MAY 2014 . VOL 89
AMA Queensland Membership Magazine
REVISED CONTRACTS ROLL OUT GREATER PROTECTION FOR QUEENSLAND PUBLIC SERVICE EMPLOYEES
CHASER’S CRAIG REUCASSEL TO HOST JDC COCKTAILS FREE TO AMA QUEENSLAND MEMBERS
1 DoctorQ MAY 2014 OBITUARY: DR HUMPHRY CRAMOND MBE OAM
CONTENTS
THIS ISSUE REVISED CONTRACTS ROLL OUT THERE HAS BEEN UNPRECEDENTED UNITY AMONG DOCTORS AND IN TURN, QUEENSLAND HEALTH HAS DELIVERED GREATLY IMPROVED CONTRACTS.
14
REGULARS
If we maintain that unity, we’ll get outcomes that are beneficial for our patients and for doctors.
4
FROM THE EDITOR’S DESK
6
PRESIDENT’S REPORT
8
CEO’S REPORT
28 FOUNDATION NEWS 39 MEMBER NEWS
10
people & events 10 THANK YOU DOCTOR 22 JUNIOR DOCTOR CONFERENCE
Current issues
26 STARTING AND WORKING IN PRIVATE PRACTICE
12 GREATER PROTECTION FOR QUEENSLAND PUBLIC SERVICE EMPLOYEES
34 CALENDAR 42 OBITUARY: DR HUMPHRY CRAMOND MBE OAM
16 STATE BUDGET SUBMISSION
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18 NURSES TO BE GIVEN MORE POWERS 20 ETHICAL AGONY AUNT: FACEBOOK TROLLS AND MEDICINE
44 ANNUAL CONFERENCE
business tools
40
46 PORTFOLIO ASSET ALLOCATION
47 MANAGE YOUR INCOME TO REAP THE BENEFITS
24 GP SALARY SURVEY
48 YEAR END TAX PLANNING 50 PRIVATE PRACTICE CONTRACTS
features
36 AMA QUEENSLAND HEALTH VISION: WORKFORCE AND TRAINING
52 TESTIMONIALS A NO-GO WITH NEW AD GUIDELINES
40 A DAY IN THE LIFE OF A JUNIOR DOCTOR: DR LISA BYROM
Life
54 TRAVEL 55 WINE 56 ALL ABOUT YOU 57 OCKER DOCTOR
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58 MOVIES 59 ON STAGE 62 IN PRINT
DoctorQ MAY 2014
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editor’s desk
FROM THE EDITOR’S DESK MICHELLE FORD RUSS Doctor Q Editor With the contracts deadline now at 31 May, we’ve included an update on the revised contracts to use as part of your careful consideration (p14). Senior Medical Officer members can also ring HR Law for a 20 minute free consultation for any questions that may arise on your contract. Work on the annual Women in Medicine breakfast is moving ahead, with the inspirational Turia Pitt as our guest speaker. After being badly burned in a marathon in 2011, Turia is the embodiment of hope and determination in the face of adversity. Book your ticket now by calling (07) 3872 2222. Each guest will also receive a copy of Turia’s book, Everything to Live For.
The State Budget Submission was quite different this year, drawing on our Health Vision consultation (p36). As well as asking for commitment on a series of spending initiatives, we have also suggested a number of areas where the Queensland Government can save money. Taking into consideration beyondblue’s 2013 survey into doctors and mental health, AMA Queensland has suggested improving the coping skills of our medical workforce. We plan to cover this issue in more detail in our July edition. With a much lighter note required, we’ve called on Dr Matt Young, a very ocker doctor based at Inala to inject some humour into our humble publication. As captain of the Ned Flanders Cricket Club (a story for another day, I’m sure!) Dr Young shares with us some of the gems of life as a doctor. Q
The following AMA Queensland members have recently passed away, our condolences to their families. Dr Ernest Humphry Cramond MBE OAM General Practitioner Late of Clayfield Past President, Vice President Member for 67 years
AMA Queensland would also like to express our sincere sympathy to Dr Chris Davis and Dr Kate Sinclair on the recent death of their daughter Jessica.
Our apologies to Dr Catherine Yelland, who was awarded a Public Service
Medal for outstanding public service, excellence and leadership in Older Persons Medical Services. Our database told us that Dr Yelland had been a member for nine years, while Dr Yelland informs me she is quite proud of her 32 years of membership. Q
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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MAY 2014 DoctorQ
Dr David Alcorn Honorary Secretary
Dr Shaun Rudd President-Elect
Dr Alex Markwell Elected Member
Dr Sharon Kelly Chairperson
Dr John Hall Elected Member
Dr Chris Zappala Treasurer
Dr Richard Kidd Elected Member
COUNCIL Dr Tom Arthur Gold Coast Area
Dr Kelly Macgroarty Specialist Craft Group
Dr Sharmila Biswas Far North Area
Dr Bav Manoharan Greater Brisbane Area
Dr Kimberley Bondeson Greater Brisbane Area
Dr Dilip Dhupelia Part-Time Medical Practitioner Craft Group
Dr Bill Boyd Capricorn Area Dr Ben Duke Greater Brisbane Area Dr Larry Gahan General Practitioner Craft Group
Dr Sharon Kelly Specialist Craft Group Mr Nicholas Gattas Medical Student Group Dr Vanessa Grayson Residents and Registrars Craft Group Dr Wayne Herdy North Coast Area
Dr John F. Murray Full -Time Salaried Medical Practitioner Craft Group Dr Carl O’Kane North Area Mr Callum Potts Medical Student Observer Dr Shaun Rudd General Practitioner Craft Group Dr Jonathon Shirley Greater Brisbane Area Dr Mason Stevenson General Practitioner Craft Group
AMA QUEENSLAND SECRETARIAT Jane Schmitt Chief Executive Officer
CORRECTION The letter to the editor titled 97 per cent agreement is conflict? had an error in that it did not include the author’s name. Dr Deborah Mills wrote this letter in response to criticism of her article in the November edition.
Dr Christian Rowan President
Dr Noel Hayman Greater Brisbane Area
OBITUARIES Professor William Sydney (Bill) EGERTON AM Surgeon Late of Montville Member for 32 years
BOARD OF DIRECTORS
Filomena Ferlan General Manager Corporate Services Colleen Harper Manager - AMA Queensland Foundation
Holly Bretherton General Manager Member Relations and Communications Andrew Turner Manager - Member Services
Editor: Michelle Ford Russ Graphic Designer: Erin Sticklen Journalist: Rachael Finley Advertising: Louise Glynn Doctor Q is published by AMA Queensland Contact Phone: (07) 3872 2222 Postal Address: PO Box 123, Red Hill QLD 4059 Print Post Approved PP100007532 Email: amaq@amaq.com.au
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Offering vehicles that combine luxury and performance with a programme that includes a range of unique privileges. It is with pleasure the Lexus of Brisbane Group offers the Lexus Corporate Programme to AMA Queensland members. The Lexus of Brisbane Group and AMA Queensland partnership allows AMA Queensland members access to the Lexus Corporate Programme benefits as Tier 1 status; normally reserved for BRW Top 50 companies in Australia on new vehicles across the entire Lexus range. Benefits of the Lexus Corporate Programme include: • Three year / 60,000km complimentary scheduled servicing* • Four year / 100,000km warranty# • Reduced dealer pre-delivery fee • Priority production if built to order The Lexus Corporate Programme also incorporates Encore Privileges: • Complimentary service loan cars and pick-up and drop off during servicing • Lexus DriveCare providing 24 hour roadside assistance • Lexus Exclusive Events • ‘Beyond by Lexus’ magazine
Exclusive to AMAQ Members: • Priority invitations to Lexus of Brisbane Group corporate events • Dedicated Lexus/AMA Queensland contact person for all enquiries • Access to Lexus of Brisbane Group’s Valet Parking; collection & return service from Brisbane Airport^. • Earn one Qantas point** for every dollar spent on any new Lexus The Lexus of Brisbane Group looks forward to our partnership with AMA Queensland and their members. For any queries please contact Peter Thomas, Lexus Concierge, on (07) 3327 1777.
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*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. # Whichever occurs first.**Offer applicable to Private and ABN buyers (who are members of AMAQ) on all new vehicles purchased between 1st Feb - 31st December 2014 and delivered by 31st January 2015. Lexus of Brisbane Group reserves the right to extend any offer. Excludes demos and pre-owned vehicles. You must be a member of the Qantas Frequent Flyer program to earn and redeem points. Complimentary membership will be offered to customers who are not already members. Membership and points are subject to the terms and conditions of the Qantas Frequent Flyer Program available at Qantas.com/terms. To earn points Qantas Frequent Flyers must provide their membership number. Please allow six weeks for the points to be credited to your account. Points can only be awarded on the purchase of an eligible new vehicle between the 1st Feb -31st December 2014. Points paid on total net contract price of vehicles after discount but before trade-in. ^Visit lexusofbrisbane.com.au for full terms and conditions.
PRESIDENT’S REPORT
HANDING OVER THE ROBES IN THIS LAST ISSUE OF DR Q BEFORE THE INAUGURATION OF A NEW PRESIDENT, WE TAKE THE TIME TO LOOK BACK AT OUR ACHIEVEMENTS OVER THE LAST YEAR AND LOOK FORWARD TO THE FUTURE FOR AMA QUEENSLAND.
DR CHRISTIAN ROWAN President, AMA Queensland THE HEALTH VISION AND BUDGET SUBMISSION In 2013, AMA Queensland developed a Health Vision policy framework in consultation with our council and members. We used member feedback to determine key policy platforms and priority areas for our advocacy work. This included holding several forums around the state to ensure members had the opportunity to voice their opinions. A Health Vision blog was also developed which allows AMA Queensland to further engage with members and share information about policy related issues. Guided by the values of compassion, knowledge and trust, the Health Vision will guide our advocacy work for the future. The Health Vision helped to determine the priorities for AMA Queensland’s 2014-2015 state budget submission. We are mindful of the needs of members, patients and the medical profession as a whole. It is with this knowledge that we have provided a series of recommendations for new spending initiatives and areas where money can be saved to result in the best health outcomes for patients.
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MAY 2014 DoctorQ
ADVOCACY AND AWARENESS
FINAL THOUGHTS
As President, I have worked diligently to increase awareness and reduce the stigma associated with alcohol and drug dependency. Through partnerships with organisations such as Hello Sunday Morning and the School of Hard Knocks Institute, I have advocated for a different approach to alcohol in Australia as well as increased support and health initiatives to assist those with substance dependency.
AMA Queensland’s Board, Council and Secretariat team have been an instrumental part of our success over the last year. I thank them for their time and ongoing commitment to AMA Queensland as well as the medical profession as a whole. Importantly, I thank members for their continued support. Q
This advocacy work has been a pillar of my presidency. With AMA Queensland’s strong community partnerships, we have been able to start a dialogue about alcohol and drugs in Australia and call for strong education, support and enhanced clinical service initiatives across Queensland. LOOKING FORWARD FIRST ANNUAL JUNIOR DOCTOR CONFERENCE There’s a lot to look forward to at AMA Queensland, but one event I am particularly excited about is our first Junior Doctor Conference which will be held on 28-29 June in Brisbane. I remember how challenging and rewarding it is being a young doctor, and this conference will allow medical students and junior doctors to collaborate, learn from each others’ experiences and listen to a range of speakers on medical and non-medical topics.
With AMA Queensland’s strong community partnerships, we have been able to start a dialogue about alcohol and drugs in Australia... Hello Sunday Morning is a movement towards a better drinking culture. Find out more at www.hellosunday morning.org
PHONE 1800 0 SNORE FAX REFERRAL TO 1800 1 SNORE Email: snore@snoreaustralia.com.au Web: snoreaustralia.com.au
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DoctorQ MAY 2014
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ceo’S REPORT
A HARD-FOUGHT WIN DELIVERS FAIR CONTRACTS MONTHS OF NEGOTIATION HAS ENDED WITH A GREAT NUMBER OF CHANGES MADE TO QUEENSLAND HEALTH’S INDIVIDUAL CONTRACTS.
JANE SCHMITT Chief Executive Officer, AMA Queensland SENIOR MEDICAL OFFICER CONTRACTS After many months of advocating for fair contracts for Senior Medical Officers, negotiations between Queensland Health, AMA Queensland, AMA Federal, ASMOFQ, Together and members of the SMO taskforce, for significant and important changes made to the contracts in April.
Join AMA Queensland for complimentary drinks and canapés and to discuss the issues facing the medical profession in your region.
This has been a long and hard fought issue but a critical one for the future of the senior medical officer workforce in Queensland. I’m very proud of our Queensland and Federal AMA team who worked tirelessly over an extended period with many stakeholders to achieve a greatly improved and fair contract. I’m also particularly grateful for the ongoing support of our members who stood shoulder to shoulder with AMA Queensland and their colleagues through this challenging period. Members may require some advice as they review their contracts in their final form. Our lawyers are on hand to assist via our telephone hotline number: 1300 356 155. MEMBERSHIP VISIT We are excited to be launching our membership visit to Cairns and Cape York in May. Our President-Elect Dr Shaun Rudd, Council Member Dr Dilip Dhupelia and I will make a trip to Far North Queensland to visit a number of health practices, Hospital and Health Services, Medicare Locals and engage with members.
AMA Queensland is committed to all of its members across the state, and we look forward to the opportunity to meet members in the Cairns and Cooktown area to discuss their key concerns, priorities and how we can support the most efficient health system locally and across Queensland. Members in the region are encouraged to join us for complimentary cocktails and canapés at the Rainforest Atrium at the Holiday Inn Cairns on 12 May from 6 7.30pm. We look forward to the opportunity to speak about the issues affecting the medical profession in your region. FEDERAL BUDGET As you will have seen in the news, there have recently been announced a number of proposed changes in health care to be handed down in the upcoming federal budget.
Federal Budget recommendations include bulk-billing co-payments for GP visits and a requirement for higher income families to utilise private health care in place of Medicare 8
MAY 2014 DoctorQ
Federal Budget recommendations from the Commission of Audit were recently announced that propose a number of changes to health care including bulkbilling co-payments for GP visits, an increase in co-payments for medications on the Pharmaceutical Benefits Scheme, and a requirement for higher income families to utilise private health care in place of Medicare. AMA Queensland believes these recommendations would limit Australians’ access to affordable and reliable healthcare. Though we are cognizant of the increasing expenses in the healthcare industry, we do not believe these recommendations will best serve patients and hope the budget handed down on 13 May is inclusive of recommendations made by those in the health industry. AGM AND INAUGURATION Members are invited to attend our Annual General Meeting on Tuesday 20 May. Each member is entitled to register one vote or alternatively appoint another member as a proxy to attend and vote in his/her place. All members are also welcome to attend the upcoming Presidential Inauguration with the installation of Dr Shaun Rudd as President 2014 - 2015. This event will be held at 7.30 on Friday 13 June. Visit our website for more information. Q
news
ELECTION FOR AMA PRESIDENT
AMA MEMBERS ARE GETTING READY TO FAREWELL DR STEVE HAMBLETON THIS MONTH, AT THE END OF HIS THREE YEAR TERM.
Dr Steve Hambleton has been Federal President of the AMA for the past three years, previously serving two years as Federal Vice President and as AMA Queensland President from 2005 - 2006.
The candidates are current Vice President and member of the Executive Council, Professor Geoffrey Dobb, who is the Head of Intensive Care at Royal Perth Hospital; and AMA NSW President and member of the AMA Executive Council, Associate Professor Brian Owler, who is a Consultant Neurosurgeon at The Children’s Hospital at Westmead and other hospitals in Sydney.
PRESIDENT:
CHAIRMAN OF COUNCIL:
Professor Geoffrey Dobb (WA)
Dr Iain Dunlop (ACT)
A/Prof Brian Owler (NSW)
FINAL NOMINATIONS
There will be an election to decide the next Federal AMA President, which will take place at the AMA National Conference in Canberra later this month.
There will be an election for the position of Vice President. The candidates are Dr Richard Kidd, a Brisbane GP; Dr Roderick McRae, an anaesthetist from Victoria; and AMA Victoria President and member of the AMA Executive Council, Dr Stephen Parnis, an Emergency Department specialist. Q
TREASURER:
VICE PRESIDENT:
Dr Elizabeth Feeney (NSW)
Dr Richard Kidd (QLD) Dr Roderick McRae (VIC) Dr Stephen Parnis (VIC)
Dr Janusz Bonkowski NeurosurgeoN & spiNAl surgeoN
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People & EVENTS
THANK YOU FUNCTION Donors, corporate sponsors, Foundation Board members and Foundation Patron Tim Fairfax AC, gathered recently at the Lexus of Brisbane’s showroom in Fortitude Valley, for the AMA Queensland Foundation’s Thank You to Donors Cocktail Function and Official launch of the Thank YOU Doctor campaign. It was an exciting evening and several You Tube clips were shown of the fantastic philanthropic projects the Foundation supports, which highlighted the Foundation’s mantra of ‘doctors doing good’.
campaign is to offer patients the opportunity to express their appreciation of their doctor, in a tangible tax efficient way. All funds are directed to philanthropic projects driven by AMA Queensland members. If you would like more details on the AMA Queensland Foundation’s Thank YOU Doctor campaign, please contact (07) 3872 2204 or amaqfoundation@amaq.com.au
DOCTORS DOING GOOD
ABOVE: Dr Ailhbe and Dr Frank Cunningham
The Foundation would like to take this opportunity to thank Lexus of Brisbane for providing the complimentary venue. Q
The Thank YOU Doctor campaign was also officially launched and corporate supporters MDA National, Queensland X-Ray and Sullivan Nicolaides Pathology were thanked for their significant support. The focus of the
ABOVE: Dr Noel Hayman and Gina Fairfax
ABOVE: Dr Dan Hart, Denise Schellbach, and Dr Glenda Powell Dr Eugene Lim, Dr Barry and Jean Hickey
Colleen Harper, Lisa Story, Dr Steve Hambleton, Katharine Philp, Jane Schmitt, Tim Fairfax AC and Ross Noye
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MAY 2014 DoctorQ
WEDNESDAY 6 AUGUST, 7AM
MODA PORTSIDE, 39 HERCULES ST, HAMILTON
Many are familiar with Turia Pitt’s story of recovery and persistence. The former mining engineer and model was participating in an ultra-marathon in WA when she and five other runners were caught in a rapid grassfire. Suffering burns to over 65 per cent of her body, Turia’s long recovery has included over dozens of surgery and countless hours of rehabilitation. Though the injuries sustained were devastating, Turia’s story is one of hope. She demonstrates how much can we can overcome with a fighting will, a positive attitude and a strong support network. Turia serves as an ambassador for Interplast, an organisation that provides free reconstructive surgery to those in developing nations. She was also recently named the NSW Premier’s Woman of the Year and was a 2014 finalist for Young Australian of the Year.
FRE BOO E K
Rece ive of Tu a FREE co py Every ria’s bo ok, thing t on ar o Live For r i val RRP
Turia is currently training for three upcoming events: the 20km Lake Argyle Swim, the Variety Cycle from Sydney to Uluru and a section of the Great Wall of China – all to raise money for Interplast. Every woman, whether in her personal or professional life, is bound to face times of change and challenge. Thriving during these challenging times is only possible with resilience, perseverance and determination. We’re honoured to have Turia Pitt as our special guest presenter for the annual AMA Queensland Women in Medicine Breakfast, and look forward to hearing her discuss: Her own experiences of recovery and perseverance after sustaining devastating injuries in a 2011 grassfire Coping with all aspects of change and approaching it with positivity The importance of hope and determination in the face of adversity
$35.00
TICKET PRICE: $70 AMA Queensland member (Includes staff in a member practice) $80 Non-member $65 Medical students and DiTs (AMA Queensland members only) $650 Member table of 10 (inc. GST) $750 Non member table of 10 (inc. GST)
CONTACT: For further details phone (07) 3872 2222 or to register email registrations@amaq.com.au
CURRENT ISSUES
GREATER PROTECTION FOR QUEENSLAND PUBLIC SERVICE EMPLOYEES NEW LEGISLATION ALLOWS GREATER PROTECTION WITH ENHANCED CIVIL PROTECTIONS TAKING EFFECT FROM 31 MARCH 2014 FOR HOSPITAL AND HEALTH SERVICE EMPLOYEES. KATHARINE PHILP AND RACHEL DREW FROM TRESSCOX LAWYERS EXPLAIN.
RACHEL DREW & KATHARINE PHILP TressCox Lawyers
On 19 February 2014, the Queensland Parliament passed new legislation which affords greater protection to Queensland public service employees from civil liability and provides certainty that the State will afford them legal protections for the discharge of their official duties. The Public Service and Other Legislation (Civil Liability) Amendment Act 2014 (the Act) took effect from 31 March 2014. The Act defines State employees to include employees of entities that represent the State. Hospital and Health Service (HHS) employees are therefore captured under the definition and can expect greater protection from civil liability. THE ACT REFORMS The Act amends the Public Service Act 2008 (Qld) (PSA) and the Police Service Administration Act 1990, by inserting provisions providing: 1. Protection from civil liability for State employees for engaging in, or as a result of engaging in, conduct in an official capacity; 2. Preservation of the rights of potential claimants by transferring civil liability of State employees to the State; and 3. For the State to have a right to recover financial contributions from State employees who have engaged in conduct but only if the conduct was other than in good faith, and with gross negligence. STATED OBJECTIVES OF THE ACT The explanatory notes to the Public Service and Other Legislation (Civil Liability)
Amendment Bill 2013 provide that the enhanced protection from civil liability will support State employees to: Perform their roles to make decisions independently, and To innovate and improve service delivery without the concern of litigation and the accompanying financial risk. CIVIL LIABILITY AND THE SCOPE OF PROTECTION Civil liability is defined by reference to liability to pay amounts. This encompasses direct costs such as compensation or financial settlements, as well as liability because of an obligation to do something that involves payment of an amount, such as rectifying damage to property. Importantly, the immunity will “not preclude an employee being named in proceedings or prevent a court making orders issuing injunctions about specific conduct by employees, such as orders to cease contraventions of an Act”. A new section 26C of the PSA provides that “an employee does not incur civil liability for engaging in, or as the result of engaging in, conduct in an official capacity”, transferring this liability instead to the State. However, where an employee is found to have engaged in conduct other than in good faith, and with gross negligence, the State can seek a contribution from the employee. Conduct is defined to include both acts and omissions. This section of the PSA is designed to capture conduct of an employee either engaged in their official duties or as part of their official duties. Such scope recognises the range of duties undertaken by State employees.
It means patients and even other doctors will not be permitted to pursue claims against doctors personally. 12
MAY 2014 DoctorQ
The requirement that a financial contribution can only be obtained in circumstances where the employee has acted other than in good faith and with gross negligence, sets a high bar practically and will curtail most circumstances where a contribution may be sought. CONCLUSIONS Simply put, the effect of the legislation is that doctors are protected from personal liability for claims such as negligence and discrimination. That means patients and even other doctors will not be permitted to pursue claims against doctors personally. The only way the Department can claim contribution from a doctor personally is if they have acted in bad faith AND are grossly negligent. That is a fairly high threshold. It’s important to note that the new provisions will apply to all incidents on or after 31 March 2014. This is a great development and should set minds at rest. Impact on insurance premiums is yet to be seen. Q
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DoctorQ MAY 2014
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Feature story
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in 2013, the
Better H lueprint for B e th d se d relea dustrial an vernment a legal, in . ensland Go m rs e o u , ce fr Q m ffi ir e e o l fa st th a n sy ic Since ward view u r med r our senio from the a ere in our fo w rs o s st ct ct re o a n d u tr t n g l co ovin grea mean rem g individua ission. introducin acts would d tr n se tions Comm o co la p e e ro R p th l a t s, ri n ri st rm ns p u e d te lu c In b The to the negotiatio . In basi ors access progress in l int of view ct a o o ti p d n g rs’ a re n st ce yi ca b n ffi h healt and su and de dical O ong doctors ctive rights alaried Me e S m ll a n y co a it li g n ra u in p d st strip ente e Au skforce. nsland, th n unpreced the SMO Ta ere has bee AMA Quee d , th n A r, a , M te n A la io e r n a a ye ent, th ether u acts More than d Governm nced contr Q), the Tog e had bala Queenslan d (ASMOF n w e a to re th sl n n su e ce e n e la e e u betw OF Q ble to em in p MOF), ASM better syst gotiating ta S e a n (A d e e n w, d o o th e ti N e . to ra n Fede future rnment sed, we contracts in sland Gove . Once revi e n n e o th e se ti u o a to Q lt th s e e n su th chang und o ut con as to bring re making serious gro rally witho fo e te e a m b il s n so The plan w n u e ia d d e ic a m ng clin not be cha nsult with ter, we have that could ealth Minis lth would co a H e e H th d d n a n a sl een eral g of ensure Qu irector Gen e beginnin on of the D d with at th ti n te e n rv se te re in p ere with e one we w irer than th fa y tl issues. n t. ca n ifi sign djace ’ve vements a is month is pefully we u review th of the impro mbers. Ho e e yo m in ct r tl a u u tr o o n n e y n wn b st wh we The co uded a en at its be lidarity sho e have incl se so W s e a s. l n th w o n is ti e h a e T ti ent. has b nego from genera ir employm egotiation taken calls fa n r n is fo ve t th e h f g o ve fi t a d ou r an We h ve to come contracts. ick togethe One positi ry different d, we will st e ve sh g u n p vi a n e h ite . t, wh profession as one desp shown tha campaign. y the whole VMOs work port to the b p d n n su a ru ir s n e O ig th a M camp saw S ted to lend d a strong rs who wan rs realised tiations an o g e n practitione h g s, as docto u th ro n o th m n o w w fe past es that are ave been bers in the get outcom l m cessions h il e n w m co e f t o w n r y, e ca unit umb Signifi a record n intain that y. If we ma s recruited a a h w d th n a . a p ll sl e st n as w was our be AMA Quee r certainty for doctors g together with greate nsland and e y, e ll u fu Q e that workin p in o ts H be further rtise. r our patien n and expe ot going to n io ss re a a p beneficial fo s m ve co li re, ily at our fam need our ca knowing th tients who a rk p o w ve a t h a rs th . Docto lt t on with nsultation this difficu we can ge s without co ort during p ct p a tr su in our lives, n ir e co th to for y changes akeholders disrupted b ff and our st a st r u o , rs r membe to thank ou I would like time.
udd Dr Shaun R d Queenslan Elect, AMA tn e d si re P
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MARCH 2014 DoctorQ
Feature story
REVISED CONTRACTS ROLL OUT AMA Queensland is of the in principle view that a satisfactory resolution of our concerns with the proposed contracts has been reached. It is important to emphasise that this is still subject to the finalisation of relevant documentation so that it faithfully reflects matters agreed. SMOs and VMOs now have an appropriate period to consider and negotiate the final details of their contract with their Hospital and Health Service. Carefully consider your individual contract and assess its merit on your personal circumstances. On receiving your individual contract, members are entitled to a free 20 minute consultation with HR Law. Call the contract hotline on 1300 356 155.
THE KEY IMPROVEMENTS Robust and binding dispute resolution and unfair dismissal processes Guarantee that contract conditions cannot be changed negatively SMOs can reject a proposed transfer or shift change if reasonable grounds exist Intent of original Govt addendum incorporated in reissued contract The words “profitability”, “viability” and “reputation” removed from the contract termination clause The choice of a three or six month notice period Hospital and Health Services (HHS) to provide for current clinical support time arrangements A guarantee that translated option A benefits will be carried with SMOs moving to a different HHS PDL can only be directed to address or improve performance issues Intellectual property rights to only be related to actual duties performed for the employer Improvement in wages and certain allowances can be arbitrated every three years Future improvements to contracts need to go through a contract advisory committee.
DoctorQ MARCH 2013
15
CURRENT ISSUES
STATE BUDGET SUBMISSION HEADING TOWARDS THE RELEASE OF THE 2013-2014 STATE BUDGET, POLICY OFFICER LEIF BREMERMAN GIVES A SUMMARY OF AMA QUEENSLAND’S SUBMISSION TO GOVERNMENT, GUIDED BY OUR HEALTH VISION WORK.
LEIF BREMERMANN
Policy Advisor, AMA Queensland
The 2013-2014 Queensland Budget was something of a mixed bag for the Health Sector. On the one hand, the health and hospitals budget was boosted to a total of $12.3 billion, making it the biggest health budget in Queensland’s history. However, this extra funding did not keep up with CPI or population growth and was not an across the board increase. Overall, there was much to welcome but there was also a lot of room for improvement to ensure essential surgical and public health services are maintained across the state. AMA Queensland delivered its Budget submission to the Queensland Government in early April. Many budget submissions ask governments to commit to a series of spending initiatives, and in that respect at least, AMA Queensland’s 2014-2015 budget submission is no different. However, our submission also suggests a number of areas in which the Queensland Government can responsibly save money, with the savings generated being used to help fund the new initiatives we have suggested. These forward thinking savings measures have been identified as a result of our work on developing AMA Queensland’s Health Vision, which was itself informed by the knowledge, dedication and feedback of our organisation’s strongest asset; its
These forward thinking savings measures have been identified as a result of our work on developing AMA Queensland’s Health Vision... members. For this reason we believe it is fair to say that our 2014 Budget submission will, if adopted by the Queensland Government, deliver not only for AMA Queensland members but for Queenslanders as well. The highlights of AMA Queensland’s 2014 Budget Submission include: END OF LIFE CARE Our core value of compassion directed us to advocate that Queensland should commit to becoming a world leader in advance care planning. Building on recent work undertaken in the Medical Journal of Australia and by Palliative Care Australia, our Budget Submission recommended the Queensland Government provide funding to help doctors learn how to discuss end of life care with patients, and to support patients who make the choice to develop an Advanced Care Plan. It also made practical suggestions on the need for a standardised advance care plan.
CARING FOR OUR DOCTORS Following the work of the 2013 beyondblue survey, which found doctors suffer from more than twice the level of very high psychological distress than the general population and more than ten times the level of other professionals, AMA Queensland has advocated for Queensland Health to improve the coping skills of the medical cohort by investing in evidencebased training such as mindfulness. Studies have shown mindfulness training can help doctors become more focused, more empathetic and less emotionally exhausted. This resulted in better outcomes for patients and greater efficiency gains. We also recommended the Queensland Government commit to a campaign to improve health literacy by ensuring every Queenslander has their own GP and, importantly, that doctors follow this advice by getting their own GP too. The submission also contained a number of other notable recommendations, including funding for Closing the Gap, public health initiatives around obesity and rural health and improving services for mental health. We highly recommend all members read the document at www.amaq.com.au Q
The mental and physical health of medical students and doctors in Australia is an ongoing concern within the medical profession and community.
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If you or somone you know needs help, call the Doctors’ Health Advisory Service 24 hour helpline on (07) 3833 4352
CURRENT ISSUES
NURSES TO BE GIVEN MORE POWERS
HEALTH MINISTER LAWRENCE SPRINGBORG HAS RELEASED THE STRENGTHENING HEALTH SERVICES THROUGH OPTIMISING NURSING STRATEGY AND ACTION PLAN WHICH AGAIN RAISES THE ISSUE OF INDEPENDENT NURSE PRACTITIONERS. POLICY ADVISOR LEIF BREMERMANN EXPLAINS WHY THESE CHANGES MIGHT JUST BE A CASE OF TOO MANY CAPTAINS WILL SINK THE SHIP.
LEIF BREMERMANN
Policy Advisor, AMA Queensland
The concept of nurse practitioners is not a new one. Every once in a while a politician or bean counter will get a glimmer in their eye and come up with the notion that asking nurses to do the job of doctors is a pathway to savings and better services for patients. In the case of nurse practitioners, history does, it seems, often repeat. And so it is that Queensland’s Health Minister, Lawrence Springborg, has announced the “Strengthening Health Services through Optimising Nursing Strategy Action Plan”, which makes the following recommendations. 1. Expand access to the Medicare Benefits Schedule (MBS) for services provided by nurses, streamline referral pathways and identify patient rebateable services. 2. Remove requirement for nurse practitioners to be in collaborative arrangements. 3. Expand access to the Pharmaceutical Benefits Scheme (PBS) for nursing services. 4. Inform and influence the regulatory mechanism for medicines, poisons and therapeutic goods to remove unnecessary barriers or restrictions to nursing scope of practice. 5. Expand current provisions enabling access rights to public and private hospitals for nurses, including admission and discharge privileges. 6. Optimise nursing models under public private partnerships. 7. Promote flexible employment opportunities and new ways of working by optimising alternate business models. These proposals are of concern to the AMA. It might seem trite to say so, but put simply, nurses are not doctors. Like the recent Queensland trial allowing some pharmacists to administer flu vaccinations, a proposal that your AMA also objected to, it is important to note the inherent 18
MAY 2014 DoctorQ
dangers of allowing people who do not possess the appropriate medical training to practice medicine. It is claimed that nurse practitioners will save the health system money, but there isn’t any empirical evidence to back this up. And even if there was, when patient safety is at risk, any potential savings simply don’t add up. If we want more people practicing medicine and helping their community, more doctors, not cost cutting is the answer. While it is acknowledged that there are workforce issues which currently constrains the ability to supply more doctors where and when they are needed most, only hard work and sensible policy decisions will deliver real solutions. Legislating to provide the capacity to substitute independent nurse practitioners only shows an unwillingness or inability for Governments to address the underlying issues related to medical workforce shortages. The AMA’s position supports nurses as complementary to doctors, not as a substitute. Our clear message has always been support for a model of health care that places the general practitioner as pivotal in a patient’s health care team. Q
FROM THE AMA’S POSITION STATEMENT ON NURSE PRACTITIONERS The role of nurses in the health care setting does not include: Formulating medical diagnosis; Referring patients to specialists; ordering Independent pathology or radiology;
of
Prescribing medication and issuing repeat prescriptions; and Deciding on the admission of patients to, and discharge from, hospital. The AMA does not accept that medical practitioners should be legally responsible when errors of omission or commission by medically unsupervised independent nurse practitioners warrant subsequent medical intervention.
erous to quite dang y ll a n o rs e p to be in I feel it is for nurses ts n e m e ir octors. e requ ts with d remove th n e m e g n a in ve arr . Working collaborati lready here a is re a t a s h e k w These nurs Don’t brea . rs to c o th d r ith ost fo e a team w dd extra c a d n a , g rkin already wo t. on n e ley Bondes governm Dr Kimber have ueensland Q A M A uncil at ractitioners We at Co ut nurse p o b a th g n le e major spoken at ears and th y f o le p u o in this ast c agreement over the p y n a g in d e ld only t conc oners wou point abou ti ti c ra p e n at nurs ollaboratio issue was th ess IF in c c c a S B M be allowed rs. ahan with docto Dr Larry G
CURRENT ISSUESaunt ethical agony
FACEBOOK TROLLS AND MEDICINE
SLANDER IS NOT A NEW CONCEPT, BUT SOCIAL MEDIA CAN CERTAINLY SPREAD A MALICIOUS COMMENT FASTER AND TO MORE PEOPLE THAN EVER BEFORE. THE ETHICS AND MEDICO-LEGAL COMMITTEE EXPLAIN HOW TO CHALLENGE A FACEBOOK TROLL IN A PROFESSIONAL SETTING.
Dear Committee, Much to my surprise and despair, a colleague has shown me a link on her Facebook page where another (junior) colleague had written about me – ‘what an arse, whoever let him pass his exams must have been deaf, blind and stupid. He’s a moron’ My disparager and I do not work together, or for the same organisation, so I do not understand why she has done this. I am extremely upset, confused and angry about what has been said about me to other medical practitioners, colleagues and patients. I am unsure about what to do. Is this a case where I should just suck it up and take one on the chin?
DO YOU HAVE AN ETHICAL ISSUE? The experts from our Ethics and Medico-legal Committee answer your ethical dilemmas. Send your ethical dilemma to policy@amaq. com.au.
Deafandblind
Dear Deafandblind, It is good to see that you have maintained your sense of humour in the face of this challenge. We commiserate with you about the pain these comments have caused to you. Hurtful and disparaging remarks by colleagues are particularly harmful as they represent potential rejection by colleagues and the profession, humiliation and a threat to your reputation and livelihood. As such, they should be taken seriously. The explosion of the role of social media in our world has meant that online abuse is an increasingly common problem. Sadly, we have recently seen the devastating effects of ‘trolling’ and social media gossip. It appears that there is little which regulates this conduct in the community. Doctors, however, have a professional duty which calls them to a higher standard of conduct than the general public. The Good
Medical Practice: Code of Conduct for Australian Doctors emphasises that good relationships with medical colleagues, nurses and other healthcare professionals strengthen the doctor-patient relationship and enhance patient care. It goes on to say that good medical practice involves ‘behaving professionally and courteously to colleagues and other practitioners including when using social media.’1 From what you have described, it appears that your colleague’s behaviour has fallen short of the standard called for by the Code. We, on the Committee, would advise that you do take this conduct seriously and address it. This conduct does no credit to the profession and has clearly caused you much pain and anxiety. There are several avenues of redress that are open to you: One option would be to contact your colleague and express your disappointment in their behaviour, point out that they have breached the code and request a retraction and apology. It will be up to you to decide whether you are satisfied with your colleague’s response. Another strategy might be to make a notification to the Medical Board regarding the breach of the Code. You may also seek legal advice about any avenues of legal redress that are available to you. Your MDO may be able to offer advice and support in this area.
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This brave new world of social media transforms a private, unkind comment, said in a moment of anger, to a seemingly indelible public denigration. The online social and professional environment has changed so much over the last decade that it is unsurprising our behaviour is taking some time to adapt. This brave new world of social media transforms a private, unkind comment, said in a moment of anger, to a seemingly indelible public denigration. It is possible that your colleague has not realised the seriousness of her conduct or the pain that reading her comment may cause. This conduct, however innocently or flippantly done, is serious and should be treated as such. Professional conduct, collegiality and mutual trust lie at the heart of our profession, and social media should be used to support and not undermine these values. Good luck and tweet yourself and others with respect! Q
1 Good Medical Practice, Clause 4.2.3. AHPRA has also just released a Social Media Policy which can provide extra guidance on appropriate ways of using social media and online communications.
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JDC COCKTAIL PARTY Dig out your dressy gear, cast your eye over the cocktail menu and join The Chaser’s Craig Reucassel for the inaugural JDC Cocktail Party on Pullman Terrace. The Pullman offers a glittering view of King George Square and City Hall and we’re told there’s a substantial array of canapes and drinks to help unwind after the first day of the conference. The ticket price is $75, but is included if you’ve registered for two days of the conference.
JDC COCKTAIL PARTY HOST
CRAIG REUCASSEL Craig Reucassel is an Australian writer and comedian who is best known for his work on ABC’s The Chaser and is currently in The Checkout on the ABC. Craig was a founding member of the satirical multi-media group The Chaser team, and worked to produce their satirical newspaper, as well as television shows on ABC TV including The Election Chaser, CNNNN, The
REGISTER NOW Conference Prices Student/Intern Intern members of AMA Queensland are eligible for the student rate to attend Day 1
Day 2
Both Days
Cocktail Party
$135
$135
$250
$75
Doctor in Training Years 2 - 5 Day 1
Day 2
Both Days
Cocktail Party
$185
$185
$350
$75
Senior Doctors Day 1
Day 2
Both Days
Cocktail Party
$220
$220
$410
$75
PROF BRETT MCDERMOTT Professor Brett McDermott, beyondblue Director and Director of Child and Youth Mental Health Services at Mater Hospital will speak on junior doctors and mental health. The presentation will focus on beyondblue’s world first national survey of over 14,000 Australian doctors and medical students launched in October 2013, including the practical actions that need to follow on from the key findings. The survey revealed that young or female doctors were most at risk of experiencing mental health issues. Professor McDermott will talk about junior doctors and medical students maintaining their mental and emotional health.
Chaser Decides and The Chaser’s War on Everything and Yes We Canberra. For two years Reucassel co-hosted the drivetime radio show Today Today on Triple J with fellow Chaser Chris Taylor. The pair returned with their Sunday afternoon show Bloody Sunday to do relief shifts for the following two years.
AMA QUEENSLAND COUNCIL OF DOCTORS IN TRAINING PRESENT
LEARN
FROM
TODAY,
INSPIRATION FOR TOMORROW.
JDC 2014 AMA QUEENSLAND JUNIOR DOCTOR CONFERENCE
SATURDAY 28 - SUNDAY 29 JUNE 2014 To view the full program and costs and download a registration form, visit www.amaq. com.au
PULLMAN HOTEL, KING GEORGE SQUARE BRISBANE
SATURDAY 28 JUNE PLENARY ONE - INSPIRATION 30 years of creating smiles: the story of ‘Operation Smile’ Associate Professor Richard Lewandowski, Plastic Surgeon and Board Member, ‘Operation Smile’ Fistula Repair - treating women with genital tract fistulae in developing countries in Africa and Asia Professor Judith Goh Battling melanoma in the skin cancer capital of the world Professor Adèle Green AC, QIMR Berghofer Medical Research Institute TASTING PLATE MINI WORKSHOPS Talking, teaching and technology Dr Victoria Brazil Protocol development for clinical trials - the essential takeaways Dr Louise Cullen, Senior Staff Specialist, Department of Emergency Medicine, Royal Brisbane and Women’s Hospital Making friends with statistics - the essential lessons Dr Kerenaftali Klein, QIMR Berghofer Medical Research Institute PLENARY TWO - COLLABORATION Lessons learned in public health for tomorrow’s leaders Professor Michael Daube, Director of the Public Health Advocacy Institute and the McCusker Centre for Action on Alcohol and Youth A race against time: the interrelation of public health and the macro economy in developing economies Professor Stephen Leeder AO Navigating the mess of medical information Professor Paul Glasziou THE INAUGURAL JDC COCKTAIL PARTY
Proudly sponsored by:
Premium sponsor:
SUNDAY 29 JUNE Rejuvenation breakfast QRRRF: Learn more about the Queensland Residents and Registrars Research Foundation and how you can apply for a research grant. JDC inspirational leader lecture Daniel Flynn , Co-Founder and Managing Director of Thankyou Group JUNIOR DOCTOR HEALTH AND WELLBEING 2013 National mental health survey of doctors and medical students Prof Brett McDermott, beyondblue Director Personal resilience Dr James Scott, Royal Brisbane and Womens Hospital JUNIOR DOCTOR FORUM Then and now: navigating the challenges for junior doctors Then – where have we come from? Dr Steve Hambleton, President, Australian Medical Association Now – current challenges and the road ahead Dr Will Milford Winning strategies for cover letters, resumes and practical interview skills Kathryn Cassidy, Career Advisory Service Australian Medical Association Cutting edge technology - 3D printers and the future of surgery Dr Dimitrios Nikolarakos, Surgeon, Gold Coast Hospital QRRRF SPONSORED ‘BEST MOMENTS IN MEDICINE’
CURRENT CURRENT ISSUES ISSUES
GP SALARY SURVEY THE FIRST AMA GENERAL PRACTICE SALARY SURVEY WAS CONDUCTED THROUGHOUT FEBRUARY 2014 AS A JOINT PROJECT BETWEEN THE VICTORIAN, NEW SOUTH WALES AND QUEENSLAND STATE BRANCHES. THE RESPONDENTS PROVIDED THE FOLLOWING INFORMATION REGARDING PAYMENT ARRANGEMENTS:
87%
Over 430 across the eastern states completed the survey. This was the first survey to understand the salary and services arrangements throughout metropolitan and regional areas. This inaugural survey yielded rich data, with the responses providing for interesting analysis. Overall the respondents demonstrated a thorough knowledge
of their payment arrangements and/or employment entitlements. Further, there was little ambiguity between the various types of arrangements which exist such as independent contractor agreements and employment arrangements. The intention is that this survey is conducted annually, so that more information can be gleaned from this under researched area. Q
Service Providers - paid fixed proportion of billings
12%
Employee - hourly rate of pay
99%
49% Sunday
Saturday
Monday to Friday After Hours Saturday Sunday
WHAT PERCENTAGE OF YOUR BILLINGS DO YOU RETAIN? EMPLOYEE ENTITLEMENTS
Sup
eran
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nua
tion
Non eo abo f the ve
GYM MEMBERSHIP
22% 86%
LUNCH
Sic
l ona essi nt Prof elopme Dev Leave SABBATICAL LEAVE
ave k Le
RACGP MEMBERSHIP
ve Lea ual nts n n A yme Pa
8%
PROFESSIONAL SUBSCRIPTIONS
11%
OTHER INCIDENTAL PAYMENTS WERE REPORTED SUCH AS:
MOTOR VEHICLE ALLOWANCE
12%
EMPLOYEES RECEIVED THE FOLLOWING PERCENTAGE OF BILLING
ANNUAL REGISTRATION/ RENEWAL FEES
Nursing Homes
After Hours
Monday to Friday
56%
62% 67%
AMA Queensland Business Support Services
Saving you valuable time Our professional team can help you with:Â Bookkeeping
Marketing and communications
Meetings and events
Customised services
Membership needs Who do we help? Private practices, committees, associations, societies and colleges. Find out today how AMA Business Support Services can save you valuable time! P: (07) 3872 2222 W: www.amaq.com.au E: bss@amaq.com.au
As a new client you will receive a free award subscription update!
SPECIAL OFFER!
How would you know if you bought an unsuitable life insurance product? Experien Insurance Services are leading insurance brokers to the medical industry, we tailor our advice to ensure you receive maximum return in the event of a claim. We would like to extend a 15% cash back offer on any new personal insurance policy, simply quote AMA QLD to take advantage of this offer. Contact an Experien Insurance adviser for an obligation free insurance review, 1300 796 577. Life Insurance services are provided by Experien Insurance Services Pty Ltd ABN 99 128 678 937. Experien Insurance Services Pty Ltd is a Corporate Authorised Representative (No. 320626) of ClearView Financial Advice Pty Limited ABN 89 133 593 012 AFS Licence No. 331367. General Insurance services are provided by Experien General Insurance Services Pty Ltd trading as Experien Insurance Services ABN 77 151 269 279 AFS Licence No. 430190. This information is of a general nature only and has been prepared without taking into account your particular financial needs, circumstances and objectives. While every effort has been made to ensure the accuracy of the information, it is not guaranteed. You should obtain a copy of the product disclosure statement and obtain independent professional advice before acting on the information contained in this publication. * Promotion only applies to new policies from the Experien Insurance Services (EIS) life insurance offering - Trauma Insurance, Total & Permanent Disablement (TPD) Insurance, Needle stick Cover, Life Insurance, Key Person Insurance, Income Protection Insurance, Business Succession (Buy/Sell) Insurance or Business Expenses Insurance - and not to any existing policies that are transferred to EIS as adviser or products offered by Experien General Insurance Services (EGIS). Only one rebate will be issued per client (or related entity/party) and cannot be used in conjunction with any other EIS offer. The rebate only applies to the first year’s premium. Rebates will be issued to eligible clients at the end of the promotion period and only on policies that complete in the promotion period (1 February 2014 - 31 May 2014).
AMAQ_March_ad.indd 1
2/17/2014 2:08:14 PM DoctorQ MAY 2014
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18 - 19 JULY | BRISBANE
FRESH THINKING STARTING & WORKING IN PRIVATE PRACTICE CONFERENCE 2014 With unprecedented employment changes to conditions in the Queensland public sector, you may be considering transitioning to private practice. The Fresh Thinking program has been designed to provide information you require in establishing a private medical practice (fundamentals stream); or if you are working in an already established medical practice, to enhance and refine your skills and knowledge (advanced stream). This conference will equip doctors, practice staff and consultants with access to experts in the area, and is open to both members and non-members as a part of AMA Queensland’s Workplace Relations service. Once registered, delegates may attend any session of their choosing to best meet their specific requirements. Register now for an education-packed conference that will give you the crucial information required for starting and/or working in private practice.
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CONTINUING PROFESSIONAL DEVELOPMENT POINTS *Subject to approval
“This is one of the best conferences of the year – not to be missed if you are in private practice.” Dr Judith Reddrop General Practitioner, Women’s Wellbeing Clinic
“Needs to be at least an annual event. The subjects and content have real relevance to our GP industry and I will be able to go back to the practice and make further improvement.” Ms Suzanne Stott Practice Manager, The Lockyer Doctors
EARLY BIRD
SPECIAL REGISTER BY 20 JUNE 2014
SPONSORED BY:
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MAY 2014 DoctorQ
PROGRAM
Beginners stream Advanced stream
DAY 1
DAY 2
8.00am-8.20am
Registration
8.30am - 9.00am
Registration
8.20am - 8.30am
Opening
9.00am - 10.00am
8.30am - 9.30am
Effective patient engagement in the 21st century
Everyone’s watching: The impact of social media on your practice
Associate Professor Michael Greco, Patient Opinion Australia
9.30am - 10.30am
Exceeding patient expectations
Allyson Alker, MDA National
10.00am - 10.15am
Morning Tea
10.15am - 11.15am
Breakout Room 1 PCEHR, eHealth and new technology Andrew Turner, AMA Queensland
Colleen Sullivan, FAAPM Life Member
10.30am - 11.00am
Morning Tea
11.00am - 12noon
Breakout Room 1 Financial foundations - Getting it right from the start Julie Smith, William Buck (Qld)
Breakout Room 2 Financial healthcheck for your practice Paul Copeland, William Buck (Qld) 11.15am - 12.15pm
Breakout Room 2 New privacy reform and medicine Andrew Turner, AMA Queensland 12noon - 1.00pm
Breakout Room 1 Quality assurance through accreditation AGPAL Breakout Room 2 Expanding your practice – Balancing people, profits and the environment Stacy Kambouris, HMED Consult, Health and Medical Consulting
1.00pm - 2.00pm
Lunch
2.00pm - 3.00pm
Emerging employment issues in 2015 Rachel Drew, TressCox Lawyers and Andrew Turner, AMA Queensland
3.00pm - 4.00pm 4.00pm - 4.30pm
Breakout Room 1 Reasonable management action: WorkCover and your staff Kate Macartney, WorkCover Queensland Breakout Room 2 Embracing new technology in your practice Deana Scott, Virtual Medical Office
12.15pm - 1.00pm
Lunch
1.00pm - 2.00pm
Breakout Room 1 Healthy financial strategies for private practice Simon Moore, Investec Specialist Bank
Breakout Room 2 Healthcare marketing: Why it matters and how you can make it work for you Damien Edmonds, Edmonds Marketing 2.00pm - 3.00pm
Setting up your business structure Lynette Reynolds, TressCox Lawyers
Breakout Room 1 Engaging support staff George Sotiris, AMA Queensland
Breakout Room 2 Having difficult conversations with problem patients Luke Donaldson, AMA Queensland
Afternoon tea and networking
3.00pm - 3.30pm
Afternoon tea and networking
To view the full brochure go to www.amaq.com.au or request a copy by completing your details below.
REQUEST A BROCHURE: NAME: PRACTICE: EMAIL: PHONE:
RETURN TO:
Email: j.ovnic@amaq.com.au
Fax: (07) 3872 2280 DoctorQ MAY 2014
27
FOUNDATION
HOMELESS NUMBERS RISE IN CAIRNS MEET DR SHARMILA BISWAS, LONG-TIME AMA QUEENSLAND MEMBER AND CAIRNS GP. DR BISWAS RECENTLY SPENT TIME VOLUNTEERING WITH THE ROSIES CAIRNS FOOD OUTREACH PROGRAM AND WAS AMAZED AT THE AMOUNT OF HOMELESS PEOPLE ACCESSING THE SERVICE. Cairns is being dubbed the homeless capital of Australia after a recent demographic study revealed 1.6 per cent of the Far North Queensland city’s population are without a home—the highest proportion of Australia’s 18 major cities. Recently released data suggests more than 2,300 people are sleeping in the city’s streets, overcrowded dwellings and other temporary accommodation. As if that’s not alarming enough, this figure is on the rise. Local GP, Dr Sharmila Biswas is familiar with the homelessness epidemic reportedly taking over in the city she has called home for 20 years. “It’s a very, very complex social challenge,” says Sharmila. “Homelessness is not just about being without a secure house or shelter, it’s an extreme form of social disadvantage and moreover, social exclusion. The impact is not only felt by the individual, but the community as a whole. Sometimes at the Gateway to the Great Barrier Reef—a popular holiday destination—their presence is seen as a terrible hindrance.”
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MAY 2014 DoctorQ
For those forced to sleep on the city’s streets, survival is knowing where to get a feed or a cold or hot drink, a blanket or a bed, or the savvy to avoid the dangers that surround them out in the open with no shelter or protection. There is no doubt in Sharmila’s mind that without the presence of Rosies’ outreach food van in Cairns, many of the homeless wouldn’t survive. “Neglected and disadvantaged children would have no food, youth unable to connect with their families would have no-one to talk to, and women who are victims of alcohol and domestic violence would have nowhere to go. Young and old socially isolated men, the Indigenous peoples far from their homelands, and anyone in need of medical attention exacerbated by hunger would continue to suffer,” she says. Having recently spent time out in the van with the street outreach volunteers, Sharmila witnessed first-hand the increasing number of people who are relying on their support, not only for basic needs such as food, but also to feel some connection with the community around them.
DONATE ONLINE TODAY AT www.amaqfoundation.org.au
Your gift will aid doctors doing good, directly supporting causes and projects aimed at relieving sickness, suffering and disability among Queenslanders in need.
“The outreach program has been operating in Cairns for the past 24 years and the present vehicle is over 20 years old,” Sharmila explains. “It has extensive rust and has been deemed not mechanically safe. A reliable and serviceable vehicle is vital to the program and without a replacement van, those who are most vulnerable in our community will have no access to food, drink, emergency clothing, and blankets.” A new, fully fitted out van costs a massive $50,000. “Some of my patients that I have seen over the years are regular patrons of the local outreach van making up just a few of the 120 or so homeless people they connect with each week. I’m told these numbers have been steadily increasing over the past 18 months, and a new and larger van would not only enable the program to continue but also allow it to grow. It would be able to carry more volunteers and amenities safely.” The AMAQ Foundation desperately needs your support to raise $50,000 for a new van for the Rosies Cairns food outreach program. Q
FOUNDATION DOCTORS DOING GOOD
Do you have a project which needs financial assistance? Contact Colleen Harper, Foundation Manager: Phone: (07) 3872 2204 Email: c.harper@amaq.com.au Website: www.amaqfoundation.com.au
@AMAQ_FOUNDATION The AMA Queensland Foundation has joined the world of social media! To keep up to date on all the latest Foundation developments and projects, including how our fundraising appeals are tracking and much more: like us on Facebook
‘AMA Queensland Foundation’; follow us on Twitter ‘@AMAQ_Foundation’; check out our YouTube channel; or visit www. amaqfoundation.com.au and click on the links. Q
BEQUEST STORY Have you thought of remembering AMA Queensland Foundation in your Will? A bequest is a long-lasting gift that will help secure the Foundation’s long term future and it is an opportunity for you to make a very special, tangible and lasting contribution. After all, the Foundation’s mantra is Doctors Doing Good. Please contact Colleen Harper, Foundation Manager for a discreet chat. Strictest confidentiality will be maintained. We recommend you take legal advice when making a will. TressCox Lawyers have kindly offered to provide a discount for this service. Please contact Paul de Silva, Special Counsel (07) 3004 3520 or Paul_de_Silva@ tresscox.com.au for further details. Q
DoctorQ MAY 2014
29
AROUND THE REGIONS
LOCAL MEDICAL ASSOCIATION ROUND UP
JOIN YOUR LMA
STAY CONNECTED WITH COLLEAGUES AND UP TO DATE WITH THE LATEST HEALTH NEWS AND ISSUES AFFECTING YOUR LOCAL AREA. DON’T STAND ON THE SIDELINES —JOIN YOUR LOCAL MEDICAL ASSOCIATION TODAY AND MAKE A DIFFERENCE.
SUNSHINE COAST
CENTRAL QUEENSLAND
REDCLIFFE & DISTRICT
Monthly dinner meetings are generally held on the fourth Thursday of each month.
For information on meeting dates and membership contact Central Queensland LMA Secretariat Dr Harley Wilson.
Next meeting: 28 May
Convenor: Jo Bourke
Phone: 0419 277 611
Convenor: Margaret MacPherson
Phone: (07) 5479 3979
Email: harleywilson00@gmail.com
Phone: (07) 3121 4043
Venue: Maroochydore Surf Club
Venue: Golden Ox Restaurant, Redcliffe Time: 7pm for 7.30pm
Fax: (07) 5479 3995 Email: jobo@squirrel.com.au For further information or to join visit www.sclma.com.au
BUNDABERG For information on meeting dates and how to join, contact Bundaberg LMA President, Dr Daud Yunus.
CAIRNS
Phone: (07) 4152 2888
For information on meeting dates and membership contact Cairns LMA President Dr Sharmila Biswas.
Fax: (07) 4153 3245
Phone: (07) 4036 4333
TOWNSVILLE For information on meeting dates and membership contact Townsville LMA President Dr Carl O’Kane. Phone: (07) 4433 1111
Email: daud.yunus@gmail.com
TOOWOOMBA & DARLING DOWNS For further information, go to www.tddlma. org.au or email info@tddlma.org.au Membership to the Toowoomba and Darling Downs LMA is just $50. To join, download an application form at www.tddlma.org. au/membership.html
BRISBANE NORTHSIDE Meetings are generally held on the second Tuesday of alternate months. Convenor: Dr Graham McNally Phone: (07) 3265 3111 For further information or to join, visit www. northsidelocalmedical.wordpress.com
GOLD COAST Monthly meetings are generally held on the third Thursday of each month. For information on meeting dates go to www. gcma.org.au or email info@gcma.org.au A membership form can be downloaded from our site. Phone: (07) 5575 7054 Fax: (07) 5575 7551 Email: info@gcma.org.au
CAN’T FIND YOUR LOCAL AREA?
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If your Local Medical Association does not appear above or your details are incorrect, please email amaq@amaq.com.au with corrections, contact details, how to join, web address, dates for upcoming meetings and who to contact for further information.
mutual group
Your Advantage
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2014
Rural Doctors Association of Queensland 25th Annual Conference Sofitel Brisbane Central 6th – 8th June 2014
A Rural Health Renaissance
RDAQ Conference 20I4 – Register today! The Rural Doctors Association of Queensland 25th Annual Conference (RDAQ 2014) will focus on celebrating achievements and innovations in rural medicine and address key challenges facing Queensland’s rural doctors. Taking place at the Sofitel Brisbane Central from 6th – 8th June with two additional days of pre-conference workshops, the program will include the latest updates in clinical practice and training, topical presentations, discussion forums, policy updates and RDAQ’s traditional medico-political forum. The conference program will offer five concurrent sessions with topics across themed streams.
CONCURRENT SESSION HIGHLIGHTS RDAQ Stream
Clinical Update Stream
Doctors In Training Stream
Telehealth Steam
Rural cardiology – “How can you mend a broken heart?” During this three hour session Dr Spencer Toombes will address the management of acute coronary syndrome in rural settings without immediate access to tertiary facilities and resources. Advanced members forum – “Friends of The shocking truth about RDAQ – engagement and advocacy” anaphylaxis – with interactive audience participation RDAQ President, Dr Sue Masel, will lead an A one hour session presented by extended member’s forum. The session Dr Anthony Brown that will expose will be topical and focused on points of the pitfalls and dispel the myths interest nominated by members prior to associated with anaphylaxis. This the conference. An opportunity for RDAQ session will be based on real members to freely discuss the areas of policy, scenarios with active audience advocacy and RDAQ services that concern participation. them the most, preceding the RDAQ Annual General Meeting on Saturday afternoon.
Rural clinical skills – “Doing it right, not doing it rough” Students and doctors in training will benefit from this three hour session. Delegates will be run through a series of clinical skills stations in small groups to enhance their learning experience. RDAQ academic award – presentations by medical student finalists. Four clinical case reports relevant to rural and remote medicine, written and presented by RDAQ Academic Award finalists. The overall winner will be announced at Sunday night’s David Horn Memorial Gala Dinner and Awards.
Critical care in the bush – “Help is on the line”
Technology vs hands on skills – “Opening New Windows – are we teaching The Right Stuff?” This will be the topic of a lively debate. The affirmative team will argue - teaching of traditional clinical skills is an essential process in medical education. The negative team will rebut - we no longer need to spend time teaching these old fashioned and sometimes subjective methods when cutting edge technology is available.
Neonatal emergencies and resuscitation
The future is you – the road to rural practice
This one hour session will assist rural doctors in the identification and management of neonatal emergencies.
This session will address the challenges trainees face in identifying pathways to a career in rural medicine. A panel will identify resources and organisations to assist trainees to achieve their goal to practice medicine in rural Queensland.
Social media advocacy – “With a little help from my friends” Panellists will give real examples and practical ‘how-to’ tips so that delegates can use the mobilising power of social media. Whether progressing concerns of a local area, broad policy or preventative health.
Community advocacy – “It never rains, it pours” Floods, drought and cyclones impact rural communities, leaving homes, livelihoods and industries all affected. This session will focus on the roles of a rural doctor and his/her family in dealing with extreme events – not just in terms of clinical and public health services, but as a community leader, advocate and resource to help the community bounce back.
The scenario - a major agricultural accident in a small rural community. Panellists will demonstrate how outcomes for victims of major trauma are improved using telehealth. Video link between referring hospital and city based emergency specialists is the basis of this scenario and will highlight available educational videos on FOAM ed. Technology delivers to rural doctors support and training which was only a dream for the future 25 years ago. Models of Shared Care – “Using technology to improve outcomes for rural people”
Rural GP’s in the electronic age can enhance their skills, increase their confidence and improve management outcomes by using telehealth. Two rural doctors, one in private practice, the other in full-time hospital work will present typical cases in conjunction with the specialists to whom they refer their patients using video / audio conferencing. Obstetric emergencies Medical education – training the Rural medicine in the 21st century – “Turning on to technology” trainer, tricks and tips This session will give rural This session is for those delegates Rural doctors do not have to be doctors a snapshot of obstetric interested in where medical exceptionally IT savvy to make the most emergencies and their treatments, education is now and where it might of new advances in information and as well as how to prepare your be heading into the future. Our communication technology to benefit their patient for retrieval. speakers will be experienced across patients. domains of medical education from A practical session covering the basics of university medical schools through telehealth technology using plain language. to the pre-vocational and vocational training.
To view the current RDAQ Conference 2014 program please visit the conference website conference.rdaq.com.au
Celebrating 25 Years
RDAQ CONFERENCE 2014 KEYNOTE SPEAKER – Tanveer Ahmed THE insightful and engaging Dr Tanveer Ahmed has been confirmed as this year’s keynote speaker for the RDAQ 2014 annual conference. A former national representative for junior doctors within the Australian Medical Association, Dr Ahmed first came to Australia as a child of Bangladeshi new arrivals at age five. He was raised in western Sydney and educated at Sydney Grammar School and Sydney University, where he studied arts and medicine. He has since become one of Australia’s most influential thinkers and social commentators, chosen by a prime ministerial committee as one of 100 future leaders of Australia and selected twice as one of 50 “young men of influence” by a popular men’s magazine.
PRE-CONFERENCE WORKSHOPS The Rural Doctors Association of Queensland will be running the following pre conference workshops:
Health Workforce Queensland will be running the following workshops prior to the conference:
Musculoskeletal Workshop on Thursday 5th June
Womens Health on Thursday 5th June
ALS Workshop on Friday 6th June
Diabetes on Friday 6th June
ENT 1½ hr Workshop on Friday 6th June
For more information on these workshops please visit the Health Workforce Queensland website www.healthworkforce.com.au
Information on these workshops can be found on the conference website conference.rdaq.com.au
ACCOMMODATION
HOW TO REGISTER
Special conference rates have been negotiated at a number of hotels in Brisbane and can be conveniently booked using the booking codes found on page 11 of the registration brochure or sent with your online registration confirmation.
Registration is now open for this must attend rural medical event!
CONTACT DETAILS Viv Culverwell/ Renee Dobbin RDAQ Conference Managers 2014 Health Workforce Queensland GPO Box 2523, Brisbane, Qld 4001 Phone: 07 3105 7800 Fax: 07 3105 7801 Email: conference@rdaq.com.au Web: conference.rdaq.com.au
Please go to conference.rdaq.com.au to register online or to download the RDAQ Conference 2014 registration brochure.
Event Management services provided by Health Workforce Queensland
A Rural Health Renaissance
events calendar People & EVENTS
COMING
UP
6 AUGUST
WHAT’S ON
28-29 JUNE
Brisbane
JUNIOR DOCTOR CONFERENCE
Enjoy more than a century of tradition when we celebrate the installation of Dr Shaun Rudd as President and present prestigious awards. Black tie or academic dress and decorations.Refreshments will follow the formal ceremony.
Pullman Hotel, Brisbane
Junior doctors will be inspired to reach their potential by exposure to world-leading, widely respected orators from medical and nonmedical fields. The program seeks to highlight the importance of collaboration between individuals, researchers and institutions.
18 - 19 JULY
TO VIEW THE FULL EVENTS CALENDAR
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PRIVATE PRACTICE CONFERENCE Brisbane Based on delegate feedback, the program now offers two concurrent streams – a fundamentals stream for those looking to move into private practice and an advanced stream, designed for those who wish to grow and improve the efficiency of their current practice.
Moda Events, Portside Don’t miss our annual Women in Medicine breakfast featuring special guest speaker and NSW Woman of the Year Turia Pitt. Turia will talk about resilience and thriving in adversity.
JUNE - JULY
PRIVATE PRACTICE SERIES Statewide
Learn how to navigate the new employment landscape with topics such as how to manage underperformance or chronic absenteeism, and how to ensure terminations, workplace bullying, and harrassment complaints are compliant with the Fair Work Act.
Or to register for an event, visit amaq.com.au or contact the AMA Queensland Membership team on (07) 3872 2222 or email registrations@amaq.com.au
1 NOVEMBER
13 JUNE
PRESIDENTIAL INAUGURATION
WOMEN IN MEDICINE BREAKFAST
MEDICOLEGAL CONFERENCE Brisbane Featuring incoming Health Ombudsman Leon AtkinsonMcEwan, this conference will explore consent and capacity, the recent privacy legislation changes and essential risk management strategies.
AMA Queensland President Dr Christian Rowan along with the AMA Queensland Council invite you to attend the
PRESIDENTIAL
INAUGURATION INCORPORATING: The 2013 - 2014 President’s Address by Dr Christian Rowan The Presentation of Awards The Memorial Roll of AMA Queensland The installation of Dr Shaun Rudd as President for 2014 - 2015 To be held on Friday 13 June 2014 – 7.30pm for an 8pm start Please RSVP to (07) 3872 2222 or email inauguration@amaq.com.au by Friday 31 May 2014. Black tie or academic dress and decorations. Refreshments will follow the formal ceremony.
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CURRENT health vision ISSUES
AMA QUEENSLAND’S HEALTH VISION
WORKFORCE & TRAINING Compassion. Trust. Knowledge. These are the values of the medical profession, which were identified by AMA Queensland members as part of our Health Vision project last year. These values will guide AMA Queensland’s advice to government and direct our leadership within the profession.
This year we’re turning our attention to the practical application of these values to the real world and this edition we’ll be talking about workforce and training. Here we are exploring the issues as they face doctors today with articles from Dr John Hall, a rural generalist obstetrician and Dr Jim Houston, Director of Medical Services at Greenslopes Private Hospital.
THE RISE OF GENERALISM
DR JOHN HALL IS A RURAL GENERALIST OBSTETRICIAN WORKING IN DALBY AND MOREE. HE WAS RDAQ PRESIDENT IN 2008 AND WON THE 2013 RDAQ LEGEND OF THE BUSH AWARD. HERE HE DISCUSSES THE KEY HEALTH AND SERVICE ISSUES RURAL COMMUNITIES FACE IN 2014.
Lack of adequate health workforce continues to be the main issue affecting the health outcomes of our country cousins. Many rural towns are struggling with inadequate medical and nursing staff numbers. The old era of one doctor towns is no longer ethically acceptable considering fatigue provisions and modern award regulations, however many doctors are still working in this context. More towns are without a doctor now than ever before. The decline in workforce has seen a significant reduction in the range of services that are being provided in our rural hospitals. For example, over the last 15 years we have lost more than half of the birthing services that used to function in rural Queensland. This has seen an increase in poor outcomes for mothers and babies with a spike in the perinatal mortality in towns without elective birthing. All this in the context of a very low peri-natal mortality rate 36
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(better than state and national averages) in rural towns where elective birthing continues. However, while the supply of specialists is not sufficient to staff all rural communities, generalist medicine may offer a solution. We know services, including surgery, can be provided safely in the rural context, in the hands of specialists and generalists. Queensland is leading the nation in the resurgence of generalism, following a global trend supporting the safety, efficacy and economics of the generalist approach to health care, and not only in rural areas. In 2009, Queensland announced the Rural Generalist Pathway – a Queensland Health funded and supported training support pathway for GP registrars developing essential procedural skills to support surgical and obstetric services in rural towns. This has attracted interest federally and recently the Mason Report
has recommended a Queensland style pathway be supported and rolled out nationally. Many of the other states are well on their way to implementing similar pathways independently. However, even with the introduction of greater generalist pathways, there is a major policy failure federally that has had a dramatic negative impact on rural doctor numbers. Namely, the revised rural classification system known as the ASGC-RA. This system is a geographic classification of rurality to which rural incentive payments are linked. This classification tool has effectively labelled regional towns as rural giving the doctors there the same incentives as those in more isolated rural towns. For example Dalby and Millmerran are classified in the same band as the significantly larger and more cosmopolitan cities of Cairns and Townsville! This system has seen a drift from rural to regional practice within the medical workforce, however, this system is currently under review and hopefully significant changes are afoot. It will always be a challenge to support the delivery of essential services including emergency, obstetric, surgical and primary care in our rural areas. However recent movements at the state and federal level have renewed hope that with the increase in numbers of medical graduates and support for generalism will see a return to the days of a healthy and robust rural medical workforce! Q
CURRENT health vision ISSUES
GET INVOLVED Visit amaqhealthvision.com Send us an email at healthvision@ amaq.com.au Follow us on facebook and twitter at amaqueensland using the hashtag #amaqhealthvision Come to one of our events Call us on (07) 3872 2222
SHARING THE LOAD OF MEDICAL TRAINING DR JIM HOUSTON IS THE DIRECTOR OF MEDICAL SERVICES AT GREENSLOPES PRIVATE HOSPITAL IN BRISBANE, AND A FORMER ADJUNCT PROFESSOR OF HEALTH MANAGEMENT AT QUT. HERE HE CHALLENGES THE ASSUMPTION THAT THE HEALTH SYSTEM DOES NOT HAVE ROOM FOR ALL MEDICAL GRADUATES – BUT ALL DOCTORS NEED TO GET INVOLVED.
More than eight out of 10 doctors are either moderately satisfied or very satisfied with their jobs. This is great, but with this privilege comes a responsibility for us to maintain high job satisfaction and ensure it translates to good patient care. This time of the year is the time of ‘Medical Gold Lotto’ preparation; ahead of the intern and junior doctor recruitment phase for the upcoming year. There are about 4,600 positions in Queensland hospitals that need to be filled both for service provision and for doctor training. One in five of these positions are intern positions. Little less than half are specialty training positions and there are 1,200 JHO/SHO positions for the interns to go into after registration. So the career path for the large number of interns, 705, isn’t too bad. This doesn’t include 1,200 GP training places across Australia this year. In spite of concerns about limited employment opportunities, the future for new doctors is still very good. The increased numbers of graduates is being accommodated by the major changes
in lifestyle expectations and hospital rostering. Working hours have decreased significantly over the past 20 years. The bulk of on-call periods are now covered by FTE shifts. This requires more doctors and leaves more capacity for more flexible leave arrangements within hospitals. Being able to take time off is high on the list of aspects of the job that make it satisfactory. The move to more sensible and appropriate hours of work has led to greater satisfaction for doctors. The other major factor leading to high job satisfaction is good professional support networks. This is where the AMA, and you as doctors, can have the greatest beneficial impact. Improved education for junior doctors is the most obvious structural change over the years. Doctors now actively seek hospitals and programs that provide the best support and education. The competition between teaching hospitals for the best doctors is now based on good educational programs. In the past there has been a similar numbers of trainees to the number of
trained doctors – now this ratio has become biased towards trainees. There are no longer the trained supervisor numbers for the old one-on-one apprenticeship. Supervisors are expected to be involved at several levels of education- specialty trainees, interns, and medical students. This shift has resulted in extra pressures for us as trained specialists. All of us have to be involved in teaching, supervising and mentoring the next generation. I ask you to consider your responsibilities for us: All of us must be prepared to supervise students and trainees. We must be prepared to offer teaching and supervision in all areas of practice; including the private sector. We must become educated and skilled in teaching in the new environment where the number of students will far outweigh the number of supervisors. We must explore teaching and learning opportunities with nurses and allied health groups with whom we practice. Very little of our teaching is done with other health professionals, but all our patient management does. This is a much ignored contradiction. Q DoctorQ MAY MAY2014 2014 DoctorQ
37 37
MEMBER NEWS
MEMBER NEWS
CONGRATULATIONS
to the following doctors who are now elected members of AMA Queensland. FEBRUARY 2013 DOCTORS IN TRAINING Dr Kellie Hillsley Dr Anthony Makridakis Dr Homa Forotan Dr Pey Wen Ho Dr James Teng Dr Tamara Johansen Dr Flora Cheong Dr Anthony Chellappah Dr Amitoj Baath Dr Xinning Lan Dr Mridula Mokoonlall Dr Jeffrey Hocking Dr Melissa Whitehouse Dr Edmond Marzan Dr Alison Lally Dr Edwina Morgan Dr Hugh Simpson Dr Paul Chan Dr Ji HyeLim Dr Shannon Laycock Dr Bonita Armstrong Dr Carmon Guy Dr Annabelle Harrocks Dr Venetia Whitehead
GENERAL PRACTITIONERS Dr Kevindhra Naicker Dr Ellen Dooris Dr Patrick Hogan Dr Jeremy Furyk Dr Kim Fuller Dr Vikas Moudgil Dr Harpreat Moudgil Dr Claire Furyk Dr Helen Brown Dr Sonu Nigam Dr Ravinder Batra Dr Luping Zeng Dr Rajendra Prakash Dr Edwin Kruys Dr Spomenka Borojevic
PRIVATE SPECIALISTS Dr Johannes Stofberg Dr Kelly McClymont Dr Shannon Webber Dr Christopher Aubrey Dr Jataveda Mahapatra Dr Graham Hay-Smith Dr Benjamin Darveniza
PART-TIME PRACTITIONERS Dr Simone Headrick Dr Mark Lai Dr Heather McNeil Dr Ashok Raj Dr Kathryn Brunello Dr Kellie Ovenden Dr Melissa Gan Dr Torben Wentrup Dr Rory Howard Dr Leslie Griffiths Dr Robert Walker Dr David Johns Dr Ursula McCrann Dr Alison Kearney Dr Markus Schuemann Dr Simone Kaye Dr Jarrod Ngan Dr Olaf Sander Dr Neeraj Bhadange Dr Beverley Fairclough Dr Paul Scott Dr Lesley Everard
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Dr Paul Zimmerman Dr Margaret Lewis Dr Jane Elms Dr Paul Clark Dr Melissa Eastgate Dr Donna Dowling Dr Tanya Wood Dr Ramya Krishnan Dr Michael Edwards Dr Kate Sharpe Dr Frances Malczewski Dr Mark Dooris Dr Astrid Drobetz
SALARIED PRACTITIONERS Dr Sharon Morris Dr Melissa Jessop Dr David Van Der Walt Dr Nitin Chavan Dr Wilhelm Dreyer Dr Robert Park Dr Robert Thomas Dr Anupinder Kaur Dr Goran Bosnjak Dr Behin Moser Dr Mark Fairley Dr Iain Thomson Dr Jane Brazier Dr Paul Thomas Dr Matthew Alfredson Dr Rohan Samarasinghe Dr David Reid Dr Peter Hodgkinson Dr Ann Harris Dr Janene Davies Dr Huang-Liang Lee Dr Lionel Tan Dr Benjamin Shepherd Dr Tamlan Haggett Dr Jason Howard Prof John Fraser Dr Sultan Dastagir Dr Arun Menon Dr Thulasi Thayanandarajah Dr Vinod Gopalan Dr Harry Venema Dr Andrew White Dr Anthony Bloch Dr Steven Grant Dr Shantha Kanagarajah Dr Deanne Crosbie Dr Paul Lane Dr Christopher Joyce Dr Robert Miskeljin Dr Hasan Shohag Dr Po-Ling Inglis Dr Vishvanatha Wijesekera Dr Gary Hall Dr Shirley Cheung Dr Gloria Liu Dr Frances Dark Dr Russ Scott Dr Michael McManus Dr Gregory Keir Dr Sean Tracey Dr Kim Chia Dr Michael Curtin Dr Robert Elliott Dr Benjamin Margetts Dr Nina Raju Dr Mateen Allahwala Dr Theron Sather Dr Peter Reynolds Dr Brian McGowan Dr Geoffrey Strutton Dr Charmian Kalic Dr Arina Dan
Dr Antonio Pais Dr Chamudri Attudawage Dr Leela Sharma Dr Christopher Hammett A/Prof Ann Rudden Dr Catherine Tacon Dr Stephen Parker Dr Shiv Erigadoo Dr Saurabh Gupta Dr Fraun Flerchinger Dr Daniel Faulke Dr Anatoli Sobtchouk Dr Aman Ahuja Dr Neil Archer Dr Usha Gurunathan Dr David Hannay Dr Sanjaya Herath Dr Beng Ong Dr Rudolf Van Der Westhuizen Dr Nadine Forde Dr Gabriela Strey Dr Udeni Welgama Dr Rishi Tandon Dr Elizabeth Gooch Dr Madhavi Goonetilleke Dr Ravi Walisinghe Dr Kimberley Oliver Dr Christa Bell Dr Robert Lattik Dr Martin Wakefield Dr Gaurangkumar Barot Dr Martin Batstone Dr Suzana Milosevic Dr Craig Daniel Dr Hamish Pollock Dr Rebecca O’Connor Dr Dougal Brown Dr Ann-Louise Keulder A/Prof Emma Duncan Dr Simon Wood Dr Sandeep Bhuta Dr Antony Pan Dr David Whybrew Dr Heidi-Marie Feberwee Dr Lucy Dakin Dr Adam Brand Dr Charles Britton Dr Francesca Rawlins Dr John Meneer Dr Rajesh Brijball Dr Kwai Siew Dr Jason Sly Dr Jennifer Benedict
MARCH 2013 DOCTORS IN TRAINING Dr Erinn Marrington Dr Da Wei Thong Dr Natasha Romond Dr Ross Tomlinson Dr Eavan O’Brien Dr Jonathan Mott Dr Nicholas Jorgensen Dr David Brooks Dr Euan Robinson Dr Denise McCool Dr Joshua McGuigan Dr Damien Daniel Dr Annabelle Lamprecht Dr Christopher Sadler Dr Timothy Baird Dr Kate Kerridge Dr Ryan Watts Dr Kate Hughes
Dr Catherine Stoyanov Dr Simon Porter Dr Mohomed Ghafoor Dr Rebecca Arvier Dr Emma Wawn Dr Melissa Manahan Dr Drusilla Poiner Dr Christopher Cameron Dr Cara O’Callaghan Dr Shruti Nagarkar Dr Paul Hamilton Dr Gayle Williams Dr Andrew Davidson Dr Roland Bartholdy Dr Mantho Kgosiemang Dr Kevin Lee Dr Kean Wong
GENERAL PRACTITIONERS Dr Matthew Young Dr Ian Housego Dr Nagavinanthi Ramnanan Dr Francesco Martinese Dr Lucia Nicolae Dr Dana Hrdlicka Dr John Atherton Dr Mugurel Nicolae Dr Ravi Rawlley Dr Nirjahar Nandi Dr Syeda Zinat Dr Shilpi Gupta Dr Staya Devineni Dr Manik Guduri Dr Benjamin O’Leary
PRIVATE SPECIALISTS Dr Vasilis Mantzioris Dr Matthew Howes Dr Terri Hall Dr Sarah Lindsay Dr John Hill Dr Brian Kirkup Dr Jerry Minei Dr Jason Tsung Dr Jatinder Randhawa
PART-TIME PRACTITIONERS Dr Joanne McNaught Dr Naomi Pearson Dr Paul McEniery Dr Pritpal Bansi Dr Melanie Bond Dr Murray Towne Dr Martina Meyer-Witting Dr Rathika Krishnasamy Dr Viral Chikani Dr Jack Huang Dr Peter Gourlas Dr Kylie Johnson Dr Rebecca Ryan Dr Karen Barry Dr Leith Banney Dr Yasmin Whately Dr Linda Beckmann Dr Karynne Finniear Dr Tania Dutton Dr Kar-Hin Ooi Dr Cindy Ding Dr Sinu Balakrishnan Dr Christine Rowe Prof Paul Crouch-Chivers Dr Maureen Runganga Dr Gillian Mahy Dr Vanessa Greig Dr Lisa Kelly Dr Wei Chan Dr Andrina McGivern Dr Polly Adams
Dr Richard Harris Dr Nga Tran Dr Heidi Webster Dr Anne Miller Dr Gerald Feeney Dr Glenda McDonald Dr Jane Hay Dr Steven Leong Dr Sheyna Manawwar Dr Stephen Rodrigo Dr Shanthi Kannan Dr Allan Drummond Dr Toni Redman Dr Alana Sheahan Dr Kailas Roberts Dr Nadia Maqboul Dr Wendy Muircroft Dr Halia O’Shea Dr Derek Rosen Dr Anne Williamson Dr Lyndal Naughton Dr Lara Kane Dr Simon Gatehouse Dr George Kennedy Dr Sharyn Van Alphen Dr Julia McLeod Dr Shanthi Sarma Dr Clare Thomas Dr Monika Walia Dr Leah Purcell Dr Mridula Kayal
SALARIED PRACTITIONERS Dr Tina Bazianas Dr Cameron Curley Dr Martin Atkins Dr Stephen Priestley Dr Raefe Gundelach Dr James McLean Dr Ian Brandon Dr Stephen Malone Dr Cameron McAndrew Dr Andrew McCann Dr David Anderson Dr Mahilal Ratnapala Dr Thomas Lloyd Dr Alistair Reid Dr Jason Paterdis Dr Roanna Byrnes Dr Werner De Wilzem Dr Marc Ziegenfuss Dr Carol Douglas D Jonathan Robertson Dr Anne Stewart Dr David Austin Dr Kym Boon Dr Janice De Souza-Gomes Dr Marion Woods Dr Mark Elcock Dr Greg Masterson Dr Simon Quinn Dr Nathan Milne Dr Paul Gould Dr Taryn Naggs Dr Geoffrey Crawford Dr Umesh Patel Dr Matthew Hawthorne Dr Song Tan Dr Paul Flanagan Dr Peter Schuller Dr Vijay Kanagarajah Dr David Trappett Dr Robert O’Sullivan Prof John Upham Dr John Cairns Dr Peter Burke Dr James Stevenson Dr Jennifer Chang Dr Tiffany Wilkes
Dr Thomas Hess Dr Kirsten McMahon Dr Stanley Ngai Dr Judy Flores Dr Alexandra Simpson Dr Matthew Burge Dr Christopher Cole Dr Damian Amato Dr Benjamin Howes Dr John Coucher Dr Christopher Vernon A/Prof Kassam Mahomed Dr Genevieve Goulding Dr Elizabeth Gillett Dr Paul Vella Dr Robyn Price Dr Nevin Taylor Dr Zarnie Lwin Dr Sharadchandra Ratanjee Dr Katie Tinning Dr Carolyn McIvor Anand Krishnan Dr Adrian Chin Dr Andrew McNabb Dr Joerg Rhau Dr Prasoon Gupte Dr Lisa Banks Dr Colin Banks Dr Nora McCullagh Dr Julio Barbarro Dr Vivien Wurm Dr Claire Heney Dr Kalmin Senaratne Dr Ilamurugu Kaliaperumal Dr Elena Kreimer Dr James Musson Dr Daniel Bartlett Dr Melanie Sloane Dr Roy Cherian Dr Johanne Neill Dr Ramesh Iyer Dr Marina Dujmovic Dr Geoffrey Muduioa Dr Ian Yang Dr Vinodkumar Raveendran Dr Kim Vidhani Dr Damon Thompson Dr Caroline Collard Dr Sidney Cabral Dr Judith Ochola Dr Grace Lim Dr Joseph Tobias Dr Josie Stroud Dr Daljeet Gill Dr Hayley Alexander Dr David Wood Dr Amgad Said Dr Florian Grimpen Dr Krishna Rachakonda Dr Leena Aggarwal Dr Peter Goodyear Dr Rayleen Bowman Dr Henry Marshall Dr Ravisubramanian Chockalingam Pillai Dr Darren Neillie Dr Jonathan Samaan Dr Murty Mantha Dr Marlon Radcliffe Dr Suren Putter-Lareman Dr Penelope Astridge Dr Madhur Kishore Dr Kwun Fong Dr Jagannathan Alagarsamy Dr Gerald Kaye Dr Craig Buchan Dr Richard Ward-Harvey
MEMBER NEWS
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. BE REWARDED & RECEIVE A DISCOUNTED 2015 MEMBERSHIP Refer 1 member: 25% discount on your 2015 membership Refer 2 members: 50% discount Refer 3 members: 75% discount Refer 4 members: pay no membership fee for 2015 To take advantage of this offer, ensure the member you refer puts you full name in the comment section of the membership application. Q
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.
ABOVE: DHAS(Q) President Dr Frank New with Dr Richard Kahler, Managing Director of BrizBrain & Spine
DHAS GETS A BOOST FROM BRIZBRAIN & SPINE DHAS(Q)’s volunteer phone counsellors will receive a training boost thanks to BrizBrain & Spine, Queensland’s first combined neurosurgery and orthopaedic spine surgery clinic. Over the coming months, DHAS(Q) will provide further training opportunities which will include: developing the skills to be a ‘doctor’s doctor’ managing the distressed doctor identifying health access barriers experienced by doctors These sessions will also be complemented with increased engagement with the General Practice Registrar training providers to ensure that junior doctors have access to educational resources. DHAS(Q) continue to provide input into the teaching of medical students at UQ, Bond and Griffith Universities. Q
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 Quality service through our network of hand-picked corporate partners in accounting, legal, banking and finance, insurance and automotive sectors You will receive your Member Benefits 2014/15 booklet and new member card by the end of May. If you have not received your copy, email membership@amaq.com.au or call (07) 3872 2222. Q
DHAS
Doctors’ Health Advisory Service
The Doctors’ Health Advisory Service (Queensland) has been supporting doctors for over 25 years. It is an independent telephone service that is available 24 hours a day; providing confidential advice to doctors and medical students about their health.
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MEMBER NEWS
A DAY IN THE LIFE OF A
JUNIOR DOCTOR
SO WHAT DOES DAILY LIFE LOOK LIKE FOR A SENIOR HOUSE OFFICER AT THE MATER? DR LISA BYROM, DEPUTY CHAIR OF AMA QUEENSLAND’S COUNCIL OF DOCTORS IN TRAINING, GAVE US A GLIMPSE INTO HER BUSY SCHEDULE.
AMA Queensland’s Council of Doctors in Training formulates policy and drives change in the areas of medical education and training and employment for junior doctors.
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MEMBER NEWS
It’s 6am and my alarm goes off for the first time. Since starting work as a junior doctor at Mater Adult and Children’s Hospital in Brisbane, I have developed a love/hate relationship with the snooze button. As I drink my first coffee of the day I watch an online lecture. You learn very quickly where you can utilise your incidental study time. I have also learnt how to utilise incidental time with my husband, who is also a junior doctor at Mater. I walk to work with him in the morning and we discuss the challenges that we may face during the day and help each other problem solve. I arrive at work, sit down at my computer, and update ‘the list’. The list is the start of the loads of paperwork that junior doctors do each day! This is a list of all patients under our service, where they are in the hospital, their recent investigation results, outcomes of other specialty consults, and
These moments make the years of studying worthwhile as you feel you have helped someone and their family during their most vulnerable time.
anything that is planned for the patient that day (like a MRI, biopsy, or family meeting). Then I attend a teaching ward round with the consultant. Each week the junior doctors are delegated a topic to research and report back their findings to the remainder of the team. The topic is typically inspired by a patient on the ward and encourages us to bring evidence-based medicine from the textbooks to the bedside. This is followed by lunch on the run as I meet my medical students. This is one of the highlights of my day. As students are experiencing different aspects of medicine for the first time, I have the privilege of sharing those moments with them. A few weeks ago they all heard a heart murmur for the first time and today they recognised the specific type of murmur. As a medical student I was based at Mater and appreciated the amount of effort their doctors put into our education. I now understand why they continued to do so. I then prepare for the multidisciplinary team meeting where we discuss our patients with members of allied health. Mater has a strong focus on holistic patient care thus we all ensure that we are all up to date with the patients progress, any current issues, and also to plan for discharge planning. I am currently working in Palliative care and Oncology at Mater Adult Hospital. This has been an incredible learning opportunity, which has given me insight into the care of cancer patients and also those towards the end of their life. Regardless of the patient’s belief system, Mater Palliative care unit demonstrates respect for all cultural beliefs and emphasises maintaining human dignity at the end of life. I first started work at Mater as a paediatric physiotherapist in the neonatal nurseries.
The doctors I worked with provided me with the inspiration to return to university and study medicine. I feel like I have now come full circle, working with patients and their families at their most vulnerable, at the beginning and the end of life. In palliative care you see patients towards their end of life however you also see patients improve despite their condition. Today I experienced both. I had been there when one of my patient’s families was called in to say their goodbyes. Today I was there when the patient had turned a corner for the better and I joined them for a walk around the ward with their child. I was also there as another patient continued to deteriorate but sadly died from their cancer. Both families expressed their gratitude for the support they had received from the team and myself. These moments make the years of studying worthwhile as you feel you have helped someone and their family during their most vulnerable time, the end of life. It has been an absolute privilege to be involved in the management of these patients. I thoroughly enjoy working at Mater. All the staff, from the cleaners to the nurses, makes my job feel less like work and more like an enjoyable career choice. After work my husband and I debrief the events of the day whilst making dinner. We have learnt that we don’t need to make big plans to spend quality time together; we make the most of the usually mundane activities as our quality time. In the evenings I then spend quality time with my laptop! As a research higher degree student this is my main time to do literature reviews, write papers, and work on my projects. I finish my day with a cup of chamomile tea before going to bed to start it all again tomorrow. Q
DoctorQ MAY 2014
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6 April 1924 – 15 March 2014
obituary
Member for 67 years
DR E.H. (HUMPHRY) CRAMOND MBE OAM MBBS MRCGP FRACGP FACRRM FAMA Dr E.H. (Humphry) Cramond held the position of Vice President of AMA Queensland when he died peacefully in RBWH after a very short illness. His quiet and dedicated commitment to his family, the AMA, medicine and to the broader communities in which he was involved provided an inspiration to those fortunate enough to interact with him and to experience first-hand his exceptional qualities. Humphry Cramond was born in Townsville on 6 April 1924, the second child of Stuart and Mary Cramond. The family moved to Brisbane when Humphry was five years old and tragically, his father died four years later. Humphry was educated at St Joseph’s College Nudgee and he always remained a proud and loyal Nudgee old boy. It was here at Nudgee that his interest in literary matters first became apparent, as well as his interest in sport. Both were further evident during his years at University where he won a half blue and represented Queensland at basketball. His literary talents were seen as editor of Trephine, the Journal of the University of Queensland Medical Society (UQMS) and the editor of Semper Floreat, the magazine of the Student Union. In later years Humphry gave many hours to AMA Queensland as its Honorary Librarian and Honorary Archivist. As President of the UQMS, Humphry’s commitment to his colleagues and his profession was seen when the students took Queensland Health to court – and won obtaining an award for doctors of a 54 hour week averaged over 4 weeks ie no overtime until the doctor had worked 216 hours. After graduating in Medicine from the University of Queensland in 1947, Dr Humphry Cramond spent two years at the Brisbane Hospital and the Hospital for Sick Children (now RBWH and RCH) before going to Bundaberg Hospital. After marrying 42
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Margaret Shalcross, a Brisbane nurse, Humphry moved to Dalby where he became Medical Superintendent of Dalby Hospital and so began Humphry and Margaret’s long and committed association with Dalby and its community. Firstly as Medical Superintendent and then in private practice in Dalby, Humphry, as is typical of rural doctors, did everything from emergency surgery to the management of heart attack and road trauma and delivered a great number of Dalbyites as was remembered by some of ‘his babies’ who attended his funeral. He served on the Dalby Hospital Board and Ambulance Training Committee and established the first coronary care unit outside a metropolitan area. He was an Alderman on the Dalby Council for 20 years, serving as Deputy Mayor for 15 years and was Chairman of the Health Committee. As well as his professional activities, he supported many other community activities in Dalby particularly through Apex of which he was President, and the Endeavour Foundation and the Bush Children’s Health Scheme and was an active contributor to the Dalby Swimming Club assisting in the training even in icy Dalby winters. Humphry and Margaret were integral in the Dalby community and their home provided a loving environment for their four children,
Virginia, Phillip, Izzy and Gordon. Sadly two of their children died, Virginia as a neonate and Phillip aged six years, and then tragically Margaret also died in 1981 while awaiting cardiac surgery. Dr Humphry Cramond joined the Queensland Branch of the BMA on graduation in 1947 and gave long and valued service to the profession through the BMA and since 1962 through the Queensland Branch of the Australian Medical Association. He established and for many years chaired the Dalby Local Medical Association. He served on AMA Queensland Branch Council for five years and represented Queensland as a Federal Councillor in 1985. He was President of the Queensland Branch of the AMA in 1984-85 commuting from Dalby to fulfil this demanding role. He was awarded a Fellowship of the AMA in 1982 for his service to the profession and the Association. In 1993 the Council of AMA Queensland honoured his significant commitment to the Association over many years by asking him to become a Vice President of the Queensland Branch of the AMA. Humphry provided many, many years of advice and assistance, and action on behalf of the AMA. He was Honorary Librarian from 1985, Chairman of the Historical Committee and a source of great wisdom on all things AMA including the detailed preparation of the Memorial Roll read out each year at the Formal AGM of the Association.
Humphry gave unstintingly of his time, wisdom and expertise to support his profession, a commitment he then shared with Tess.
Obituary
It was through the AMA that Professor Tess Brophy, a Past President came on the scene. Humphry and Tess were married on 24 April 1985. After their marriage, Humphry made an enormous sacrifice in relocating to Brisbane. He believed Tess’ work in anaesthetics, pain medicine and palliative medicine had to take precedence. However, he was always a country GP at heart despite his successful and happy 16 years with Drs Larry and Carole Gahan at Zillmere. Humphry and Tess were both Past Presidents of AMA Queensland and both honoured by the Branch for their commitment to the AMA in being invited to become Vice Presidents of the Branch. Their presence annually as part of the official proceedings at the formal AGM and Presidential Inauguration was a continuing source of inspiration to many younger members. They shared also their faith, the profession they served and the community projects they supported – especially through the Sovereign Military Order of Malta – for health and education in Timor Leste and Callan Services in PNG and Mt Olivet in Brisbane. Dr Humphry Cramond was admitted to membership of the Royal College of General Practitioners in 1954 and when the Royal Australian College of General Practitioners was established he was a Foundation Member and one of the early practitioners to obtain Fellowship by examination in 1972. He was admitted as a Fellow of the Australian College of Rural and Remote Medicine in 1999. He was a member of the Doctors’ Health Advisory Service (DHAS) since its inception. Humphry was a dedicated rural and then urban general practitioner, a committed member of the Australian Medical Association and gave unstintingly of his time and wisdom and expertise to support his profession, a commitment he then shared with enthusiasm with Tess. He will be greatly missed not only by Tess and his own family but also the AMA family who have all enjoyed his enormous care and concern and dedication. Q
He was an active contributor to the Dalby Swimming Club assisting in the training even in icy Dalby winters.
Conference
HEALTH HAS A POSTCODE (SOCIAL DETERMINANTS OF HEALTH)
DOES LIVING IN A POOR NEIGHBOURHOOD MEAN YOU’RE DESTINED FOR A LIFE OF POOR HEALTH AND POOR CHOICES? DOES LIVING IN A WEALTHY NEIGHBOURHOOD GUARANTEE A HEALTHY FUTURE? EXPLORE HOW A PATIENT’S POSTCODE COULD DETERMINE THEIR HEALTH AT AMA QUEENSLAND’S ANNUAL CONFERENCE IN CAPE TOWN, SOUTH AFRICA.
KEYNOTE SPEAKER: PROFESSOR VICTOR NOSSAR As a Senior Consultant in Community Paediatrics, Professor Nossar has more than 20 years experience in implementing community-based services to enhance the health and development of children and young people, both in Australia and overseas. Professor Nossar is also part of the leadership team developing and implementing the Australian Nurse-Family Partnership Program for the Australian Government’s Office for Aboriginal and Torres Strait Islander Health (OATSIH). This is a sustained nurse home visiting for Aboriginal and Torres Strait Islander families across Australia, and part of the Australian Government’s $260 million commitment to closing the life expectancy gap and improving the health of Indigenous women and children, ensuring Indigenous children are healthy, happy and ready to learn.
CONFERENCE KEYNOTES Conference coordinator Neil Mackintosh has locked in keynote speaker Professor Victor Nossar, Program Leader – Child and Youth Health, Northern Territory Department of Health and Families.
WHO SHOULD ATTEND? The AMA Queensland Annual Conference is tailored for medical practitioners, practice managers, registered nurses and industry professionals. As a conference delegate you will learn from world renowned Australian and International speakers and develop a better understanding of the medical issues that will affect you and your patients.
In South Australia, Prof Nossar headed Every Chance for Every Child, implementing Australia’s largest sustained nurse home visiting service. In NSW, he worked with The Cabinet Office of NSW and the NSW Commission for Children and Young People to develop and implement the Families First Initiative across NSW. Prof Nossar has reviewed child health services in several of the states and territories in Australia, and undertaken consultancies for AusAID, UNFPA, WHO and The World Bank in the Pacific, in China, in Africa and several Indian Ocean countries.
A SELECTION OF SPEAKERS Graeme Wilson Australian High Commissioner to South Africa Topic: Australian/South African cooperation - Diplomacy, commerce, medicine and medical research Professor Tim Noakes Director Exercise and Sports Science Division, University of Cape Town Topic: Obesity, nutrition and exercise Professor Eric Bateman Professor of Medicine, University of Cape Town Topic: Spreading the net for chronic diseases – Options for poorly resourced countries Dr Albie de Frey Travel doctor, Johannesburg Topic: Health has NO postcode in Africa
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Topics for discussion include: Health has a Postcode (Social Determinants of Health) The First Three Years Child and Adolescent Health Obesity Nutrition and Exercise Body Image Mental Health and Depression Drugs/alcohol/sex Access to Services
To find out more about this conference, download a brochure or to register please visit the events page at www.amaq.com.au
CONFERENCE THEME:
Health has a Postcode Social Determinants of Health
AMA Queensland Annual Conference
SPONSORS
21-27 SEPTEMBER 2014
professional services
PORTFOLIO ASSET ALLOCATION AND INVESTMENT SELECTION KEY IN 2014 GROWTH IN MAJOR ADVANCED ECONOMIES IS EXPECTED TO GATHER PACE AS ACTIVITY MOVES INTO THE NORTHERN SPRING AND THE CONSTRAINING IMPACT OF SEVERE WINTER WEATHER ON KEY ECONOMIC DATA ABATES. ROSS NOYE FROM MACQUARIE EXPLAINS. Ross Noye
(07) 3233 5805 0438 779 955 ross.noye@macquarie.com Ross Noye is a stockbroker and financial advisor at Macquarie who specialises in investment and retirement planning.
GLOBAL BUSINESS CYCLE HIGHLIGHTS IMPROVING PERFORMANCE We continue to expect the global business cycle to highlight the improving performance of the major advanced economies against the background of still favourable financial conditions. However, for those emerging economies with external financial imbalances and structural rigidities, the outlook is for continued unstable macroeconomic conditions.
Australian Shares
AUSTRALIAN ECONOMY MAY HAVE PASSED ITS CYCLE LOW In Australia, the economic data continues to suggest the economy appears to have finally passed its cycle low and the transition from mining investment-led growth to a broader-based consumer led economic growth now appears to be underway.
In Australia, the economic data continues to suggest the economy appears to have finally passed its cycle low... IMPORTANT INFORMATION: This information provided by Macquarie Equities Limited ABN 41 002 574 923 (MEL), Participant of the Australian Securities Exchange Group, Australian financial services licence 237504, 1 Shelley St, Sydney NSW 2000. This information has been prepared by MEL and does not take into account your objectives, financial situation or needs. Before acting on this information you should consider whether it is appropriate to your situation. We recommend you obtain financial, legal and taxation advice before making any financial investment decision. Except for MBL, any Macquarie subsidiary noted on this page is not an authorised deposit-taking institution for the purposes of the Banking Act (Cth) 1959. That subsidiary’s obligations do not represent deposits or other liabilities of MBL. MBL does not guarantee or otherwise provide assurance in respect of the obligations of that subsidiary, unless noted otherwise. Past performance is not necessarily indicative of future performance. Charts provided are current as at 8 April 2014.
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MARKET INDICES 31-MAR-14
1 YEAR %
3 YEAR %PA
5 YEAR %PA
13.39
S&P/ASX 200 Accumulation
13.46
8.54
S&P/ASX 200
8.62
3.70
8.53
All Industrials Accumulation
15.53
15.86
17.35
All Resources Accumulation
5.79
-9.63
2.63
All Industrials
10.25
9.91
11.43
All Resources
2.56
-12.02
0.21
S&P/ASX 20 Accumulation
15.84
10.60
14.27
S&P/ASX 50 Accumulation
14.50
9.93
13.80
S&P/ASX 100 Accumulation
14.26
9.33
13.62
17.28
International Shares MSCI World Index Hedged in $A
18.75
11.54
MSCI World Index ($A Unhedged)
31.03
11.90
9.21
MSCI Emerging Markets ($A Unhedged)
7.93
-1.72
5.45
Dow Jones
12.89
10.13
16.68
S&P 500
19.32
12.19
18.60
Regional Markets (local currency returns):
It is notable; however, that consumer confidence is still struggling to show sustained recovery after falling for the fourth consecutive month in March, the lowest in 10 months and 10 per cent lower than a year ago. Notwithstanding this, the fourth quarter GDP growth and January retail sales were ahead of expectations, while January building approvals enjoyed their strongest monthly performance in over a decade.
Toronto Comp
12.43
0.51
10.45
Nikkei
19.60
14.98
12.83
Dax
22.59
10.71
18.53
FTSE 100
2.91
3.75
10.94
Hang Seng
-0.67
-1.99
10.29
NZSE 50
11.55
8.95
9.16
S&P/ASX 200 Property Trust Accumulation
5.02
11.72
15.52
Australian Direct Property (as at Feb 2014)
8.70
8.60
5.10
AUSTRALIAN PROFIT PERFORMANCE AHEAD OF EXPECTATIONS
UBS Australia Composite Bond All
3.30
6.74
5.95
Citigroup World Govt Bond Index Hedged
3.80
7.93
7.13
Citigroup World Govt Bond Index
14.02
5.70
-1.98
UBS Australia Bank Bill Index
2.77
3.74
3.93
Importantly, the February reporting season results for the first half of the 2014 financial year were ahead of investor expectations confirming a positive earnings momentum and the market on track to deliver a second consecutive year of stronger earnings growth and higher share prices. DIVERSIFIED ASSET ALLOCATION REDUCES RISK AND CAN INCREASE RETURNS The economic news and market outlook continues to place the importance on a diversified asset allocation. The table to the right shows the performance of the various asset classes over the last five years and highlights the argument for holding international equities and property in your portfolio and taking into consideration the economic outlook to guide the shorter term tactical asset class tilts to take advantage of relative asset class out-performance.
Property
Cash and Bonds
UNDERWEIGHT
NEUTRAL
Australian Equities
X
International Equities
X
Property
X
Fixed Interest
X
Alternatives Cash
OVERWEIGHT
X X
While many investors continue to focus their investment efforts on Australian shares property and cash, the table above highlighting the various sector and asset class performance suggests investors may improve overall performance and reduce risk by further diversifying their investment portfolio to include international equities. Q
Sources: MPW Research; Macquarie Research, IRESS; Bloomberg; unless otherwise indicated.
Macquarie Private Wealth
professional services
MANAGE YOUR INCOME TO REAP THE BENEFITS AS THE END OF THE FINANCIAL YEAR LOOMS, IT SEEMS SENSIBLE TO MINIMISE YOUR TAXABLE INCOME, BUT THAT’S NOT NECESSARILY THE BEST IDEA. JEFF MILLER FROM INVESTEC EXPLAINS WHY THERE’S A SIGNIFICANT DIFFERENCE BETWEEN MINIMISING YOUR INCOME AND MANAGING IT.
Jeff Miller
With a high taxable income, most members are looking for extra deductions around this time of year—it’s very rare that somebody would not need or want that. My role is to assist when you’re looking to purchase assets or stock or anything to get those extra deductions. We can offer financial products and help structure facilities to maximise tax efficiency. Obviously, we don’t offer tax advice—that’s the job of your accountant or financial adviser— but we will say, ‘here are some structures you might want to consider’. For example, you might want to take out a loan to buy some stock, then immediately pre-pay the interest on that loan. In this particular example, we could offer an unsecured product, or one secured against the practice, or against commercial property or residential property. We can be really flexible compared to other banks. A strategic approach to managing your income can pay off, it’s important to plan. This means investigating which costs you can prepay, such as leases on equipment, interest on loans and any other expenses you might like to pay that relate to the coming financial year. If you do own a larger practice, a $100k purchase might get you $24k+ worth of deductions almost immediately on a well-structured lease agreement. And further benefits come into play with interest rate reductions. Pre-paying a lease can mean a one or two per cent saving on the effective interest rate which can result in significant benefits. I’m not just talking to practice owners either. When it comes to employees, or those that don’t have large practices, prepaying investment properties or car loans, or interest on any commercial property may be worth considering. And don’t forget superannuation - depending on your circumstances, you may not have used this year’s allowance for concessional contributions to super. To take advantage of these strategies, generally, you’ll need access to cash. But if that proves difficult, using an overdraft, then paying it back over the next six or twelve months, can prove useful.
Investec 1300 131 141 www.investec.com.au/medical Investec offer a range of financial products and services specifically tailored to the medical sector.
Some people do find this idea a bit weird—taking on debt in order to pay down debt, but we often see clients adopt this strategy so they can prepay some loans to gain the tax advantages. If you’re looking at a big taxbill and you can manage that liability forward a year, that’s an extra 12 months you can hang on to your tax money. An alternative to taking on an overdraft may be to use your credit card for purchases, which can have a similar effect of spacing repayments across the financial year. Of course there might be expenses associated with that strategy, but they may be balanced out if your card offers generous incentives such as frequent flyer points for eligible spend. If you’re not thinking of cash flow, you may be planning to take advantage of various end-offinancial-year sales to do a bit of shopping, perhaps for a new car. It’s often the best time of year to buy when there are plenty of deals to be had. With cars it may be that you can claim some deductions even if you buy the car on June 28. When you’ve only owned it for two days and if you finance and prepay a lease, you might realise $10 to $15k worth of deductions. Investec are known for their speed and efficiency. We’re willing to come to see you, we’re very flexible, competitive and we specialise in lending to medical professionals. We have people calling us up in the morning to get a car in the afternoon. They’re used to that, and we do it. Of course, if you’re talking about a mortgage, there’s more of a process. In general I’d say to each of you, start early because until you have an idea of what your income may be, it’s very hard to do any planning to manage it. Q
Don’t forget superannuation— depending on your circumstances, you may not have used this year’s allowance for concessional contributions to super. DISCLAIMER: The information contained in this article (“Information”) is general in nature and has been provided in good faith, without taking into account your personal circumstances. While all reasonable care has been taken to ensure that the information is accurate and opinions fair and reasonable, no warranties in this regard are provided. We recommend that you obtain independent financial and tax advice before making any decisions.
DoctorQ MAY 2014
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YEAR END TAX PLANNING – ARE YOU READY? AS THE YEAR MARCHES ON TOWARDS 30 JUNE, YOU MAY BEGIN TO WONDER “AM I PAYING TOO MUCH TAX AND IS THERE ANYTHING I CAN DO ABOUT IT?” JULIE SMITH FROM WILLIAM BUCK EXPLAINS WHY IT IS ALWAYS BENEFICIAL TO REVISIT THE ISSUES TO ENSURE YOU ARE MAXIMISING YOUR FINANCIAL POSITION EACH YEAR. Julie Smith William Buck (07) 3229 5100 julie.smith@williambuckqld.com.au
Julie Smith is Tax Services Director at William Buck Chartered Accountants and Advisors.
The process of tax planning essentially involves a review of your overall taxation affairs including investment structures, income and deductions to make sure that you are taking advantage of any possible tax savings. This process is most beneficial if it is done throughout the year, but there may still be some advantages in examining your available deductions at the end of the financial year.
Despite this extra tax, deductible contributions into superannuation are still considered to be highly tax effective because:
Whether you are an employee or in business, some of the areas to consider include:
When you retire, your superannuation savings may be able to be withdrawn tax-free. SALARY SACRIFICE ARRANGEMENTS
This continues to be a tax effective way to provide for your retirement as tax on contributions is generally limited to 15 per cent in superannuation funds. There are differing rules governing the availability of deductions, depending on whether or not you are employed, but generally, if you are under 50 years of age, you can contribute up to $25,000 per year and obtain some tax benefit. For example, if you are self-employed on an income level of $250,000 per year, a $25,000 contribution into superannuation will save you approximately $8,000 in tax, (the difference between a 46.5 per cent personal marginal tax rate, and the 15 per cent super fund tax rate).
If you are employed, salary sacrifice arrangements for either superannuation or other benefits are always worthwhile considering, as in some cases the tax savings can be significant. As sacrifice arrangements are only valid for prospective wages, it is critical to review this option now to ensure that you obtain any potential benefit before 30 June.
SUPERANNUATION – EXTRA TAX ON CONTRIBUTIONS FOR HIGH INCOME EARNERS Effective 1 July 2012, the Government introduced a new tax on superannuation contributions for high income earners. This tax is known as the ‘Division 293 Tax’ and applies to taxpayers who earn over $300,000 in a financial year (after making a few adjustments).
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Ongoing earnings derived by the contributions within the fund are likely to be subject to a maximum 15 per cent tax rate; and
SUPERANNUATION
If you are an employer, you may be able to bring forward deductions for compulsory super contributions by making sure they are paid prior to 30 June.
DISCLAIMER: This article has been prepared by Julie Smith of William Buck. The article is intended to be general in nature and should not be relied upon by any person without seeking advice concerning their own circumstances.
The effective tax rate applied to contributions is still lower than the highest marginal tax rate
As a result of this tax, contributions tax levied on concessional contributions made by high income earners is effectively increased from 15 per cent to 30 per cent. The tax is levied to the taxpayer in the first instance, but the taxpayer can request that his/her super fund pay the tax on his/her behalf. The assessment notice for Division 293 Tax usually issues a few months after your personal tax return has been lodged with the Tax Office.
INTEREST DEDUCTIONS For those of you with investment related debt, it is worthwhile to review your level of interest deductions at the end of the year. In some circumstances it may be possible to prepay interest to obtain additional tax deductions this year. PROPERTY INVESTMENTS - CAPITAL ALLOWANCES The most popular form of tax deductions are referred to as ‘non-cash deductions’. Accelerated depreciation on income-producing buildings is one such deduction. If you own either a commercial or a residential property, obtaining a quantity surveyor report to determine the amount of additional depreciation that may be claimable in relation to the buildings is a low-cost avenue to optimise your tax position. OTHER OPPORTUNITIES There may be many other opportunities available to you, depending on your personal or business situation. These opportunities will not be available to everyone but may include prepaying or bringing forward business expenses. You may also have structure specific issues (such as may occur in a company or trust) that compulsorily require some level of action by you prior to 30 June. Q
We don’t have a one size fits all solution.
Our experienced advisors listen to your goals and aspirations and how they can help you achieve them.
William Buck (Qld) GPO Box 563, Brisbane QLD 4001 Telephone: +61 7 3229 5100 Facsimile: +61 7 3221 6027 williambuck.com
CHARTERED ACCOUNTANTS & ADVISORS
professional services
PRIVATE PRACTICE CONTRACTS – AVOID THE TRAPS MUCH HAS BEEN WRITTEN ABOUT THE CONTRACT DISPUTES BETWEEN QUEENSLAND HEALTH AND EMPLOYED SMOS WITH SOME SAYING THE DISPUTE COULD DRIVE SENIOR DOCTORS OUT OF THE PUBLIC SYSTEM AND INTO PRIVATE PRACTICE. FOR DOCTORS THINKING OF MAKING THE SWITCH TO PRIVATE PRACTICE, CHRIS MARIANI FROM AMA QUEENSLAND INSURANCE SOLUTIONS EXPLAINS SOME OF THE COMMON TRAPS. Chris Mariani AMA Queensland Insurance Solutions 1300 883 059 chris.mariani@amaqis.com.au Chris Mariani is a medical indemnity specialist at AMA Queensland Insurance Solutions.
We frequently witness doctors who have failed to pay adequate attention to the contract they have signed (this equally applies to practice owners). Contracts often contain an unfair ‘indemnity clause’ that extends the doctor’s liability above their common law position.These clauses generally trigger an exclusion in the doctor’s insurance policies. A typical example of a Contractual Liability Exclusion in an insurance policy:
“The insurer is not liable… for any liability that the insured assumed by contract, waiver, guarantee or warranty, unless liability would have attached in the absence of such contract…” At a practical level, the impact of an indemnity clause is best shown by a hypothetical example as below.
SCENARIO: Dr X contracts to XYZ Medical. There is a written contract in place which includes an indemnity clause effectively stating “Dr X agrees to indemnify XYZ Medical for all liability XYZ Medical incurs arising from, or in consequence of, or in any way related to any act, error or omission of Dr X, whether or not XYZ Medical contributed to such act, error or omission”. Imagine there is a breakdown in the practice systems and processes that significantly contribute to Dr X’s patient suffering delayed or missed diagnosis (eg the practice staff file away test results rather than bring these to Dr X’s attention). In this scenario, the courts would likely find that both Dr X and the practice are jointly liability (from the doctor perspective, the patient may allege the doctor had a non-delegable duty of care to follow up the test results themselves). Assume the courts award the patient $1 million and find the practice 30 per cent liable and the doctor 70 per cent. Further assume both held appropriate insurance, each should be covered for their proportion of liability. Dr X’s insurers agree to pay his $700,000 liability. However, the practice (or its insurer) also write to Dr X pointing out the indemnity and demand Dr X fully pay the claim, including the practice’s $300,000. Dr X sends this to his insurer, who advises Dr X he is not covered for this $300,000 as it is a contractual indemnity and excluded by his medical indemnity policy.
Contracts often contain an unfair ‘indemnity clause’ that extends the doctor’s liability above their common law position.
DISCLAIMER: AMA Queensland Insurance Solutions is a trading name of KSLR Pty Ltd, a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, AFSL 240549. Corporate Authorised Representative No: 366807. The information provided in this article is of a general nature and does not take into account your objectives, financial situation or needs. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.
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As you can see from this hypothetical, Dr X is now facing a $300,000 liability with no insurance coverage, simply because of a single clause in his contract. So what should Dr X have done before he signed the contract? We believe a number of actions are appropriate:
“You’re responsible for your mistakes and I’m responsible for mine” (this is essentially the common law position). Our experience is most practices are equally unaware of the impact of this sort of clause and it is not their intention to leave the doctor with an uninsured liability.
1. Dr X should have sought independent legal advice. This could include AMA Queensland, his Medical Defence Organisation or from his own lawyers.
There are many other areas within a contract that need particular attention and you should seek appropriate legal advice. Some are commercial in nature such as non-compete clauses and others relate to medico-legal considerations such as the need for the doctor to be able to access patient records even after leaving the practice (such as a patient claim or medical board investigation).
2. Also seek advice from his insurance broker on the contract and how it may impact his insurance. The broker would also look at the types of insurances the contract may require (such as public liability insurance in addition to medical indemnity). 3. Seek to have the indemnity clause changed to a fairer clause. From a purely insurance perspective, this would be along the lines of
AMA Queensland Insurance Solutions advise many AMA Queensland members on their insurance needs. Please contact us if you would like us to review your current situation. Q
www.amaqis.com.au
Complimentary insurance health check with your Association’s Insurance Advisors
Make sure you are fully covered at the right price We know doctors have a busy schedule, and while it may be easy to renew your insurance each year without proper revision, changes may have occurred for which you may not be fully covered and premiums need competitive comparison.
For peace of mind and an insurance healthy practice, contact AMA Queensland Insurance Solutions on 1300 883 059.
All insurance needs covered for all members through AMA Queensland Insurance Solutions.
professional services
TESTIMONIALS A NO-GO WITH NEW AD GUIDELINES THE MEDICAL BOARD OF AUSTRALIA HAS UPDATED ADVERTISING GUIDELINES TO MAKE TESTIMONIALS A CLEAR NO-GO IN YOUR OWN ADVERTISING OR ON SOCIAL MEDIA. KATHARINE PHILP FROM TRESSCOX LAWYERS EXPLAINS HOW IMPORTANT IT IS TO KEEP YOURSELF APPRAISED OF UPDATED GUIDELINES PUBLISHED BY THE MEDICAL BOARD OF AUSTRALIA. Katharine Philp Partner (07) 3004 3536 Katharine_Philp@tresscox.com.au Katharine Philp is a Partner at TressCox Lawyers and is highly regarded for her Health Law and Medical Negligence expertise.
Section 41 of the Health Practitioner Regulation National Law Act 2009 (National Law) provides that a code or guideline approved by a National Board is admissible as evidence of what constitutes appropriate professional conduct or practice for a health profession. Consequently doctors should keep themselves apprised of all codes and guidelines published by the Medical Board of Australia. It will be no defence to say you didn’t know of a requirement set out in the codes and guidelines if you face disciplinary proceedings relating to an alleged breach. UPDATED ADVERTISING GUIDELINES
UPDATE On 26 March 2014, the Medical Board of Australia announced that it intends to change the updated advertising guidelines that came into effect on 17 March 2014. The Medical Board has explained that it will amend section 6.2.3 of the updated advertising guidelines. This is the section that regulates the use of testimonials. Please see the Medical Board’s media release at www. medicalboard.gov.au
Substantial sections of these guidelines have been rewritten and there is a clear focus on testimonials and advertising on social media. Section 133(1)(c) of the National Law provides that a health practitioner cannot use a testimonial in an advertisement for a health service. The updated guidelines take a very broad approach to the ban on the use of testimonials, including the following requirement at paragraph 6.2.3: ‘A practitioner must take reasonable steps to have any testimonials associated with their health service or business removed when they become aware of them, even if they appear on a website that is not directly associated and/or under the direct control or administration of that health practitioner... This includes unsolicited testimonials’. The updated guidelines explain that ‘reasonable steps’ include requesting removal of the testimonial from a website.
The following codes and guidelines were updated to take effect from 17 March 2014: 1. Good medical practice: a code of conduct for doctors in Australia (the Code of Conduct);
Further a new policy on social media has been introduced and it too is to take effect from 17 March 2014.
2. Guidelines for advertising of regulated health services; and
All policies, codes and guidelines can be found at www.medicalboard.gov.au.
3. Guidelines for mandatory notifications.
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The updated advertising guidelines also contain a new section on social media. Paragraph 7.1 makes it clear that health practitioners are responsible for all of the content on social networking pages that they control or administer. This standard applies regardless of who posted the content. This means that you are required to remove a testimonial or any other content from your own social networking page if it breaches the updated advertising guidelines or the National Law. In light of these changes, we encourage all health practitioners to read the updated guidelines very carefully before publishing any type of advertising. SOCIAL MEDIA The new social media policy complements the updated guidelines for advertising and the Code of Conduct. The key message of the new social media policy is clear: Health practitioners must be aware their professional obligations apply to their online activities in exactly the same way as a face-to-face consultation with a patient. When using websites such as Facebook, Twitter and LinkedIn, health professionals must ensure that patient confidentiality is not breached. For example, a dermatologist cannot post unauthorised before and after photographs of a patient on a Facebook page. The new social media policy makes it very clear that this conduct is unacceptable even if the social networking site has the highest possible privacy settings in place. The new policy also reminds health practitioners that the guidelines for advertising health services apply to social media. For example, a doctor cannot post a testimonial on his or her Facebook page from a former patient. This means that a Facebook page or Twitter account is no different to a health practitioner’s own website for the purposes of advertising health services. Given the significant penalties for advertisements that contravene the guidelines and the National Law, doctors should contact their medical indemnity insurer if they have any concerns. With thanks to TressCox Partner Lara Larking and Solicitor Chris Spain. Q
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• • • • • • Business structuring and contracts
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lifestyle
WINTER
For more in AMA Tra formation call o r email R vel Quee os at nsland.
Escapes
PHONE : 1800 26 2 885 FAX: (0 7) 5556 72 00 EMAIL: travel@ amaq.co m.au WEB: www.am aq.world travel.co m.au
O’Reilly ’s
Mt Tambori ne
Greece
FOR SOME, WINTER MEANS DUSTING OFF THE SNOWBOARD AND PREPARING TO HIT THE SLOPES, FOR OTHERS IT’S A TIME TO HIBERNATE OR PERHAPS ESCAPE THE COLD FOR A WARMER CLIMATE. ROS BULAT FROM AMA TRAVEL SHOWS US HOW. THREDBO From gentle beginner runs to some of the most advanced terrain in the country. It’s run is almost six kilometres, has a two metre snowfall and a summit elevation of 2,037m. To get there you can fly via Sydney or catch a coach transfer from Canberra airport. The Thredbo Snow Sports School runs daily classes for all levels. Thredbo is a bustling winter hotspot so make sure you get there early for fresh tracks. MT BULLER Mt Buller is only a three-hour drive northeast from Melbourne, making it one of the most accessible slopes in Australia. Mt Buller is renowned for its downhill runs, and cross-country enthusiasts have nine kilometres of trails at their disposal. MT HOTHAM Mt Hotham hasn’t been branded ‘The Powder Capital of Australia’ for nothing. Tucked away in Victoria’s north-east, Mt Hotham is best known for its steep valley 54
MAY 2014 DoctorQ
runs. It has an elevation of 1,861m and has the highest level of natural snow of anywhere in Victoria. There are easy runs for first-timers and plenty of natural gullies, halfpipes and tree runs for the more experienced. MT PERISHER Perisher is the largest alpine resort in the Southern Hemisphere - so expect to be rubbing shoulders with some of Australia’s keenest skiers and boarders. Perisher peaks at 2,054m and is the largest of seven mountains in the village. It boasts a superpipe, three kilometre run and over 100km of cross-country trails suited to all levels. You can fly via Sydney or drive from Canberra. FALLS CREEK Cross-country skiers look no further, as Falls Creek is the place for you. Home to Australia’s National Cross Country Ski Team, Falls Creek has over 65km of worldclass trails. The main access point is via Mt Beauty, or, you can travel via helicopter from
Albury. Unique to Falls Creek is snow biking which will set you back around $40 for a onehour guided session. HIBERNATE Brisbane and the Gold Coast are gateways to an incredible array of retreats that are perfect for a winter escape. Consider one of Queensland’s Ultimate destinations for an escape for couples at the Gamekeepers Cottage at Lisson Grove, Tamborine. The design of the cottage is a traditional hunting lodge offers a genuine open fire. Nestled within World Heritage listed Lamington National Park, in the Gold Coast Hinterland, O’Reilly’s offers the Lost World Spa, a true nature haven for those seeking rejuvenation, relaxation and balance. ESCAPE WINTER ALTOGETHER If escaping the winter and heading to the Northern Hemisphere sounds like you, check out the current hot spot at Smuggler’s Cove, Zakynthos, Greece. This is one of the many warm up European spots this season. Q
lifestyle
Barossa TRAVELLING THE
TRAVELLING TO ONE OF AUSTRALIA’S ICONIC WINE REGIONS CAN PRESENT SOME DAUNTING CHALLENGES, ESPECIALLY IF YOU’RE TIME POOR BUT AS PHIL MANSER EXPLAINS YOU CAN SEE SO MUCH IN SUCH A SHORT TIME.
The Barossa Valley is one of Australia’s most famous wine regions to visit just one hour drive from the CBD. There’s plenty on offer for lovers of massive Shiraz, ripespicy Grenache and the red drinker’s white, Semillon.
imposing Johan Georg Shiraz, sourced from vines planted in 1875. I have sent many of my clients here during their visit to South Australia and the feedback is always stellar, both about the wines and the amazing hospitality.
When we think Barossa, we are reminded of the usual suspects; Jacobs Creek, Wolf Blass and Penfolds which you can get at the local BWS, but if you dig a little deeper there are dozens of new and established Australian owned wineries making world class wines.
Another of what I regard as the old guard is The Willows Vineyard, owned and operated by the Scholz family. The cellar door sits adjacent the family homestead which used to be the Barossa’s first private hospital. Here you will enjoy a compact range of Barossa’s finest reds, but what I have always enjoyed most is the Semillon sourced from their first commercial plantings dating back to 1936. This is a stunning wine, hilariously inexpensive and one of the Barossa’s best kept secrets.
Top of my ‘must see’ list is Kalleske, a family owned winery with six generations of wine growing heritage. Brothers Troy and Tony Kalleske preside over a diverse range of Organically produced wines from the world beating Clarry’s red blend to the dark and
GETTING THERE The Barossa is just an hour’s drive north east of the Adelaide airport, so it’s simple to jump in your car (or a hire car) and quickly find yourself in the middle of one of the world’s most famous wine regions. Visit www.barossa.com for all you need to plan your own wine tour.
As I mentioned earlier, South Australian travel guides will send you to the likes of Penfold’s, Wolf Blass and co. These are all great destinations but for that X factor you’ll reminisce about these are high on my list of must do’s. If you’re going to do The Barossa give me a call, my list is long! Q
There are dozens of new and established Australian owned wineries making world class wines.
Phil Manser Wine Direct 1800 649 463 phil.manser@winedirect.com.au
Image by Dragan Radocaj Photography. Copyright Barossa Grape and Wine Association.
DoctorQ DoctorQ MAY MAY 2014 2014
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all about you
BOOKLOVERS
NON-FICTION
NON-FICTION
CLUB
LOOKING FOR A NEW READ?
Put that work down for a minute and check out these great titles. Q
MAWSON: AND THE ICE MEN OF THE HEROIC AGE: SCOTT, AMUNDSEN AND SHACKLETON
APP SNAP My Hours
PETER FITZSIMONS An Australian, a Norwegian and an Englishman and their race to be the first to reach the South Pole: Peter FitzSimons and his trademark in-depth research provide a compelling portrait of these great Antarctic explorers. For the first time, he weaves together their legendary feats into one thrilling account, bringing the jaw-dropping events of this bygone era dazzlingly back to life.
My Hours is a unique time-management tool that changes the tedious exercise of recording your upcoming schedule for work or school into a fast and simple task. Record your upcoming schedule quickly and easily, sync to any calendar on your device, tracks your hours and your pay by week, month or year or export your entries onto a spreadsheet. Q
CHILDREN’S BIRTHDAY CAKE BOOK THE AUSTRALIAN WOMEN’S WEEKLY If your mum was good enough to make you the train or the swimming pool cake when you were a kid, there’s now a vintage edition of the AWW’s Birthday Cake Book in case your mum won’t pass on her copy. A cult classic among Australian kids, the next generation of parents can now create cute characters with more butter cream and lollies than a child should probably ever have. And hey, if it doesn’t work out, you can always take a picture and post it as a very funny epic fail.
It wasn’t too long afterwards that Samantha started blogging somone else.
WHAT IS MINDFULNESS?
The Happiness Trap author and former GP Dr Russ Harris defines mindfulness: Mindfulness is increasingly recognised as an effective way to reduce stress, increase self-awareness, enhance emotional intelligence, and effectively handle painful thoughts and feelings. Mindfulness involves consciously bringing awareness to your here-and-now experience with openness, interest, and receptiveness. Mindfulness is about waking up, connecting with ourselves, and appreciating the fullness of each moment of life. Kabat-Zinn calls it, “The art of conscious living.” It is a profound way to enhance psychological and emotional resilience, and increase life satisfaction. 56
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ocker doctor
TO BE OR NOT TO BE A GP
OUR VERY OWN OCKER DOCTOR, DR MATT YOUNG, HELPS LIGHTEN THE LOAD WITH SOME MEDICAL MUSINGS. THIS EDITION, HE SHARES THE REAL REASONS THAT MAKE GENERAL PRACTICE A DELIGHT.
DR MATT YOUNG General Practictioner
When medical students ask me why they should consider General Practice as their future, it gives me a great opportunity to reflect on and justify my own career choice. It isn’t the medical smorgasbord of General Practice, it isn’t the pay and it isn’t even the broad variety of people that I meet. It certainly isn’t the red tape, the reams of bureaucracy or even the ubiquitous threat of litigation. No. It’s getting to live the full spectrum of the human emotional experience vicariously through my patients and having a few laughs along the way, that keep me turning up for work every week. That and my mortgage.
It’s getting to live the full spectrum of the human emotional experience vicariously through my patients and having a few laughs along the way, that keep me turning up for work every week. That and my mortgage. and I love the idiosyncratic way they relate their stories to me or interpret my advice.
Seeing people at their best and their worst is a real education into the intricacies of humanity and it is a privilege to be able to witness these defining moments of people’s lives at such close quarters. We belong to a fascinating species.
I remember seeing a woman with rectal bleeding who became disdainful as I explained that she’d need a rectal examination. I explained to my medical student mate that “if you don’t put your finger in it, you risk putting your foot in it”. Next morning I was in the medical director’s office to explain away the patient’s written complaint “that the doctor threatened to stick his foot up my bottom”.
There are always plenty of laughs too. I know it might sound a bit like I have lost all semblance of altruism, but I reckon the life of a GP is about the funniest career you can ever undertake. I love the way some patients mispronounce medical words (‘sugar dia-beet-us’ is my personal favorite)
There is always some poor woman who fills in the awkward silence of a PAP smear with some immortal line about cobwebs or some old fella who whips out an original one liner about at least buying him dinner, as he’s copping a prostate exam. Let’s face it, sticking your digit into various bodily
orifices is not really a natural thing to do as a career and humour just has to be the best coping mechanism. Another by-product of such intimate examinations is that this sort of exposure really facilitates honesty. The speculum is a marvelous instrument by which facades and pretentions can be dissolved. It is hard for a person to lie to their doctor after he has seen them in their entirety. Patients feel that if they can trust me enough with the most private parts of their bodies, then they can feel free enough to trust me with the innermost workings of their hearts and minds. I am sure patients often share their most guarded secrets and hopes with me before they even open up to their spouse. It really is a privileged position that leads to a unique type of friendship. I get to see people at their most vulnerable, as they face their impending death or the death of the person they have most loved through their life. It is a sad fact that so many GP - patient relationships end in the death of one of the parties. (Thankfully generally not the GP’s). I also see people at their happiest like when their long awaited IVF baby has arrived. I get to share with them their resilience and tenacity in the face of disability, disfigurement and demise. I find myself inspired and awestruck by their bravery and courage in adversity and pain. I am sure every area of medicine has its highlights, but no matter how many orifices I have to intrude or secrets I have to keep or emotional moments I share, I am very glad to be a GP and endorse it as a career choice to my junior colleagues. Q DoctorQ MAY 2014
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lifestyle
CENERENTOLA MET OPERA
15 June 1pm, 19 June 10am
ORE FOR M ISIT INFO VOM.AU .C DENDY
COSI FAN TUTTE
COMING FILMS
Met Opera
VIKINGS
1 June, 1pm and 5 June, 10am
15 May Godzilla
Music Director James Levine makes his long-awaited return to the Met podium to conduct Mozart’s beloved opera about testing the ties of love. The cast is filled with youthful Met stars: Susanna Phillips and Isabel Leonard are the sisters Fiordiligi and Dorabella, Matthew Polenzani and Rodion Pogossov are their lovers, with Danielle de Niese as the scheming Despina.
22 May Sunshine on Lieth X-Men
HOLD YOUR FUNCTION OR BIRTHDAY PARTY AT DENDY!
A peerless pair of Rossini virtuosos joins forces in La Cenerentola—a vocal tour de force for mezzo-soprano Joyce DiDonato, singing her first Met performances of the Cinderella title role, and the high-flying tenor Juan Diego Flórez, as her Prince Charming. Alessandro Corbelli and Luca Pisaroni complete the cast, with Met Principal Conductor Fabio Luisi leading the effervescent score.
29 May
Malificent A Million Ways to Die in the West
29 May
The Trip to Italy
31 July
The Rover
*Ticket prices: Club Dendy Adult - $11.50, Regular Adult - $18, Bargain Tuesday - $11.
We love hosting corporate film nights and group bookings at Dendy. It is a great way to thank clients or staff – or perhaps you have a favourite charity that you would like to raise some money for? We have a functions pack and cinema package to suit all requirements – plus a specially tailored functions menu. Please contact Events & Publicity Manager Jenny Sonter on jennys@dendy.com.au for a free quote.
from the British Museum
7 and 8 June, 1pm For nearly 300 years, from the end of the eighth century AD they set out from Scandinavia on raids and voyages of discovery and colonisation across the northern world. This special British Museum cinema event offers an exclusive private view of the BP exhibition Vikings: Life and Legend filmed live in London in April 2014. The exhibition will be brought to life with experts on Viking ships and swords, burial and beliefs, and language and legacy alongside demonstrations, stunning close-up photography of the Viking objects in the exhibition and a torch-lit burial staged in the grounds of the museum. Tickets $20, students $15, student groups of 10+ $10.
WIN MOVIE TICKETS FOR TWO Name:
Member No:
Postal address: Portside Wharf, Remora Road, Hamilton Ph: (07) 3137 6000 www.dendy.com.au 58
MAY 2014 DoctorQ
Phone:
FAX BACK TO (07) 3856 4727 or email amaq@amaq.com.au by 30 May
CULTURE
THE KING & I Until 1 June
Rodgers and Hammerstein’s legendary production of The King and I returns to Australia with the first lady of Australian musical theatre, Lisa McCune and international opera sensation Teddy Tahu Rhodes as the King of Siam. A triple crown award winner: The Tony, the Drama Desk and the Outer Critics Circle for Best Musical Revival, this dazzling show is a lavish and triumphant fresh new look at a time-honoured classic.
BANGARRA DANCE THEATRE
PATYEGARANG 15 - 23 August
Australia’s multi award winning dance theatre company Bangarra Dance Theatre commemorates the story of a young Eora woman, Patyegarang, who shared her culture and language with one of the first settlers in the place we now call Sydney. This deeply moving production is told through the acclaimed creativity of Stephen and David Page, in a powerful and meaningful dance theatre experience.
DAVID CAMPBELL & JOHN BUCCHINO IN CONCERT 6 June
Join long-time friends and collaborators David Campbell and John Bucchino for an intimate evening of song. as they return to the stage to talk about their lives, careers and the songs that have bound them together. David Campbell is one of Australia’s foremost entertainers and John is one of America’s most beloved composers.
WIN TICKETS TO DAVID CAMBELL & JOHN BUCCHINO IN CONCERT
Name:
E MOR FOR ATION RM INFO COM.AU . C QPA 36 246 R O 1
AMERICAN BALLET THEATRE SWAN LAKE | THREE MASTERPIECES
28 August to 7 September American Ballet Theatre brings two programs for this exclusive QPAC season - the imperishable classic Swan Lake and a triple bill titled Three Masterpieces which showcases the company’s contemporary repertoire. Swan Lake remains the quintessential ballet, the one that defines the standards of the Company, tests its dancers and ennobles the spirit of the audience. To demonstrate their versatility, Three Masterpieces sees ABT perform ballets by three of the world’s leading contemporary choreographers: Twyla Tharp’s Bach Partita, Alexei Ratmansky’s Seven Sonatas and Jerome Robbins’ Fancy Free.
Member No:
Postal address:
Phone:
FAX BACK TO (07) 3856 4727 or email amaq@amaq.com.au by 3o May DoctorQ MAY 2014
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QUEENSLAND BRANCH OF AUSTRALIAN MEDICAL ASSOCIATION | ACN: 009 660 280 | ABN: 17 009 660 280
FYI
Annual General Meeting The Annual General Meeting of the Members of the Queensland Branch of the Australian Medical Association will be held at: Time:
6.30pm
Date:
Tuesday 20 May 2014
Venue: AMA Queensland 88 L’Estrange Terrace Kelvin Grove, Queensland
Business
Proxy Notice
The business of the Meeting will be:
A member who is entitled to attend and register one vote at the Annual General Meeting is also entitled to appoint another member as a proxy to attend and vote in his or her place. Proxy forms can be downloaded from the AMA Queensland website (www. amaq.com.au) or by phoning Andrew Turner on (07) 3872 2207 and must be received by 6.30pm 18 May 2014.
1. To receive and consider the accounts, balance sheets and reports of: (i) The Board of Directors; (ii) Any committees instructed report to the meeting; and
to
(iii) The Auditors. 2. The declaration of the results from the election of; (i) The President Election and Council members. 3. The appointment of the Auditors and approval of the remuneration (if any) to be paid to the Auditors; 4. The President’s address; and 5. To deal with all business which any statute, the Constitution, or the By-laws requires.
Notes The Presidential Inauguration and presentation of annual AMA Queensland awards will be held on Friday 13 June 2014, where the following business will be conducted: 1. Installation of Dr Shaun Rudd as President 2014-2015; and 2. Presentation of Awards and Prizes. Annual Report The 2013 Annual Report is available online at www.amaq.com.au.
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Pine Rivers Private Hospital
Psychiatry in General Practice 2014 Please join us for talks and interactive sessions led by Psychiatrists from Pine Rivers Private Hospital. Date: Time:
Saturday 31st May to Sunday 1st June 2014
Venue:
Intercontinental Sanctuary Cove Resort
Speakers: Prof Gin Malhi (guest) Dr Jag Alagarsamy
Topics: Current Issues in Mood Disorders Nature and Management of Insomnia in General Practice Management of Agitation in the Elderly Depression as an Inflammatory Disorder
Saturday 11:30pm – 5.30pm Sunday 9:00am – 1.30pm Manor Cove, Sanctuary Cove, Queensland
Dr Chris Slack Dr Usha Kissoon Dr Anastasia Braun Dr Adetokunbo Alege Dr Usha Kissoon Dr Howard Granger Dr Jatheesh Pala Valappil Dr Sandhya Kachhap Dr Tom George Dr Ashim Majumdar Dr Wasim Shaikh Dr Chinna Samy Dr Andrew Khoo (guest)
Suicide Can Be Prevented – Debate
Infanticide Pain Management in General Practice Work and Stress – a Complex Interplay Grief and its Implications in Psychiatry Beyond Depressive Symptoms – Another Paradigm for Conceptualising Depression
All enquiries should be directed to Alesha Trainor on 07 3881 7222 or at Alesha.trainor@healthscope.com.au Application has been made for Category 1 (40 points) CPD accreditation and is subject to approval by the RACGP
Proudly supported by
IN lifestyle PRINT
CASE STUDIES IN EPILEPSY:
COMMON AND UNCOMMON PRESENTATIONS Epilepsy is amongst the most frequently encountered of neurological disorders. There are important emerging clinical management issues (eg first seizure, therapy-resistant seizures, ICU, pregnancy) but also differential diagnosis of nonepileptic seizures (syncopy, pseudo-seizure, paroxysmal dystonic syndromes, sleep disorders, psychosis, inborn errors of metabolism, etc.).
experts, the cases and discussions work through differential diagnoses, treatments and social consequences in paediatric and adult patients. Case studies in Epilepsy is published by Cambridge University Press and retails for $89.95. Q Doctor Q has a copy of Case Studies in Epilepsy to give away.
This selection of epilepsy case studies will inform and challenge clinicians at all stages in their careers. Including both common and uncommon cases, Case Studies in Epilepsy reinforces the diagnostic skills and treatment decision-making processes necessary to treat epilepsy and other seizures confidently. Written by leading
Simply fill out your details in block letters on the form and fax it to (07) 3856 4727 or email amaq@amaq.com.au.
Entries close 30 May
WIN THIS BOOK! Name: Postal Address:
CHECK FOR YOUR NAME!
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MAY 2014 DoctorQ
COMPETITION WINNERS
Telephone: Member No:
DENDY WINNERS
QPAC WINNERS
BOOK WINNER
DOUBLE PASS WINNERS
Dr Marjorie Busby and Dr Cecelie Lander won tickets to see Southern Cross Soloists’ Kiss Me Katharina.
Dr Mary Smyth won a copy of A Medical Centre on the Moon.
1. Dr Vicki Naumann 2. Dr Anne Kynaston 3. Dr Suzanne Gray 4. Dr Fred Leditschke 5. Dr Janice Marshall 6. Dr Ken Bowes 7. Dr Noel Saines 8. Dr Christopher Que Hee 9. Dr Mitesh Ghandi 10. Dr Alfred Lam
CLASSIFIEDS Architectually designed unique office space in Indooroopilly NOW AVAILABLE Location: 70 Coonan Street, Indooroopilly QLD 4068
Please contact: Business Manager - Fiona Galloway 07 3837 0077 0414 892 096 e: fg@endodonticgroup.com.au
Availability: Three office spaces available in a unique, human centred designed health environment. Two rooms adjoin.Conference and meeting room space available accommodating up to 30 people. Car spaces are also available. www.endodonticgroup.com.au
Unique services for adolescents to adults in a premier facility. St Vincent’s Private Hospital Brisbane specialises in pain management (adolescents & adults), neurosciences, rehabilitation, general medicine, palliative and geriatric care. Our new purpose-built pain management centre includes a dedicated operating theatre where complex pain management procedures take place using the latest technologies. Compassion
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Private Consulting Suites available for specialists in the heart of the Western Suburbs, 5km from the city Location: 185 Moggill Road, Taringa QLD 4068 Onsite administration staff available for bookings Nursing support and onsite minor operations facilities available if required. For further information, please contact Dr Shobhan Manoharan E: smanoharan@westderm.com.au P: (07) 3871 3437
W: firstnationalcommercial.com.au
FIRST FLOOR OFFICE – P.A. CENTRAL – FOR LEASE • Attractive incentives on offer • Major carpark adjoining • Opposite Centro Buranda and the PA Hospital with direct overpass access • 125 to 200m2 available • Adjoining Southern X Radiology
• Ideal for medical suites and other related services • Disabled access and amenities
CONTACT: George Koukides: 0412 872 786
DoctorQ MAY 2014
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Exclusive. Affordable. Rules were made to be broken There is a profusion of credit cards on the market, so why does the Investec Signature card stand out in the crowd? You earn more Qantas Points* on eligible spend – 1 point for 1 dollar, without any caps or limits – and enjoy Priority Pass access to over 600 airport lounges, complimentary travel insurance^, Visa Front Line entertainment access for hard-toget bookings and much, much more. You’ll feel like you’re part of an exclusive club, yet it’s surprisingly affordable.
Speak to your local finance specialist on 07 3018 8100 or visit investec.com.au/card to find out more.
Specialist Banking Equipment and fit-out finance | Goodwill funding | Credit cards | Home loans | Commercial and property finance | Car finance | SMSF lending and deposits | Transactional banking and overdrafts | Savings and deposits | Foreign exchange All finance products are issued by Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL 234975, Australian Credit Licence No. 234975 (Investec Bank). All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Information contained in this document is general in nature and does not take into account your personal financial or investment needs or circumstances. We reserve the right to cease offering these products at any time without notice. You should obtain independent financial, tax and legal advice, as appropriate. *Qantas Points are earned in accordance with the Investec Qantas Rewards Program Terms and Conditions available at investec.com.au/cards. You must be a member of the Qantas Frequent Flyer program in order to earn and redeem points. Qantas Points and membership are subject to the Qantas Frequent Flyer program Terms and Conditions available at qantas.com/terms. You earn 1 Qantas Point for every $1 of eligible spend in Australia and 2 Qantas Points for every $1 of eligible international spend on the Investec Signature credit card. See definition of Eligible Spend in the Investec Qantas Rewards Program Terms and Conditions, available at investec.com.au/cards. Investec recommends that you seek independent tax advice in respect of the tax consequences (including fringe benefits tax, and goods and services tax and income tax) arising from the use of this product or from participating in the Qantas Frequent Flyer program or from using any of the rewards or other available program facilities. ^Investec card Insurances are underwritten by ACE Insurance Limited (ABN 23 001 642 020, AFSL No. 239687) (ACE) and are subject to the terms, conditions and exclusions contained in the policy of insurance between Investec (ABN 55 071 292 594, AFSL & ACL No. 234975) (Investec) and ACE relating to the Investec card. It is important for you to read the Terms and Conditions available at investec.com.au/cards and consider the appropriateness of that insurance in relation to your individual requirements. When you purchase your return travel tickets on your Investec card you, your spouse and dependent children, if travelling together, will automatically have access to travel insurance for trips of up to 90 days.