Dr Colson may not lose his job, but one thing is for sure, he probably wishes he hadn’t sent that email. Q
We are well connected to the health industry, so we offer a deep understanding of the issues
twitt e r.c om/ Tre s s C o x
www.tresscox.com.au Phone: 07 3004 3500 • • • • • • • • •
Asset Protection Trusts Property transfers to related parties Conveyancing Leasing Employment arrangements Acquisition of medical practices Property syndicates Succession planning, wills and estates Structuring of medical practices
This case study has been published with the permission of MDA National
DIVULGING PATIENT DETAILS:
A DIFFICULT CALL FOR DOCTORS DOES A DOCTOR IN PRIVATE PRACTICE HAVE AN ABSOLUTE DUTY TO ENSURE THE CONFIDENTIALITY OF A PATIENT’S HEALTH RECORD? MDA NATIONAL MEDICO-LEGAL ADVISER, DR JULIAN WALTER EXAMINES THIS PERENNIAL MEDICO-LEGAL ISSUE.
A GP received a letter from a local council requesting the release of confidential patient information.
A doctor in private practice does not have an absolute duty to ensure the confidentiality of a patient’s health record. Disclosure is governed by the Privacy Act 1988 (Cth). Several broad categories exist where disclosure may be permitted:
The council had discovered illegally dumped waste, which included a discarded medication packet. The medication packaging had a prescription label with a patient’s name, the prescribing doctor’s name, as well as the date and the name of the pharmacy that had dispensed the medication. The council then wrote to the GP (who was the prescribing doctor) requesting the full name, address and date of birth of the patient. The request was made under an obscure piece of environmental legislation (the Protection of the Environment Operations Act 1997 (PEOA)) which carried a penalty in the form of an infringement notice if the GP did not comply. The GP contacted MDA National’s 24/7 Medico-legal Advisory Service to seek advice on whether they should release the information.
Express or implied consent by the patient Mandatory disclosure under compulsion of law An overriding duty in the public interest to disclose where there is a risk of harm or safety to the patient or others. This case concerned a duty to disclose under compulsion of law. Typically this will involve issues such as court orders (including subpoenas, summons and search warrants), mandatory reporting (e.g. child abuse and notifiable diseases) and administrative disclosure (births and deaths). However in this case, the law was somewhat more arcane. After examining the PEOA legislation and the National Privacy Principles (which will become the Australian Privacy Principles from March 2014 following substantial
Several broad categories exist where disclosure may be permitted...
DISCLAIMER: This article is provided by MDA National. They recommend that you contact your indemnity provider if you have specific questions about your indemnity cover.
SEPTEMBER 2013 DoctorQ
changes to the Privacy Act) – to ensure that the request represented a valid interpretation of the law and that no specific exceptions applied – we advised the GP that the release of the requested information was appropriate. A letter was provided for the GP to submit to the council outlining why the information was being released and the relevant concerns the release of information raised. We also advised the GP to inform the patient that their name, address and date of birth had been released to the council after legal advice had been obtained in relation to the council’s request. On this occasion, although the information requested by the council was still protected under privacy legislation, it was not particularly sensitive. However each case would be assessed on its merits – weighing up the sensitivity ofthe requested health information against the relevanceand penalties of the legislation underlying the request. Q
TRAVEL VALUE WITH AN INVESTEC CREDIT CARD WITH ONE QANTAS POINT FOR EVERY $1 OF ELIGIBLE SPEND ON YOUR INVESTEC SIGNATURE CREDIT CARD, A BIG PURCHASE FOR YOUR PRACTICE COULD MEAN SIZEABLE QANTAS POINTS TOWARDS FLIGHTS OR YOUR NEXT SHOPPING TRIP. One of the golden rules of any business is to ensure it is operating as efficiently as possible to maximise the return from every dollar spent. How attractive, then, is the option to make big-ticket business equipment and asset purchases like motor vehicles on your credit card and earn Qantas points in the process? That’s exactly what’s on offer with Investec Visa credit cards. We had one client who recently purchased equipment for $2.5 million on their Investec Signature credit card, and that meant they earned a sizeable number of Qantas points as we offer one Qantas point for every $1 of eligible spend with no cap on how many points you can earn. What we then do is simply convert that card transaction into a finance contract with Investec which pays off the purchase from the credit card. Additionally, we allow the client to make their monthly repayments for that contract on their Investec credit card so they can earn even more points, generally at least twice as many Qantas points as the purchase alone would earn. This is a service not available through most other financial organisations, but we make it easy for our clients as we facilitate the whole process for them. Clients can then redeem their points on the Qantas website. This can be a significant benefit for clients in terms of taking care of their travel needs for the future, all by doing something as simple as using your Investec credit card. It could also be of huge
benefit if the client is travelling to, say, a medical conference or a well earned holiday, and they have enough points to upgrade their flight. But the value of adding to the balance of Qantas points is not all about flights. For those who are not interested in flying there are also retail store vouchers and merchandise that can be redeemed using the points on the Qantas Store. We have clients who use them to buy end of year gifts for patients and staff.
Jeff Miller Investec 1300 131 141 www.investec.com.au/medical Investec offer a range of financial products and services specifically tailored to the medical sector.
Clients can choose between Investec Platinum or Investec Signature credit cards. The Investec Signature card offers one Qantas point for every $1 of eligible spend in Australia, and two Qantas points for every $1 of eligible international spend. The Platinum card offers one Qantas point for every $2 spent on eligible transactions in Australia and one Qantas point for every $1 spent on eligible international purchases. In addition to Qantas points, every return ticket purchased on an Investec card is automatically covered by up to 90 days of travel insurance, protecting the safety of not only the cardholder, but also their spouse and dependent children. Other benefits for the primary signature cardholders include a Priority Pass membership, which opens doors for the client and a guest to over 600 VIP lounges in 300 cities, as well as access to Visa Concierge and the Visa Luxury Hotel Collection for services at a selection of superior hotels. Investec is a specialist financial service provider for medical and dental clients and has a bonus partner reward program for a range of suppliers within the medical and dental industries. So even if you use the Investec Visa card to buy business consumables, through this deal with the specific partners, you can further enhance your Qantas points balance as well. If people can earn rewards that enable upgrades or free tickets or merchandise, and they can do all that by just using their credit card, then it is a pretty easy way to travel for free. We are striving to deliver value to our clients, with minimum fuss. Our clients see a real value in these points as it opens up so many possibilities for them in the manner in which they are conducting their business and personal banking and they only need to carry one card – the Investec card. Q
We offer one Qantas point for every $1 of eligible spend on the Investec Signature credit card spent with no cap.
DISCLAIMER: Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL and, Australian Credit Licence 234975 (Investec Bank). All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges may apply. We reserve the right to cease offering these products at any time without notice. The information contained in this article (“Information”) is general in nature and has been provided in good faith, without taking into account your personal circumstances. While all reasonable care has been taken to ensure that the information is accurate and opinions fair and reasonable, no warranties in this regard are provided. We recommend that you obtain independent financial and tax advice before making any decisions.
DoctorQ SEPTEMBER 2013
THE GRANGE VERDICT
THE AMA GRANGE CHALLENGE SET OUR MEMBERS TO TASK: CAN YOU PICK THE GRANGE IN A BLIND TASTE TEST? PHIL MANSER FROM WINES DIRECT HOSTED THE CHALLENGE WHERE SIX RED WINES WERE PUT FORWARD.
The night began with two Grand Cru Blanc be Blancs Champagnes from Le Mesnil, a relative youngster in the context of Champagne established in 1937. Both the NV and 2005 vintage were very well received and showcased the richness and intensity of flavour this village is famous for, no wonder really when you consider that a good deal of their fruit is bound for Krug and Salon with a little held back for their own label. A fitting prelude to the ensuing full frontal assault of young Australian shiraz… Unlike most tastings of this ilk the wines were served blind, six wines in six decanters numbered 1 through to 6, each wine double decanted two hours before the event, one of which was Grange but which one? That was the question I put to our guests who eagerly embraced the concept and armed with their tasting glasses sipped, swirled and tasted their way through the lineup. All that was required of them was to rank these
VOTED E RIT FAVOU
wines from 1 (favourite) to 6 (least preferred). A fair fight by anyone’s standards as all the dressing was removed and only the wine could speak. It’s fair to say that this is a tough class and while these statistics might be far from exhaustive in terms of its findings, the point of the exercise was to get people to assess wine on its merits and that was certainly the case here. The Kalleske was a standout on the night but each wine had attracted their own following as was evidenced by the empty bottles, Velvet Glove in particular was guarded jealously to the last drop. In closing the night was a huge success, at least half the room got to cross Grange off their bucket list and some outstanding
PARACOMBE SOMMERVILLE ADELAIDE HILLS SHIRAZ
Which one was the Grange?
VOTED E RIT FAVOU
KALLESKE JOHAN GEORG BAROSSA SHIRAZ
Phil Manser Wine Direct 1800 649 463 email@example.com
VOTED E RIT FAVOU
flagship reds were enjoyed by all. There is no doubt the mention of Grange is what oversubscribed this event and rightly so, Grange has set an impressive benchmark for decades but what is highlighted very loudly by this exercise is that there is some outstanding value at this level if you’re prepared to ignore the hype. Q
TIM ADAMS ABERFELDY SHIRAZ
TURKEY FLAT THE TWIST BAROSSA SHIRAZ
Which one do you think is the Grange?
6 votes 54
SEPTEMBER 2013 DoctorQ
MOLLYDOOKER VELVET GLOVE SHIRAZ
170 3 votes
BIG TICKET TRAVEL
EVER DREAMED OF JET-SETTING OFF TO THE FARTHEST CORNERS OF THE EARTH TO FIND BEAUTY, ROMANCE AND ADVENTURE, OR MEETING BABY ELEPHANTS IN KENYA? GETTING AN IN-DEPTH LOOK AT YVES SAINT-LAURENT’S PRIVATE ARCHIVES WITH A PARISIAN FASHION HISTORIAN? WALKING IN THE FOOTSTEPS OF EMPERORS THROUGH NORMALLY OFF-LIMITS SECTIONS OF BEIJING’S FORBIDDEN CITY? ROS BULAT FROM AMA TRAVEL TELLS US HOW.
These are some of the world’s most soughtafter travel experiences—those that take you behind the scenes, allowing privileged access to people, places, and events that are verboten to most. But you won’t read about any of these exploits in the guidebook. At AMA Travel we are here to make it possible through the right connections; travel specialists with the inside contacts to transform your fantasies into reality. Now let’s get you inspired. GORILLAS IN THE MIST For those of you who are adventurous or who have a true interest in research, you could be truly inspired by travel to Rwanda in Africa where you could visit the regional headquarters of the Mountain Gorilla Veterinary Project , a conservation program that studies and monitors the health of the endangered mountain gorilla. After a tour of the research facilities and a Q&A session with the staff, go into the mountains for two days of gorilla tracking.
BECOME A HUSKY HELPER! Spend a day at a husky breeding and training farm in Saariselkä, 150 miles above the Arctic Circle...
AN ELEPHANT ENCOUNTER Take a tour of Daphne Sheldrick’s Elephant Orphanage in Nairobi. Sheldrick was the first person to hand-rear orphaned newborn elephants successfully and release them back into the wild. Most visitors watch the elephants from behind ropes; you’ll be able to approach them and talk to their keepers, who sleep side by side with the animals. DINE AROUND TOWN IN ARGENTINA Have a private, progressive dinner across Buenos Aires: each of your four courses will be served in a different restaurant, opened early just for you. At every stop, you’ll have a chance to talk to the head chef about his or her inspiration and philosophy of cooking. Venues will be tuned to your taste but might include such noteworthy establishments as Casa Cruz, Thymus, and Oviedo, as well as several private, closed-door eating societies. Your sommelier guide, a well-known food critic in the city, will choose wines to match each restaurant’s signature dish. The night will end at her home with dessert and a lateharvest wine.
BECOME A HUSKY HELPER FOR THE DAY For those who have some prior large dog experience – you could spend a day at a husky breeding and training farm in Saariselkä, 150 miles above the Arctic Circle. You’ll get to follow the caretakers as they feed and groom the farm’s 250 dogs, and drive a team of six huskies. ART ON THE RIVIERA You could take a VIP tour of the art scene in St-Paul-de-Vence, a famous artists’ colony outside Nice. You’ll start at the private home of the owner of Angle Gallery, one of the most respected sources of modern and contemporary art in town. Here you’ll see pieces by Warhol, Cézanne, Miró, and David Lachapelle. After lunch at La Colombe d’Or, the restaurant’s owner will show you his own art collection and explain how his grandfather and father acquired the pieces from Picasso, Matisse, Utrillo, and other artists. No matter where your interest lies, AMA Travel is able to assist with making that next trip a trip of a lifetime.
For mo re inform AMA T ation c a ravel Q ueensla ll or email Ro s at nd.
PHONE : 1800 262 885 FAX: (0 7) 5556 7200 EMAIL : travel@ amaq.c om.au WEB: www.a maq.w orldtra vel.com .au
DoctorQ SEPTEMBER 2013
ADAPTIVE VARIABLE SUSPENSION. VARIABLE GEAR RATIO STEERING. 8-SPEED SPORT PROGRAMMED DIRECT SHIFT. WE COULD GO ON, BUT LET’S JUST SAY…
It’s not every day that a vehicle makes you feel this way. The all-new Lexus IS 350, IS 300h and IS 250 sedans, available as F Sport models, are designed to quicken your pulse and turn heads. With aggressive body design and razor sharp handling, F Sport models are instantly recognisable and will take your breath away. Experience it for yourself at Lexus of Brisbane. For more information please contact Peter Thomas, Lexus of Brisbane Group Concierge on (07) 3327 1777. IS 350 F Sport model shown.
LEXUS OF BRISBANE Cnr Moggill Rd & Rennies Rd, Indooroopilly www.lexusofbrisbane.com.au
LEXUS OF BRISBANE Cnr Ann & James St, Fortitude Valley www.lexusofbrisbane.com.au
LEXUS OF MAROOCHYDORE 63 Maroochy Boulevard, Maroochydore www.lexusofmaroochydore.com.au
LEXUS OF SOUTHPORT 161 Ferry Road, Southport www.lexusofsouthport.com.au /LexusofBrisbaneGroup
DR LARRY GAHAN WAS LUCKY ENOUGH TO BE INVITED TO THE NEW LEXUS IS LAUNCH AT PHILLIP ISLAND, WITH A CHANCE TO DRIVE THE IS250, IS350 AND THE NEW HYBRID ADDITION, THE IS300H.
The Lexus IS series was named Best Prestige Car in its launch year in 1999, and in 2006 and 2007. While the progress since then has been substantial, there is now a quantum leap to the latest model, just released. The IS 250 has a 153kW 2.5 litre V6, the IS 350 a 233kW V6, and the IS300h has a 2.5 litre 4 cylinder petrol engine which combined with an electric motor gives a derived 164kW/300. NEW FEATURES Lexus states that for the $12,000 of extra gear in the now IS250 model, the price has only increased by $100. Enhanced equipment levels from IS250 up are substantial, which will give the European marquees a shake up. We are all aware of the vast (and expensive) options lists to make some European models ‘usable’ in the modern era. Basic equipment in the new IS Line now includes rear view camera with rear guide assist, front and rear parking sensors, widescreen 7” colour multimedia screen with DVD, Memory CardSatellite Navigation and voice command. The new Enform system has enhanced connectivity with destination information, fuel finder, weather reports, traffic updates, and more applications will be added in the future. Push button start, Bi-xenon High Intensity Discharge headlights (LED optional on IS300h), LED daytime running lights, and LED tail lights (which pulse if you brake heavily at speeds above 55kph). Selected models include a Pre-collision Safety System which pre arms Brake Assist. The system automatically engages precollision braking if the driver doesn’t respond and a collision is unavoidable. In the case of pedestrian impact, the clever Pedestrian Safety bonnet unhinges near the windscreen to cushion the blow. Also available is LDW (Lane Departure Warning), and AHB (Automatic High Beam) which senses oncoming traffic and dips the headlights.
Lexus have addressed the issue of restricted rear seat legroom in the previous IS series by increasing the wheelbase by 70mm and sculpting the rear seats. The effect is that most of the increased dimension is translated into rear legroom, while also enhancing headroom and cargo space. The new body has a ‘more racy style’ with upswept lines and wider stance while reducing the aerodynamic drag coefficient to Cd of 0.27 -0.28.
AMA QUEENSLAND MEMBERS AMA Queensland members have been upgraded to Tier 1 in the new Lexus Corporate Program due to the support of the Lexus brand from AMA Queensland. Tier 1 is usually reserved for the BRW Top 50 companies in Australia. This includes factory corporate rebates across the range, reduced dealer delivery fees, three years complimentary servicing, invitations to events and the Lexus Encore programme. Warranty is 4 years/100,000km and battery on the hybrid is 8 years/160,000km. *These are manufacturer’s list prices and exclude on road costs which vary depending on the engine.
PICK OF THE BUNCH The new Lexus IS300h with its hybrid petrol electric technology allowing claimed fuel consumption of 4.9L/100km and 113g/km of CO2 emission is expected to account for 50 per cent of IS sales within five years. The hybrid now only weights 75kg more than the petrol variant, and with that weight kept low over rear axle, it enhances driver appeal with lower centre of gravity and contributing to near 50/50 balance front to rear. VERDICT The new IS Line will make a significant impact on the luxury car market in Australia with its significant level of standard equipment and enhanced driver appeal. Lexus are determined to present a bolder, more aggressive, sportier aspect to their vehicle line up and what better way than to release the new IS Line at Phillip Island Raceway where we could drive them in various conditions and tests, and experience hot laps with professional race drivers like Tony D’Alberto and Neal Bates. Q
Enhanced equipment levels from IS250 up are substantial, which will give the European marquees a shake up.
DoctorQ SEPTEMBER 2013
LUXURY IS STYLE STYLE IS PERFORMANCE PERFORMANCE IS INNOVATION INNOVATION
One thing leads to another in the impressive all-new Lexus IS 300h. It not only delivers uncompromising luxury with outstanding high-end performance, it delivers it through the Lexus Hybrid Drive. A combined power output of 164kW is the result of an advanced Atkinson Cycle petrol engine working with a high output 650-volt electric motor, to create an acceleration response second to none. Also available as the IS 300h F Sport with Adaptive Variable Suspension and Sports Suspension. Experience it for yourself at lexusofbrisbane.com.au. For more information please contact Peter Thomas, Lexus of Brisbane Group Concierge on (07) 3327 1777 IS 300h F Sport model shown.
LEXUS OF BRISBANE Cnr Moggill Rd & Rennies Rd, Indooroopilly www.lexusofbrisbane.com.au
LEXUS OF BRISBANE Cnr Ann & James St, Fortitude Valley www.lexusofbrisbane.com.au
LEXUS OF MAROOCHYDORE 63 Maroochy Boulevard, Maroochydore www.lexusofmaroochydore.com.au
LEXUS OF SOUTHPORT 161 Ferry Road, Southport www.lexusofsouthport.com.au /LexusofBrisbaneGroup
all about you
LOOKING FOR A NEW BOOK TO READ? Join us in reading a variety of books for the chance to win a copy of next edition’s book club book. Send your feedback to firstname.lastname@example.org. Q
APP SNAP Smilebox Turn your phone photos into little creations with Smilebox. You can quickly and easily add animation, create collages, apply filters, and enhance photos with captions, frames, stickers, and more. Then, you can share them via Instagram, Facebook, Twitter, email or text. Friends can then like and comment. Q
A DEADLY AFFECTION HISTORICAL
CUYLER OVERHOLT Set in New York City in the 1900s, A Deadly Affection features medicine, women’s rights, mystery and humour. After a past family tragedy for which she holds herself to blame, Dr Genevieve Summerford wants nothing more than to succeed in her new career as a psychiatrist, and win back the respect of her family and peers. That goal is thrown into jeopardy, however, when one of her patients is arrested for murder—a murder Genevieve fears she may have unwittingly provoked.
“What fits your busy schedule better, exercise 30 minutes a day or being dead 24 hours a day?”
HIS STUPID BOYHOOD: A MEMOIR PETER GOLDSWORTHY Few Australian writers have delved as deeply as Peter Goldsworthy into the mysterious state of being that is childhood. In this memoir Australian writer Peter Goldsworthy applies his fascination with that state to his own boyhood, from his bizarre first memories to the embarrassments of adolescence. For all his working life Goldsworthy has been both doctor and writer and here he reveals a mind charmed equally by science and literature, by the rational and the imagined.
HELLO SUNDAY MORNING! Sick of spending your Sundays with a giant hangover instead of getting out and enjoying life? The Hello Sunday Morning (HSM) program encourages Aussies to change our drinking culture by taking a break from alcohol and discovering a life without it. Here’s how it works: Desire to change your drinking pattern Sign up to commit to a period without alcohol Incentivise your HSM with goals to achieve during this period. President Dr Christian Rowan has signed up for three months of abstinence
Use your HSM blog to write, read and reflect on your journey. Be empowered to make better choices about drinking. Why not join us at www.hellosundaymorning.org?
DoctorQ SEPTEMBER 2013
UNDERCOVER PARKING AT DENDY!
GREAT ART ON SCREEN
Vermeer and Music: The Art of Love and Leisure 19 - 20 October, 1pm The National Gallery, London, is offering a major exhibition on one of the most startling and fascinating artists of all-time Johannes Vermeer, painter of The Girl with a Pearl Earring. Vermeer painted little more than 30 works that still exist, and the National Gallery has chosen to focus on his art in relation to music. Music was one of the most popular themes of Dutch painting and revealed an enormous amount about the sitter and the society.
COMING FILMS 5 September
Blue Jasmine I’m So Excited
Thanks for Sharing Gravity
Railway Man Captain Phillips
MET OPERA ENCORE Turandot
22 September, 1pm and 26 September, 10am Director Franco Zeffirelli’s breathtaking production of Puccini’s last opera is a favourite of the Met repertoire. Turandot follows the story of a princess whose hatred of men is so strong that she has all suitors who can’t solve her riddles beheaded. That is until she meets a mysterious unknown prince.
SCHOOL HOLIDAY FAMILY FLICKS Tickets are just $8 for any kids when accompanied by a full paying adult.
ORE FOR M ISIT V INFO OM.AU .C DENDY
CLASSIC FILMS 23 September
The Godfather I
The Godfather II
* Classic Films tickets are $6.50 for Club Seniors, $7.50 for Club Adults and $9 for all other tickets.
CORPORATE EVENTS & GROUP BOOKINGS We love hosting corporate film nights and group bookings at Dendy. Hosting a corporate screening event is a great way to thank clients or staff – or perhaps you have a favourite charity that you would like to raise some money for? We have a functions pack and cinema package to suit all requirements. Contact Events & Publicity Manager Jenny Sonter on email@example.com for a free quote.
WIN MOVIE TICKETS FOR TWO Name:
Postal address: Portside Wharf, Remora Road, Hamilton Ph: (07) 3137 6000 www.dendy.com.au 60
SEPTEMBER 2013 DoctorQ
FAX BACK TO (07) 3856 4727 or email firstname.lastname@example.org by 30 September
WHEN TIME STOPS 6 – 14 September, Playhouse, QPAC From award-winning Australian choreographer Natalie Weir comes When Time Stops - an ethereal voyage of life-changing moments. Bringing together 20 artists, When Time Stops is Expressions Dance Company’s most ambitious work to date, with design by Bill Haycock, lighting by David Walters, and original composition by multi award-winning Australian composer Iain Grandage performed live by Queensland chamber orchestra, the Camerata of St John’s.
E MOR FOR ATION RM INFO COM.AU . C QPA 36 246 R O 1
DR SEUSS’S CAT IN THE HAT
CHITTY CHITTY BANG BANG
OPERA QUEENSLAND’S OTELLO
1 - 5 October, Playhouse, QPAC
24 October - 2 November, Lyric Theatre, QPAC
From 19 November, Lyric Theatre, QPAC
With mischievous humour and madcap style, The Cat in the Hat introduces his new friends to a crazy afternoon. Based on the all-time favourite book by Dr Seuss, The Cat in the Hat is now a magically witty play produced by the National Theatre of Great Britain (producer of the theatrical masterpiece War Horse) with an all Australian cast.
Celebrating the Verdi Bicentenary, Johannes Fritzsch, Chief Conductor of Queensland Symphony Orchestra and Graz Opera, will make his long-awaited Opera Queensland theatre debut in a bold new production of Otello created by Australia’s foremost director of Shakespeare, Simon Phillips. From its first explosive moments, describing the terror of a storm at sea, to the three gentle kisses bestowed upon Desdemona’s cold lips by her dying husband, Verdi’s magnificent score is one of the great pinnacles of the opera repertoire.
Sensational sets, stunning special effects, Ian Fleming’s irresistible story, and an unforgettable score by the Sherman Brothers (Mary Poppins) all add up to a blockbuster musical that everyone will love. Boasting a stellar Australian cast of over 70 headed by David Hobson and “A Rachael Beck. Chitty MARVEL OF Chitty Bang Bang holds STAGE MAGIC” the Guinness World THE Record for the most AUSTRALIAN expensive stage prop!
Joined by the twin mischief-makers, Thing 1 and Thing 2, The Cat in the Hat promises to be a purr-fect day out for both children and parents alike!
WIN DOUBLE PASSES TO WHEN TIME STOPS
FAX BACK TO (07) 3856 4727 or email email@example.com by 5 September DoctorQ SEPTEMBER 2013
CLINICAL CASES IN OBSTETRICS, GYNAECOLOGY AND WOMEN’S HEALTH SECOND EDITION This handy, lab coat pocket-sized new edition of Clinical Cases in Obstetrics, Gynaecology and Women’s Health, 2e broadly covers the whole syllabus for the medical student, and the whole range of obstetric and gynaecological problems likely to come into the path of the busy junior hospital doctor or general practitioner.
Doctor Q has a copy of Clinical Cases in Obstetrics, Gynaecology and Women’s Health, 2e to give away. Simply fill out your details in block letters on the form and fax it to (07) 3856 4727 or email firstname.lastname@example.org.
CHECK FOR YOUR NAME!
SEPTEMBER 2013 DoctorQ
Entries close 3o Sept 2013
Clinical Cases in Obstetrics, Gynaecology and Women’s Health, 2e uses problem-based learning to introduce students to typical clinical situations and then encourage them to think about how they would take appropriate histories, examine, investigate and finally treat their patients. Being an
Australian author team, tips are included for those junior doctors faced with obstetric or gynaecological problems in a smaller metropolitan or rural setting. Published by McGraw-Hill Education, Clinical Cases in Obstetrics, Gynaecology and Women’s Health, 2e retails for $55. Q McGraw-Hill Education is offering Doctor Q readers 15% OFF Clinical Cases in Obstetrics, Gynaecology and Women’s Health, 2e Promo Code: DECOSTA13 www.mcgraw-hill.com.au/medical
WIN THIS BOOK! Name: Postal Address: Telephone: Member No:
DOUBLE PASS WINNERS
Dr Noel Saines and Dr Alison McColl won double passes to shake + stir theatre company’s Tequila Mockingbird.
Dr Alison McColl won a copy of Health Promotion Strategies and Methods, from McGraw-Hill Education.
1. Dr Marjorie Busby 2. Dr Alison McColl 3. Dr Cecilie Lander 4. Dr Chris Ho 5. Dr Brian Wilson-Boyd 6. Dr Noel Saines 7. Dr Kevin Lee See 8. Dr Sui Mien Yeoh 9. Dr Nigel Dore 10. Dr Alex Markwell
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• Not a bulk-billing practice • Surgical upskilling provided • Complete administration support
GP REQUIRED FOR SKIN CANCER UNIT 360UV Skin Cancer Clinic is looking for a dedicated general practicioner qualified, or willing to undertake further training, in skin cancer diagnostics and treatment.
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PROFESSOR ROGER ALLEN Professor Roger Allen is a highly regarded and widely published Respiratory and Sleep Physician who has been practicing sleep medicine for 30 years.
active member of the Australasian Sleep Association and the Thoracic Society of Australia and New Zealand, his caring and understanding will instil confidence in your patients.
Professor Roger Allen is renowned for his meticulous work in regard to medicolegal reporting in asbestos and other occupational diseases. He is a leading Australian expert in the management and diagnosis of sarcoidosis.
Professor Roger Allens rooms are conveniently located at the Wesley Medical Centre, Auchenflower, Brisbane. He has his own modern lung function laboratory onsite and also a resident CPAP specialist. His friendly staff will ensure that your patient receives the highest quality care while attending.
His clinical interests include sleep apnoea, narcolepsy, periodic leg movement disorder, parasomnias and insomnia. As an To make an appointment, please call 07 3719 5577.
Business Support Services
Referrals may be faxed or emailed to email@example.com
AMA Queensland Business Support Services has been providing quality professional service to associations, members, colleges, foundations and trusts since 1996. Our team can provide a wide range of services: ADMINISTRATION – including database management, all meeting preparation and post meeting support and report preparation.
Professional, highly experienced,
with excellent written and verbal skills and attention to detail. Ms Sue Tremlett CEO, PCPA (Private Cancer Physicians of Australia)
Contact us for a quote and to discuss how we can help you
(07) 3872 2218
BOOKKEEPING – Accounts receivable and payable, payroll (including superannuation and payroll tax), Business Activity Statements, monthly financial reporting and budgeting. EVENT MANAGEMENT – scheduling appointments and meetings, venue preparation, workshops, conferences, catering and travel. MARKETING – promotional materials, website updates, newsletters and publications. Why should you use AMA Queensland Business Support Services? Increase your resources without employing extra staff Improve your productivity, efficiency and client services We are professional, friendly and flexible!
Fax: (07) 3856 4727
Email: firstname.lastname@example.org PO Box 123, Red Hill Qld 4059 88 L’Estrange Terrace, Kelvin Grove, Queensland 4059
DoctorQ SEPTEMBER 2013
You’re not exactly patient We hear you
When you speak to your bank, don’t you find it frustrating to have to deal with people who have no idea who you are or what you’re talking about? You don’t have to put up with it – at Investec, we understand that your time is too precious to waste. Investec is a leading Australian specialist bank offering a full range of financial services to the medical sector. Our team knows the idiosyncrasies of your profession inside out, so you won’t have to explain yourself to someone who doesn’t get it. Nor will you have to tolerate mediocrity – our specialist financial experts uphold the same professional standards as you do.
Take a look at investec.com.au/medical or call one of our financial specialists on 1300 131 141 to find out how we can help.
O u t o f t h e O r d i n a r y™
Home loans | Car finance | Transactional banking and overdrafts | Savings and deposits | Credit cards | Foreign exchange | Goodwill and practice purchase loans Commercial and industrial property finance | Equipment and fit-out finance | SMSF lending and deposits | Income protection and life insurance Issued by Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL 234975, Australian Credit Licence 234975. The information contained in this document is general in nature and does not take into account your personal financial or investment needs or circumstances. Terms and conditions, fees and charges apply. Insurance products are offered by Experien Insurance Services (Representative No. 320626), the preferred supplier of insurance products to Investec Bank.
Published on Aug 21, 2013