WINTER 2017 | VOL. 103
Resident Hospital Health Check WHICH HOSPITAL W I L L AT T R A C T THE BEST REGISTRARS?
Doctors breathe easier under new Industrial Relations Act New President, Board and Council 457 VISA changes cautiously welcomed
Doctor Q is free to AMA Queensland Members Doctor Q Winter
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LEXUS OF BRISBANE lexusofbrisbane.com.au
LEXUS OF SOUTHPORT lexusofsouthport.com.au
1. Complimentary scheduled servicing expires at 3 years or 60,000km from the date of first registration, whichever occurs first. Conditions apply. See your Lexus dealer for further details. 2.. Eligible employees must provide such about-us/benefits for full terms and conditions. *Offer applicable to Private and ABN buyers, who are current members of AMA Queensland, on all new vehicles purchased and delivered between 1st January – 30th June 2017. The will be offered to customers who are not already members. Membership and Qantas Points are subject to the terms and conditions of the Qantas Frequent Flyer Program available at Qantas.com/terms. To earn Qantas Points, June 2017. Points paid on total net contract price of vehicles after discount but before trade-in.
2 Doctor Q Winter
LUXURY HAS ITS REWARDS PURCHASING A NEW LEXUS NOW WILL BE EVEN MORE REWARDING Earn one Qantas Point* for every dollar spent on any new Lexus until June 30.
LEXUS CORPORATE PROGRAMME Lexus represents an incomparable driving experience and the Lexus Corporate Programme builds upon this by providing a service uniquely tailored to our corporate clients. It is with pleasure the Lexus of Brisbane Group offers the Lexus Corporate Programme to AMA Queensland members across the entire Lexus range including luxury sedans, coupes and SUVs.
FEATURES OF THE LEXUS CORPORATE PROGRAMME: • • • • •
3 year/60,000km complimentary scheduled servicing1 Factory support across the entire range2 Reduced dealer pre-delivery fee Access to Lexus Corporate Evaluation Vehicles Priority ordering and allocation
LEXUS CORPORATE PROGRAMME INCORPORATES ENCORE PRIVILEGES PROGRAMME: • • • •
Complimentary service loan vehicles or pick-up/drop off during servicing Lexus DriveCare providing 24 hour roadside assistance Lexus Exclusive Events “Beyond by Lexus” Magazine
ADDITIONAL BENEFITS FOR AMA QUEENSLAND MEMBERS: • • • •
Priority invitations to Lexus of Brisbane Group corporate events Dedicated Lexus of Brisbane Group representative for all enquiries Access to the Lexus of Brisbane Group’s Airport Valet Parking - collection and return service from Brisbane Airport3 Earn one Qantas Point for every dollar spent on the purchase of a new Lexus*
The Lexus of Brisbane Group looks forward to our partnership with AMA Queensland and their members. To discuss these benefits offered to you as a AMA Queensland member, phone or SMS our dedicated Lexus of Brisbane Group representative Derek Klette today. Derek Klette | Group Sales Manager derek.klette@lexusofbrisbane.com.au | 0419 723 937
L A N FI YS DA
LEXUS OF SPRINGWOOD lexusofspringwood.com.au
LEXUS OF MAROOCHYDORE lexusofmaroochydore.com.au
documentary evidence as Lexus or the Lexus Dealer may require to confirm entitlement to receive factory support. Terms and conditions apply. See your Lexus dealer for further details. 3. Visit http://www.lexusofbrisbane.com.au/about/ Lexus of Brisbane Group reserves the right to extend any offer. Excludes demonstrator and pre-owned vehicles. You must be a member of the Qantas Frequent Flyer program to earn and redeem points. Complimentary membership Qantas Frequent Flyers must provide their membership number. Please allow six weeks for the points to be credited to your account. Points can only be awarded on the purchase of an eligible new vehicle between the 1st January - 30th
Doctor Q Winter
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Brisbane • Cairns • Gold Coast • Mackay • Toowoomba • Townsville
CONTENTS
14
RESIDENT HOSPITAL
H E A LT H C H E C K 2 0 1 7
24
D O C T O R S T O B R E AT H E
EASIER UNDER NEW INDUSTRIAL
26
N E W P R E S I D E N T, D R B I L L
BOYD
R E L AT I O N S A C T
REPORTS
F E AT U R E S
BUSINESS TOOLS
6
Editor’s Desk
14
Resident Hospital Health Check results
54
8
President’s Report
24
10
CEO’s Report
Doctors breathe easier under new Industrial Relations Act
Risk managing the Privacy Amendment Bill 2016
56
Consent - End of life care
16
AMA Queensland Council of Doctors in Training update
26
Meet AMA Queensland President Dr Bill Boyd
58
Social media in the workplace
50
Member news
28
60
AMA Queensland’s new Board and Council
What to consider when purchasing a medical practice
63
The practice purchase conundrum
PEOPLE & EVENTS
CURRENT ISSUES
LIFESTYLE
18
VISA changes cautiously welcomed
12
Social photos
62
Dendy
20
AMA calls for marriage equality
33
Local Medical Association round up
64
22
Demystifying personal/carer’s and compassionate leave
42
First associate members
World’s best golfing holiday destinations
44
Events calendar
65
Vintage of the year
46
Meet JDC speaker Dr Renee Lim
66
Restaurant review: Kooroomba Vineyard and Lavender Farm
47
Junior Doctor Conference - Future Frontiers in Medicine
68
All about you
48
Annual AMA Queensland Conference
69
Ocker doctor: Heroes
49
Obituary: Ross Noye
70
InPrint: The Intentional Mentor in Medicine
32
Queensland-specific solutions to regional, rural and remote issues
34
End of life care campaign continues
36
Unity the best protection
38
Keeping health workers safe
40
Extending the compassion to our colleagues
Doctor Q Winter
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Editor’s Desk AMA Queensland each year conducts the Resident Hospital Health Check – a comprehensive survey to analyse how hospitals are doing on key performance areas such as addressing bullying and harassment, working conditions, work hours and overtime. Check out the results on p14. We’ve also got a full list of the 2017-18 Board and Council members on p28. Any information or issues you provide to your craft group representative, geographical representative, or AMA Queensland directly can then be raised at Council meetings with feedback provided to you. Any feedback is always welcome to editor@amaq.com.au.
Dr Bill Boyd President Dr Jim Finn Vice President Dr Shaun Rudd Chair of Board and Council
The following AMA Queensland members have recently passed away. Our sincere condolences to their families. Dr Ian Keith ROBINSON General Practitioner Late of Cornubia Member for 60 years
Dr Brian Hooper COURTICE Surgeon Late of Indooroopilly Member for 73 years
Dr Harold STRONG General Practitioner Late of Mount Morgan Member for two years
Dr Andrew BRYANT Gastroenterologist Late of Wilston Member for 31 years
D R A N D R E W B RYA NT Dr Andrew Bryant’s wife, Susan, recently wrote: “If more people talked about what leads to suicide, if people didn’t talk about it as if it was shameful, if people understood how easily and how quickly depression can take over, then there might be fewer deaths.” It is timely to reflect on these words. This is a call for doctors to be mindful of our colleagues and dare to respond and support each other. If you, or someone you know, is experiencing a personal crisis, there is help available. Lifeline: 13 11 14 and beyond blue: 1300 224 636 can provide urgent support. Queensland Doctors’ Health Programme (QDHP) provides an independent, confidential, colleague-to-colleague support service for doctors and medical students. While this is not designed as an emergency service, the QDHP helpline - (07) 3833 4352 - is available 24 hours a day, seven days a week. www.qdhp.org.au.
Dr Bav Manoharan Member Appointed Director
Dr Dilip Dhupelia Member Appointed Director
Dr Kirsten Price Member Appointed Director
Dr Richard Kidd Member Appointed Director
Dr Dilip Dhupelia Part-time Medical Practitioner Craft Group
Professor Steve Kisely Greater Brisbane Area
Dr Katherine Gridley Greater Brisbane Area
Honor Magon Medical Student Craft Group
COUNCIL Dr Tom Arthur Gold Coast Area Dr Kimberley Bondeson Greater Brisbane Area Douglas Brown Medical Student Observer Dr Paul Bryan General Practitioner Craft Group Dr Matthew Cheng Doctors in Training Craft Group
OBITUARIES
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BOARD OF DIRECTORS
Dr Michael Cleary Greater Brisbane Area Dr Michael Clements North Area Dr Sarah Coll Specialist Craft Group
Dr John Hall Downs and West Area Associate Professor Geoffrey Hawson Retired Doctors Craft Group Dr Wayne Herdy North Coast Area Dr Scott Horsburgh General Practitioner Craft Group Dr Viney Joshi International Medical Graduate Craft Group
Dr Bav Manoharan Greater Brisbane Area Dr John F. Murray Specialist Craft Group Dr Alex Ritchie Specialist Craft Group Dr David Shepherd Far North Area Dr Nicholas Yim General Practitioner Craft Group Dr Chris Zappala Immediate Past President
AMA QUEENSLAND S E C R E TA R I AT Jane Schmitt Chief Executive Officer
Filomena Ferlan General Manager Corporate Services
Editor: Michelle Ford Russ
Doctor Q is published by AMA Queensland
Graphic Designer: Nathan Pitt Journalist: Chiara Lèsevre Advertising: Louise Glynn
Phone:
Holly Bretherton General Manager - Member Relations and Communications
(07) 3872 2222
Address: PO Box 123, Red Hill QLD 4059 Email:
amaq@amaq.com.au
Print Post Approved PP100007532
Disclaimer – All material in Doctor Q remains the copyright of AMA Queensland and may not be reproduced or transmitted in any form without permission. While every care is taken to provide accurate information in this publication, the material within Doctor Q is for general information and guidance only and is not intended as advice. Readers are advised to make their own enquiries and/or seek professional advice as to the accuracy of the content of such articles and/or their applicability to any particular circumstances. AMA Queensland, its servants and agents exclude, to the maximum extent permitted by law, any liability which may arise as a result of the use of the material in Doctor Q.
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www.gssuites.com.au Doctor Q Winter
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President’s last report
D R C H R I S Z A P PA L A
In discussing my handover to Dr Bill Boyd as President of AMA Queensland, he asked me what was most important to me. I realised the answer was a composite of several of the key themes I’ve discussed many times, built on some modest successes in recent times. The greatest need for the AMA and our profession is for it to be more active in developing consensus, promoting internal leadership and, as a result, taking greater control of its own destiny rather than being reactionary or divided and inconsequential. We must find unity in diversity and use this with amplified intent and effectiveness. This effort seminally starts with the interactions we have on a daily basis with colleagues. I remember attending a meeting once and I made the point that colleges needed to become much more active in monitoring their own workforce dynamics and needs, and take an active hand in controlling this via training pathways. This empowering notion managed to penetrate the torpor and allow attention to be focussed. Workforce 8 Doctor Q Winter
surveillance and planning is not done well for the profession as a whole. For example, the recent medical workforce report released by Queensland Health contains some unusual data and conclusions.
It’s time to lead. It’s time to discard inter-professional jealousies and parochialism and recognise once again our mutual interdependence. After a moment’s quiet thought, one realises that political attempts to correct workforce shortages or geographic maldistribution have often led to disastrous consequences for the profession, as with the various contemptible role substitution models of care. Hence, the profession’s need to get their collective act together and provide cooperative assistance for mutual benefit. Mutual benefit is a concept that seems to lose focus when challenged by self-interested, parochial thinking that dominates
medical politics. A popular refuge for ideology defined by a dangerous, myopic perspective is to criticise others (especially those perceived as competition) in order to create the illusion of self-importance. Strong, effective leadership can avoid such internecine conflict and this can only really come from the AMA as the nationwide, fullyinclusive representative body for the profession. It is frightening to ponder where doctors would be without the AMA – I can guarantee high-level decision-making would largely occur without medical input and doctors would quickly be subjugated, which I genuinely believe would have deleterious effects on patient outcomes. I am very pleased that AMA Queensland was successful in preventing the expansion of non-medical endoscopy throughout Queensland. Beyond the obvious, evidence-based arguments supporting medical-led care as being both cost-effective and optimal in terms of outcome, it enabled us to start a positive conversation regarding how we can become more innovative with our generalist
training to meet workforce demands. Besides training GP proceduralists to have additional skills, we can also be expanding our concept of general specialist training. For example, general physician training could easily encompass echocardiography or endoscopy training to the usual standard accepted by the college, without having to undertake dual training in two specialties. Such individuals would be extraordinarily useful in rural and regional locations and have additional skills to enhance their job satisfaction. A professionled change such as this would help subvert future mischievous political (or competitive interest group) efforts towards medical role substitution. AMA has written extensively on policy changes which would help correct the geographic maldistribution of doctors. This excellent work includes the need for regional training networks and easy entry with gracious exit models for regional practices. Exponential growth in the workforce has however not helped. While the
AMA largely believes the profession’s workforce is currently ‘in balance’ – I’m not convinced and believe over-supply is a current
By being absent from leadership roles, hopelessly divided and obsequious in our desire to placate anyone accusing us of being elitist or not team players, we’ve allowed this to happen. burgeoning problem for us all. Flooding the market with doctors has disastrous consequences in all facets of training and practice which are only just beginning to dawn, so we need more tangible suggestions to make authentic and hopefully immediate improvements in the maldistribution of our workforce. Outside Brisbane this exigency is keenly felt and always raised in discussions. Dr John Hall will chair the Queensland Regional, Rural and Remote working group, who are developing a position paper that builds on previous work, to provide suggestions to correct this maldistribution of doctors. I want to once again entreat all of my colleagues to develop their leadership credentials and enthusiasm in order to re-capture many of the governance positions that the profession has historically filled but afforded only desultory attention. This misguided approach with a collegiate shortsighted dismissiveness
of anyone pursuing administrative positions has been exacerbated by the sub-specialisation and fragmentation of the medical profession which allowed ugly self-interest to dominate medical politics instead of professionwide perspectives. The lamentable result has been the removal of doctors from leadership positions by other tribal groups who relentlessly aim to subsumed all medical responsibility creating an inimical system that now delights in over-regulation and subjugation of doctors. The only resolution that will vanquish this enervating masochism is for doctors to truly be able to influence and enact policy and lead governance at all levels within institutions, practices and government. In small increments in all settings, we must actively and capably compete for leadership positions with active support from colleagues. In reclaiming a greater role in clinical governance and policymaking, our influence can naturally increase. In Queensland we have just won the right to have a doctor chair the medical board once again, with a majority of doctors as members – reversing the disastrous changes of the prior State Government. When doctors are working in leadership positions, we need to recognise that we MUST always still advocate strongly and unashamedly for doctors in any way possible regardless of our job description. Everyone else is blatantly doing the same and doctors are often the only suckers with an over-inflated sense
of fairness. When a nonmedical administrator uses the term ‘multidisciplinary team care’ that is a euphemism for medical subjugation and role substitution with doctors still bearing all medicolegal responsibility but with marginalised decisionmaking ability. I assure colleagues I am not being alarmist or inappropriately jaded. Who else beside the AMA is fighting strongly for all doctors? Quite honestly……. It’s no one! Colleges and professional associations largely remain insular and focussed in their efforts without the authority to speak for the profession as a whole. We have allowed AMA membership to fall to the point that we are potentially in danger of losing our credibility and stature – this only endangers us all. Do not be surprised when we lose yet another political stoush or continue to suffer other tribal groups in health care incrementally subsuming the medical profession. By being absent from leadership roles, hopelessly divided and obsequious in our desire to placate anyone accusing us of being elitist or not team players, we’ve allowed this to happen. It’s time to lead. It’s time to discard inter-professional jealousies and parochialism and recognise once again our mutual interdependence. It’s time to remind everyone we have a medical-led system of care still in this country that depends on a highlytrained and strong medical profession. It’s time for doctors to unashamedly re-assert themselves and gain prominence in clinical
governance once again. Unity, persuasive argument, control of perception and ability to influence the public are what matters. This rests on stature, credibility, professionalism and reach. There is an urgent need for doctors to realise the importance of their collective voice and effort through the AMA and to join the association and enhance its effectiveness. We must actively support our medical colleagues in filling every possible policymaking and administrative job available in the country – we’re being overrun and marginalised while we continue to quaintly believe simply being effective at our daily clinical jobs is sufficient to acquire influence and that common sense and good evidence is sufficient to win medicopolitical arguments. The AMA truly embodies the strength and potential of the profession and it is up to each of us individually to help realise and augment this. As my term as AMA Queensland President has now come to an end, I wish to thank our CEO, Board, Council and staff members for working as a team to keep AMA Queensland at the forefront of medico-political advocacy in Queensland. I would like to thank AMA Queensland members for your feedback, your energy, and your dedication to your patients, your peers, and the profession.
Doctor Q Winter
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CEO’s Report ENSURING A RESILIENT WORKFORCE
Tragically, a number of recent doctor suicides has brought doctors’ wellbeing sharply into focus. Firstly, I offer my greatest sympathies to the family and friends of these doctors. The health and the wellbeing of our members is our primary concern and we are working with members and others to better understand what AMA can do to support members. We currently have a number of resources and we are focused on extending these. Our Resilience on the Run program helps strengthen junior doctors’ coping skills to survive and thrive in medicine. We are calling on the Queensland Government to implement the exemption to the mandatory reporting legislation (as is the case in WA) to ensure medical professionals are able to seek treatment without the fear of crippling their career. At our recent AMA Federal Council meeting, councillors were very concerned about the mental health of their colleagues and formed a specifically focused working group to fully consider what the AMA can do and act on this. At our AMA National Conference on 26 May, Australian Health Minister Greg Hunt announced a partnership with AMA to develop programs for caring for the carer and to develop suicide prevention and mental health support programs, specifically for medical practitioners. We look forward to working with the government to progress this initiative. If you have suggestions on improving the health and wellbeing of doctors at all stages of their careers, please email ceo@amaq.com. au. Please 10 Doctor Q Winter
remember that if you, or someone you know, is experiencing a personal crisis, Queensland Doctors’ Health Programme (QDHP) provides an independent, confidential colleagueto-colleague support service to doctors and medical students.
HOPING FOR A H E A LT H Y B U D G E T
Ahead of the 2017 State Budget, we presented our pre-budget submission to the Queensland Health Minister Cameron Dick, with three key recommendations that will ensure a more sustainable and accountable health system. Our submission advocated increased funding to the Office of the Health Ombudsman (OHO); increased funding for palliative care and care at the end of life initiatives; and the establishment of a Queensland Medical Education Training Institute (QMETI). The Health Minister has advised that many of our priorities aligned with those of the Queensland Government, including investing in a healthy workforce. The Queensland Government recently introduced into Parliament their Healthy Futures Commission Queensland Bill. The Health Minister announced $20 million for this commission to reduce the number of overweight and obese Queenslanders. As you know, AMA Queensland has long called for the government to take a coordinated whole-of-government approach to public health, including obesity. We are encouraged by this announcement and will continue our discussions with Cameron Dick and his team to ensure AMA Queensland member views are fed into this initiative.
CHAIR OF MEDICAL BOARD AUSTRALIA
In the past few months we have been vigorously campaigning to ensure that the Chair of the National Medical Board of Australia remains a medical practitioner. The concerning proposal to allow the appointment of a community member to become
chair of the National Board was made at the March COAG Health Council. Queensland, due to its unicameral parliament, is the host jurisdiction for the bill for introduction mid-year. We have been clear in our opposition to this proposal to the Queensland Health Minister and have been working closely with Members of Parliament and the other boards who would also be affected by this proposal. I wish to extend a sincere thanks to all the members who promptly jumped on board and wrote to their local and federal Members of Parliament to oppose the proposed amendment. Please continue to join us in opposing this.
WELCOME TO THE 2017-18 BOARD AND COUNCIL
I welcome incoming President Dr Bill Boyd and Vice President Dr Jim Finn and congratulate Dr Shaun Rudd on his reappointment as Chair of Board and Council. I look forward to what we will be able to accomplish. It has been my pleasure of the last two years to work with Dr Chris Zappala, whose commitment and passion for the profession are evident in the association’s achievements during his presidential term. Chris has been a stalwart for the association and the medical profession. His tireless passion and commitment to serving our membership and the profession has been admirable. I thank him again for two outstanding years of dedicated service.
A S S O C I AT E M E M B E R S
Our new associate membership category acknowledges services provided by a person who is not a medical practitioner and who has given honourable and substantial service to the medical profession. Our first two associate memberships have been awarded to Colleen Sullivan and Patrick Staunton. Thanks to both Colleen and Patrick for their significant contribution to the medical profession over many years.
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Doctor Q Winter 11 www.svphb.org.au
Regional Private Practice: Series One C O M P L I A N C E AT W O R K AMA Queensland’s Workplace Relations Team delivered workshops around the state in April and May around Workplace Health and Safety (WHS) policies and procedures. Guests learned more about identifying hazards, risk management, risk control, and the need to record near misses and injuries. The team showed how a practice might demonstrate compliance with the Workplace Health and Safety Act 2011, provide training to all staff on WHS responsibilities and policies. The team visited the Gold and Sunshine Coasts, Toowoomba, Brisbane West, South and North, Bayside, Mackay, Townsville, Cairns, Rockhampton and Bundaberg.
Transitioning to Private Practice seminar Members gathered at AMA Queensland’s offices to get coordinated insight into setting up and running a private practice. Attendees heard from Angela Jeffrey from William Buck Accountants about choosing the right practice structure and essential considerations for tax, while BOQ Specialist’s Simon Moore spoke about the fundamental considerations for practice banking and finances. TressCox Partner Lynette Reynolds explained the legal aspects around structuring and ensuring your practice structure is protected and MGRS’ James Warwick presented on how to manage risk through having the right practice procedures and the right insurance in place. Our Workplace Relations Team gave an update on staffing obligations when hiring and Dr Mark Craig from My Medical Best Practice inspired guests with his presentation patient-centred approaches to delivery of private practice and how to exceed patient expectations. If you would like to speak to any of these experts regarding your practice, give us a call on (07) 3872 2222.
Medical Society Executive Education Day LOOKING AF TER THE HEART O F Y O U R O R G A N I S AT I O N AMA Queensland brought the executives from each medical society in Queensland together to cover the essentials of legal structuring, risk, governance, accounting, disaster and media management, events management and marketing, along with advice on building resilience and enhancing wellbeing. The program also provided an update on AMA Queensland’s activities and how we can support student members and junior doctors. Looking after the heart of your organisation was well received and left the executive teams enthusiastic and inspired. 12 Doctor Q Winter
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Resident Hospital Health Check 2017 AMA Queensland surveyed 465 Resident Medical Officers (Intern, Junior House Officer, Senior House Officer, Continued Residency) to evaluate the state of Junior Medical Officer employment in Queensland, and subsequently compare hospitals across Queensland. These results represent approximately 20 per cent of Queensland’s approximate 2,267 Resident Medical Officers (RMOs).
Find out your hospital’s score at www.amaq.com.au Login with your member details or email membership@amaq.com.au for a copy
1.
Clinical rotation preferences
55% were quite to extremely satisfied
The results showed the top six RMO priorities in order of 1 - 6, with one being the highest out of a possible 12 domains: 4. Annual leave allocation; 5. Personal safety at work; and 6. Bullying and harassment.
1. Clinical rotation preferences; 2. Teaching and education standards; 3. Un-rostered overtime payment;
2.
Teaching and education standards
Not at all satisfied
Slightly satisfied
Moderately satisfied
Very satisfied
Extremely satisfied
53% felt their hospital provided teaching and training at very or extremely satisfied levels
up to
4
40 % 1
14
up to
hrs
nil
up to 4 hrs
31%
90 % wo rk
+2
hour sI
are concerned claiming would negatively affect their end of term assessment
Advised not to claim by a more senior Medical Officer
16%
Would reflect better on my work values not to claim Did not see anyone else claiming overtime Advised not to claim by an Administrative Officer Do not think residents should claim overtime Did not know claiming overtime was possible
More than 50%
are advised not to claim overtime by senior staff
17% Ye
31%
s
Did you get paid for the overtime you claimed? o
on ly c
14 Doctor Q Winter
42%
Did not believe the amount of overtime was worth claiming
claiming un-rostered overtime
31% N
me d so me lai
Concerned it may negatively affect my workplace assessment
10% 5% 4 hrs
Average hours of overtime worked per fortnight
ed
My supervisors would think better of me if I did not claim
%
52o% f the
If you did not claim un-rostered overtime, what was the reason?
per week time r e ov of
hrs 24
ndents work over 1 4h spo e r ou of rs
3. Un-rostered overtime payment
of those who claim are not getting
paid for it
Concerningly, it appeared the number of respondents working overtime and not being appropriately paid for this overtime (31%) has remained unchanged since the 2016 survey. Forty-six per cent (46%) of respondents felt their supervisor would think better of them for not claiming overtime, and a further 42% were worried it may negatively affect their end of term assessment if they were to claim.
4. Annual leave allocation
5. Personal safety at work
Moderately satisfied
Twenty per cent (20%) of respondents reported feeling their safety was compromised at work, equally distributed between males and females. Although any number is too high, AMA Queensland is encouraged by the Queensland Health campaign to combat this problem within our hospitals, and hope that this number continues to reduce in future years.
20% feel they had their personal safety compromised at work
Quite satisfied Extremely satisfied
43% feel they have made a clinical error due to worked hours
6. Bullying and harassment Respondents who had personally experienced or witnessed bullying, discrimination or sexual harassment in their workplace
Overall
By year (2017)
If witnessing bullying, discrimination or sexual harassment, did you feel there was anything you could do?
2016
2017 2016
2017
PGY1 (Intern)
PGY2 (JHO)
PGY2 3 (SHO)
Bullying and harassment rates showed no improvement this year amongst our RMOs. Forty-seven percent (47%) of respondents have been exposed to bullying, harassment and discrimination in their workplace, compared to 45% in 2016. Shockingly, 61% of respondents said they feared negative consequences in their workplace and for future training if they were to report bullying, harassment and discrimination.
We invite any interested directors of clinical training, directors of medical services or other interested parties, who wish to learn more about the results pertaining to their location (and discuss possible ways of improving their conditions for prospective junior doctors), to contact us at cdt@amaq.com.au. AMA Queensland looks forward to working with hospitals around the state to improve the working conditions for our current and future doctor in training colleagues.
The AMA Queensland Industrial Relations Team also provides confidential, assured advice to Doctor in Training members on employment terms and conditions, and any aspect of your employment that is causing you concern. Contact the team on (07) 3872 2222.
PGY 3+
(Continued Residency)
61% were concerned of negative consequences if they reported harrasssment
50%
of all bullying, discrimination and harassment came from Consultants
Disclaimer: The AMA Queensland Council of Doctors in Training Resident Hospital Health Check Survey was completed on a voluntary basis by Queensland doctors in training (Interns, Junior House Officers, Senior House Officers and Continued Residency). The purpose of this document is to assist graduating medical students as well as current interns and residents with their decision making process when deciding on which hospitals to apply for in the upcoming intern and RMO campaigns. This information is provided in good faith and should only be used as a guide and is intended to be general in nature and is made available on the understanding that the AMA Queensland and the AMA Queensland Council of Doctors in Training do not make any comment or assertion that the information provided by participants is correct, or reflects the experiences of doctors who did not participate in the survey. Before relying on the information contained in the survey results provided, users should carefully evaluate its accuracy, currency, completeness and relevance for their purposes, personal objectives and career goals, and should make their own enquiries, including consulting with the relevant Hospital and staff at the relevant Hospital. Whilst every effort has been made to ensure the accuracy of the collation of the information in this survey, AMA Queensland, its employees and the AMA Queensland Council of Doctors in Training cannot be held responsible for the information provided by participants in the survey and cannot be responsible for any loss or damage arising from any person or organisation as a result of the publication of this survey of information. AMA Queensland and the AMA Queensland Council of Doctors in Training do not take any responsibility for the outcomes published in the survey.
Doctor Q Winter 15
AMA Queensland’s Council of Doctors in Training - ready to go to work for you Dr Matthew Cheng, Chair, AMA Queensland Council of Doctors in Training
EXECUTIVE Chair Dr Matthew Cheng Princess Alexandra Hospital Deputy Chair Dr Katherine Gridley QEII Hospital Deputy Chair Dr Chris Maguire Logan Hospital
AMA Queensland Councillor Dr Bavahuna Manoharan Sunshine Coast University Hospital AMA Queensland Councilllor Dr Lisa Byrom Mater Hospital
Medical Student Group Representative Honor Magon University of Queensland Immediate Past Chair Dr Tom Arthur Gold Coast University Hospital
PORTFOLIO LEADS The AMA Queensland Council of Doctors in Training (CDT) has an enthusiastic new team for 2017 (adjacent) who are ready to continue advocating for you. In particular, we have pushed initiatives across three domains affecting all doctors in training: 1) improving workplace conditions; 2) doctor in training health and wellbeing; and 3) providing you with quality career-enhancing professional development.
Improving workplace conditions We have just published our second Resident Hospital Health Check (RHHC). This survey will help inform doctors in training decision-making for their intern/RMO campaign hospital preferences. The CDT will also use the results to drive change at the local hospital level to improve the working conditions for doctors in training across the state.
Providing you with quality, career enhancing professional development CDT will deliver its fourth annual Junior Doctor Conference. This is the largest junior doctor conference in Australia and serves as an opportunity to inspire, guide and equip doctors in training on their journey in medicine. The program features exceptional keynote presentations from luminaries such as Professors Gordian Fulde and Karen Dwyer, along with practical career-development sessions on interview skills and getting that illusive college training place. This flagship conference is being held on Saturday 1 – Sunday 2 July 2017 at the Hilton Brisbane. If you have not already registered, I encourage you to do so. Through our hard work in attracting sponsors, we can offer subsidised rates of just $335 for both days including all social functions for interns and students to attend, and $390 for junior doctors years 2 – 5. The conference also attracts junior doctor CPD points. For more information on the program and how to register see page 46. A reminder also to please keep your membership current, and encourage your colleagues to join. Without your ongoing support as members, we can’t achieve the crucial changes and reforms that are needed to support you in your early career and beyond. Remember each and every membership counts and makes a difference. 16 Doctor Q Winter
Rural and remote Dr Ekta Paw Townsville Hospital Rural and remote Dr Ben Wakefield The Prince Charles Hospital
Communication Dr Tahlia Gadowski Royal Brisbane and Women’s Hospital
Educations and training Dr Kimberly Bradshaw Hervey Bay Hospital
Industrial Relations Dr Mila Greenslopes Hospital
Events Dr Tom Crookes Royal Brisbane and Women’s Hospital
H O S P I TA L R E P R E S E N TAT I V E S Dr Wayne Lee Rockhampton Hospital
Dr Shannan Searle Redcliffe Hospital
Dr Alexander Robinson Royal Brisbane and Women’s Hospital
Dr Emily Shao The Prince Charles Hospital
Dr Adam Keys Lady Cilento Children’s Hospital Dr Sophie Manoy Cairns Base Hospital Dr Mikaela Seymour Royal Brisbane and Women’s Hospital Dr Sascha Reimann Princess Alexandra Hospital Dr Devlin Elliott Royal Brisbane and Women’s Hospital
Dr Siyaguna Ekanayake The Prince Charles Hospital Dr Yung Koh Princess Alexandra Hospital
Dr Kamaljit Sandhu The Prince Charles Hospital Dr Rebecca Conrick The Prince Charles Hospital Dr Dinesh Palipana Gold Coast University Hospital
Dr Darius Ashrafi Princess Alexandra Hospital
Dr John Leou Gold Coast University Hospital
Dr Thomas Randell Princess Alexandra Hospital
Dr Katie Darch Princess Alexandra Hospital
Dr Alix Pichon Cairns Base Hospital Dr Lindon Collins Rockhampton Hospital
Dr Nicholas Tsang Mackay Hospital Dr Marina Tan Mackay Hospital Dr Elizabeth Hamilton Townsville Hospital
Your hospital not on the list? Please contact Holly Bretherton, General Manager – Member Relations & Communications at cdt@amaq. com.au to express your interest to join CDT as a Hospital representative.
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Doctor Q Winter 17
457 VISA changes cautiously welcomed The AMA has cautiously welcomed the government’s new visa arrangements while it waits for more information about the possible impact of the changes on medical workforce shortages. In April, Prime Minister Malcolm Turnbull signalled the end of the current temporary skilled workers visas regime. The 457 visas will be replaced with a new Temporary Skills Shortage Visa (TSS) in March 2018. The new system will have tighter conditions and cater for a smaller number of eligible occupations. It will also be harder to progress to permanent residency from the new visa class. Doctors will still be eligible for the new visa, but there is little detail about medical specialties or groups. Existing 457 visa holders will continue on the same conditions they have now, but it is important that doctors with these visas who have been working hard towards permanent residency are not disadvantaged. AMA President Dr Michael Gannon said international medical graduates (IMGs) have made a huge contribution to the Australian medical workforce, especially in rural areas and during periods of chronic workforce shortages. “Many communities would not have doctors if it were not for the excellent work of IMGs,” Dr Gannon said. “Australia is presently in the fortunate position of producing sufficient 18 Doctor Q Winter
locally-trained medical graduates to meet current and predicted need. “It is time to focus our energies on training the hundreds of Australian medical graduates seeking specialist training. “But we still need to have the flexibility to ensure that undersupplied specialties and geographic locations can access suitably-qualified IMGs when locally trained ones cannot be recruited.” Dr Gannon said it was important to strike the right balance between filling vacancies with locally trained graduates and ensuring communities, especially in rural and remote Australia, have doctors in the right numbers and with the appropriate specialist skills and experience to meet patient needs. “The AMA welcomes the emphasis of the new arrangements to better target recruitment and the mandatory requirement for labour market testing, which the AMA has been calling for in light of the significant increases in locally-trained medical graduate numbers,” he said. “The government needs to step up policy efforts to encourage local graduates to work in the areas and the specialties where they are needed.” “We need flexibility in the arrangements, so for those specialties or those areas of the workforce where genuine shortages remain, we are able to get staff from overseas.
“But what we’ve seen too much of is this mechanism gamed. We need employers to be more honest about the needs for extra staff, and what we need is greater investment in training positions for those hundreds of locally trained doctors who are now lining up desperately trying to find specialist training. “And then deploy them where they’re needed, making sure that Australians in rural and regional areas continue to be well serviced by health professionals.” The AMA is calling for a third of all medical students to come from rural areas, and wants to see more positive experiences for junior doctors and medical students when they go to the regions. “We know from evidence that that means they’re more likely to go and work in the bush later,” Dr Gannon said. “There’s a moral dimension to these changes. Every time Australia recruits a doctor from a third world country, or from another country, we are taking those doctors away from populations that desperately need them. “Australia’s definitely reached selfsufficiency in terms of total numbers of medical graduates. “We’ve got to make sure that the public hospitals, the private hospitals, the general practices, have the training positions so that we can get Australian-trained doctors out there and working.”
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AMA calls for marriage equality AMA President Dr Michael Gannon, has written to Prime Minister Malcolm Turnbull and Opposition Leader Bill Shorten, urging a bipartisan approach to marriage equality. Releasing the AMA Position Statement on Marriage Equality 2017, Dr Gannon said that excluding same-sex couples from the institution of marriage has significant mental and physical health consequences for lesbian, gay, bisexual, transgender, intersex, and queer/ questioning (LGBTIQ) Australians. “Discrimination has a severe, damaging impact on mental and physiological health outcomes, and LGBTIQ individuals have endured a long history of institutional discrimination in this country,” Dr Gannon said. “This discrimination has existed across the breadth of society; in our courts, in our classrooms, and in our hospitals. “Many of these inequalities have been rightly nullified. Homosexuality is no longer a crime, nor is it classified as a psychiatric disorder. The ‘gay panic’ defence is no longer allowed in cases of murder or assault, and same-sex couples are allowed to adopt children in most jurisdictions. “However, LGBTIQ-identifying Australians will not enjoy equal treatment under Australian law until they can marry. “It is the AMA’s position that it is the right of any adult and their consenting 20 Doctor Q Winter
adult partner to have their relationship recognised under the Marriage Act 1961, regardless of gender. “There are ongoing, damaging effects of having a prolonged, divisive, public debate, and the AMA urges the Australian Parliament to legislate for marriage equality to resolve this.” While there is no definitive data on the number of Australians who identify as LGBTIQ, same-sex couples made up approximately 1 per cent
“Discrimination has a severe, damaging impact on mental and physiological health outcomes, and LGBTIQ individuals have endured a long history of institutional discrimination in this country,” Dr Gannon said. of all Australian couples in the 2011 Census, and more than 3 per cent of respondents to a 2014 Roy Morgan survey identified as homosexual. People who identify as LGBTIQ have significantly poorer mental and physiological health outcomes than those experienced by the broader population. They are more likely to engage in high-risk behaviours such as illicit drug use or alcohol abuse, and have the highest rates of suicidality of any population group in Australia.
“These health outcomes are a consequence of discrimination and stigmatisation, and are compounded by reduced access to health care, again due to discrimination,” Dr Gannon said. “The lack of legal recognition can have tragic consequences in medical emergencies, as a person may not have the right to advocate for their ill or injured partner, and decision-making may be deferred to a member of the patient’s biological family instead. “Marriage equality has been the subject of divisive political and public debate for the best part of the past decade. “It is often forgotten that, at the core of this debate, are real people and families. It’s time to put an end to this protracted, damaging debate so that they can get on with their lives. “As long as the discrimination against LGBTIQ people continues, they will continue to experience poorer health outcomes as a result. “LGBTIQ Australians are our doctors, nurses, police officers, teachers, mothers, fathers, brothers, and sisters. They contribute to this country as much as any Australian, but do not enjoy the same rights. “It is time to remove this discrimination.” To view the AMA Position Statement on marriage equality, visit ama.com. au/position-statement/marriageequality-2017.
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Doctor Q Winter 21
Demystifying personal/carer’s and compassionate leave For members who employ staff in a private medical practice, sometimes trying to understand how to apply the leave provisions in the National Employment Standards (NES) can cause headaches, particularly when dealing with personal/carer’s leave (‘sick’ leave) or compassionate leave requests.
Is there a cap on the leave employees can accrue, or take, in any one year? Permanent employees do not have a cap on the amount of paid personal/ carer’s leave they accrue. Full-time employees accrue 10 days per year, and part-time employees receive a pro-rata entitlement based on ordinary hours of work. The leave will accumulate from year to year. So if you have a full-time employee employed for 10 years who has never accessed this leave – they will have 100 days of personal/carer’s leave accrued. Additionally, under the NES there is no cap on the amount of paid personal/ carer’s leave that an employee can take in any one year (there was an annual cap in previous legislation). Compassionate leave is a separate entitlement to personal/carer’s leave – it does not fall within the 10-day entitlement listed above. Instead, an employee is entitled to two days of compassionate leave per ‘permissible occasion’ which is defined to include where an employee’s immediate family 22 Doctor Q Winter
or household member suffers from a personal illness/injury that poses a serious threat to life, or dies. Of course, the notice and evidence requirements apply for this leave. For example, an employee cannot rely on a large personal/carer’s leave balance for a holiday just if they felt like it – they still need to be able to provide evidence upon request that they were:
unfit for work because of personal illness/injury, or providing care or support to an immediate family or household member who requires care or support due to: a personal illness/injury or an unexpected emergency affecting that member.
What notice and evidence is required for this leave? Under the NES, an employee must give notice of their taking of personal/ carer’s or compassionate leave as soon as practicable (which may be a time after the leave has started). An employee that has given notice of the leave must, if requested by the employer, provide evidence that would satisfy a ‘reasonable person’ of the employee’s entitlement to the leave. The employer may commonly require an employee to provide a medical certificate or a statutory declaration to support the leave.
What can you do if you suspect an employee is misusing this leave? Employers do have the ability to investigate the authenticity of a personal/carers or compassionate leave claim where they believe they have evidence indicating that the leave is not genuine. However, an employer needs to first seek advice where necessary, particularly if the employee has provided a medical certificate. Otherwise, employers run the risk of unlawfully taking disciplinary action against an employee for exercising their workplace right to personal/carer’s or compassionate leave. Several Fair Work Commission and court decisions indicate a general rule of holding medical certificates as sacrosanct, given that a medical practitioner has an ethical, professional and legal obligation to issue medical certificates in a genuine manner.
Do GP Registrars have the same personal/carer’s and compassionate leave entitlements as other private practice employees? GP Registrars have specific leave entitlements additional to the NES. Refer to clause 6.3 of the National Terms and Conditions for the Employment of Registrars (NTCER) for more information. AMA Queensland recommends that employers have a workplace policy, which sets out expectations for staff in relation to personal/carer’s and compassionate leave. Members can contact the Workplace Relations Team for a template policy. AMA Queensland members can contact the Workplace Relations Team on (07) 3872 2222 or workplacerelations@amaq.com.au.
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Doctor Q Winter 23
Doctors breathe easier under new Industrial Relations Act AMA Queensland’s Workplace Relations Team had the chance to sit down for a Q&A with Grace Grace, Minister for Employment and Industrial Relations, to discuss the new Industrial Relations Act and its effect on doctors. Here’s an excerpt from the full interview available at www.amaq.com.au
What is the difference between unfair dismissal and general protections and what will that mean for people in the health service? Under the former Industrial Relations Act they had access to protection against unfair action that resulted in dismissal. The change now is that the new general protections regime doesn’t have to be tied to a dismissal. So if adverse action is taken against a doctor, and it may be because of lack of promotion or adverse action because they spoke out and were reprimanded or whatever the situation may be, you can now take an adverse action claim on issues that are obviously not connected to unfair dismissal alone. The protection is greater than what it was before and not tied just to unfair dismissal.
Trust and confidence is a big part of the act. How does trust and confidence manifest itself, when would this come into play in the relationship between an employer and a doctor? 24 Doctor Q Winter
When you are looking at how do you bring about a productive and cooperative workplace and if you’re working around maintaining high standards of health and let’s say the government wants to do something, but it’s got nothing to do with the patient and everything to do with cutting costs. In that case you can understand doctors may feel very conflicted with their ethical standards that they have to abide by, that they have to be pushed into agreeing to stuff that is breaking down that trust and confidence in the government creating the best health system for the patients. If there was a dispute manifestly about an action the government is taking that doctors firmly believe is outside of all ethical standards, does nothing about building trust and confidence in where it’s happening, they could take their dispute to the commission. There they could say “look, if this proceeds, whatever the situation is, it’s also breaking down this ability for us to promote trust and confidence because this is
just so far-fetched on how a doctor needs to be operate”. The commission may say “look, based upon one of the objects of the act about building that, you know let’s have a look at this dispute and how we can resolve it”.
So this is something that could be to the advantage of doctors themselves? This could definitely be, yes. The commission has the ability to determine whether or not that’s an appropriate one to do, they might say you really are blowing your horn here, it’s got nothing to do with trust and confidence, it’s about government managing, but it could be that they say “well no that’s right, doing this could manifestly breach that object of trust and confidence.”
If decisions do go to the commission, that is final and binding? Subject to all of the appeals mechanisms in the act – single commissioner, full bench, industrial court – yes, based upon the decision and what the situation is. But in arbitration, clearly you know it’s a last resort, the commission has the
ability to arbitrate, you can appeal that arbitration, subject of course to the necessary appeals that are in the IR act.
The act makes it easier for long-term temporary employee to become permanent, what would the process be, how has that been changed and what is the level of protection? At the moment in the public service, and it could be happening in the profession of doctors as well, there seems to be an unacceptably high amount of temporary employees that have been temporary for a long time. Where someone has just been continually rolled over as a temporary employee for no apparent operational or good reason, the directive is going to be manifestly changed and there’s stakeholder consultation at the moment to enable this to be handled in a proper way.
What steps would someone in that situation take to get that reviewed? They are going to be put into the directives that the
We want a trusting, confident, productive, effective public service, where bargaining is a cornerstone of agreement-making and we look forward to entering our new agreement Public Service Commission is directing at the moment, but they will set out the framework under which you can make application to do that. ASMOFQ were very supportive of this but also other unions that were seeing this occurring and we struck a really good balance between an operational requirement, as opposed to no real reason – that doesn’t really help anyone, it doesn’t help the worker, it doesn’t help the HHS. We support full-time permanent employment. If there’s a dispute, then it can go to the commission and then directives are written in line with that as well.
AMA Queensland has expressed concern about the levels of workplace bullying, especially with junior doctors in Queensland. Do you think this is likely to trigger an increase in the number of claims, given it’s the first time staff have had the opportunity to go to an independent umpire? [Bullying] is a serious subject. This can have significant ramifications on someone’s performance in the workplace. It’s totally unacceptable, it should be eradicated and
people should be very, very respectful in the workplace and there is zero tolerance on behalf of the government. Clearly, if someone believes that they are being bullied within the proper definition of what bullying is, systemic, that kind of stuff, there’s a remedy for them because we have identified that it is a serious issue and should not be allowed to continue unchecked. Now, whether that means an increase in claims because people now can come forward and they are protected, then of course those people should be able to get the justice that they deserve. It is something that we don’t condone and we want to ensure you work in a workplace that’s respectful, valued. Clearly there are allegations from time to time, now people are comforted by the fact that they know that if that is occurring they have got somewhere to go to receive a hearing.
How will a stop-bullying order work in the workplace? It’s a new area but the commission is very experienced, these are very experienced practitioners, like doctor are very experienced in the work they do. These practitioners can identify if they do need an order, what is required for that order. It might be the manner in which people communicate, it might be the manner in which individuals conduct themselves, it’s hard to speculate.
They will take all of those into consideration and we have enough confidence in those practitioners, as very expert in their area, to be able, if they have to make an order, to make an appropriate one based upon each individual case.
In 12 months how do you think the landscape for doctors will look with the passage of this bill? The act came in on 1 March so the provisions are up and operating at the moment. Quite clearly, we have got a new bargaining regime, I know the medical officers’ agreement is due for negotiation in June 2018, so we look forward to bargaining with doctors around that time. We think the framework under which bargaining is the cornerstone for agreement-making with doctors is the best way forward, we don’t intend to impose individual contracts and that type of stuff as was done by previous governments. We understand the legitimacy of bargaining, we do have this new vehicle of a bargaining award, it could be something the parties believe is a really good thing for doctors, they are in a single award environment,
If you’re not under threat of losing and you’re not struggling with frontline services as we know a lot of doctors were when cuts were being made, of course you provide a better service to the public.
rather than having two documents they might tick off the new bargaining award, we’ll leave that to the two parties to determine, but it’s under a regime with the imprimatur of the government. We want a trusting, confident, productive, effective public service, where bargaining is a cornerstone of agreementmaking and we look forward to entering our new agreement. Hopefully, I’ll be here to sign it all off in June 2018.
Does this in anyway positively affect the experience of patients going through the health system? Of course. If you’re not under threat of losing your job or being put off as nurses, if you’re not struggling with frontline services as we know a lot of doctors and nurses and other allied professionals were when cuts were being made, of course you provide a better service to the public and that’s what this is all about – an environment where it is cooperative, it is productive and one based upon not losing sight that patients are obviously the ones that we want to look after. A happy public service is a good public service! Please note this is an edited excerpt from the original interview. The full transcript is available on our website at www.amaq.com.au.
Doctor Q Winter 25
MEET NEW AMA QUEENSLAND PRESIDENT
Dr Bill Boyd
26 Doctor Q Winter
Last we heard of Dr Bill Boyd, he was undertaking a 380-kilometre walk from Mackay to Townsville. Now Dr Boyd is taking on a whole new challenge: Presidency at AMA Queensland. Dr Boyd has strolled the halls around Hunstanton (AMA Queensland’s offices) for many years in a number of different roles, most recently as Chair and Vice President. “I have joined a variety of clubs and organisations over the years and invariably I seem to end up in the chair. Call me ambitious but the lure of our Presidency has been there for some time and you may well ask me why. “I can say that there are those in life who are content to let others run the show and there are those who are driven to run that show. Sometimes I feel I should sit back but I have never been one to just let things happen. I have had my fingers in all sorts of pies and right now AMA Queensland is my priority,” said Dr Boyd. Dr Boyd’s CV includes a year in a University Hospital Pathology department doing autopsies and histopathology, a year as general practitioner in Weipa, specialist obstetric gynaecology training in Dundee, London, Cardiff, Redcliffe and Adelaide with numerous air retrievals.
“Central Queensland has been a study in regional health care, with particular reference to the self-reliance health care workers develop when deprived of support,” said Dr Boyd. “Getting to know IMGs - I am one - is undoubtedly an enriching experience and one which fosters an appreciation not only of cultural differences and the challenges those differences bring but also an appreciation of how likeminded we are,” he said. When quizzed about what he saw as the most important issues affecting members, Dr Boyd is passionately against the increasing bureaucracy of medicine. “If you are really sick, the only person who is in a position to help you is a doctor. “There are those who would just love to control the medical profession, tell us where and when we will work and what we will be paid. Drip by drip there has been a move to homogenise doctors into a two dimensional blancmange which can be manipulated and served with a spoon.
“Doctors across Australia are very unhappy indeed at present with suffocating, wasteful administration. We have seen too many non-medical staff interfering with what’s best for the doctor and their patient,” he said. “I hear around the clinics that doctors are concerned about the overinvolvement of administration in clinical care. A senior country GP said recently that five people now wedge between him and his patient. There is concern about regulatory authorities and their interference with good medicine,” Dr Boyd said. Dr Chris Zappala, who has served as President for the past two years, officially handed over to Dr Boyd at the Annual General Meeting on 12 May. “To have the confidence of the members of any organisation is a privilege afforded to few people. To have the confidence of AMA Queenland is something of a life event and one to which any President must look upon with a sense of awe and not a little trepidation,” said Dr Boyd.
Over the last 30 years, Dr Boyd has worked in Mackay, servicing nine different country towns, working with the general practitioners, many of whom were also international medical graduates (IMGs). “I worked at every level in a range of hospitals from ward orderly in geriatrics to Chairman of a Medical Advisory Committee. “My time as an orderly gave me an acute understanding of the various levels of hospital staff and their concerns. My time in Weipa gave me deep understanding of solo GPs in isolation. Adelaide showed me there are different ways of doing things in health care.
STROLLING THE BRUCE The walk, done for a second year in a row, aims to walk the talk: showing how doctors, who advise patients on the benefits of exercise, need to get out and make time for their own health too.
"Every day doctors, allied health practitioners and nurses deal with people who are overweight. People look to us for advice and that is where the 'Walk the Talk' message fits in. "If we want to be successful rolemodels and spread the message about healthy living, then it all begins with us."
Doctor Q Winter 27
2017 - 2018
Board and Council Dr Bill Boyd MBCHB (DUNDEE) FRCOG FRANZCOG GAICD
Dr Jim Finn DIPT BED MBBS FRACGP FACRRM
Councillor
Board member
Dr Shaun Rudd MBBCH BAO (BELFAST) FAMA
President Specialty: Obstetrics and gynaecology
Vice President Specialty: Addiction medicine
Chair Specialty: General practice
“It is my intention as President to work closely with the Board of AMA Queensland to further the interests of our members. I will support and uphold AMA Queensland, its standards and aspirations and will work on behalf of the members towards achieving the goals of the association.”
“I support continued government funding of the public and private medical sectors with no reduction of services in either sector. In these times of fiscal austerity, an AMA Queensland Council, which continues its support for government funding of medical services at historical levels of service growth, is vital. AMA Queensland’s continued excellent advocacy in the field of preventative health is even more essential in these financially restricted times. I am excited to be part of such a forward-looking, innovative, evidencebased organisation and look forward to further initiatives, which support the cohesion of the profession.”
“My goal is to represent and serve the members of our association and continue building a strong membership and financial base that provides us with a powerful lobbying platform.”
Dr Tom Arthur BSC MBBS G R A D D I PA P PA N AT
28 Doctor Q Winter
BSC MBBS FRACGP DCH General Practitioner Craft Group Specialty: General practice, skin cancer medicine
Gold Coast Area Representative Specialty: Surgery “I’m a firm believer in the importance of the AMA to the medical profession and the health system as a whole. It is an organisation that can, and does, initiate change for the better. My role within the Council is to promote the interests of practitioners in my region, so that they can have a voice in the decisions that affect our profession and our patients. As a trainee, I have a particular interest in the education and training of doctors, and will advocate strongly to ensure doctors in training have adequate educational and employment opportunities.”
Dr Paul Bryan
Dr Kimberley Bondeson BSC (HONS) MBBS FRACGP DAME
Greater Brisbane Area Representative Specialty: General practice, aviation medicine “My intention is to represent the views and voices of the doctors in the Greater Brisbane area. This includes both public and private doctors, specialists, general practitioners, and doctors in training. I will ensure that concerns of our patients and the public are listened carefully to, and advocate for those who do not have a voice. We are proud to have set up ongoing dialogue between politicians, AMA Queensland and our local doctors.”
“Our profession is at a crossroads: general practice and public healthcare remain chronically underfunded, of particular concern given the ageing population and growing burden of chronic disease; our rural workforce crisis shows no sign of abating, whilst the burgeoning number of graduates creates bottlenecks in the training pipeline and threatens the quality of vocational training; pharmacist and allied health groups continue to agitate for a greater role in primary care, whilst emerging technologies threaten to fragment care and undermine the doctorpatient relationship. As an AMA Queensland Council Representative, I intend to be a tireless advocate for junior doctors, general practice, and the medical profession in general.”
Responsible for determining questions and matters of policy for the association, making by-laws about ethical considerations (including handling complaints related to the profession), and making recommendations to the Board of Directors about representing the association on all matters of policy with government or other stakeholders, the 2017-18 AMA Queensland Councillors are here to represent and advocate on behalf of all members.
Dr Matthew Cheng AMUS A BSC MBBS (HONS)
Dr Michael Cleary PSM MBBS FACEM MHA FRACMA AFACHSE
Doctors in Training Representative Specialty: Plastic and reconstructive surgery
Greater Brisbane Area Representative Specialty: Medical administration and emergency medicine
“As a doctor in training and the Chair of the AMA Queensland Council of Doctors in Training, I endeavour to be a strong voice for all doctors in training around the state. The most significant issues facing doctors in training include workforce planning and fair access to training programs, bullying and harassment, industrial relations and professional development. A particularly vulnerable group are non-accredited registrars. I will continue to be a strong advocate and ensure matters facing doctors in training are highlighted and addressed.”
“Leadership by the medical profession in the design and operation of the Australian healthcare system is essential. AMA Queensland’s role in supporting the development of medical leadership is essential in ensuring well-constructed and considered advice is provided to the community, government and health managers.”
Dr Dilip Dhupelia
LRCPS (IRE) DIP OBST ACOG FRACGP FARGP AFRACMA FAICD
Dr Sarah Coll MBBS FRACS FAOA Specialist Craft Group Representative Specialty: Orthopaedic surgery “I am keen to represent regional doctors, and those who work too hard to represent themselves. I would like to see doctors advocate for their own quality of life and set an example of healthy living. I am interested in the role doctors have to play in advocating for change in nutrition and activity practices across their communities.”
Dr Michael Clements
MBBS B.ECON(HONS) MPH MHM DAVMED
North Area Representative Specialty: General practice “My goal on the AMA Queensland Council is to represent and promote the interests of Far North Queensland doctors and practitioners in private general practices, in particular those in rural and remote areas. AMA Queensland also offers a lot in terms of support and advocacy for junior doctors and general practice registrars and I look forward to supporting our members in Far North Queensland in these matters.”
Dr Katherine Gridley BSC MBBS PGCERTAEROMED
Member Appointed Director Specialty: General practice
Greater Brisbane Area Representative Specialty: Emergency medicine
“Having had extensive medical experience in both the public and private sectors, as well as within the federal and state government sectors, I feel I have a good grasp of health policy drivers, ensuring holistic care within a seamless patient journey and improvement strategies in areas such as integration of primary and secondary services in rural areas. As an AMA Queensland Councillor and Board Director, I look forward to working within a wide-ranging team and hopefully add value to the fine work already being performed in representation, leadership and advocacy.”
“As a trainee, I believe I bring a different perspective to the AMA Queensland Council. My work with the Council of Doctors in Training means I am aware of the contemporary issues facing our large trainee cohort and I endeavour to ensure their voices are heard. What I lack in years of medical experience I believe I make up for in my constant engagement with my local trainee, medical student and AMA community, and I continue to strive to be an approachable colleague whom they can trust to advocate on their behalf.”
Doctor Q Winter 29
2017 - 2018
Board and Council Dr John Hall
MBBS BSC (HONS) FRACGP FACRRM DRANZCOG (ADV) GRADDIPRURAL ACSCM
Dr Geoffrey Hawson
FRACP FACHPM DIP CLINHYP CFTE [ ATA A ] F R C PA
Downs and West Area Representative Specialty: Rural procedural medicine and general practice
Retired Doctors Representative Specialty: Clinical haematology, medical oncology, palliative care
“As a representative of rural and regional Queensland, I hope to help advise the Council on issues affecting the health of rural Queenslanders and their health care teams. I intend to highlight important issues including the strengthening of the rural health care workforce; access to essential health care for the bush, including quality primary care, emergency services, inpatient care and maternity services; and strengthening access to outreach specialty services.”
“Having reached the point of imminent permanent retirement, I am passionate about ensuring we medical professionals can continue to contribute to medicine and a lifetime of training does not go to waste. I hope to be able to lobby on behalf of our senior members. If a retired judge can run a royal commission, why are we considered past our prime just because we hang up our shingle? Consideration needs to be made for genuine impairment but, if not impaired, why waste a resource?”
Councillor
Board member
Dr Wayne Herdy MBBS BA (HONS) LLB LLM FACLM North Coast Area Representative Specialty: General practice “I aim to represent the views of my constituents to Council; to promote patient safety especially by diminishing role substitution and developing task delegation; and to assure the future of young graduates by promoting best education and best career prospects.”
Professor Steve Kisely MD PHD FRANZCP FRCPSYCH FFPH FAFPHM FACHAM
Dr Scott Horsburgh B NURS MBBS FRACGP General Practitioner Craft Group Representative Specialty: General practice “As an AMA Queensland Councillor, I hope to focus on improving the MBS rebate for medical practitioners to help make general practice viable. I feel it is important that we keep advocating for improved clinical training pathways for medical students and junior doctors with access to general practice exposure during that time. I have worked across many aspects of the health care spectrum including critical care, general practice and defence. I look forward to working with the hard-working team that makes up the AMA Queensland Council and I hope to continue advocating for all doctors.”
30 Doctor Q Winter
Dr Richard Kidd BHB MBCHB DIP OBS Member Appointed Director Specialty: General practice “I intend to work for doctors to be free and safe to practice and teach medicine to the highest standards and thereby promote patient and community good health.”
Greater Brisbane Area Representative Specialty: Psychiatry, public health and addiction medicine “I was elected last year on a platform of AMA reform with a refocus on advocacy and equity for all members irrespective of gender, age, career stage, practice location and country of graduation. Importantly, office-bearers must remain independent of party politics and pursue the interests of physicians and patients irrespective of the government in power. My goal is to improve the Council’s transparency for AMA Queensland members.”
Dr Bav Manoharan
Dr John F. Murray
MBBS BSC
MBBS FFARACS
Member Appointed Director Specialty: Surgery
Specialist Craft Group Representative Specialty: Salaried anaesthetist
“As a training doctor and a Brisbane and Gold Coast region representative, I will focus on representing my colleagues at both the Council of Doctors in Training (CDT) and Council level. We need to work to improve the quality of and fair access to training and education in both the prevocational and vocational arenas, including ensuring training is affordable to trainee doctors and working conditions and awards are protected and enforced. As an organisation, we need to prioritise our engagement with our membership and deliver value to them. I look forward to assisting all directors, councillors and members of the profession who ask for my counsel.”
“My intention is to present the concerns of specialist AMA Queensland members to Branch Council.”
Dr Alex Ritchie
“As a new consultant in specialist medicine, with a broad practice that encompasses the public and private sector, I feel I can contribute meaningfully to the AMA Queensland Council and explore some of the challenges faced by junior Specialist doctors. I look forward to working with my fellow AMA Queensland councillors as we strive to continually improve the delivery of best medical care for all in Queensland.”
MBBS MBA FRACGP GAICD Member Appointed Director Specialty: Breast physician, general practice “The AMA has a powerful voice, and we must ensure that we work constructively toward outcomes that are real and useful. I am pleased to do my part to achieve the best possible health care for Queenslanders, including assuring sustainable high quality training for our junior colleagues.”
Dr David Shepherd MBBS FRACS FAORTH A Far North Area Representative Specialty: Orthopaedic surgery “My intention on the AMA Queensland Council is to represent the views and needs of Far North Queensland doctors by acting as a conduit for communication between them and the AMA organisation.”
BA BSC MBBS (HONS), FRACP Specialist Craft Group Representative Specialty: Thoracic and sleep medicine
Dr Kirsten Price
Dr Nicholas Yim BPHARM MBBS FRACGP General Practitioner Craft Group Specialty: General practice
Dr Chris Zappala
MBBS(HONS) MHM AMUSA GCAE GAICD MD FRACP
Immediate Past President Specialty: Thoracic and sleep medicine “I’m interested in emphasising the central importance of members to our organisation. I want AMA Queensland to be a proactive and positive participant in health care reform. The fundamental purpose of AMA Queensland is to restore faith whenever it is required and, through broad representation, be able to respond to industry and professional threats and opportunities in an intelligent and evolving manner to best meet our collective objectives. Key to this is a critical requirement to always find unity and strength from our diversity.”
“I hope to bring enthusiasm and representation to address issues facing regional Queensland. I intend to advocate for all doctors and to ensure the high standards of the clinical training, which I hope will in turn improve the health of our communities and patients.”
Doctor Q Winter 31
Queensland - specific solutions to regional, rural and remote issues
poorer outside major cities. The main contributors to higher death rates in regional and remote areas are:
These higher death rates may relate to differences in access to services, risk factors and the regional/remote environment:
Dr John Hall, Chair, Regional, Rural and Remote working group, AMA Queensland AMA Queensland has always been dedicated to representing the interests of all Queensland doctors and the communities they serve. We have a proud history of promoting healthy living through a strong public health program, and working with government to improve health service delivery. Over 30 per cent of Queensland’s population live outside our metropolitan areas and in 2017, we have a renewed focus on the health of rural, regional and remote Queenslanders. We know that the health outcomes for rural Australians are significantly worse than those living in metropolitan areas. Death rates increase with increasing remoteness from 5.5 per thousand population in major cities to 8.4 in very remote areas; and the rate of suicide is 66 per cent higher in the country than in major cities. Health outcomes, as exemplified by higher rates of death, tend to be
32 Doctor Q Winter
coronary heart disease; other circulatory diseases; motor vehicle accidents; and chronic obstructive pulmonary disease (e.g. emphysema).
The life expectancy of Australians living in regional areas is 1–2 years lower and in remote areas is up to seven years lower than for those living in major cities. People in outer regional and remote areas (excluding Very Remote areas and discrete Aboriginal and Torres Strait Islander Communities) are more likely than urban dwellers to: be a daily smoker (outer regional and remote 22 per cent compared with 15 per cent in major cities); be overweight or obese (70 per cent compared with 60 per cent); be insufficiently active (60 per cent compared with 54 per cent); drink alcohol at levels that place them at risk of harm over their lifetime (24 per cent compared with 19 per cent); and have high blood cholesterol (37 per cent compared with 31 per cent). Higher death rates and poorer health outcomes outside major cities, especially in remote areas,
also reflect the higher proportions of the populations in those areas who are Aboriginal or Torres Strait Islander people. AMA Queensland recognises that the health of people living in Queensland’s rural communities is compromised by the maldistribution of doctors, with insufficient access to appropriately qualified, skilled and trained medical professionals and health care teams. We have also identified the importance of strong and robust regional hospitals to support the care delivered in the bush. Queensland’s regional hospitals are lacking in the range and number of essential specialties to service the whole state equitably. Lack of appropriate medical workforce is a key component to this inequity and as such has become the initial focus of our policy work in this area. In late 2016, AMA Queensland formed the Queensland Rural, Remote and Regional (QRRR) working group to investigate Queensland-specific solutions to issues of medical workforce shortages in this state’s regional, rural and remote areas. The QRRR has been tasked with developing a discussion paper to find solutions for the workforce problems facing RRR areas. As part of the discussion paper, the QRRR will develop tailored solutions for the Hospital and Health Services (HHSs), which cover these areas. The QRRR working group has developed a survey to canvass members and local medical associations to find out what specific solutions each HHS needs to resolve shortages in these regions. This survey of members will inform our policy going forward with a view to providing practical solutions to the ongoing problem of rural health disadvantage in Queensland.
Local Medical Association round up Redcliffe District Local Medical Association (RDLMA)
Ipswich & West Moreton Medical Association (IWMMA)
Gold Coast Medical Association (GCMA)
Contact:
Contact:
Contact:
Dr Kimberley Bondeson, President Web: www.rdma.org.au Phone: (07) 3284 9777 Meetings: 27 June 25 July 23 August - AGM 12 September 25 October 1 December - networking function
Sunshine Coast Local Medical Association (SCLMA) Contact: Jo Bourke, Secretariat Web: www.sclma.com.au Email: jobo@squirrel.com.au Phone: (07) 5479 3979 Meeting: 22 June 27 July 31 August 26 October 30 November
Bundaberg Local Medical Association (BLMA) Contact: Dr Daud Yunus Email: daud.yunus@gmail.com Phone: (07) 4152 2888
Mackay Local Medical Association (MLMA) Contact: Phone:
Dr Bill Boyd 0419 676 660
Phone:
Dr David Morgan, President; Dr Aletia Johnson, Meetings Convenor; Dr Thomas McEniery, Treasurer (07) 3281 1177
Brisbane Northside Local Medical Association (NLMA) Contact:
Dr Robert (Bob) Brown, President Web: www.northsidelma.com Phone: (07) 3265 3111 Meetings: 13 June 8 August 10 October 12 December
Toowoomba and Darling Downs Local Medical Association (TDDLMA) Contact:
Dr Mark Wyche, President; Dr Peter Schindler, Treasurer Web: www.tddlma.org.au Email: info@tddlma.org.au Phone: (07) 4633 1939 Wilsonton Medical Centre (Dr Peter Hopson) Meetings: First Tuesday of each month, 7pm at St Andrew’s Hospital, 280 North Street, Toowoomba
CAN’T FIND YOUR LOCAL AREA?
Chantell Badenhorst, Secretariat Manager Web: www.gcma.org.au Email: info@gcma.org.au Phone: 0419 780 505 Meetings: 16 June – social 20 July – clinical 17 August – clinical 21 September – clinical 19 October – clinical 17 November – social
Fraser Coast Local Medical Association (FCLMA) Contact: Dr Nicholas Yim, Secretary Email: drnnyim@gmail.com Phone: 0421 659 892
Cairns Local Medical Association (CLMA) Contact: Phone: Meeting:
Dr Sharmila Biswas (07) 4036 4333 17 March 2017
Central Queensland Local Medical Association (CQLMA) Contact: Phone:
Dr Michael Donohue 0419 715 658
If your Local Medical Association does not appear or your details are incorrect, please email amaq@amaq.com.au. Doctor Q Winter 33
End of life care campaign continues
AMA Queensland’s campaign to raise the profile of care at the end of life continues with a social media campaign for over 50s to talk to their GP about advance care planning.
There were three elements to the campaign: a media launch, a digital campaign and a discussion paper to the Queensland Government.
Our recommendations to government included:
increasing access to and the use of advance care planning; reviewing Queensland’s palliative care needs to ensure funding targets areas in need; increasing funding to ensure palliative care services are available to all Queenslanders; setting up fully resourced specialist palliative care units in each region; establishing the Queensland Medical Education and Training Institute (QMETI) to provide specialist palliative care and palliative medicine training.
The digital campaign featured seven videos urging Queenslanders to talk to their GP about how they want to be treated and cared for at the end of their lives. The videos included Oakey GP Dr John Hall with 99-year-old Merle McCoist and her daughter Dianne Reed, as well as Townsville palliative medicine specialist Dr Will Cairns and Brisbane GP Dr Richard Kidd. The one-minute end of life care videos are a valuable resource that you could use when discussing the end of life care with your patients. The videos included:
34 Doctor Q Winter
Care at the end of life Making an Advanced Care Plan
What is advance care planning? Why is advance care planning important? How do I make an Advanced Care Plan? Advance Care Plan, what to do? Merle McCoists’s Advance Care Plan
Stage two of the end of life care campaign, to be rolled out later this year, will involve a statement of choices booklet for children and young adults. AMA Queensland has convened a working group, the Paediatric Palliative Care Working Group, to develop a planning document to help doctors, families and patients discuss their wishes at the end of life for children and adults with a terminal illness. Similar documents exist overseas but it was identified that a gap existed in Australia in this space. Our hope is this will reflect the adult document recently introduced in Queensland Health and become just as useful in time. AMA Queensland believes that with more funding for palliative care and a humane, compassionate approach, Queensland could lead the nation in end of life care. The campaign has certainly started a conversation, with coverage on ABC TV and news, 4BC radio and social media. We continue to work with stakeholders and will expand our campaign to maximise its impact to further encourage the Queensland Government to implement initiatives that support best practice in end of life care. Watch the videos at the AMA Queensland YouTube channel: https://www.youtube.com/user/ AMAQLD
Looking for a new medical job?
Sign up to the jobs board dedicated to medical professionals:
jobs.doctorportal.com.au Doctor Q Winter 35
Unity is the best protection excitement that I made my way to L’Estrange Terrace that evening. I understand this may not be everyone’s idea of a good time, but for a young man who has enjoyed rolling up his sleeves beyond the elbow and discussing the finer points of employment awards since work choices days, it had an appeal.
Dr Chris Maguire, Junior House Officer, Logan Hospital; and Deputy Chair, AMA Queensland Council of Doctors in Training
I was recently invited to attend an Australian Salaried Medical Officers Federation of Queensland (ASMOFQ) meeting as a junior doctor observer. As a beneficiary of the pay rise negotiated by this union (among other parties) in MOCA 4, I was grateful for the opportunity to attend, if for no other reason than to offer my thanks for a job well done. I have now been involved with AMA Queensland for a number of years - I have attended AMA Queensland Council meetings, doctors in training meetings, conferences, and dinners - but I had never been to an affiliated medical union meeting. So it was with a certain degree of 36 Doctor Q Winter
Open disclosure, I have had a long association with unions in a number of minor capacities and have held an elected position in a Labor branch. All of this, understandably, has impacted on my views regarding workplace relations. In general, most trade and service industry workers have been a sympathetic audience for unions. Interestingly though, despite the similarities in workplace role (apprenticeship models of training, and service provision) doctors are not. The reasons for this are no doubt multifaceted: a self designation of ‘professional’ rather than ‘trade worker’; a likelihood to pay more tax dollars than are received in social services (notwithstanding HECS); and, a propensity to view medicine as a vocation rather than as a service industry. The are no doubt many others. These reasons are not trivial, and I understand
them, but the outcome is that union membership among doctors is not a source of pride. In many cases, it is unspoken and incidental - hidden behind reciprocal membership agreements that exist with AMA Queensland. We are not unionists so much as collegiate members of a professional body that just so happens to offer union benefits via a third party. This is functional but not ideal. It is also harmful to the least empowered and least flexible members of the profession - its junior members. The difference between SMO employment benefits and those received by doctors in training is considerable, and represents more than just a difference in experience and specialisation. There is a significant power imbalance that exists between the two in the absence of effective collective bargaining. The loss of a vascular surgeon, or a paediatrician, or an intensive care physician to Queensland Health is far greater than the loss of a resident - that is self evident. And a resident does not have the opportunity for private practice as a recourse. Without effective union membership, collective bargaining and true unity between all levels of experience, the outcome of this is an ever-widening gap in
employment standards between the most senior members of the profession and their junior colleagues. The meeting that I attended was necessarily bureaucratic. It spent hours on the important but nuanced details of niche award and certified agreement clauses. However, it was punctuated by personal updates of real people who had been unjustly treated and who in that moment had turned to the union for help. These were people who had retained their jobs, been exonerated of spurious claims, or compensated for harassment - colleagues of ours who had needed an advocate and had found one. As a whole, it was unionism at its best effective, meticulous and unheralded. There is no such thing as a perfect organisation. As a royal commission has now evidenced, unions are not immune to corruption, abuse, and bullying. Reform is needed, greater vigilance remains essential, but rejection will not serve anyone. The answer remains greater engagement, and most importantly engagement by people who care about their peers and what happens to them. This has always been the core of unionism and it should always remain so.
Doctor Q Winter 37
Keeping health workers safe Dr David Rosengren Emergency Physician and Chair of the Queensland Clinical Senate
It is a real privilege to be a health professional and to provide care to people when they are at their most vulnerable. As a general rule, the community value and respect the opportunity they have to receive that care. Sadly though, as an emergency physician in one of Queensland’s busiest emergency departments (ED), I witness incidents of violence and aggression and the impact this has on staff and other patients. I’ve seen clinicians unable to return to work following vicious assaults from patients or visitors in the hospital and I’ve seen patients self discharge from the ED before essential medical care is completed because they fear for their safety due to the volatile environment. This is not just a problem in our EDs with incidents of violence in mental health facilities, in outpatient clinics and on medical and surgical wards. It is completely unacceptable that 3,000 Queensland healthcare workers report abuse each year. Concerningly, it is well recognised that many more incidents of abuse go unreported. Healthcare professionals go to work to provide care to patients—they shouldn’t expect to become patients themselves. We should not have to become experts in self-defence in order to safely deliver care in our hospitals. Every healthcare worker in Queensland should feel safe walking to their car 38 Doctor Q Winter
at the end of shift and not worrying about the threat of violence from the relative of the patient they were caring for earlier during the day. It is really pleasing to see that there is a strong investment across Queensland to reduce the incidence of violence and aggression in our healthcare facilities. Championed by Health Minister Cameron Dick and led by Ken Whelan, Chief Executive for Metro North Hospital and Health Service (MNHHS), the Statewide Occupational Violence Implementation Committee is overseeing the implementation recommendations from the Occupational Violence Prevention Taskforce - http://qheps.health.qld.gov. au/safety/occup_violence/taskforce.htm Following a recent trial in Metro North, all emergency departments now have permanent security staff embedded within the department, and security officers now are equipped with body worn cameras. These cameras—the same as those used by our colleagues in the Queensland Police Service (QPS)—act as a deterrent for potential violence and assist the QPS to prosecute offenders. CCTV has been upgraded and expanded across many HHSs and swipe card readers trialled at the Royal Brisbane and Women’s Hospital have now been installed in a number of emergency departments around the state. This technology enables staff to easily and quickly record incidents of violence. More broadly across Queensland, additional initiatives are underway to tackle the problem including staff training on prevention and response,
violence reporting hotlines, greater investment in support for victims of violence. Strong partnerships have been forged with ambulance and police colleagues and a $1.35million public awareness campaign is being rolled out. We still have a long way to go but there is a commitment at all levels for this work to continue and we are definitely starting to see a difference. Frontline staff are feeling supported. Anecdotally, we’re hearing that the initiatives are working to safeguard our staff and to change community behaviour, and that we’re seeing less violent and aggressive incidents as a result. At the most recent meeting of the Queensland Clinical Senate, the importance of occupational violence prevention and the need for continued action was reinforced by a series of mock violent incidents based on real life scenarios. The hypotheticals stimulated great discussion around occupational violence prevention and served as a critical reminder for each of us to take responsibility for promoting the implementation of statewide and local initiatives designed to keep healthcare staff safe. Occupational violence needs to be recognised and promoted as a ‘clinical issue’ in the same way patient care is. The Queensland Clinical Senate commends the leadership provided by the Queensland Government and Occupational Violence Prevention Implementation Committee to address violence in the workplace.
Escorted Study Tours in 2017 & 2018
Culture and Cuisine Cruise in the Mediterranean
History of Medicine Cruise in the Mediterranean
Iran: Historical and Contemporary
3 – 15 September 2017
3 – 15 September 2017
2 – 15 October 2017
Cruise through Spain, France and Italy and see how culture, history and geography shape cuisine, with private visits and tastings with John and Kate Lethlean.
Explore how history, medicine and culture intertwine with private visits and talks as you cruise the Mediterranean with Dr Simon Chaplin and Natasha McEnroe.
Discover the soul of Iran with renowned archeologist Dr John Tidmarsh. Enjoy exquisite teahouses and gardens, spectacular architecture and archaeology.
Medical and Military History in South Africa
Journey Along the Malabar Coast
Palliative Care in South India
16 – 29 January 2018
28 January – 12 February 2018
7 – 22 February 2018
Travel through this spectacular country and learn about its overlapping medical, military and cultural histories with tour leader Dr Paul Luckin.
Explore India’s bewitching Malabar coast, a meeting place of cultures throughout history, its lush landscapes redolent with spices, culture, trade and heritage.
This tour takes you to three very different states in South India to give you a top to bottom view of palliative care within the context of its culture and society.
A Grand Heritage Tour to North India
Medicine in Brazil and Argentina
Paediatrics and Child Health in China
3 – 18 March 2018
4 – 17 March 2018
15 – 28 April 2018
India is a land like no other in the richness and diversity of its people, its culture and its history. Follow in the footsteps of its history and hear its stories.
Travel from Rio to the vast waterfalls of Iguazu and onto sophisticated Buenos Aires. Extension to the glaciers of Patagonia.
Look at paediatrics and child health in China within the context of a fastchanging society in the company of tour leader, Dr Nicki Murdock.
To book or enquire about these and other tours contact: Jon Baines Tours (Melbourne) Tel: 03 9343 6367 • Email: info@jonbainestours.com.au
www.jonbainestours.com Doctor Q Winter 39
Extending the compassion to our colleagues
Dr Katherine Gridley, Doctor in training representative, Queensland Doctors’ Health Programme
QDHP
Queensland Doctors’ Health Programme
Queensland Doctors’ Health Programme (07) 3833 4352
I recently found myself working in a rural Queensland emergency department, inadvertently rostered on for 15 days straight with four nights on call, and I was not happy.
me constantly sleep-deprived and stressed. My mind was failing, and I could have easily made an anaphylactic drug error, or sent home the feverish child only to return mottled and septic.
It was day nine of my never-ending fortnight that broke me. I only truly appreciated my exhaustion when I found myself standing at the fridge pressing the button on my car keys, perplexed as to why the door wouldn’t open. One of the SMOs at work became increasingly cross with me, and my worsening cognitive sluggishness had lead him to pull me aside. When he asked, “What on earth is going on?”, I embarrassingly burst into tears.
Although it didn’t solve the problem, having my SMO realise that I was broken meant that the roster could be rearranged to bring my horrific run of shifts to an end. A simple act of compassion from a senior doctor was all it took for me to have some calm restored in my otherwise hectic life. A case in point – doctors are powerful.
What no one from work knew, was that in conjunction with this nightmare roster, I was dealing with the spectacular mental breakdown of a loved one, who like many doctors, was withdrawing from everyone who cared in the false hopes that this would protect them from his pain. There is little as scary as days of silence from someone you love, knowing they desperately need help but knowing that you cannot be physically there for them. This fearful helplessness is only made worse when their medical specialty grants them access to some dangerous means of achieving a quick and painless death if required. My emphasis is not on the inconvenience of this situation, but of the powerful effect that being a doctor has in these circumstances, and why it is so damn important that we start to take doctors’ mental health seriously. Because when a doctor is struggling, a whole world around them suffers. Their partner, their family, their friends, and consequentially, their patients. While I myself was not suffering from depression, knowing that someone I adored was acutely suicidal with the means to achieve this was complete torture. It left
40 Doctor Q Winter
Consultants have such a privileged role to play in the mental health of their juniors, but only if they choose to do so. Never mind the “well, in my day…” attitude. We’ve gone from a system with an abundance of jobs and few practitioners two decades ago, to a stampede of junior doctors bombarded with the stress of competing for jobs, muddled amongst their lives already overloaded with financial concerns, family commitments and a vague resemblance of attempting to ‘be healthy’. While our lives may have changed, deep down the inherent compassionate nature of medicine has not. So I pose a question to my senior colleagues – if your partner or child was mentally falling apart, how would you feel? Then add to this anxiety a 100hour fortnight, a mortgage and specialty exams, and then demand that you take better care of yourself. Suddenly it doesn’t quite seem so easy. While I don’t have the answer to solve the doctors’ mental health crisis in our midst, I can suggest that a little kindness goes a long way – because everyone you meet is fighting their own battle, you just don’t know about it yet. The QDHP provides an independent, confidential, colleague-to-colleague support service to assist doctors and medical students.
STOP DREAMING. START DRIVING.
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HERTZ.COM.AU Doctor Q Winter 41
First associate members
AMA Queensland’s updated constitution allows the Board to award associate membership to a person who is not a medical practitioner, but who has given honourable and or substantial service to the medical profession in Queensland. Congratulations to Colleen Sullivan OAM and Patrick Staunton, who have been awarded the first associate memberships with AMA Queensland.
Patrick Staunton Colleen Sullivan OAM BA FAAPM LIFE MEMBER CPM DIP PRAC MAN
Colleen has a strong commitment to healthcare practice management and the role of the practice manager. She is a presenter and assessor with the UNE Partnerships Professional Practice Management Program. Colleen has been a strong and active supporter of AMA Queensland for over 20 years. She has been a key point of contact between our association and the Australian Association of Practice Managers. She has assisted the Workplace Relations Team with their training activities, through direct advice and participation as guest speaker. She has been a guest speaker and planner for the AMA Queensland Annual Conference.
42 Doctor Q Winter
CA ANZ ADIPCOMP BBUS GRADDIP ACCTG DIPFINPL AN GRADCERT APP FIN
Patrick is a chartered accountant who established a successful salary packaging company that later became a subsidiary of a listed company, where he continued as CEO until 2007. Patrick operates his own practice, mainly in the areas of taxation accounting and superannuation for smallto-medium businesses. He has also worked extensively on projects with medical specialists for Queensland Health and other organisations, as well as working closely with clients as a consultant in their business management. Patrick has been a strong and active supporter of AMA Queensland for over 15 years and has been the Chair of the Finance Risk and Audit Committee since 2009.
the
adventure of a L IFET IME awaits...
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The Great Ocean Road 100km Walk, 7-13 Sep 2017 To find out more contact our fundraising team on: phone: 07 3506 0999 or email: fundraising@diabetesqld.org.au
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Doctor Q Winter 43
Events Calendar
WORKPLACE R E L AT I O N S W E B I N A R TRAINING SERIES Date: Friday 23 June 2017 In the first webinar of the series, AMA Queensland’s Workplace Relations Manager George Sotiris will take you through Personal/Carer’s Leave and Compassionate Leave 101. Log in on the day, or, if you can’t attend the live webinar, you can register to receive a recording of the webinar to listen to in your own time. Webinars on social media and managing underperformance will happen later in the year.
Visit www.amaq.com.au for more information or to register for our upcoming events 44 Doctor Q Winter
JUNIOR DOCTOR CONFERENCE
DOCTORS IN TRAINING AWARDS
Time: Saturday 8am – 10pm Sunday 9am – 4pm
Time: 6.30pm – 9pm
Date: Saturday 1 - Sunday 2 July 2017 Location: Hilton Brisbane Explore future frontiers in medicine with a fantastic lineup of speakers: Master and Commander scriptwriter Dr John Collee, Transplant Physician Professor Karen Dwyer, Professor Gordian Fulde and Dr Renee Lim. This year, we’ve also added Clinical Skills Simulympics to the mix, but we’ve kept the cocktail party, the live junior doctor issues forum and the research abstracts.
Date: Saturday 1 July 2017 Location: Hilton Pool Deck, 190 Elizabeth Street, Brisbane Attire: Business attire or smart casual AMA Queensland will celebrate junior doctors with excellent clinical skills, who have undertaken community or volunteer work, provided support to colleagues and who consistently demonstrate the AMA Queensland values of compassion, trust and knowledge. The Doctors in Training Awards have two categories: Junior Medical Officer (Intern/Resident) and Registrar. The awards will be presented at the Junior Doctor Conference cocktail party.
RACGP POINTS APPLIED FOR *Subject to approval
P R I VAT E P R AC T I C E & MEDICO-LEGAL CONFERENCE
Future-proofing your practice Friday 6 – Saturday 7 October 2017 Brisbane Convention & Exhibition Centre (BCEC)
The Private Practice and Medico-Legal Conference will focus on future-proofing your practice. From e-health, to passing accreditation, exploring new income streams for private practice, digital marketing and managing emerging risks in practice, we have you covered. Streams are available for those new to practice and those who wish to develop and improve upon their existing practice procedures, technology and income. Visit www.amaq.com.au to download the full program and to register.
Preferred Medical Indemnity Provider
Doctor Q Winter 45
Meet JDC speaker Dr Renee Lim Junior Doctor Conference 2017 speaker Dr Renee Lim is a medical doctor, speaker, lecturer, presenter, actor and consultant, working as the health grants advisor for the Paul Ramsay Foundation. She combines all these roles in her position as Director of Program Development at the Pam McLean Centre. Dr Lim has starred in TV drama All Saints, SBS’s East West 101, and more recently, comedy Please Like Me and The Secret Daughter. She also has a number of roles in shorts and films and as a presenter. In 2017, her medical and acting worlds have collided; she has taken on a role as a doctor/presenter on the ABC show Ask the Doctors and as a script consultant and fictional anaesthesiologist on medical drama Pulse. She is a physician, mostly working in part-time, locum posts in emergency medicine, geriatrics, and palliative care departments, and a clinical lecturer at the University of Sydney’s Northern Clinical School. Acting and medicine are two vocations that aren’t normally seen together, but Dr Lim has managed to combine them in her role at one of the leading communication training organisations in health in Australasia, that works with Sydney University and NSW Health. Her great ability for acting is based on her knack of delving into 46 Doctor Q Winter
someone else’s mind and sharing their experiences and her empathetic approach to stepping into the shoes of others. Her passion for treating the whole patient and not just a disease and her interest in developing the team dynamics in our often-overwhelmed hospital system have led her to join the Pam McLean Centre.
patients leaves both parties more satisfied with treatment and produces better health outcomes. Patients are diagnosed more accurately, suffer less pain, recall important information more clearly, and comply more readily with treatment,” said Dr Lim.
The family of Pam McLean donated funds that Professor Steward Dunn, in collaboration with Northern Local Health District and Sydney University staff, used to create the Pam McLean Centre in 2001 after her death from breast cancer in 1995. During her tenyear battle with cancer, husband David McLean said his wife experienced the best and worst in doctor-patient communication. Mr McLean felt moved to create an organisation that would help improve communication between patients and health professionals.
Dr Lim’s work involves creating and implementing interactive teaching programs across all disciplines, specialties, and experience levels on the many facets of communication that occur within the health sector. She is in charge of program development in evidence-based medical communication skills training, which involves experiential simulation workshops. She works with a team of highly skilled scenario researchers and more than 40 professional actors to deliver workshops and training DVDs that allow participants to literally step inside challenging situations and explore these interactions in a safe, supportive and educational space.
Studies from the Pam McLean centre have shown that 70 per cent of junior medical officers are not confident and are unsure of how to break bad news. 20 per cent of all formal complaints about health practitioners are in the category of communication and diagnosis.
Catch Dr Renee Lim at this year’s Junior Doctor Conference, where she will explore the future of medical communication and its importance to patient-centred care, along with practical techniques doctors in training can implement to improve patient communication.
“Extensive research demonstrates conclusively that good communication between health professionals and
Future Frontiers in Medicine S A T 1 J U LY - S U N 2 J U LY 2 0 1 7 H I LT O N B R I S B A N E
Affordable member rates available for two-day or single-day registration. Visit amaq.com.au and click on the JDC tab for more information and to register
Day one
Day two
Dr John Collee
Dr Renee Lim
Former Emergency Doctor and Screenwriter Walking the unconventional path in medicine
Chief Medical Officer and Director of Program Development, Pam McLean Centre Looking to the future of patient-centred care and communication
Professor Karen Dwyer Nephrologist and Transplant Physician, St Vincent’s Hospital Melbourne; and Deputy Head, School of Medicine, Deakin University How a nephrologist became involved in hand transplantation: Australia’s first hand transplant surgery
Professor Gordian Fulde Senior Staff Specialist, Director of Emergency Department St Vincent’s Hospital Sydney; Senior Australian of the Year 2016 Emergency medicine in the ice age: Challenges and advice for junior doctors
Dr Kathleen Thomas Advanced Intensive Care Trainee, St George Hospital, Sydney; and Médecins Sans Frontières volunteer Leadership and team work from the front line of chaos
Junior Doctor Live Issues Panel
The Hon Cameron Dick MP Minister for Health and Ambulance Services, Queensland Health The Health Minister’s Annual Address
Dr Tony Bartone, General Practitioner, Lalor Medical Centre and Vice President, AMA Dr Kate Kearney, Cardiology Advanced Trainee, St Vincent’s Hospital; and Deputy Chair, AMA Council of Doctors in Training
Jane Anderson
Dr Ruth Mitchell, Registrar, Royal Melbourne Hospital and AMA Junior Doctor of the Year 2016
Q & A with recent successful college applicants
Members of AMA Queensland’s Council of Doctors in Training
Clinical Skills Development Service presents Simulympics
Dr James Fielding, Former Doctor; Chief Executive Officer, Audeara; Chief Operating Officer, Field Orthopaedics; and Founder, Robotics Engineering Research Laboratories The MDA National session - Innovations in medical thinking and turning your research dream into a commercial reality
Careers Coach, Jane Anderson Consulting Building your personal brand in medicine and preparing for interviews
Brush up on your emergency clinical skills in this live simulated emergency department scene. Watch the teams battle it out against the clock, navigating an obstacle course of broken body parts, spurting arteries and crunching ribs. Doctor Q Winter 47
Annual AMA Queensland Conference P L A N YO U R R O M A N H O L I DAY
With the theme “Personalised health care – Evolving health care needs through the cycle of life”, the conference will feature a range of worldleading European and Australian keynote speakers on the future of health care, including pertinent topics such as:
The personal journey in health care; Medico-legal issues in relation to personalised health care; The importance of mental and physical fitness throughout life;
Future challenges for infection management; Developments in precision medicine; Issues around end-of-life care; The Health Care Home;
Health care in the formative years; Practice responsibility in the treatment plan; and Shared patient records through life (including My Health records).
Delegates will be educated and entertained by eminent medical speakers from Rome universities, the World Medical Association and leading clinicians from Australia including:
Dr Greg French, the Australian Ambassador to Italy Prof Francesco Curcio, Professor of General and Clinical Pathology, University of Udine Medical School Dr Katriona Munthe, PhD, Consultant Psychologist, University of Siena Dr Marco Falcone, Department of Public Health and Infectious Diseases, University of Rome
Dr Chris Cunneen, Occupational and Environmental Physician, Brisbane Prof Roberto Verna, Sapienza University of Rome Colleen Sullivan, Practice Manager, Brisbane Prof Pablo Requena, Vatican Medical Association.
RACGP points will be on offer. For any enquiries about the program:
Keen to book your Roman holiday now?
Contact Neil Mackintosh AMA Queensland Conference Organiser E: n.mackintosh@amaq.com.au P: (07) 3872 2267
Contact Ros Bulat AMA Travel E: ros.bulat@worldtravel.com.au P: (07) 5556 7222
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TREVI FOUNTAIN The Trevi Fountain, not only the location of our favourite gelato shop in Rome, but also the largest and most famous Baroque fountain in Rome. Freshly restored, after 17 months under reconstruction, the fountain features Neptune (God of the Sea), flanked by two Tritons and symbolising the contrasting natures of the sea. Do as so many others do and throw in your coin to make your wish.
S PA N I S H S T E P S Within walking distance is the famous Spanish Steps, the Piazza di Spagna. Not only is this historic masterpiece beautiful to view but so are the fashion shops located in the Piazza and nearby streets. The area also hosts major fashion shows during the summer months, using the steps as part of the runway.
Ross (Roscoe) Noye 26 JUNE 1958 – 24 MARCH 2017
AMA Queensland Foundation Director and Macquarie Advisor Ross Noye, known to many of you, died suddenly in March while taking part in a charity bike ride from Christchurch to Queenstown for the Mater Foundation to raise funds for cancer research. Ross was one of six children, all born in Goondiwindi. He married wife Mandy in 1975 and had daughter Sarah and son Nick. In life and at work, Ross always built strong friendships. He started out at Metway Bank, where he served as manager of the superannuation and financial planning businesses and served as a foundation member of the Bank’s Investment Committee. Prior to joining Macquarie Wealth Management, Ross was a Partner/ Executive Shareholder and senior
adviser at an ASX listed Australian investment banking, stockbroking and wealth management firm for more than 18 years. At Macquarie Private Wealth, Ross provided retirement planning, investment management, asset allocation advice and stockbroking services to individual investors, corporations, superannuation fund trustees and trustee boards. He also provided specialist investment consulting and management services for Charities and Not-For-Profit organisations focusing on income and dividend imputation management. With this expertise, he has been a strong, reliable supporter of AMA Queensland for more than 17 years. He was a major sponsor and participated as a speaker in all of the AMA Queensland conferences since the first conference in 2001, where delegates enjoyed and learned from his presentations and enjoyed his company together with his wife Mandy. Ross served as a Director of the AMA Queensland Foundation since September 2004. He brought a sharp business mind to the Foundation and his input was always appreciated and valued by his board colleagues. As a sponsor and commercial partner of AMA Queensland, he has supported the association for almost twenty years. He has been a regular
contributor to our magazine, Doctor Q, where he provided valuable, accurate and up-to-date advice on financial management and wealth creation issues for our members. Ross also served as a member of the Australian and New Zealand Head and Neck Cancer Research Foundation Advisory Board. Ross also was a trusted mentor and adviser to a number of other aspiring young people searching for their own success in life and business. From the team at AMA Queensland, we pass on our condolences to Mandy, Sarah, Paul and Nick. We thoroughly enjoyed working with Ross over so many years. His professionalism, his sense of humour and willingness to go the extra mile for AMA Queensland and the AMA Queensland Foundation will be sorely missed. Warren Acworth and Kat Brook at Macquarie were overwhelmed by the calls and emails of support from Ross’s clients.Their comments speak volumes of his character, personality, professional capability and the high regard in which he was held: “He was not only our valued financial adviser, but also a friend and I am sure his passing will have sent a tidal wave through that community. We will miss his integrity and advice and meeting up with him at the AMA conferences.” Doctor Q Winter 49
Member get a member BUILDING THE FUTURE OF OUR PROFESSION.... TOGETHER.
As an active member, you know first-hand the value your membership provides in helping achieve career success and strengthening the medical profession. The AMA Queensland Member-Get-A-Member Campaign provides the ideal opportunity to share this success by encouraging your non-member colleagues to join. A vital and growing AMA Queensland means greater recognition for the medical profession, more resources and support for members, and a louder voice in Queensland. With your help:
AMA Queensland benefits by representing another doctor The new member you recruit benefits by taking advantage of all membership has to offer You benefit by strengthening AMA Queensland and sharing the value of membership with another colleague – plus there are incentives for recruiters.
To take advantage of this offer, ensure the member you refer puts you full name in the comment section of the membership application.
REFER 1 MEMBER
REFER 2 MEMBERS
25% discount on your membership
50% discount on your membership
REFER 3 MEMBERS
REFER 4 MEMBERS
75% discount on your membership
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No membership fee for one year
New members JANUARY Doctors in Training Dr Jane Poon Dr Samantha Howard Dr Sarath Bodapati Dr Vishal Chand Dr Jemma Porrett Dr Stephen Walsh Dr Devesh Dhulekar Dr Angus Lloyd Dr Sean Holland Dr James Ling Dr Hethal Hargovan General Practitioners Dr Adnan Qureshi Dr Rupert Templeman Dr Savithry Unnikrishnan Dr Diepiri Ogolo Dr Pratima Singh Dr Jacki Mein Dr Edward Guirguis Dr Gagandeep Rajpal Dr Amir Abbas Dr Md Shariful Alam Dr Murugesampillai Anandakumarasamy Dr Yasemin Anderson Dr Altaf Ayyaril Dr Trevor Beall Dr Raham Behrouz Dr Ian Butler Dr Javier Armando Campuzano Ortiz Dr Daniel Chew Dr Manuj Chhabra Dr Joel Collins Dr Ashley Collins Dr Poshitha De Silva Dr Chad Donnelly Dr Ghassan Eltatary Dr Manuel Enrile Dr Benjamin Glockler Dr Gwynne Hannay Dr Reza Hayatbakhsh Dr Alborz Jahangiri
Dr Lisimoni Kami Dr Shadi Khalili Dr Satish Kharia Dr Indika Leelasena Dr Aaron Lewis Dr Ji Lim Dr Muhamad Menon Dr Farnaz Moghadam Dr Shaheed Moideen Dr Rouzbeh Mokhtari Dr Reza Moradi Parashko Dr Ikechukwu Osondu Dr Sumer Phutela Dr Ariel Mase Pimping Dr Rajendra Prakash Dr Anil Ratnam Dr Muhammad Raza Dr Mehdi Saeidpour Dr Nathaniel Salmon Dr John-Paul Sanggaran Dr Robert Scott Dr Oliver Segui Dr Momin Sid Dr Seng Tan Dr Theary Thou Dr Christopher Tomsett Dr Rajendra Vimalan Dr Jimmy Wang Dr Ijenikhoumwen Wellington Dr Ryan Wellington Dr Surya Yedavilli Dr Amith Zainudheen Dr Anis Zand Irani Specialists Dr Hugh McGregor Dr Sarah Blyth Dr Daevyd Rodda Dr Raymond Banh Dr Sharon Poulter Salaried Medical Officers Dr Bob Scott Dr Lovell Aseervatham
Dr Thangeswaran Rudra Dr Sasikaran Nalliah Part-Time Practitioners Dr Li-Zsa Tan Dr Oscar Whitehead
FEBRUARY Doctors in Training Dr Sally Fry Dr Charlotte Piesse Dr Alyssa Vass Dr Michael Kwok Dr Anam Asad Dr Alison Beaumont Dr Paula Jeffries Dr Carla Smerdon Dr Ashvin Paramanathan Dr Susan Petrie Dr Htoo Myat Dr Anamika Sharma
Salaried Medical Officers Dr Sean Keogh Dr Kieran Rowe Dr Brian Wood Part-Time Practitioners Dr Leanne Browning Dr Geoffrey Menzies Dr Harriet Wood Dr Pankaj Saxena
MARCH Doctors in Training Dr Rachael Yin Foo Dr James Morris Dr Ivan Rykin Dr Bonnie Taylor Dr Melissa Clarke Dr Emma Rossato Dr Nikki Brennan Dr Abhilash Sangam Dr Bushra Abbasi
General Practitioners Dr Frank Wang Dr M D Aminul Islam Dr Shylet Sitima Dr Dona Dias Dr Aaron Chambers Dr Shimal Jobanputra Dr Matthew Kelly Dr Angela Wills Dr Rajbeer Sian Dr Sohail Yousuf Dr Kulbir Hayer Dr Hao Lim
General Practitioners Dr Jasmina Bajramovic Dr Naveen Thalluri Dr Radha Raman Bohra Dr Liz Christensen
Specialists Dr Daniel Hagley Dr Ramesh Tripathi Dr Amirreza Shameli Dr Andrew Chang Dr Joshua Jervis-Bardy Dr Benjamin Rahmel Dr Ian McKenzie Dr Cornelis Van Meer
Salaried Medical Officers Dr Zia Ul Haq Ansari Dr Robyn Brogan Dr Peter Reynolds Dr Krishnan Rangaswamy Iyengar Dr Nicola Townell Dr Elango Subramonia Pillai
Specialists Dr Craig Costello Dr Tarunisha Sharma Dr Savio Sardinha Dr Angela Robson Dr Mahen Drakumar Meta
AMA Queensland member discounts You can access great discounts as part of your AMA Queensland membership. If you’re out for a bite to eat, you can get a 15 per cent discount at these restaurants. Show your electronic voucher or use the voucher to the right.
15% discount
Are you regionally based? Let us know the cafe/ Expires 31 December 2017 restaurant you would like a discount at and we will make the approach. Email membershop@amaq.com.au and let us know.
Thank you for being a member... Often in these busy times it’s rare to have someone thank you. AMA Queensland would like to thank you for being a member. Your membership to AMA Queensland shows your commitment to shaping a better, healthier future – not just for patients and yourself as a doctor, but Queensland as a whole. This is your association and you are encouraged to take advantage of the wide range of benefits and services AMA Queensland has to offer:
coordinated representation on the crucial issues impacting the profession, regardless of your career stage or specialty; trusted workplace relations advice and resources; great value member rates for our refreshed conference, seminar and training programs; and quality service through our network of hand-picked corporate partners in accounting, legal, banking and finance, insurance and automotive sectors.
Check out these benefits and more in your 2017 Member Benefits Guide.
Doctor Q Winter 51
Supporting the art of general practice GPCE IS COMING TO BRISBANE!
1–3 September 2017 BRISBANE EXHIBITION & CONVENTION CENTRE
GPCE BRISBANE REGISTRATION OPENS 13 JUNE Use code DRQ20 before 21 July for 20% Discount
Find out more at gpce.com.au
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WHAT’S NEW IN 2017? NEW TRIENNIUM, NEW LOOK, NEW PROGRAM Delivering a fresh, new and diverse educational conference program, GPCE Brisbane will cover education and updates across a breadth of therapeutic areas for the whole practice team. Earn up to 94 CPD points across three days! Don’t miss NEW Active Learning Modules – session spaces limited! • Management of Paediatric Medical Emergencies • Mastering the Art of Heart Failure Management • Alzheimer’s & Dementia – UPDATED • Optimising Outcomes in Skin Cancer
FREE INSPIRING KEYNOTE SESSIONS
CPD Accredited Activity
Returning in 2017, the highly popular keynote sessions will take place daily and feature leading speakers discussing the hottest topics facing primary care today.
MEDTALKS
CPD Accredited Activity
Inspiring, controversial, topical, challenging… Brand new for 2017, join us for the GPCE ‘MedTalks’ launching with drinks and canapes on Friday 1 September from 5:30pm. This session is FREE and open to all primary healthcare professionals.
CPR TRAINING
CPD Accredited Activity
Take advantage of our CPR training sessions, based on the Australian Resuscitation Council guidelines and delivered by highly trained paramedics. FREE for conference delegates/$100 for Exhibition only visitors.
DISCOVER THE LATEST PRODUCTS, TREATMENTS & INNOVATIONS Meet with leading Queensland suppliers and explore new products and services for your practice via the GPCE Brisbane exhibition, open daily from 8am–5pm. Exhibition entry is FREE for all healthcare professionals.
PLATINUM SPONSOR:
SILVER SPONSOR:
GPS | NURSES | PRACTICE MANAGERS | REGISTRARS | ALLIED HEALTH Doctor Q Winter 53
Risk managing the Privacy Amendment Bill 2016 JAMES WARWICK Senior Account Executive, Medical & General Risk Solutions P: 1300 883 059 E: james@mgrs.com.au
Disclaimer: Medical and General Risk Solutions is a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, Australian Financial Services Licence No 240549, ABN 15 003 886 687. Authorised Representative No 436893. The information provided in this article is of a general nature and does not take into account your objectives, financial situation or needs. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.
References 1.
Hiscox Cyber Readiness Report 2017 https:// www.hiscox.co.uk/cyber-readiness-report/
2.
Cyber Security Ventures 2016 Cybercrime Report http://cybersecurityventures.com/ hackerpocalypse-cybercrime-report-2016/
3.
ISACA 2015 Global Cybersecurity Status Report https://www.isaca.org/pages/ cybersecurity-global-status-report.aspx
4.
Verizon 2016 Data Breach Investigations Report http://www.verizonenterprise.com/ verizon-insights-lab/dbir/2016/
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Privacy breaches affect hundreds of millions of electronic and paper based records a year. The cost of cyber crime globally is even more sobering with losses attributed to it expected to rise from the estimated $450 billion calculated in 20161 to a truly incredible $1 trillion in 2021 (with some estimates putting the upper limit at $6 trillion2). It becomes even worse when one considers a recent study conducted by the Information Systems Audit and Control Association (ISACA) which determined that only 38 per cent of those organisations surveyed believed they were prepared to meet the rising threat of sophisticated cyber-crime3. Given the financial cost and lack of industry preparedness, the government has passed new legislative requirements for the handling, storage and dissemination of sensitive client information. This legislation also includes mandatory reporting should unauthorised parties compromise a client’s confidential information. The legislation is targeted primarily towards organisations with an annual turnover of more than $3 million, however the Privacy Act also applies to specific businesses with an annual turnover of under $3 millionprincipally private sector health services providers who are subject from the first dollar earned. Under the new legislation, if you have reasonable grounds to suspect that an eligible data breach has occurred, you will be obliged to investigate and assess that breach and notify your findings to the Australian Privacy and Information Commissioner.
Your notification to the commissioner will require you to:
prepare a statement setting out your businesses identity and your current contact details; provide a description of the breach, including details on the type of sensitive information that has been compromised; provide recommendations about what individuals should do in response to the breach; notify the contents of the statement to each of the affected individuals to which the relevant information relates or are at risk from the breach; and if not practicable to notify affected individuals, publish a copy of the statement on your website (if any) and take reasonable steps to publicise the contents of the statement.
If you’ve been lax with your privacy security policies - and let’s be honest there would be very few of us that could say that our IT procedures in particular are impeccable - this legislation is a good wakeup call that the government is now taking data security and privacy breaches very seriously and, as a consequence, so should you. With penalties for non-compliance of up to $360,000 for individuals and $1.8 million for corporate entities and not to mention the associated crippling reputational costs following a reportable breach now is the perfect time to take a good hard look at how you’re protecting your client’s data and whether or not your existing cybersecurity and privacy practices are adequate.
So what can you do to help both meet the requirements as set out under the legislation and at the same time reduce the risk of a Breach? We recommend a one-two combination of proactive and reactive strategies. Proactive risk management is where you strive to identify and introduce preventative measures to help combat risks before an incident occurs, whereas a reactive risk management program should be considered after an incident is identified or confirmed. Pro-active cyber risk management involves personally introducing steps that can actively help diminish the chances of a privacy breach occurring. Some of the proactive steps you can introduce include:
Taking the time to understand your obligations under the Privacy Act and get advice where necessary from the relevant experts and ensure your documentation is up to scratch (e.g. new patient consent forms, privacy policy that can be presented to your clients). Have contingency plans and procedures set in place in the event of a privacy breach. This involves raising awareness and continuing to educate staff annually about your organisation’s internal procedures and how to respond to an actual or suspected privacy breach.
Ensure your electronic systems are always patched to the latest versions. Most attacks exploit known vulnerabilities that have never been corrected. In fact, the top 10 known vulnerabilities accounted for 85 per cent of successful exploits4. Limit remote access to your systems directly from the Internet to only those individuals, systems and services that really require it. If you outsource any of your IT or have arrangement with third parties who will hold or have access to sensitive information, ensure you have contractual provisions in place to ensure they maintain and enforce compliance with the new legislation.
So now, you’ve implemented a comprehensive proactive risk mitigation program for your office and you’re confident you are compliant with the new legislation- excellent! So what happens if (despite all your efforts to prevent it) you suffer an attack and your client’s personal data is compromised? Well this is where your reactive risk management measures come into play and you can fall back on your response triggered safety nets such as- yes wait for itinsurance!
For a set annual premium, a cyber liability policy will allow the insured access to the necessary specialist expertise they will require after an eligible breach (e.g. lawyers, PR and IT specialists amongst others) that normally would be obtained at best at a cost of tens of thousands of dollars and, at worst, given a serious enough breach - millions. A good cyber protection policy should include at a minimum the following covers:
business interruption; e-theft loss, financial loss due to the fraudulent input of data into a computer system or through a network into a computer system; e-threat loss, including the cost of a professional negotiator and ransom payment; e-vandalism loss, even when the vandalism is caused by an employee; crisis expenses, including the cost of public relations consultants; and disclosure liability, including claims by customers arising from system security failures resulting in the dissemination of private information on the internet.
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Consent – End of life care Decisions to withhold or withdraw life-sustaining treatment are ethically, professionally and legally complex, especially when the patient has lost decision-making capacity. This article discusses some of the legal principles associated with the provision of endof-life care and outlines the consent process which underpins these decisions.
LEGAL PRINCIPLES
DR SARA BIRD
Manager, Medico-legal and Advisory Services P: 1800 011 255 E: peaceofmind@ mdanational.com.au
Preferred Medical Indemnity Provider
Disclaimer: This article is provided by MDA National. They recommend that you contact your indemnity provider if you need specific advice in relation to your insurance policy.
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Doctors are not under a legal duty to provide ‘futile’ care, even if this is requested by the patient and/or their family. In end-of-life care, medically futile treatment can be considered to be treatment that gives no, or an extremely small, chance of meaningful prolongation of survival and, at best, can only briefly delay the inevitable death of the patient.1 That is, where the treatment is of no medical benefit to the patient, or the burdens of the therapy are out of all proportion to any potential benefits. Futile treatment may include life-sustaining treatment. The determination of futility must be appropriately made and, ideally, there should be consensus with the patient and/or their substitute decisionmaker with respect to the assessment of futility. A patient, their family or substitute decision-maker can challenge a decision not to provide futile treatment in the courts.
It is a crime to deliberately take another person’s life or to assist another person to suicide. A doctor should never provide treatment with the intention to end a patient’s life, or to assist the patient in doing so. However, a doctor can administer medication to a patient with the sole intention of relieving pain and suffering (‘good effect’), even though this may hasten their death (‘bad effect’). This is commonly referred to as the “doctrine of double effect” and is an exception to the general rule that taking active steps to end a person’s life is unlawful. In this situation, administering medication to the patient should not achieve pain relief by hastening their death, and the need to relieve the pain and suffering must be such that it outweighs the consequences of hastening death.
A D U LT P A T I E N T S W H O H AV E C A PA C I T Y T O MAKE THEIR OWN T R E AT M E N T D E C I S I O N S
By law, all patients who are 18 years or over are assumed to have capacity to make decisions, but that presumption can be rebutted where the need and evidence arises. Generally, a person with capacity will be able to:
understand the facts of the situation;
still had capacity; or a spouse, other family member or unpaid carer. These substitute decision-makers must act in accordance with the patient’s wishes (if known) or in the patient’s best interests. Where there is no available substitute decision-maker, an application can be made to the relevant Guardianship Tribunal for the appointment of a guardian.
understand the main choices available; weigh up those choices, including benefits and risks; make and communicate their decision; and understand the ramifications of the decision.2
An adult patient who has capacity can refuse any medical treatment, even if this refusal will result in their death.3
ADVANCE CARE DIRECTIVE (ACD)
Life-sustaining medical treatment can also be refused through an ACD. An ACD is generally a written document, intended to apply to future periods of impaired decision-making capacity, which provides a legal means for an adult to record preferences for future health and personal care and/or to appoint and instruct a substitute decision-maker.4 ACDs are not clinical care or treatment plans, but clinical care and treatment plans can and should be informed by ACDs. The common law recognises, as part of the right to self-determination, that an individual can complete an ACD that will bind a health practitioner who is treating that person, even if the directive refuses life-sustaining treatment. A 2009 NSW Supreme Court judgment confirmed that if an ACD is
made by a competent adult, is clear and unambiguous, and extends to the situation at hand, it must be respected.5 Legislation governing ACDs has also been enacted in every state and territory, except NSW and Tasmania, although the legislation varies from state to state and is subject to change.6,7 In some states, the legislation places limits on the application of an ACD – for example, in some states the ACD may only operate if the patient is suffering from a terminal illness or has no reasonable prospect of regaining capacity.
A D U LT P A T I E N T S W H O L A C K C A PA C I T Y T O MAKE THEIR OWN T R E AT M E N T D E C I S I O N S As outlined above, where a patient lacks capacity to make their own decisions, priority must be given to a valid ACD, if it exists. In the absence of an ACD, consent should be obtained from a substitute decision-maker. Every state and territory has guardianship legislation which regulates, to varying degrees, medical treatment decisions for adult patients who lack decision-making capacity. The legislation outlines a hierarchy of decision-makers. This may include an enduring guardian who was appointed by the patient when they
Decisions to withhold or withdraw life-sustaining medical treatment are complex and serious, especially in view of the gravity of the outcome. In some states and territories, the legal authority of a substitute decisionmaker to decide to withhold or withdraw a patient’s life-sustaining medical treatment is not clear. There are also differences in the definitions of life-sustaining treatment or measures. This is a complex area of the law and you should contact your medical defence organisation for advice in a particular case if you are uncertain how to proceed. Further Reading 1.
End of Life Law in Australia. Available at: end-oflife.qut.edu.au
References 1.
Australian Medical Association. Position Statement on End of Life Care and Advance Care Planning. 2014. Available at: ama.com.au/system/ tdf/documents/AMA_position_statement_on_end_ of_life_care_and_advance_care_planning_2014. pdf?file=1&type=node&id=40573
2.
Walter J. Assessment of Capacity. Defence Update Spring/Summer 2015. Available at: defenceupdate.mdanational.com.au/en/articles/ assessment%20of%20capacity
3.
Bird S. To Treat or Not to Treat. Australian Family Physician. Vol 38, No 11, November 2009
4.
Willmott L, White B, Matthews B. Law, Autonomy and Advance Directives. Journal of Law and Medicine 2010;18:366.
5.
Hunter and New England Area Health Service v A [2009] NSWSC 761.
6.
Advance Care Planning Australia. The Law of Advance Care Planning. Available at: advancecareplanning.org.au/health-professionals
7.
Bird S. Advance Care Planning and Advance Care Directives. Defence Update Autumn 2014. Available at: defenceupdate.mdanational.com.au/articles/ advance-care-planning
Doctor Q Winter 57
Social media in the workplace A R E Y O U R T W E E T S I N A R O W… ? At least 8 out of 10 online Australians participate in social media activities. The reality is posts, Snaps and Tweets made by employees are not really private and can have consequences in the workplace.
Hint #1 – Have a social media policy Negative or inappropriate comments made by an employee about their employer, workplace or co-workers are reasonable grounds for disciplinary action, including dismissal. The grey area arises when an employee makes these sorts of posts in their own time, using their own social media. Having a social media policy is a great demarcation tool. Social media policies should clearly state that out-of-work and out-of-hours conduct that is relevant to the workplace is no longer a private matter. The policy should emphasise that the employer has a legitimate right to be concerned about inappropriate comments made online as they may potentially damage the employer’s reputation, breach patient confidentiality and privacy, or constitute workplace harassment, bullying or discrimination. It is also important to set out consequences for non-compliance. It is imperative that the content of the policy is communicated to and understood by all staff. This not only educates your staff, but provides you with evidence if you need to take disciplinary action or defend a claim.
Hint #2 – Workplace complaints Workplace complaints of any type should be taken seriously and evidence gathered quickly. The use of social media presents some challenges for employers, leaving you susceptible to litigation or being held vicariously liable for an employee’s inappropriate conduct online. 58 Doctor Q Winter
Employers can overcome these challenges by taking a common sense approach and reasonable steps such as regularly updating onboarding materials and policies, training staff, and handling investigations properly when complaints arise. For cases involving Snapchat (or other similar platforms where the message automatically destructs once viewed), employers need to tell the person to take a screen shot of the message to preserve the content, so that it can be used as evidence.
VANESSA JAMESMCPHEE Senior Associate TressCox Lawyers
P: (07) 3004 3512 E: Vanessa_James-McPhee @tresscox.com.au
The FWC found those posts which were political could not be regulated by the employer as Mr Starr had an implied constitutional right to freedom of political communication.
Hint #3 – Make sure you can regulate the conduct Employers should be careful to ensure they are entitled to regulate the conduct complained of before taking any disciplinary action, particularly dismissal. In Daniel Starr v Department of Human Services [2016] FWC 1460, the Fair Work Commission (FWC) ordered reinstatement of Mr Starr even though he made a number of inappropriate comments, including referring to Centrelink clients as “spastics” and “whinging junkies” on social media. In this case, Vice President Hatcher identified a difference between Mr Starr’s social media posts which were political in nature, and those that were critical of his place of employment.
However, the posts that criticised Centrelink management and clients could be subject to disciplinary action and justified Mr Starr’s termination. Nonetheless, the FWC found Mr Starr’s dismissal was harsh given his comparatively unblemished employment record and his length of service. In addition, the FWC found his comments were in reaction to other posts and general in content. The commission also found that he was remorseful and his comments were not done to intentionally harm the department.
Conclusion Employees and employers need to be aware of where to draw the line between private and public, and of the legal minefields that they can create when those lines are blurred. If you need help with a social media policy or need some advice about a workplace issue, please feel free to contact TressCox to discuss.
Look no further...TressCox Lawyers can assist you At TressCox we make it our business to know about Health and Aged Care. We can help guide you through the increasingly complex operational, legislative and policy framework. We can provide you informed legal advice on litigious, disciplinary and commercial issues at all levels. With considered legal advice we can assist you to operate a commercially viable business that complies with the health services industry’s unique and ever changing regulatory environment.
We can help you with: Setting up your practice, including buying a business, business structuring, contracts and advice on restraint of trade clauses Running your practice, including IR & Workplace Safety, employment, service, and locum contracts; and corporate governance Group practice issues and bringing in additional owners including partnership, shareholder and buy-sell agreements
Vanessa James-McPhee, Senior Associate
Brisbane P. (07) 3004 3512 M. 0438 874 511 Vanessa_James-McPhee@tresscox.com.au
Bill Hickey, Partner
Brisbane P. (07) 3004 3523 M. 0421 756 502 Bill_Hickey@tresscox.com.au
www.tresscox.com.au
Paul de Silva, Special Counsel
Brisbane P. (07) 3004 3520 M. 0422 858 807 Paul_de_Silva@tresscox.com.au
Selling your practice including helping to get ready for sale, workout and earn-out arrangements Resolution of disputes about restraints, contracts (including building contracts and shareholder agreements) and debt collection Regulatory issues including investigations by the OHO, AHPRA and Medicare Australia Your personal matters including buying, selling and leasing property and Estate Planning.
Tony Mylne, Partner
Brisbane P. (07) 3004 3545 M. 0422 044 210 Tony_Mylne@tresscox.com.au
Katharine Philp, Partner
Brisbane P. (07) 3004 3536 M. 0409 586 785 Katharine_Philp@tresscox.com.au
Lynette Reynolds, Partner
Brisbane P. (07) 3004 3555 M. 0416 069 573 Lynette_Reynolds@tresscox.com.au
P. (07) 3004 3500 @TressCox
Doctor Q Winter 59 @TressCoxHealth
What to consider when purchasing a medical practice Have you found yourself thinking about what the next step is for you professionally? Are you becoming more ambitious and want to start building your own asset? Or maybe, you are looking for the freedom to practice your own way and want to establish control around this. It could be time you started thinking about purchasing your own medical practice.
P R E PA R AT I O N I S K E Y
If you are considering purchasing your own practice, you need to ensure that you are well prepared in order to proceed when the right opportunity presents itself. You should meet with specialist advisory accountants prior to starting this process to discuss what type of practice you are hoping to purchase and to discuss the process, value and structuring options available to you. Overpaying for a practice, not undertaking financial due diligence or using the wrong structure can all potentially lead to disastrous financial and tax outcomes.
K N O W W H AT Y O U A R E BUYING
As demonstrated in the diagram below, the value is in the net income of the practice that is in earned addition to your own patient fees.
Doctors
Service Fee
Practice
Receives Service Fee, Pays Practice expense
Business Advisory Director, William Buck Accountants
Service Fee
Distributes net income to you or your family group
Value you are purchasing
ALIGN WITH THE EXPERTS
During this time, it might seem like a good idea to sign on the dotted line, but it is important to make appointments with not only your accountant, but also your solicitor and banker to ensure the purchase works for you.
Generally speaking, as an individual doctor you earn your patient fees and pay a service fee as a percentage of your fees to the practice. This will remain unchanged if you purchase a medical practice.
Your solicitor can assist you in reviewing the agreement and ensuring the conditions within the contract are suitable to you and your circumstances.
However, when you purchase a practice, you are purchasing the additional income that is generated by the practice. This is where the value is generated and this is the asset that you will want to grow and protect.
You will also need to meet with your Personal Banker or broker to obtain the necessary finance to complete the purchase. You may also wish to consider obtaining pre-approval to ensure you have the capacity to complete the purchase.
60 Doctor Q Winter
J U L I E O ’ R E I L LY
P: (07) 3229 5100 E: Julie.OReilly@ williambuck.com
SPECIALIST
ADVISORS TO THE MEDICAL
INDUSTRY WITH A DEDICATED HEALTHCARE PRACTICE, WILLIAM BUCK CAN HELP YOU STRUCTURE YOUR PERSONAL INVESTMENTS TO ACHIEVE THE AFTER-HOURS LIFE THAT YOU WANT.
CONTACT ONE OF OUR DIRECTOR’S FOR A CONFIDENTIAL & COMPLIMENTARY CONSULTATION
William Buck is experienced at structuring personal investments such as property or self managed superannuation funds, and can assist you with the following:
(07) 3229 5100
— Advice on setting up appropriate investment structures — Comprehensive assistance with your personal taxation affairs — Develop strategies to help you make the most out of your superannuation and investments, including assessing the taxation consequences
Paul.Copeland@williambuck.com Angela.Jeffrey@williambuck.com Julie.OReilly@williambuck.com
— Securing your financial freedom with business and retirement planning
Doctor Q Winter 61
UPCOMING MOVIES* 22 June
13 July
Detour
Baby Driver
Cars 3
The Beguiled
Diary of a Wimpy Kid: The Long Haul
20 July
29 June
29 July
Lady Macbeth
André Rieu’s 2017 Maastricht Concert
Dunkirk
The House 6 July Everything, Everything
3 August The Trip to Spain
*Please note upcoming films may be subject to change
Win movie tickets for two! Name:
Telephone:
Member no:
Fill out the form and fax it to (07) 3856 4727 or email competitions@amaq.com.au. Entries close 1 July Portside Wharf, Remora Road, Hamilton P: (07) 3137 6000 www.dendy.com.au
62 Doctor Q Winter
IDOMENEO 17 June, 1pm | 18 June, 1pm 22 June, 10am Met Opera James Levine conducts a rare Met revival of Mozart’s Idomeneo, set in the aftermath of the Trojan War. JeanPierre Ponnelle’s classic production, which has its first Met revival in over a decade this season, stars Matthew Polenzani in the title role. The cast also includes Elza van den Heever as Elettra, Nadine Sierra as Ilia, Alice Coote as Idamante, and Alan Opie as Arbace.
ROSENCRANTZ AND GUILDENSTERN ARE DEAD 24 June, 1pm | 25 June, 1pm 28 June, 6pm | 29 June, 10am National Theatre Live Daniel Radcliffe, Joshua McGuire and David Haig star in Tom Stoppard’s brilliantly funny situation comedy, recorded live from The Old Vic theatre in London. Against the backdrop of Hamlet, two hapless minor characters, Rosencrantz and Guildenstern, take centre stage. As the young double act stumble their way in and out of the action of Shakespeare’s iconic drama, they become increasingly out of their depth as their version of the story unfolds. In a literary hall of mirrors, Stoppard’s brilliantly funny, existential labyrinth sees us witness the ultimate identity crisis.
ANTONY & C L E O PAT R A 1 July, 1pm | 2 July, 1pm Royal Shakespeare Company Following Caesar’s assassination, Mark Antony has reached the heights of power. Now he has neglected his empire for a life of decadent seduction with his mistress, Cleopatra, Queen of Egypt. Torn between love and duty, Antony’s military brilliance deserts him, and his passion leads the lovers to their tragic end. Iqbal Khan returns to the Royal Shakespeare Company to direct, following his critically acclaimed productions of Othello (2015) and Much Ado About Nothing (2012).
MICHELANGELO: LO V E A N D D E AT H 22 July, 4pm | 26 July, 10am This film offers a full and fresh biography of Michelangelo who, with Leonardo, is considered one of the greatest artists of the Renaissance – and perhaps of all time. It explores his relationship with his contemporaries and his immense artistic practice that included painting, sculpture and architecture. Among the works explored are the universally adored David in Florence, the Sistine Chapel in Rome and the Manchester Madonna. This major new film goes to the heart of just who was this tempestuous, passionate giant of art history.
The practice purchase conundrum To help doctors navigate the process of owning their own practice, BOQ Specialist has recently developed a Guide to Practice Ownership (available online at www.boqspecialist.com.au/guideme). CEO Dr Brett Robinson draws on excerpts from the guide to assess the pros and cons when deciding whether to rent or purchase a practice premises. In this low interest rate environment, the prospect of buying a practice premises could make more commercial sense than you think. Of course, practice ownership is a major, multifaceted decision that requires careful business and financial planning – but you don’t have to go through it alone.
In control of your own destiny Renting gives you some additional flexibility such as getting to understand a specific area or neighbourhood. There may be benefit in assessing if the location is exactly right for your practice, in a particular neighbourhood and gives you the flexibility to re-assess your decision without the long-term commitment associated with buying. However, with renting, you are likely to have limitations on the improvements you can make and the property owner may not be as prompt as you would like them to be on maintenance and repairs. It’s also sensible not to make significant improvements on an asset you don’t own. There is also a risk that the owner may decide to increase the rent beyond your means or sell the property. This could mean moving at a less convenient time and leaving tens of thousands of dollars of investment behind in your rented practice.
Owning your own practice premises gives you the freedom to model your treatment rooms and layout to reflect your own taste and requirements, without the risk of potentially losing the investment in setting up in your preferred layout through a forced move. Ownership also means you can invest with confidence in fit-out improvements and equipment, knowing the improvements will add to the value of your practice, assisting both with any potential exit strategy and the appeal to prospective clients and future buyers.
Continuity is key While it may sound simple, continuity can be a major crunch factor for both clients and staff. Practice premises ownership gives you a long-term address, allowing you to have security of tenure and most importantly, a familiar environment. In a highly competitive market, doctors need to be doing all that they can to build and maintain their client-base in their communities. By purchasing your own practice and by staying in the same location for a number of years or even decades, you are making it easier for your clients to repay you with their loyalty.
Financially practical On the surface, renting might appear to make more sense for an early stage business, with flexibility to easily relocate when your practice grows and is often associated with low barriers to entry. Renting might also give you access to capital that you may need elsewhere in the business, as you will spend less
DR BRETT ROBINSON
BOQ Specialist CEO www.boqspecialist.com.au
of your monthly earnings on financial responsibilities that come with owning. These include items such as building insurance, maintenance and repairs. On the flip side, buying your own practice can be as financially practical as renting. With the right financier, the deposit you need for your original loan may be close to the bond required for a rental property and loan repayments on your mortgage may often be no higher than rent. Mortgage repayments are a direct investment in your business and any upward changes in price can result in increasing equity you can borrow against. However, there are plenty of financial specialists on hand to help you navigate some of these considerations as you decide what the right thing is for you. In the final part of the series, Dr Brett Robinson will outline the key loan options available to you when purchasing a practice.
The information contained in this article 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. BOQ Specialist is not offering financial, tax or legal advice. We recommend that you obtain independent financial and tax advice before making any decisions.
Doctor Q Winter 63
World’s best golfing holiday destinations What makes the perfect golfing holiday? The scenery counts, so too does the accommodation. However, it’s the golf courses themselves that really matter. With this in mind, Ros Bulat from AMA Travel Queensland brings you the world’s best golfing holiday destinations.
ST ANDREWS
THE ALGARVE
MISSION HILLS
Not many places can challenge St Andrews as the top golfing holiday destination in the world. St Andrews is home to an endless array of world class and historic golf courses. Following recent developments, there are now plenty of outstanding hotels and resorts to stay at too. The region is relatively central to many of Scottish golf’s more famous names, such as Turnberry, North Berwick and Gleneagles. But the impressive Old Course Hotel is perfectly situated beside the 17th hole on the Old Course. From here golfers can access all the great courses in the St Andrews area. This includes the Duke’s Course, the Kyle Phillipsdesigned Kingsbarns, and the two great courses at the Fairmont. The exceptionally difficult Carnoustie is just 50 kilometers north as well. The bonus of staying at the Old Course Hotel, is eating breakfast overlooking the Old Course—moments away from playing.
The Algarve has long been the front runner when it comes to golfing holidays in Europe. The best spot on the Algarve is Vilamoura. Vilamoura is home to many of the most sought after courses in Portugal. These include the Oceanico Old, Victoria, Pinhal, Laguna and Millennium Courses. It’s also a stone’s throw from Algarve’s biggest names including Vale Do Lobo, Quinta Do Lago and San Lorenzo. Quinta do Lago is Europe’s answer to Augusta, perfect in every way, challenging and a pure joy to play. Meanwhile, San Lorenzo plays right beside the Ria Formosa Nature Reserve and the Atlantic Ocean. The Algarve also boasts other golfing hotspots like Monte Rei to the east and Penina to the west. The Algarve’s endless array of world class golf courses is supplemented by five star resorts. Resort options include Sao Rafael, Tivoli Marina, Hotel Quinta do Lago, or Monte da Quinta Club. Simply a golfer’s paradise.
The problem with Mission Stunning Myrtle Beach Hills is that there are is a world leader when it two of them. The original, comes to golf. There are spread over Guangdong more than 120 golf courses Province, is a 20km2 golf in the area, which means complex featuring twelve you could return to Myrtle 18-hole championship Beach year after year and courses. Each course has still have plenty of new been designed by golf’s courses to discover. It’s not greatest legends and just the quantity of golf architects. The complex has courses though - many of the courses have been hosted the region’s most designed by leading names important tournaments, in golf. For accommodation, including the World Cup of try the beach front Golf and the Asian Amateur Championship. The newest properties, Myrtle Beach Mission Hills Resort is on Marriott and Myrtle Beach Hainan Island and hosts Hilton, which both offer the Omega Mission Hills world-class comfort, luxury, World Cup of Golf. Held and convenience. Likewise, on the Blackstone course, the accommodation and the tournament draws courses at the Barefoot Resort and Golf are a two of the best players dream come true, while the from each of the world’s Legends Golf Resort offers golfing nations. They then great variety with three compete as a country to be world champions. The charming Scottish-style golf resort has been designed courses. for the whole family, with spas, swimming areas, and kid’s activities— including golf or email rmation call lessons. For more info sland.
Scotland
64 Doctor Q Winter
Portugal
China
MYRTLE BEACH South Carolina, USA
avel Queen Ros at AMA Tr 5556 7200 885 F: (07) P: 1300 262 aq.com.au E: travel@am m.au orldtravel.co www.amaq.w
Vintage of the year 2017 will be known as a very late vintage with an unusually long growing season delaying vintage by nearly a month. In the southern Adelaide Hills, many of us who had staved off disease and kept our canopies healthy chewed nervously on our fruit and glanced hopefully at our weekly analysis with itchy trigger fingers poised to get bird nets off and rip into harvest. A burst of warm weather in early April provided great relief to us and our neighbours as beaumes (sugars) strolled into the low to mid- teens. One last visit to our winemaker Phil Christiansen confirmed what we all suspected, a perfect balance of sugars and acids, fruit poised to make wine with amazing flavour without the usual belting of alcohol we’ve all become accustomed to… time to pick. Enter the weather. With ‘substantial’ rain forecast by Bureau of Meteorology later in the week, commencing Easter Monday, we were suddenly moving with purpose, nets off Tuesday and in the early hours of Wednesday morning picking began in earnest. In the course of the morning, clouds began to mass like some terrifying sci-fi movie but by the time rain actually started falling our fruit had been whisked away and had started its journey to becoming wine. ‘Substantial’ turned out to be less than 5mm but as a producer you simply can’t keep rolling the dice and Phil couldn’t be happier with the fruit. Later that week a quick visit to the winery confirmed my greatest hopes as I threaded my way through fermenting wafts of Christmas cake and blueberries… there’s plenty of flavour on the way. Whilst my journey as a producer has been short to date I have a more heightened awareness of what it takes to make great wine and I can say without hesitation it truly starts in the vineyard… attention to detail, timing, care, experience and yes, a little luck. As the official vintage reports roll in you’ll hear more of the same but having spoken to many of my peers in South Australia, Victoria and New South Wales we are all in agreement that the fruit we’ve ended up with is of the highest quality with slightly higher stress levels than we’d like.
PHIL MAN SER
Wine Direct
After waxing lyrical about 2016, some of these reds will start appearing soon, including my own from this very vineyard.
P: 1800 64 9 463 E: phil.man ser@winedir ect.co
m.au
Doctor Q Winter 65
Kooroomba Vineyard and Lavender Farm Dr Katherine Gridley, Principal House Officer, QEII Hospital; and Deputy Chair, AMA Queensland Council of Doctors in Training You no longer need to travel to the south of France to enjoy an exceptional long lunch in a vineyard while overlooking fields of lavender. Your next day-trip to delight the senses lies a mere 60-minute drive from Brisbane, at the Kooroomba Vineyard and Lavender Farm nestled in the Fassifern Valley near Boonah. 66 Doctor Q Winter
Kooroomba encompasses a sixhectare vineyard and award-winning restaurant, with picturesque views of the Great Diving Range. The Kooroomba Kitchen, under the direction of executive chef Ray Boyer, embodies the ‘paddock to plate’ philosophy, serving contemporary Australian cuisine showcasing the local flavours that make the Scenic Rim a hidden culinary gem. The wine grown on site includes a wide variety of highly acclaimed drops including shiraz, cabernet, merlot, vermintino, chardonnay and the unique verdehlo
marsanne. Fortunately the French and Italian native lavender fields flower allyear round, with a myriad of lavender jams, sauces, soaps, perfumes and body products for purchase on site. Once you’ve enjoyed your relaxing drive through the rolling hills of the Queensland countryside, it would be remiss not to stay for lunch. However do not be fooled by the serene farmlife atmosphere, as the flavours served here are anything but placid! The restaurant menu is designed to be a three-course dining experience, and a generously served one at that. If you’re going to indulge in a glass of tipple (and why not!), then we recommend the Kooroomba Alba, a fresh and crisp white that starts fruity and finishes dry on the palate. It’s slightly too easy to drink but pairs well without overpowering the feast of flavours on the menu. Entrees include the likes of mushroom and fennel risotto, ricotta ravioli, house-baked breads and corn chowder. We highly recommend two particular
entrees that prove to be a wellexecuted exercise in culinary restraint for their bold but well-adjusted flavours - the Kooroomba Scotch egg with curry mayonnaise, chamomile raisins and shallots; as well as the pan-seared scallops with cauliflower purees, house-smoked bacon and turmeric butter sauce. The Scotch egg comprises of sausage mince encasing an egg from one of Kooroomba’s own hens. The hint of aioli refines the curry flavour in the sauce to leave a lasting tingle on the tongue without being an assault on the senses, peppered with a hint of sweetness from the plump raisins. The scallops are perfectly cooked, on a backdrop of vibrant yellow locally sourced turmeric and creamy cauliflower puree, with the inherent sweetness of the scallops complimented beautifully by the smoky bacon. Mains are equally as impressive and have a farm-house feel with finedining flavour. Lamb breast with parmesan polenta, eggplant caponata and pine nuts; a 48-hour pork belly with butter-poached mushroom and
wild rice; a rabbit galantine with leek and white bean cassoulet; and beef sirloin with black garlic and parmesan butter are all hard to choose from. The fish of the day is also a worthy contender – like the perfectly pink Atlantic salmon with creamy fennel risotto: deliciously creamy but surprisingly light when balanced with a hint of nutmeg and crisp green grapes. However we unreservedly recommended the spiced roasted duck breast, a celebration of warm autumn flavours on a plate! The aromatically spiced and slightly salt crispy skin of the duck overlying amazingly tender and pink flesh, is paired perfectly with crunchy macadamias, sweet creamy pumpkin and house grown Swiss chard, punctuated by the tartness of end-of-season plums. You may need to take a turn around the lavender field to make enough room in your dessert stomach, but you’ll be glad you did when the menu arrives. Apple panna cotta with rum raisins and almond crumble; chocolate custard tart with coconut and lime; and butter roasted pear with brioche
crumb and mandarin granita all have a homely yet creative allure to them. If you are after something lighter, the passionfruit soufflé with dark chocolate is your best choice – baked to order and fantastically fluffy as expected. But one does not simply visit a lavender farm and not try the lavender, so the lavender ice cream with wild berry compote, macadamia crumble and polenta tuile biscuit is the clear crowd favourite. Pretty in purple, the dish is almost too pretty to eat, and is again a delicate harmony between the strong scent of lavender, creamy ice cream, tart berries and a caramelised polenta crunch. Not a hint of ‘grandmother’s pot-pourri’ tasted here! The Kooroomba Kitchen at Kooroomba Vineyard and Lavender Farm is open for morning tea from 10 - 11.30am, lunch from 11.30am to 2pm and all day dining on Saturday until 8pm, although reservations are essential. Saturday evenings are particularly special at Kooroomba, where a five-course tasting menu is also available for $65 per person (or $99 with matched wines).
Doctor Q Winter 67
All about you
GRIMM
CYCLING
It’s about time someone realised the great horror potential of fairy tales! Portland detective Nick Burkhardt, descended from a long line of warriors known as Grimms, defends his city from magical creatures known as Wesen, which are part human and part animal. Many of the crimes he is investigating take on a whole new dimension when he finds out there is an underground war. All seasons are now on Netflix.
Many people find cycling can get them where they need to go – not just in location, but in their fitness goals as well. A bike is certainly cheaper to run and better for the environment than a car anyway. Cycling can improve strength and tone in your legs and butt, and a big ride to somewhere pretty can be a nice way to catch up with some friends while getting outside and seeing some sunlight and breathing some fresh air.
SHACKLED Chris Turney
When Australian-based scientist Chris Turney’s expedition got stuck in the Antarctic ice in 2013, it brought global attention to the dangers of the world’s least-known continent – and its fragility. Turney tells his own dramatic tale against the backdrop of the compelling history of Antarctic exploration and inspired by fears for the continent’s future.
D O N AT E L I F E W E E K Take it all – I won’t need them when I’m gone! A record 1,447 Australians were given a second chance at life in 2016 through organ and tissue donation. DonateLife Week, in late July, is Australia’s national awareness week to promote donation and ensure each patient’s wishes are known. Have a chat to your patients about whether they would like to register 68 Doctor Q Winter
CARAMELISED ONION TART
1 large sheet frozen puff pastry (for quiches), thawed 1 tbsp olive oil 3 brown onions, halved and sliced
500g sweet potato 100g reduced fat feta, crumbled 4 eggs, lightly beaten 1 tbs thyme sprigs
Preheat the oven to 180C. Line a 22cm loose bottom flan tin (round or square) with the pastry, and trim the edges. Line with a sheet of baking paper, and fill with dried beans or rice. Bake for 15 minutes, then remove the paper and beans and bake a further 10 minutes. Cool slightly. Meanwhile, heat the oil in a large frying pan, and add the onions. Cook over medium heat for 15 minutes, stirring occasionally, until deep golden brown. Peel the sweet potato and cut into 2cm cubes. Steam or microwave until tender. Fill the tart shell with the onions, sweet potato and feta. Pour the egg over and sprinkle with thyme. Bake for 40-45 minutes, until the egg has set. Serve warm or at room temperature. Recipe from www.eggs.org.au
Heroes
Dr Matt Young, General Practitioner, Inala Medical Centre
Some may say I have wasted my life sitting slothfully watching sport on TV with my mates. I admit to many idle hours but sometimes we manage to wax lyrical and solve the world’s most vexing questions. Like who is Australia’s greatest all time cricket XI? Would Warner edge out Hayden? Would Mal Meninga partner Inglis or Gene Miles in our greatest ever Origin team? Surely Laver would smash Federer, and Andy Murray wouldn’t even take a game off the Rockhampton Rocket. Did Wallaby David Campese’s defence really detract from his try scoring magic? But my favourite question: who is history’s greatest sportsman? I reckon there are three key criteria. Firstly, career duration. Longevity is essential. Secondly, how dominant were they, and thirdly how widely is their sport played on the world stage? I have narrowed it down to four. Of course, I love cricket and Bradman is the first contender. He spent twenty years dominating the world, or at least England, India, South Africa and the West Indies. He was twice as good as the second best, but I have to admit that cricket is really only played at elite level in ten countries, even if one of those countries, India, does comprise one seventh of the globe’s population, I have to accept that my favourite game is not as international as others.
Muhammad Ali was “the greatest” for almost a decade and a half. He won the world crown three times. Every country has boxing. In fact, I’d imagine that at any given instant, in every country, there is someone throwing a punch at someone else. He is a worthy contender. The great Usain Bolt has dominated sprinting like no one else in history. To win the 100m and 200m and to anchor the sprint relays at three straight Olympics in utterly unprecedented. Every child on the planet runs. Running is pivotal to out species’ evolution and he does it faster than anyone ever has. He too has claim to being history’s greatest. However, the man I nominate is Pele. A humble man from a poverty-stricken Brazilian family. He scored two goals in the World Cup fnal in 1958 at the age of 17, drove them to victory in 1962 and then scored another goal in the final in 1970. Winning three World Cups is unequalled. His longevity is reflected by his 13 years of international football. He is the greatest exponent of the beautiful game. He inspired teammates. He inspired his nation. Frankly, he has inspired every person who has ever kicked a ball. Finally, his game IS the world game. At least that’s what SBS has always preached. So having solved one of life’s most important questions, I also pondered
who have been the greatest doctors that I have known. I used the same sorts of criteria. Longevity easily equates to length of medical career. How much better the contenders are than their peers is entirely a subjective issue for me. Thirdly, rather than looking at how widely a sport is played across the globe, I have elected to look at the breadth of the doctors’ practice and their expertise in each area. In other words who has been the greatest generalist that I have met. In the end, I came up with a very simple choice. As a young bloke, I worked as a GP out in Dalby. The two men I worked with were extraordinary people. Barry was in his 60s and Sid was his late 70s. They did anaesthetics, general surgery, set fractures, looked after infarcts and all of the emotional maladies of the town and delivered most of the town’s babies. In fact, in several instances, they had delivered the daughters of the women they had delivered a generation before. They had looked after Dalby for countless decades. While they might erect statues of King Wally and Mal Meninga at Lang Park and of Steve Waugh at the SCG and Warnie in Melbourne, these two doctors just had to settle for the utmost respect of an entire town. They were invited to Christenings, weddings, funerals and 21st birthdays but maybe they really do deserve a statue out the front of the Dalby General hospital, holding up their stethoscopes or maybe a newborn baby. Doctor Q Winter 69
INPRINT
The Intentional Mentor in Medicine
by Dianne Salvador and Dr Joel Wight Book review by Dr Ekta Paw, Senior House Officer, Townsville Hospital, AMA Queensland Council of Doctors in Training Rural and Remote Portfolio lead.
Almost every doctor will be in a mentoring relationship at some point in our career. It is easy to recognise examples of good mentors who have helped us become better clinicians, but it takes time to sit down and distil those good qualities and then apply them. Luckily Dianne Salvador and Dr Joel Wright have done the hard work for us. The beginning of this book introduces mentoring as a process and how it contributes to our development as doctors. It assesses the current literature and clarifies the concept by delineating mentoring from other roles. Supervisors, teachers and coaches all play a slightly different part in this process. Because doctors are not simply purveyors of knowledge, mentoring involves developing values as well as performance. The second section of this book has practical advice for those trying to improve their mentoring skills. Each ‘tool’ in this section has a succinct summary and suggests how to apply it. More detailed examples are discussed in section three for those who want a realistic idea of how each conversation could occur. It is easy to forget to work on intangible skills such as communication and empathy without specific advice as to how to improve them. In addition to this guidance, the appendices are
full of worksheets and checklists for those who prefer to structure their interactions. For any readers who may not be particularly interested in the theory and background of mentoring, skip straight to these later sections to find practical suggestions to implement. This book is definitely a guide in that it is not prescriptive. It does acknowledge that mentoring interactions will be variable for differing personalities and we are also encouraged to evaluate the usefulness of our interventions. These may seem like intuitive ideas, but without specific consideration dedicated to them, they can be easily forgotten. While the advice is geared towards mentors, mentees will also find this a useful source of suggestions to gain more out of their interactions. The Intentional Mentor may not occupy your bedtime reading slot, but it provides an excellent reference and guide for doctors who want to improve on their mentoring ability.
Win this book Fill out this form and email to competitions@amaq.com.au. Name:
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Don’t forget to enter in this Doctor Q edition to win. 70 Doctor Q Winter
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Doctor Q Winter 71
If these are your everyday tools, we have your everyday bank account After 25 years of working with medical professionals, we have come to know you both inside and out of your practice. So we have designed the One Account, a unique transactional account for medical professionals, that you can choose for either business or personal use. The One Account offers a range of compelling features, including a competitive interest rate on positive balances in your account, 10 free ATM withdrawals per month*, 24/7 access through online and mobile banking, an optional overdraft facility, no ongoing fees and much more. Visit boqspecialist.com.au/oneaccount or speak to our financial specialists on 1300 131 141.
Equipment and fit-out finance / Credit cards / Home loans / Commercial property finance / Car finance / Practice purchase loans / SMSF lending and deposits / Transactional banking and overdrafts / Savings and deposits / Foreign exchange *10 free ATM transactions per month per account at BOQ, Commonwealth, Westpac, St George, NAB and ANZ branded ATMs. The issuer of these products and services is BOQ Specialist – a division of Bank of Queensland Limited ABN 32 009 656 740 AFSL no. 244616 (“BOQ Specialist”). Terms and conditions, fees and charges and lending and eligibility criteria apply. Any information is of a general nature only. We have not taken into account your objectives, financial situation, or needs when preparing it. Before acting on this information you should consider if it is appropriate for your situation. You should obtain and consider the relevant terms and conditions from www.boqspecialist.com.au before making any decision about whether to acquire the product. BOQ Specialist is not offering financial, tax or legal advice. You should obtain independent financial, tax and legal advice as appropriate. We reserve the right to cease offering these products at any time without notice.
72 Doctor Q Winter
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