SEPTEMBER 2014 . VOL 91
AMA Queensland Membership Magazine
CO-PAYMENT CAUSES CHAOS
MEET QUEENSLAND’S FIRST HEALTH OMBUDSMAN
DOCTORS AND MENTAL HEALTH HOW DO WE STOP BURNOUT? FREE TO AMA QUEENSLAND MEMBERS
SOCIAL PICSDoctorQ GALORE
SEPTEMBER 2014
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CONTENTS
THIS ISSUE JUNIOR DOCTORS AND MENTAL HEALTH
AFTER ALARMING STATISTICS FROM BEYONDBLUE SHOW DOCTORS HAVE HIGH RATES OF ANXIETY, DEPRESSION AND ATTEMPTED SUICIDE, WE TAKE A LOOK AT SOME SCHOOLS OF THOUGHT ON THE ISSUE.
22
REGULARS
features
24 EXTENDED SCOPE OF PRACTICE
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FROM THE EDITOR’S DESK
8
PRESIDENT’S REPORT
28 MEET QUEENSLAND’S
10 CEO’S REPORT 26 FOUNDATION NEWS
FIRST HEALTH OMBUDSMAN
32 MEMBER NEWS
36 AMA QUEENSLAND HEALTH VISION: STEP 2
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Current issues
people & events 12 WOMEN IN MEDICINE 14 PRIVATE PRACTICE CONFERENCE
16 CO-PAYMENT CAUSES CHAOS
14 JUNIOR DOCTOR CONFERENCE
18 QUEENSLAND CLINICAL SENATE – CONNECTING CLINICIANS
31 CALENDAR 33 OBITUARY: DR DEREK MEYERS
20 NEGOTIATING YOUR EMPLOYMENT ARRANGEMENTS
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21 ETHICAL AGONY AUNT: WHEN COMMUNITY TURNS SOUR
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34 ABOVE AND BEYOND: DR SANJEEV BANDI
business tools
38 HOW TO SUCCESSFULLY REBRAND YOUR PRACTICE 39 CYCLE GRINDS ONWARD AND UPWARD 40 THE POWER OF BENCHMARKING
I will continue to update and expand the range of clinical advice available to me.
42 HOSPITAL INDEMNIFIED – DO I STILL NEED MY OWN MEDICAL INDEMNITY? 44 BECAUSE THEY’RE WORTH IT
Life
Mr Leon AtkinsonMacEwen
46 WINE 48 TRAVEL 49 OCKER DOCTOR 50 MOVIES
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51 ON STAGE 52 ALL ABOUT YOU 53 IN PRINT
DoctorQ SEPTEMBER 2014
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editor’s desk
FROM THE EDITOR’S DESK MICHELLE FORD RUSS Doctor Q Editor Imagine the very worst day for people in different careers. Some might cost their company a lot of money, some might lose customers or make an embarrassing mistake, but the majority of professionals aren’t making decisions that affect a person’s life, health or wellbeing quite as intimately as a doctor. So it came as no real surprise when a beyondblue survey released last year found doctors and medical students have substantially higher rates of psychological distress, attempted suicide, anxiety and depression than the general population. Statistics are all well and good, but where to from here? Is psychological distress a given in such a demanding field? We had a good look at some different fields of thought as to how
OBITUARIES
to address this disturbing trend. A quote from Dr Craig Hassed from Monash University resonated for me: “I think we really need to get beyond the notion that this is just a little bit of warm fuzzy stuff you tack on at the end of your medical curriculum just to make yourself feel like you’re humanising it in some way. This is actually right upfront and centre of core clinical skill.” Wine expert James Halliday has given us a vintage pack to give away so you can check out the best wines of 2014 and if you’re lucky you might just win a movie or theatre ticket too. Q My apologies to Dr Thomas Campbell, our new Councillor, who was listed as an Opthalmologist in last edition’s Council pages. Dr Campbell rang to assure us that while he hopes to be an ophthalmologist in the future, at present he is a doctor in training.
The following AMA Queensland members have recently passed away, our condolences to their families.
Dr Brian William BARR General Practitioner Late of Cotton Tree Member for 10 Years
Dr John Brian COPE Internal Medicine Late of Burbank Member for 59 Years
Dr Colin Kenneth BRENNAN Psychiatrist Late of Chermside West Member for 58 Years
Dr Bernard Charles FIRTH Anaesthetist Late of Warner Member for 52 Years
Dr Alexander Denis CAMPBELL Surgeon Life member Late of Maroochydore Member for 53 years
Dr Doreen Elizabeth Dawson HILLIER General Practitioner Late of Mount Nebo Member for 57 Years Dr Noel LANGLEY Orthopaedic Surgeon Late of Robina Member for 10 years
Dr John LEARMONTH OAM (FAMA) Physician Late of The Range Member for 61 years Dr Derek MEYERS Physician Late of Nundah Member for 62 Years Dr Patrick Francis O’DWYER Surgeon Late of Holland Park Member for 56 Years
Our condolences to the families of Drs Roger and Jill Guard, as well as the health workers and medical researchers that were headed to the International AIDS Conference in Melbourne, who were on board the Malaysia Airlines MH17 flight that crashed over Ukraine. 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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SEPTEMBER 2014 DoctorQ
BOARD OF DIRECTORS Dr Shaun Rudd President
Dr Kirsten Price Honorary Secretary
Dr Chris Zappala President-Elect
Dr Brad Horsburgh Elected Member
Dr Bill Boyd Chair of Council
Dr Josie Sundin Elected Member
Dr Bav Manoharan Treasurer
COUNCIL Dr Tom Arthur Greater Brisbane Area
Dr Sharon Kelly Specialist Craft Group
Dr Sharmila Biswas Far North Area
Dr Richard Kidd General Practitioner Craft Group
Dr Kimberley Bondeson Greater Brisbane Area Dr Bill Boyd Capricorn Area Dr Thomas Campbell Greater Brisbane Area Dr Dilip Dhupelia Part Time Medical Practitioner Craft Group Dr Vanessa Grayson Residents and Registrars Craft Group Dr John Hall Downs and West Area Dr Wayne Herdy North Coast Area Dr Brad Horsburgh Greater Brisbane Area
Dr Luke Lawton North Area Dr Kelly MacGroarty Specialist Craft Group Dr Bav Manoharan Gold Coast Area Dr John Murray Full Time Salaried Medical Practitioner Craft Group Dr Paul Neeskens General Practitioner Craft Group Dr Kirsten Price General Practitioner Craft Group Dr Josie Sundin Greater Brisbane Area
AMA QUEENSLAND SECRETARIAT Jane Schmitt Chief Executive Officer Filomena Ferlan General Manager Corporate Services Colleen Harper Manager - AMA Queensland Foundation
Holly Bretherton General Manager Member Relations and Communications Andrew Turner Manager - Member Services
Editor: Michelle Ford Russ Graphic Designer: Erin Sticklen 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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DoctorQ SEPTEMBER 2014
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PRESIDENT’S REPORT
PUSHING FOR A HEALTHIER STATE AND A BETTER SYSTEM
WITH 67 PER CENT OF REGIONAL QUEENSLANDERS TIPPING THE SCALES INTO THE OVERWEIGHT CATEGORY, AMA QUEENSLAND HAS LAUNCHED THE LIGHTEN YOUR LOAD CAMPAIGN TO HELP FIGHT OBESITY IN THE REGIONS.
DR SHAUN RUDD President, AMA Queensland LIGHTEN YOUR LOAD Working with patients, I see the negative health effects of being overweight far too often. Though members are well aware of these chronic illnesses, you may be as surprised as I was to hear that, in some areas, as many as three in four Queenslanders are overweight. Though most people are aware that the basics of weight loss come down to eating better and exercising more, many don’t consider that their weight loss journey should start with their GP. We know GPs are best placed to consider any pre-existing or developed conditions and assist patients in taking the first step towards better health. Because of this, our campaign encourages patients to have this conversation with their GP. Beyond weight, we know those in the regions are more likely to drink excessively and smoke. There is no reason rural Queenslanders should have worse health outcomes than those in the city, and we hope as the campaign continues, it will create a dialogue about health in our regions. ALLIED HEALTH PROFESSIONALS Recently, Queensland Health signalled that it plans to extend the scope of practice for certain allied health professionals to perform specific tasks usually left to doctors. Under the proposed changes, podiatrists, physiotherapists and pharmacists would be able to issue prescriptions and perform other tasks that would normally be provided by a doctor. AMA Queensland recognises the vital role of allied health professionals in providing comprehensive quality care, and we believe they play an important role in our healthcare system. However, we steadfastly believe that expansion of the scope of practice of allied health practitioners should only be allowed where a doctor leads the team the allied health professional is working within and where the expanded scope of 8
SEPTEMBER 2014 DoctorQ
We’ve seen a number of measures taken over the last year that intend to make the health system more efficient but miss the mark when it comes to ensuring patient safety and privacy. practice does not include the medical skills of diagnosis or prescribing prescription only medications. There are a number of variables that go into ensuring prescriptions are prescribed properly. Doctors are best placed to consider a patient’s medical history as well as any other medications they are taking. It is by no means a simple process and it is not one to be taken lightly. In Queensland and across Australia, we’ve seen a number of measures taken over the last year that intend to make the health system more efficient but miss the mark when it comes to ensuring patient safety and privacy. The recent extension of the
pharmacy vaccine trial is a clear example of this. Deeper consideration is needed to safely expand the roles of allied health professionals and we will continue to liaise with Government and advocate on the best interest of the medical community. This year continues to be a pivotal time for health professionals in Queensland and Australia. As we continue to push for the safest, most equitable healthcare system, we thank you for your support. If you have any feedback to offer about recent changes or proposals, please e-mail membership@amaq.com.au or contact our membership team on (07) 3872 2222. Q
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ceo’S REPORT
CHANGES TO THE AMA QUEENSLAND CONSTITUTION
WITH HISTORIC CHANGES TO THE CONSTITUTION PROPOSED, OUR LARGEST WOMEN IN MEDICINE BREAKFAST EVER AND A MEDICO-LEGAL CONFERENCE WITH QUEENSLAND’S FIRST HEALTH OMBUDSMAN COMING UP IN NOVEMBER, THE OFFICE IS A HIVE OF ACTIVITY.
JANE SCHMITT Chief Executive Officer, AMA Queensland The AMA Queensland Board has signed off on a number of important changes to the Association’s Constitution. These changes will be put to members at an Extraordinary General Meeting on 8 November 2014. The proposed changes will have the following effect on the structure of the Board and the election process going forward. The key changes are: The Board must have a minimum of five permanent Board positions one of whom must be the President or the VicePresident and up to eight directors; A President and a Vice-President who has served one term of one year will then be eligible for re-election and may serve up to a maximum term of two consecutive years; The Chair, Treasurer and Honorary Secretary of the Board will be elected by the Council for two years (up to a maximum of six consecutive years) and any Ordinary Member may nominate for each of these positions; The Council will elect, from the current Council members, the remaining number of Directors on the Board who will serve for a term of two years (also up to a maximum of six consecutive years). These changes would create a more flexible and efficient organisation. In the lead-up to the EGM, we will provide members with additional information.
SECOND ANNUAL MEDICO-LEGAL CONFERENCE There are few professional fields more complicated than law and medicine. Due to their dynamic and evolving nature, it is imperative that medical practitioners understand the legal and ethical considerations and legislation that affects them when practising medicine.
who will outline the new system and how health service complaints will be handled going forward.
Our upcoming Medico-Legal conference will address a number of complexities such as the Mental Health Act, changes to privacy and advertising laws, recent child protection changes and end-of-life care.
WOMEN IN MEDICINE On 6 August, AMA Queensland held our annual Women in Medicine Breakfast. This is one of my favourite events as it offers members and medical professionals the opportunity to network and share from each other’s experiences.
The conference is particularly timely with the implementation of the new health complaints management process in effect from 1 July of this year. We will be joined by Mr Leon Atkinson-MacEwen, Queensland’s first Health Ombudsman,
Due to their dynamic and evolving nature, it is imperative that medical practitioners understand the legal and ethical considerations and legislation that affects them when practising medicine. 10
SEPTEMBER 2014 DoctorQ
Visit page 28 of this edition to learn more about the upcoming conference on 1 November and read an interview with Mr Atkinson-MacEwen about changes in the health complaints system.
This year was particularly special with our guest speaker Turia Pitt sharing her experience of being caught in a 2011 grassfire and her subsequent recovery. I knew it would be an inspiring morning after hearing Turia’s story, but listening to her speak exceeded all expectations. Her fighting spirit, candid nature and great sense of humour made the morning unforgettable. This was our largest Women in Medicine Breakfast to date and we thank all of our members and guests for their support. Of course, this event wouldn’t have been possible without the support of our wonderful sponsors. Q
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DoctorQ SEPTEMBER 2014
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People & EVENTS
WOMEN IN MEDICINE
UNMASKING YOUR POTENIAL The annual Women in Medicine Breakfast was bigger and better than ever this year, with more than 200 people turning out to hear NSW Premier’s Award 2014 Woman of the Year, Turia Pitt. After suffering burns to more than 60 per cent of her body in a grassfire while running a marathon in 2011, Turia surprised guests by referring to herself as the “luckiest girl in the world”. She explained how a defining few seconds turned her life upside down but she is determined to suck the marrow out of life.
Guests were inspired by Turia’s story, who graced the cover of July’s Australian Women’s Weekly. They also enjoyed breakfast at Moda Portside and had the chance to meet their fellow women in medicine. The breakfast was possible thanks to our very generous sponsors, who also donated fantastic prizes, from a lady’s vintage bike to pearls and spa vouchers. Q
PROUDLY SPONSORED BY
Thank you to our kind sponsors. From left: Julie Smith, William Buck; Katharine Philp and Rachel Drew, TressCox Lawyers; Sharon Douglas, Angels in Aprons; Sandra Reed, MDA National; Turia Pitt; AMA Queensland CEO Jane Schmitt; Squadron Leader Kelly Travers, Defence Force Recruiting; Cathy Kayess, MDA National; Corporal Jessica Costa, Defence Force Recruiting and Lynette Reynolds, TressCox Lawyers.
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SEPTEMBER 2014 DoctorQ
People & EVENTS
Thanks to the generosity of our sponsors, each guest received a copy of Turia’s book – Everything to Live For.
ABOVE: Front row, left: Dr Janet Draper, Dr Elizabeth Clark, Susan Smith, Jen Egan, Greg Swan, Nikki Knowles. Back row, from left: Dr Catherine Yelland, Emily Chalk and Jane Anderson
ABOVE: Front row, from left: Dr Jacinta Powell, Dr Anna Cooksley, Dr Sarah Bell-Allen, Dr Alex Broe and Dr Judith Somerville. Back row: Dr Jimsie Cutbush, Dr Joanne Martin, Dr Sally Matheson, Catherine Whiteman and Dr Linda Allen
TOP: Catherine Whiteman won a vintage ladies bike, thanks to Davis Recruitment. ABOVE: The team from Supporting Women in Medicine (SWIM) at UQ: Kim Carmichael, Alexandra Hand, Jessica Nguyen, Lok Tung Lee and Emily Shao.
ABOVE: Front row, from left: Dr Otilie Tork, Julia Sprengel, Tracy Bartley, Neroli Porter and Dr Deidre Starck. Back row: Dr Patricia O’Connor, Maureen Hatcher, Dr Jennifer Green, Julieanne Burke and Caroline DoctorQ SEPTEMBER 2014 Voohoeve.
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People & EVENTS
STARTING AND WORKING IN PRIVATE PRACTICE CONFERENCE Around 100 doctors, practice managers and medical professionals attended the Starting and Working in Private Practice conference at Victoria Park in July. It was designed for doctors looking to start their own practice, enter a private practice or existing private practitioners looking to improve their current practice. Q
“This is another professionally delivered conference by AMA Queensland. The breadth of topics and diversity of presenters ensured good coverage of all of the key aspects of entering or refining one’s engagement in private medical practice.”
A/Prof Michael Greco from Patient Opinion Australia talked about effective patient engagement.
MDA National’s Allyson Alker explained the impact of social media on your practice.
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SEPTEMBER 2014 DoctorQ
People & EVENTS
JUNIOR DOCTOR CONFERENCE More than 200 doctors and students turned out for the first ever AMA Queensland Junior Doctor Conference. Developed by the AMA Queensland Council of Doctors in Training, the comprehensive two-day program featuring over 50 speakers focused on research, leadership and resilience, delivered by leaders in the medical profession, business and political arenas. Junior doctors and students had the opportunity to present their preferred research topic or best moment in
medicine, with prizes awarded for the best presentations on the day. Congratulations to ‘Oral Research’ presentation winner Dr Henry Tsao and ‘Best Moments in Medicine’ – John Dorian Cup winner, Dr Katherine Gridley. Delegates let down their hair for the cocktail party on the Saturday night, hosted by firm favourite Craig Reucassel, of Chaser, CNNN and The Checkout fame. Join us next year for an even bigger and better conference on 27 – 28 June 2015! Q
Craig Reucassel gave the whole room a chance to have a laugh at themselves.
Much fun was had in the BOQ Specialist photo booth at the cocktail party! Proudly supported by the Queensland Government
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DoctorQ SEPTEMBER 2014
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CURRENT ISSUES
CO-PAYMENT ALREADY CAUSING HEADACHES AMA QUEENSLAND RECENTLY CONDUCTED A SURVEY OF ITS MEMBERS TO GAUGE THEIR VIEWS ON THE FEDERAL GOVERNMENT’S PROPOSED CO-PAYMENT POLICY.
LEIF BREMERMANN
Policy Advisor, AMA Queensland
More than 250 members responded to a recent AMA Queensland survey, showing that over 70 per cent of this group oppose the planned co-payments, at least in their current form. Several practices across Queensland have taken to notices on the door, letters, text messages and other media to convince patients the co-payment is not yet in place and may never be introduced. Members have reported a drop in appointments, difficulty in getting patients to attend follow up appointments and an increase in no-shows. “It essentially targets the poorest and least well informed members of the community. There has been some drop in attendances already indicating that people don’t
understand that it cannot be introduced until passed by parliament,” said one respondee. Most members were concerned about the increased administrative burden and some questioned whether the $7 co-payment would end up costing them money to collect. They were also concerned about how the patient’s ten visits were going to be monitored. In turn, this could also encourage patients to visit other doctors and disrupt continuity of care. Other comments from respondents showed there was support for some type of co-payment, however, objections were raised to making those with less money pay a co-payment, the implementation of this scheme and its workability and concerns were raised about the long term impact of deterring people from accessing primary care. Particular concern was raised with respect to nursing home patients who have little money and for practical reasons, are often bulk billed. There was also strong objection to cutting Medicare rebates. A large number of those opposed to the co-payment expressed concern about the cost for their elderly, poor and otherwise disadvantaged patients. Given that the proposal also includes pathology and radiology investigations, doctors are particularly concerned about the mounting cost for patients with complex chronic illnesses. Most of the respondees were concerned the co-payment would discourage patients from seeing a GP in the early stages of disease. From this aspect, the respondees were quite philosophical: “A stitch in time saves nine.” “Penny wise, pound foolish.” “The proposals make as much sense as saying ‘don’t get your car serviced regularly, just wait for it to break down’.” “Sending patients to Emergency Departments instead of their GP is
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SURVEY FAST FACTS 254 responses 184 GPs 70% don’t support co-payment 58% claim they will be greatly affected 86% believe their patients will be affected
economic lunacy. It also disrupts continuity of care, which is vital when so much of General Practice is chronic disease management,” said one respondee. On the opposite side of the fence, many of the survey’s respondees said that unless a GP visit cost the patient money, healthcare would not be valued. Many respondees believed the aim of the co-payment is to reduce GP visits, for better or worse: “I believe some price signal needs to exist if we are going to stop overuse of a limited service,” “It will cut down on unnecessary patient visits,” said respondees. Many felt GPs were being unfairly targeted: “The co-payment is targeting the wrong area as GPs are the first line of defence to keep patients at home and out of care faculties and hospitals - we need to not limit GP services, instead we should be increasing the chronic and preventative work.” AMA President Associate Professor Brian Owler said we need to make sure that there are protections for people in our community for whom even $7 is a significant barrier to accessing health care. “This is why the AMA has developed an alternative model for a co-payment system which exempts the most vulnerable patients from extra cost burdens for their health care. Under the AMA’s plan, all patients would be charged a $6.15 copayment (which aligns with the current bulk billing incentive), but the Government pays the co-payment for concession card holders and patients under 16 years of age. AMA President Brian Owler said that this model is “based the realities of day-to-day medical practice, and [helps achieve] our objective to provide higher quality primary care for all Australians.” Q
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CURRENT ISSUES
CONNECTING CLINICIANS TO IMPROVE CARE QUEENSLAND CLINICAL SENATE (QCS) CHAIR DR DAVID ROSENGREN EXPLAINS HOW THE SENATE USES CLINICIAN ENGAGEMENT TO CREATE POSITIVE CHANGES TO THE HEALTH SYSTEM.
DR DAVID ROSENGREN
Chair, Queensland Clinical Senate
Strong clinician engagement is widely recognised as a key driver in a high performing health system. In accepting the position of Chair of the Queensland Clinical Senate (QCS) in January 2013, I saw this as an opportunity to be directly involved in harnessing the collective wisdom of clinicians to inform and influence health policy and bring about positive reform. Established in 2008 under the chairmanship of Dr Bill Glasson, the QCS is charged with expanding clinician advocacy at a time of incredible health system challenges. As an emergency physician, I understand firsthand the scale and significance of the challenges we face, and as QCS Chair, I have not been disappointed in the capacity of clinicians to make their voices heard on issues fundamental to achieving positive change. The QCS brings together clinicians from across the public and private health system in Queensland and supports truly multidisciplinary representation. The Senate’s charter is to provide independent, strategic clinical advice to the Minister for Health and Department of Health, and is accountable for demonstrating tangible outcomes. Membership is comprised of a dedicated Executive Committee and 75 members including representatives from each Hospital and Health Service (HHS), Medicare Locals (ML) and the Chairs of each of the 19 Statewide Clinical Networks. The QCS has a responsibility to take a leadership role in promoting and actively contributing to the health reform agenda. To this end the QCS focuses on a limited number of priority issues that are researched, analysed and debated through working parties and QCS meetings, culminating in a series of targeted recommendations. Recent QCS outcomes include: Promotion of a Statement on Effective Clinician Engagement designed to be incorporated by each HHS into their operational strategies 18
SEPTEMBER 2014 DoctorQ
Creation of a clinician engagement survey tool for implementation by each HHS in their workforce annually Development of a standardised Advance Care Plan (ACP) document, currently being trialed Government support for the introduction of ACPs for all public hospital inpatients on a residential care pathway Development of a suite of Clinical Education and Training performance measures for use within the HHSs, with ongoing governance sponsored by the Department of Health Expansion of an evidence base for a sustainable hospital emergency access target embedded within a quality framework.
Cynics will argue the long history of tokenism of clinician engagement within the health system. Clinicians will always be at odds with the system about something, as clinician engagement is not a perfectible beast. However I am comfortable in declaring that with the strong support of the current Minister for Health, there has been increasing demonstration of genuine engagement with clinicians around strategic system challenges over the last 12 months. Amidst all the system noise, the QCS has a responsibility to sift through the clutter and together represent clinicians in providing strategic advice and leadership on systemwide issues affecting quality, affordable and efficient patient care.
I have not been disappointed in the capacity of clinicians to make their voices heard on issues fundamental to achieving positive change. More recently the QCS undertook a joint initiative with Health Consumers Queensland to stimulate a community conversation around futility and end-oflife care. This conversation was tackled at a forum on 25 July, All great stories need a good ending – consumer and clinician perspectives on end-of-life care. The overwhelming response to this initiative is heartening and indicative of the growing appetite for tacklingthe complex issues surrounding end-of-life care. Recommendations centre upon improving literacy and comfort in instigating these difficult but necessary conversations, ensuring informed patient decisionmaking and improving the delivery of end-of-life care. Moving forward the QCS will continue to work closely with consumer representatives to bring the recommendations to fruition.
In October, the Senate will meet to consider the development of a governance framework around the introduction of clinician performance measures. This is important work with the current plan to link medical officer KPIs to a percentage of income by mid-2016. This process could easily lead to system-wide benefits and, if embraced, presentsan opportunity for healingstrained relationships between clinicians and policy-makers. Q
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How the MBAQ can help you The Association provides financial assistance to help medical practitioners through crises. If you find yourself in a financial crisis, then make contact with the MBAQ to receive the application forms for assistance.
How you can help the MBAQ You may contribute to the Medical Benevolent Association of Queensland in several ways: • By becoming a member of the Association: Subscriptions - Ordinary Annual membership $30 p/a - Life membership $50 one sum • By making a tax-deductible donation to the Association. • By making a bequest in your Will. • By naming the Association as the beneficiary where there is a surplus following functions such as Year Reunions or LMA Dinners.
Tragedy is unpredictable and may strike at any age in the life of a medical practitioner... More Information Further information can be found on the MBAQ website at www.MBAQ.org.au. All donations are tax deductible.
Donate or subscribe today!
Medical Benevolent Association
of Queensland DoctorQ SEPTEMBER 2014
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CURRENT ISSUES
NEGOTIATING YOUR EMPLOYMENT ARRANGEMENTS IN PRIVATE PRACTICE ON YOUR WAY TO ESTABLISHING YOUR CAREER IN PRIVATE PRACTICE? NEED SOME IDEAS ON NEGOTIATING THE TERMS AND CONDITIONS OF YOUR EMPLOYMENT WITH PROSPECTIVE EMPLOYERS? WORKPLACE RELATIONS ADVISOR LUKE DONALDSON LAYS OUT THE FUNDAMENTALS FOR NEGOTIATING YOUR EMPLOYMENT ARRANGEMENTS.
LUKE DONALDSON
Workplace Relations Advisor, AMA Queensland
PREPARE YOURSELF
The most important step is understanding and articulating what you want versus what you need and matching these to the wants and needs of your prospective employer. For instance, you may ask yourself: Recent QCS outcomes include:
Let us never negotiate out of fear, but let us never fear to negotiate
How long do I want to be engaged for?
read and understand all of the terms and conditions and how they interrelate. In reviewing your agreement do not simply look for what is included, but also for what is absent. These provisions are designed to protect you as well as the practice.
What responsibility am I prepared to undertake?
Common clauses that are to be scrutinised include; but are not limited to:
What sort of practice structure am I after? What remuneration benefits do I want or expect?
What liability am I prepared to bear? How can I add value to the practice? These questions will set the scene, allowing you to identify the minimum arrangements you would be willing to accept. However, it is important to consider what you are willing to forego and what you are prepared to compromise.
READ IT, UNDERSTAND IT
Before you can negotiate any of the terms of your agreement, it is essential that you
Term and termination; Billing/fee arrangements; Insurance coverage; Reimbursement of expense; Ownership of medical records; and, Restraint of trade. If a term is not detailed, or if the conditions are not adequately expressed, then request an explanation and raise them as legitimate concerns, whilst keeping in mind what you are willing to forgo or compromise.
PACSER
Once you have prepared and scrutinised the employment arrangements offered, you can now consider the PACSER steps. Plan: Be prepared with information and facts. Avoid going into any negotiation and coming across as either uninformed or unreasonably aggressive. Assess: Benchmark offers and conditions to your priorities, determine what is and is not negotiable. Consider: Why the Principal is prepared to move or not, and determine how to make a counter offer to suit your priorities. See: Know when it is time to close or break off discussion. If the other party is ready to close the deal, and it is acceptable to you, make it easy to wrap up. Evidence: At the conclusion of the negotiation, pending on the outcome, get any offer or variation to the employment arrangements in writing. This will ensure that what you have agreed to is honoured. Reflect: When you complete any negotiation, always ask yourself, “Did I get a good deal?” your objective is what you want to achieve — your bottom line is what you absolutely have to achieve.
REMEMBER Set clear goals but be open-minded Seek a win-win outcome Do not settle for too little Avoid arguments and confrontation Maintain good relationships Q
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CURRENT ISSUES
WHEN A COMMUNITY TURNS HOSTILE
OUR DEAR AGONY AUNT IS HERE TO ANSWER YOUR ETHICAL CONUNDRUMS. HERE, DR DILEMMA SEEKS AN ANSWER WHEN THE COMMUNITY RELATIONSHIP TURNS SOUR.
Dear Dilemma, Firstly I sympathise with you. You are in a really tough situation. Your situation is tricky. Whilst your patients may choose their doctor, you do not always have the option of choosing your patients, especially in critical situations. As a doctor, you may be called on in an emergency to treat patients as best you can and where it is beyond your power to affect the outcome substantially. This duty is undoubtedly a heavy burden and can take a toll on the lives of those in our profession. In your case, this duty has been further complicated by expressed doubts in the community about your competency or dedication. It is important to recognise that in this situation, both you and the community are undergoing a process of grieving. Everybody deals with grief in different ways, and the uncle’s outburst may just be that. Dear Ethical Agony Aunt, I am a rural doctor and work in a close knit rural community. Recently I had a devastating experience; a young boy was killed behind the wheel on one of the country roads at night. Being the only doctor on call, I was the first responder to the disaster. I did my best and he was subsequently airlifted to a major hospital. However, sadly, he passed away a few days later in hospital. This accident has traumatised the community very much and the community is still coming to grips with it. I still think about that night and whether I might have been able to do more, however, I have to move on to be able to do my job. This week I found, myself on the end of a nasty comment from one of the town locals; at the local pub the other night, the dead boy’s uncle told me “don’t bother turning up doc” to the funeral, reflecting his views that I was unable to save his nephew. I was very hurt by these comments and was not sure how to react. Since then I have been getting a few odd looks whilst in town on my days off, as if I would not be welcome to attend the funeral. How can I continue to practice in a community where some members hold bitter views toward me? I worry that these kinds of attitudes and comments will not only damage my reputation, but also the therapeutic relationships I have with my patients. Sincerely Dr Dilemma
You must serve the community to the best of your ability, even if some among them are not supportive. Whilst your encounter with that particular family member was not pleasant, I don’t think that it should be considered the view of the community at large.
Always be aware that there will always be multiple views about your professional and personal image in this community and you cannot please everyone. Always be aware that there will always be multiple views about your professional and personal image in this community and you cannot please everyone. Your job is to do the best and to do the right thing. You will continue to play the role of a support person and professionally may encounter people who may turn to you during this process. As time passes, the community will understand and make their own sense of their grief. Your dilemma here is offending the uncle versus the whole community. I think the choice is clear, your bigger responsibility lies to the community itself. In the end, do not forget your own feelings about the devastating events. As an individual you need to look after yourself and turn to a professional colleague to help you through your grieving process too.
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.
Hoping for a positive outcome. Aunt Agony Q
DoctorQ SEPTEMBER 2014
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CURRENT ISSUES Feature story
JUNIOR DOCTORS AND MENTAL HEALTH
DHAS
Doctors’ Health Advisory Service
If you need to seek help, call the Doctors’ Health Advisory Service on 3833 4352 or visit dhasq.org.au. For more information on junior doctors and mental health, including self-assessment tools, visit www. jmohealth.org.au
BEYONDBLUE RECENTLY REPORTED THAT MEDICAL STUDENTS AND DOCTORS EXPERIENCED SIGNIFICANTLY HIGHER RATES OF DEPRESSION, ANXIETY, AND ATTEMPTED SUICIDE THAN ANY OTHER PROFESSION IN AUSTRALIA. COUNCIL OF DOCTORS IN TRAINING DEPUTY CHAIR DR LISA BYROM EXPLAINS WHY MENTAL HEALTH CARE FOR JUNIOR DOCTORS IS A PRIORITY.
Burnout is a significant problem amongst doctors across all specialties and level of training. This is important due to the potential implications on patient care, medical professionalism, the safety and wellbeing of the doctor, and the sustainability of the health care system. Females, those aged under 30 years, single, Aboriginal or Torres Strait Islander origin, or those working in a rural or remote setting were identified as particularly vulnerable groups. Within these groups lie many of our junior doctors. Doctors who need fair access to maternity leave, support during transitional points in their career, and assistance in maintaining fair work conditions as they complete training programs. This is also during a time where most experience change on a personal level such as marriage, starting a family, and caring for relatives. Coinciding college exams, conference attendance
or ongoing job applications sees many doctors needing to preference career demands over personal ones. As the number of medical graduates continues to increase, so does the degree of job uncertainty. This tsunami of medical students will inevitably lead to intern and RMO shortages and eventually, specialist college training positions. The SMO contract crisis earlier this year saw RMOs being faced with losing their teachers and mentors. Ongoing negotiations on both an RMO and SMO level continue to perpetuate the feeling of insecurity in the workplace. Despite the high level of psychological stress documented from medical students to consultants, there have been few interventions implemented to address this issue. Outcome measures for such programs are scarce. Those programs that are running are often held
Coinciding college exams, conference attendance or ongoing job applications sees many doctors needing to preference career demands over personal ones.
in the participants personal time, incur a financial cost, or aren’t medical specific. With a focus on mindfulness, many programs centre on the theoretical concept with didactic learning styles. Rather than discussing mindfulness on a conceptual level, we need to start implementing it into our day-to-day practice. Role playing scenarios, using a combination of communication exercises with mindfulness training, have already been successfully implemented internationally in the medical field. Within the Council of Doctors in Training we have a Junior Doctor Health and Wellbeing Committee designed to address this issue. AMA Queensland continues to support doctors through all stages of their career. AMA Queensland aims to not only equip doctors with the coping skills required for their day to day work but also to ensure longevity in their career. Doctor burnout, reduced quality of life, depression, anxiety, and substance abuse can all potentially affect their engagement in the work force. As such, health care providers and doctors should aim to work in partnership to meaningfully promote doctor health and wellbeing. STRESSORS: External long work hours shift work college exams job applications
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Internal perfectionism pressure to succeed
Feature story
“NOTHING QUITE PREPARES YOU FOR THE STRESS AND WORKLOAD OF BEING AN INTERN” “I remember staring down the busy corridors of the ward with patients and nurses buzzing around me, and a pile of paperwork stacked high in my arms,” said Dr Rachel Collings, who began her medical career at Townsville Hospital. “My phone wouldn’t stop beeping. I felt very overwhelmed. “Medicine is a very demanding profession and junior doctors face daily pressures outside their comfort zones dealing with heavy workloads, shift work and long hours while trying to establish a work-life balance.
“We’re training interns to be resourceful, resilient, effective clinicians who look after their patients in the best possible way,” Ms Salvador said. “The Townsville Hospital has become a leader in its field when it comes to training interns because of programs like Doctors for Doctors. “This is the third year the mentoring program has been running at the hospital and it is going from strength to strength,” Ms Salvador said.
“It is important junior doctors develop the courage to ask senior colleagues for help, it’s one of the most important skills they’ll learn.
“Sixty out of the 70 interns this year have requested a mentor to assist them to achieve their career advancement, professional development and wellbeing goals, which is more than previous years.
“During overwhelming moments, it is the people around you who can make a difference.”
“The number of mentors is also growing as doctors who have been through the program, want to pay it forward.
Dr Collings says she recognised the need for more support after feeling overwhelmed during her first days on the job.
“We’re receiving enquiries from other hospitals across Australia about how they too can offer a similar program.”
She teamed up with medical education officer Dianne Salvador to create the mentoring program Doctors for Doctors.
The program’s success inspired Dr Collings and Ms Salvador to write the book Mentoring Doctors, a how to guide for other hospitals. Q
Dr Craig Hassed is a general practitioner and senior lecturer in the Monash University Department of General Practice. He has been instrumental in introducing a variety of innovations into medical education and practice with an emphasis on the application of holistic, integrative and mind-body medicine in medical practice in a way which is grounded, balanced, scientifically valid and clinically effective.
“I think we really need to get beyond the notion that this is just a little bit of warm fuzzy stuff you tack on at the end of your medical curriculum just to make yourself feel like you’re humanising it in some way. This is actually right upfront and centre of core clinical skill.” DoctorQ SEPTEMBER 2014
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Feature story
EXTENDED SCOPE OF PRACTICE A RECENT QUEENSLAND GOVERNMENT REPORT HAS IDENTIFIED WAYS IN WHICH THE SCOPE OF PRACTICE FOR ALLIED HEALTH PROFESSIONALS CAN BE EXTENDED. POLICY ADVISOR LEIF BREMERMANN EXPLAINS WHAT THIS MIGHT MEAN FOR OUR HEALTH CARE SYSTEM, AND WHAT AMA QUEENSLAND IS DOING TO ENSURE THE BEST POSSIBLE OUTCOME FOR MEMBERS AND THEIR PATIENTS.
In early June this year, the Queensland Government released its final report on expanded scope of practice for health practitioners. This report was based on the findings of a Ministerial taskforce that had been established in March 2013 to identify such opportunities. The Ministerial Taskforce had been a commitment agreed to by the Queensland Government as part of the Health Practitioners (Queensland Health) Certified Agreement (No.2) 2011. The Minister for Health asked the Taskforce to identify; opportunities for health practitioners to work to full scope of practice (including advanced clinical practice) and extend scope in appropriate contexts mechanisms to achieve effective delegation and support better use of the health practitioner workforce an integrated education, training and clinical governance strategy to support effective introduction and integration of new roles the funding implications of implementing the recommendations. AMA Queensland was represented on this Taskforce by Past President Dr Alex Markwell. Our feedback to the Taskforce’s interim report emphasised that while we cautiously supported the aims of the Taskforce, we felt the changes should be evidence based, implanted with care and not introduced until full scope models had been successfully implemented. Further, we noted that
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there were key roles that only a medical practitioner could perform, including; Diagnosis and prognosis Complex planning
decision-making
and
care
Training other doctors Medical leadership AMA Queensland also advised that we could never support substitution of medical practitioners with other classes of health practitioners for workforce reasons or cost savings. The final report made six recommendations that aim to optimise delivery of patientcentred and cost-effective services through allied health professionals expanding their scope of practice. These were: RECOMMENDATION 1: Hospital and Health Boards to lead the implementation of models of care that include allied health professionals expanding their scope of practice. 2: Service RECOMMENDATION agreements between the Department of Health and each Hospital and Health Service to require the implementation of models of care that include allied health professionals expanding their scope of practice, and to report annually. RECOMMENDATION 3: Allied Health Professions’ Office of Queensland to showcase to Hospital and Health Services, the Queensland Clinical Senate and clinical networks opportunities to enhance patient experiences and provide
cost-effective services through allied health professionals expanding their scope of practice. 4: The RECOMMENDATION Department of Health to support redesign of models of care to improve the patient journey and deliver cost-effective services in outpatient clinics, emergency departments and mental health services by allied professionals expanding their scope of practice. RECOMMENDATION 5: The Department of Health to address barriers to allied health professionals expanding their scope of practice by: and implementing identifying alternative funding models and incentives with relevant partners amending regulation, legislation and policy developing measures and facilitating research into the outcomes of full scope of practice and extended scope tasks to further contribute to evidence. RECOMMENDATION 6: Allied Health Professions’ Office of Queensland, in partnership with education providers, accreditation bodies and professional associations, to develop and facilitate access to education, training and tools to support allied health professionals to expand their scope of practice. The report argues that these recommendations have been designed “to realise more effective and efficient use of the allied health workforce in order to achieve better outcomes for patients, the community and the workforce within Queensland Health.” AMA Queensland values the role and specific expertise of non-medical health practitioners
Feature story
We noted that there were key roles that only a medical practitioner could perform and acknowledges and supports the collaborative arrangements between medical practitioners and other nonmedical health practitioners. These kinds of collaborative care arrangements, where a medical practitioner remains responsible for leading the team and managing the care of patients, must remain the benchmark standard of practice to protect patient safety and quality of care. AMA Queensland is in the process of developing a position statement in response to the report which will represent the views of its members while also acknowledging the important role allied health practitioners play within our health care system. This position
statement will inform our discussions with the Queensland Government and offer a constructive way forward as we continue to discuss the issue. We encourage any members who wish to contribute to the discussion to get in touch with our policy team to let us know what they think about extended scope of practice for allied health practitioners. We will also keep members informed by regularly writing to you about any significant developments in the matter, and through updates on our website and social media channels. Q
DoctorQ SEPTEMBER 2014
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FOUNDATION
WILLIAM BUCK TAKES CORPORATE RESPONSIBILITY Thanks to William Buck Queensland, Cunnamulla Health Centre will have its first ever retinal camera. The provision of high quality eye services is a fundamental part of improving the health of Aboriginal and Torres Strait Islander peoples. Sadly, Indigenous adults report six times more blindness than the non-Indigenous population. 94 per cent of vision loss is unnecessary and is preventable or treatable. Diabetes retinopathy is one of the leading causes of blindness in Aboriginal and Torres Strait Islander communities. Yet simple screening for diabetes retinopathy prevents blindness.
CAIRNS HOMELESS OUTREACH PROGRAM TO GET NEW STREET VAN A huge and very heartfelt thank you from AMA Queensland Foundation and AMA Queensland member, Dr Sharmila Biswas to everyone who generously gave to our recent 2014 Tax Appeal. Your kind donations totalled an incredible $57,072, surpassing our target of $50,000 and ensuring that Rosies will be able to purchase a new street outreach van for their Cairns program. Without your help this vital service would not have been able to continue, with their current 20 year old van soon to be forced off the road. A new van, being able to carry more volunteers and amenities safely, means the outreach program can grow to cater for the increasing number of Cairns homeless, providing them with much needed food, beverages, emergency clothing, blankets and support. Local GP and AMA Queensland Far North Area Representative, Sharmila, 26
SEPTEMBER 2014 DoctorQ
has witnessed first-hand the increasing numbers of those who rely on the Cairns outreach van, not only for basic needs such as food and blankets, but also to feel some connection with the community around them. “For a short time they feel welcomed rather than shunned, and are treated with dignity and respect. The street outreach van is quite literally a life saver for these people”, says Sharmila. “I’m so grateful to my fellow AMA Queensland members and professional colleagues for their contributions to this appeal, and for reaching out to those most vulnerable in our community, ” said Sharmila. “Your generosity will ensure that the disadvantaged and destitute can eat and sleep, and provide support and a listening ear to those who society excludes”. Keep up to date with the Foundation’s activities on Facebook (AMA Queensland Foundation) and Twitter (@AMAQ_ Foundation). Q
Cunnamulla is a small town that lies on the Warrego River in South West Queensland, 206 kilometres south of Charleville. With the help of this new camera, each patient will have a retinal photo taken. Each image, via tele health, will help identify those with diabetes retinopathy. The next stage, simply involves the visiting ophthalmologist using a laser or injecting the eye to restore sight and this will be done within a few weeks. Prior to Cunnamulla receiving this camera, a patient would have to wait up to many years for treatment. Q
FOUNDATION
WORKPLACE GIVING
REGULAR GIVING–IT’S OUR LIFEBLOOD Regular or annual giving to the AMA Queensland Foundation is our lifeblood. Regular donations are vitally important as they allow us to budget, confidently plan ahead, and commit with confidence to supporting various projects and doctors doing good. Your monthly or quarterly support could help fund: improved or emergency medical services, especially in rural and remote areas medical and specialised equipment for those whose needs don’t fit into the neat boxes of other health-specific charities scholarships to medical students enrolled at James Cook University, who have demonstrated commitment to working in rural medicine improved medical education vital medical research
Dr Geoffrey Adsett Dr David Backstrom Dr Kenneth Barns Dr Judith Bligh Dr Robert Brown Dr Lee Brown Dr George Bruxner Dr Nicholas Buckmaster Dr Andrew Butler Dr Susan Colen Dr Jeffrey Conn Dr James Coombe Dr Charles Denaro Dr Zuzana Dreves Dr Mary Dunne Dr Michael Fish Dr Harold Foxton Dr Glenn Francis Dr Susan Gould
The Foundation’s Individual Giving Program makes regularly contributing easier and more convenient for our donors while providing a steady, reliable source of much needed funds, enabling us to respond to needs when and as they arise. By preauthorising monthly, quarterly, or annual deductions from their credit cards, our supporters’ gifts are two-fold in that they also reduce administrative costs and help to streamline our processing. Donors are provided with one annual receipt for their total 12 months’ donations at the end of each financial year. AMA Queensland Foundation sincerely thanks all our Individual Giving Program donors for their ongoing generosity and support. Thank you also to our Individual Giving Program donors who wish to remain anonymous. Q
Dr Mary-Louise Greer Ms Colleen Harper Dr Burnett Kann The Flynn-Kann Family Dr Samuel Kim Dr Philip King Dr Yvonne Kirkegard Dr Annette Kortlucke Prof Joan Lawrence AM Dr Laurel MacIntosh Dr Meredith MacLeod Dr Graham Mapp Dr Desmond Misso Dr Christopher Morrey Dr Thomas Murphy Dr Gregory Nutting Dr Colin Page Dr Riitta Partanen Dr Allan Perina
Dr Joanna Perry-Keene Dr Geoffrey & Dr Coralie Porter Dr John Pryor Dr Jennifer Schafer Dr Jill Seligmann Dr Bhuvana Srinivasan Dr Alan Stocks Dr Albert Thomason Dr Rachel Thomson Dr Wendy Thoreau Dr Frances Ware Dr Beres Wenck Dr Stephen Withers Dr Keith Woodhead Dr Catherine Yelland Dr Keith Zabell World Travel Professionals Ashgrove West Group Practice
“Our staff are delighted to help the AMA Queensland Foundation and their many worthwhile projects. My personal favourites are always the projects related to children, for example Townsville Hospital Emergency Department’s desperate need for a special bed to weigh seriously ill children, so they can receive the correct treatment.” - Lisa Story MD, World Travel Professionals Workplace giving is a simple and costeffective way for your organisation to support doctors doing good, increase staff morale and increase awareness of your brand as caring and altruistic. For further details, contact Colleen Harper on (07) 3872 2204. Q
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
DoctorQ SEPTEMBER 2014
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Feature story
MEET QUEENSLAND’S FIRST HEALTH OMBUDSMAN AFTER REPLACING THE HEALTH QUALITY AND COMPLAINTS COMMISSION THIS NEW FINANCIAL YEAR, QUEESLAND NOW HAS ITS FIRST EVER HEALTH OMBUDSMAN, LEON ATKINSON-MACEWEN. COMMUNICATIONS AND MEDIA ADVISOR RACHAEL FINLEY ASKED HIM HOW THINGS WILL OPERATE UNDER THE NEW SYSTEM.
Q As Queensland’s first Health Ombudsman, how do you see the role benefitting healthcare for Queenslanders?
Q Having to make a number of complex decisions efficiently, what will be your guiding factors in handling complaints?
The Office of the Health Ombudsman provides an independent, transparent, expeditious and accountable health service complaints management system. Complaints will be dealt with quickly, impartially and with a view to determining whether the health service was reasonable in the circumstances.
The Ombudsman process is inquisitorial not adversarial, and our first goal is to establish what, if anything, has gone wrong that requires our intervention. In doing so, the primary question we ask is ‘was the service reasonable in the circumstances?’. If we find that there is an issue (or issues) that require our intervention or assistance in order to be resolved, our aim is to resolve these issues in a timely and appropriate way, based on detailed information and evidence that we assess thoroughly and independently.
Q In more complex cases, especially where a potential suspension or restriction may be imposed on a medical practitioner, what steps will be taken to ensure appropriate and comprehensive clinical input is taken into consideration? Under Section 29 of the Act, I can establish a committee, comprised of appropriately qualified clinicians, to advise on complex matters involving the suspension or restriction of a medical practitioner and any views provided by advisors may be used in informing an independent, impartial and fair decision. In June, I sought expressions of interests from qualified practitioners (from all disciplines) and I will continue to update and expand the range of clinical advice available to me.
Fundamentally, we pride ourselves on making decisions that are informed and reasonable. Q What will your relationship be with AHPRA and the Medical Board of Australia? AHPRA and the Medical Board of Australia are two of our major stakeholders and their work is critical to what we do. The OHO is committed to working closely with AHPRA and the Medical Board of Australia – in addition to our other key stakeholders – as part of our efforts towards a stronger health complaints management system.
Q The point has been made that a key advantage of the Office of the Health Ombudsman is that it will create a clearer process for handling complaints. How will the Office ensure the process remains transparent and easy to use for patients and medical practitioners? We will continue to consult openly with a diverse range of organisations and community groups to ensure our services and communications are accessible to all Queenslanders, including patients and medical practitioners. Our services are available in multiple languages and forms, and we maintain communication with all parties throughout the complaints management process to address any concerns they may have. In addition to reporting each quarter to the Queensland Parliamentary Health and Community Service Committee, I am committed to publishing monthly reports on my website detailing not only the performance of the health complaints management system but my performance as well. Q The Office of the Health Ombudsman was developed to improve the complaints system in Queensland. What steps will be taken to ensure continuous improvement of the new system? I am a strong believer in the maxim ‘what gets measured gets done’. To that end, I am establishing an audit and compliance program to ensure that, for example, the recommendations coming from my investigations (or the changes in processes and procedures that health service providers state have been or will be implemented) have in fact been implemented, their efficacy reviewed and any necessary modifications made to ensure that they achieve the desired outcome(s). In addition, under the Act I have the power to conduct an investigations or a formal inquiry into systemic issues. I will use this power to ensure that systemic issues are identified and system-wide continuous improvement implemented. Q
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2
2014 IRD EARLY BPPLY RATES A Register before 19 September at www.amaq.com.au
2ND ANNUAL AMA QUEENSLAND
MEDICO-LEGAL CONFERENCE
SATURDAY 1 NOVEMBER | PRESENTED BY AMA QUEENSLAND ETHICS AND MEDICO-LEGAL COMMITTEE
The AMA Queensland 2nd Annual Medico-Legal Conference has been designed and developed in conjunction with the AMA Queensland Ethics & Medico-Legal Committee and the AMA Queensland Council of General Practice.
REGISTRATION PRICE (inc GST) $155 Doctor in Training Rate (Years 1 – 5) $255 Member Early-Bird Rate Available until Friday 19 September $305 Member Standard Rate $605 Non-Member Rate
PROUDLY SPONSORED BY:
The program will equip delegates with: A timely understanding of the new health complaints management process in Queensland as presented by new Health Ombudsman, Leon Atkinson-MacEwen A greater awareness of Recent Child Protection changes and implementation of Carmody Reforms relevant for medical practitioners as presented by Mr Steven Armitage, Commissioner for Children and Young People The latest medico-legal case digest with an update on recent advertising guideline changes as discussed by TressCox Partners Rachel Drew and Katharine Philp An understanding on the recent changes to the Mental Health Act, as outlined by Dr Bill Kingswell, Executive Director, Mental Health Alcohol and Other Drugs Branch, Queensland Health An exploration of end of life care issues including expert insight from the Clinical Senate, General Practitioner, Emergency Department Doctor, Clinical Ethicist, Palliative Care Doctor and Lawyer perspectives The key privacy legislation changes relevant for practice Knowledge on the key risks in private practice and how these can be minimised through correct procedures, protocols and insurance.
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 Contact: Jo Bourke Phone: (07) 5479 3979 CAIRNS Contact: Dr Sharmila Biswas Phone: (07) 4036 4333 TOWNSVILLE Contact: Dr Carl O’Kane Phone: (07) 4433 1111 CENTRAL QUEENSLAND Contact: Dr Harley Wilson Phone: 0419 277 611 Email: harleywilson00@gmail.com TOOWOOMBA AND DARLING DOWNS Email: info@tddlma.org.au Web: www.tddlma.org.au
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BUNDABERG Contact: Dr Daud Yunus Phone: (07) 4152 2888 Email: daud.yunus@gmail.com BRISBANE NORTHSIDE Contact: Dr Graham McNally Phone: (07) 3265 3111 Web: www.northsidelocalmedical. wordpress.com REDCLIFFE AND DISTRICT Contact: Margaret McPherson Phone: (07) 3121 4043 Web: www.rdma.org.au GOLD COAST Phone: 0419 780 505 Email: info@gcma.org.au Web: www.gcma.org.au
If your Local Medical Association does not appear 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.
CAN’T FIND YOUR LOCAL AREA?
events calendar
25 OCTOBER
COMING
FRESH THINKING -
UP
PRIVATE PRACTICE CONFERENCE Rydges Townsville Join legal, accounting and financial experts specialising in the medical profession at this one-stop-shop event for doctors, practice staff and consultants already working in or wanting to start out in private practice. The conference also includes the Sandford Jackson Oration presented by Prof David Paterson on tracking antibiotic resistance.
21 - 27 SEPTEMBER ANNUAL CONFERENCE
WHAT’S ON
OCT - NOV
PRIVATE PRACTICE SERIES
1 NOVEMBER
MEDICO-LEGAL CONFERENCE
Cape Town, South Africa
What’s in a contract?
Law Society House, Brisbane
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.
What legal considerations are required when considering how to engage staff, contractors or locums in private practice? The WR team takes you through a contract for independent contractors, services, associates and employees.
Featuring incoming Health Ombudsman Leon Atkinson-MacEwen, this conference will explore consent and capacity, the recent privacy legislation changes and essential risk management strategies. Early bird rates available.
TO VIEW THE FULL EVENTS CALENDAR
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
INTERN READINESS WORKSHOPS
HELP US PLAN GREAT MEMBER EVENTS FOR 2015
16 October - Brisbane, 4 December - Gold Coast 16 December - Townsville
2014 has seen some new events join the AMA Queensland calendar, such as the Junior Doctor Conference, with great success. But we want more! We want to hear your ideas on professional development and social programs that would best suit your needs in 2015.
Want to get the inside scoop on what to expect next year in your intern year? Presented by our Council of Doctors in Training, this free workshop for final year students will provide you with invaluable tips and first-hand advice to help you survive your intern year.
Event Survey
We’ll be running an event survey in October and we invite you to submit your ideas on topics and speakers for 2015 and your feedback on the 2014 program. Watch this space and our website for details on the survey. DoctorQ SEPTEMBER 2014
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MEMBER NEWS
CONGRATULATIONS to the following doctors who are now elected members of AMA Queensland.
JUNE 2014
JULY 2014
DOCTORS IN TRAINING
DOCTORS IN TRAINING
Dr Elangovan Thaya Needi Dr Ann Mathews Dr Viet Nguyen Dr Melanie Blenkin Dr Kaycee Hocking Dr Adam Coughlan Dr David Holcombe Dr Liam Weber Dr Jo-Lyn McKenzie Dr Arron Veltre Dr Michael O’Reilly
Dr Shambhu Samota Dr Jolyon Bond Dr Stephen Luke Dr Robert Gluer Dr Anna Brookes Dr Andrew Slack Dr Shanthi Carnelio Dr Iti Agrawal
GENERAL PRACTITIONERS Dr Lynton Hudson Dr Philip Bailey Dr Andrew Spall Dr Gaurav Singh Dr Devaradura Mendis Dr Maurice Gunhouse Dr Garikai Maphosa Dr Julian Fox Dr Mangala Tshibangu Dr Raquel Galman
SPECIALISTS Dr Scott Burgess Dr David Chin Dr Paul Trott Dr William Widdowson
GENERAL PRACTITIONERS Dr Jadon Ting Dr David Tedman Dr Luke Edwards Dr Johanna Stehbauer Dr Mirza Beg
SPECIALISTS Dr Anthony O’Neill
SALARIED PRACTITIONERS Dr David Lockwood Dr Su-Yuan Chou Dr Bruce Dixon Dr Laurie Moore
PART-TIME PRACTITIONERS Dr Michael McDowell
SALARIED PRACTITIONERS Dr Julieanne Graham Dr Kiran Shekar Dr Kah Chan Dr Raymond Lewandowski III Prof Kenneth O’Byrne Dr Ajay Chipiri
PART-TIME PRACTITIONERS Dr Lilia Rodriguez Dr David McLennan Dr Dana Newcomb Dr Mark De Wet Dr Poornima Thiruchelvam Dr Jane Lesslie Dr David King
FULL TIME ACADEMIC Dr David King
RETIRED Dr Michael Beeney
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MAKING THE MOST OF YOUR MEMBERSHIP PUBLIC ADVICE IN TIMES OF CHANGE AMA Queensland’s Workplace Relations team provides members with a confidential avenue of advice for various matters in the Public Health System. By providing you with the security and confidence you need when faced with a difficult situation, our team can guide you throughout your entire medical career, from intern to visiting medical officer. With significant legislative and industrial changes over the 2013 – 2014 period, the workplace relations team endeavours to provide: Assistance in managing underpayments and overpayments; Guidance with individual contracts; Step by step advice in dispute resolution; and, Representation for performance management and grievance handling.
AMA Queensland membership provides expert advice, access to information and resources, a showcase of interesting and practical events and quality commercial benefits through a network of premium partners.
PRIVATE PRACTICE All workplaces require assistance from time to time. As an AMA Queensland member you have access to industrial relations and workplace relations advice specifically for your private practice. There are additional legal obligations on you to manage your employees and we are there to make sure you comply with all relevant legislation. Don’t get caught out by guessing what to do, contact the Workplace Relations Department and get the right advice. We can provide the following advice for your private practice: Interpretation of relevant legislation and awards; Drafting employment contracts; Assistance disputes;
in
resolving
workplace
Advice concerning complaints made; Appearing in unfair dismissal actions; and, Assistance with establishing a practice. The workplace relations team is dedicated to providing support and advice to all AMA Queensland members so you can concentrate on getting back to the business of caring for your patients. Q
obituary Dr Derek Harry Meyers was a member of AMA Queensland for 62 years.
ventures being to the UK’s Lake District and the Zillertal in Tyrol, Austria, then the Himalayas, including areas of Nepal, India and Pakistan. The late Dr Derek Meyers (right) with Commander Paul Luckin at the 2010 ES Meyers Lecture.
DR DEREK HARRY MEYERS MD FRACP 5 JUNE 1925 – 16 JULY 2014
Derek Harry Meyers was born to Errol Solomon Meyers and Myrtle Meyers in 1925, the third of four children. Derek’s father was a surgeon, anatomist, co-founder and longest serving member of the Faculty of Medicine, University of Queensland. Derek attended Eagle Junction State School in the 1930s and to earn his keep, he rode his bike to work at the wool scour each day. Derek won a scholarship to Brisbane Grammar School, which he attended from 1939-1942 and won an open scholarship to attend the University of Queensland. On leaving school Derek joined the RAAF and became a Flying-Officer, serving until 1945. Derek resumed his medical course after the war, graduating in 1950, and winning the AMA Queensland Harold Plant Memorial Prize for excellence. After a year as resident medical officer at the Brisbane General Hospital, and three years at the Repatriation General Hospital Heidelberg, Derek became Clinical Supervisor at Royal Melbourne Hospital, and Associate-Assistant Physician. He had gained an MD in Melbourne and later became the Royal Australasian College of Physicians Wunderly Travelling Scholar. At the end of 1956 Derek, with his wife Rilda, and two young children, sailed for England as a ship’s doctor in the Simba, a Danish freighter. In 1957 and 1958, he was in turn house physician at the Brompton
Hospital and medical registrar at the Central Middlesex Hospital. After returning to Brisbane from London, Derek started as a consultant physician in private practice and was appointed visiting physician at Princess Alexandra Hospital the following year. He was befriended by Dr John Shanasy, who found him rooms at 201 Wickham Terrace, and in the following decade, Derek’s innate organising ability showed itself when, despite a good deal of adverse advice and scepticism, he helped arrange for the building of the multi-storied Alexandra at 201, over the original site. For some 26 years at the Princess Alexandra Hospital, Derek’s enormous energy burst out in all directions, serving on numerous boards and many varied roles. During his time with the Princess Alexandra Hospital, he was also visiting consultant in rehabilitation to the Commonwealth Rehabilitation Centre and Member and Deputy Chairman to the General Medical Assessment Tribunal, Compensation Board of Queensland. Derek served as a member of the Repatriation Department Team, in Vung Tau, South Vietnam for three months, being present for the first phase of the Tet Offensive. His time in Vietnam awakened a wanderlust, and from the early 1970s Derek began to make time to travel to various parts of the world to trek, his first
After leaving Princess Alexandra Hospital, he was Visiting Physician to the Repatriation General Hospital, Greenslopes and later, to Wolston Park Hospital, and Relieving Physician to Princess Alexandra and Greenslopes. He served as medical referee for seven different organisations, including the Consulate of the Federal Republic of Germany, and as chief medical examiner for a number of life assurance offices. He had extensive experience as a member and chair of Medical and Psychiatric Tribunals. Derek was active in the Australasian College of Physicians, a regular attender at Annual Scientific Meetings, and occasionally at AGMs. He sometimes differed with Council over policy, or, as in the case of euthanasia, over lack of policy. He was Local Organising Chairman in 1995 for the first ever Combined Scientific Meeting of the RACP, RACS and the Academies of Medicine of Singapore, Malaysia and Hong Kong. He wrote what was to be the constitution of the Australian Society of Consultant Physicians in General Medicine. He was for a time Chairman and Director of Red Nose Appeal. Derek was a great communicator, not only by letter, sometimes heated, but also by numerous journal publications. Derek could always be relied upon in times of trouble. He helped countless people throughout his life and donated generously to numerous charitable organisations. He also made enormous contributions to his father’s memory by supporting the annual ES Meyers Memorial Lecture. In all areas of his life Derek upheld the highest standards, and expected others to do the same. Each job, no matter how big or small, was undertaken with the utmost dedication, and seen through to completion. He was a stickler for factual accuracy and abhorred wasting time, money and words. Nevertheless, he had a wonderful sense of humour and his intellect and memory remained intact and formidable throughout his life. Q DoctorQ SEPTEMBER 2014
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MEMBER NEWS
AMA R MEMBE
ABOVE AND BEYOND WITH A MOUSTACHE AND A SMILE, DR SANJEEV BANDI HAS RAISED MONEY, CAMARADERIE AND AWARENESS FOR MEN’S HEALTH IN THE MACKAY REGION.
Dr Sanjeev Bandi knows too well how many men die of preventable conditions. He estimates that around 60 per cent of the men who visit him with testicular and prostate cancer come at least six months after they should have. Statistically, men are three times more likely than women to suicide, 1.5 times more likely to die of trachea and lung cancers and more likely to succumb to blood and lymph cancers, colon and rectum cancers, ischaemic heart disease and chronic lower respiratory diseases. After skin cancer, testicular cancer is the most common cancer for Aussie men between 15 and 39. “It is ridiculous that women talk about everything over coffee with one another without inhibition and men don’t talk to anyone if they do not realise it is a problem,” said Dr Bandi. “Changing one man’s life has inspired me to raise money and get the word out about men’s health,” he said. Dr Bandi has brought his incredible ability to rally people together to raise more than $45,000 for men’s health without corporate sponsorship. Growing an impressive moustache each November, Dr Bandi joined the Movember cause six years ago, with supporters donating money to sponsor the hairy facial art. As a sometime cricket coach, player and fan(atic), he challenged the Australian Cricket team to a mo-growing duel. Dr Bandi was the second highest fund raiser in Australia in 2012 and highest fund raiser for 34
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the My Cricket Cares network raising $34,572 personally for Movember. Amid the blokey barracks of his local cricket club and the Club Cricket Cares Network, he outlined the importance of men taking care of their own health and has rallied for greater support for men’s health, including mental health. As a respected urologist and men’s health advocate in Mackay, he has used his media profile to write columns in The Daily Mercury and his Movember webpage. The columns use humour and layman’s terms to inform the community about men’s health, including the need for men to visit the doctor more regularly and access to services. “From the day I register, through November, I use each day to raise awareness about men’s conditions so that people actually learn something,” said Dr Bandi. “Two of the young men in my team had testicular tumours but had not seen anyone about it because they did not have pain. After reading my column, they sought a referral from the GP and came to see me and were diagnosed,” said Dr Bandi. His practice manager, Vicki Morley, said Dr Bandi was “happy to put his hand up for anything cancer-related. You just can’t say no to him. During the month of November, he’s everywhere: on TV, radio, in the Daily Mercury talking about men’s health particularly the importance of regular health checks,” she said. The Movember team are incredibly gratefully for Dr Bandi’s support:
“The support Movember receives from Sanjeev each year is awesome. We’re humbled by his passion and determination to raise awareness and funds for men’s health. Not only does Sanjeev grow a Mo each year and become a walking, talking hairy billboard for men’s health, he also uses his fundraising page on movember. com to spread important health messages. Without the support of our dedicated Mo Bros like Sanjeev, Movember wouldn’t have grown from 30 Mo Bros in 2003 to the global movement it’s become today,” said Tom Betts, Movember’s Business and Community Engagement Manager. Dr Bandi always grows a Mo with variations of the letter M – for Mackay, Men’s Health and Movember - so we wait with anticipation to see the 2014 version of his M motivated Mo. Q
The Movember Foundation challenges men to grow moustaches during November to raise awareness, support and funding for men’s health problems - specifically prostate cancer, testicular cancer and male mental health. Globally, 4 million participants have raised more than $576 million, which has been used to fund over 800 men’s health programs. Register now to become a Mo Bro or support one at www.movember.com
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
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DoctorQ SEPTEMBER 2014
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CURRENT health vision ISSUES
AMA QUEENSLAND’S HEALTH VISION
STEP 2
After over a year of consultation and development, the release of the AMA Queensland Health Vision is imminent. To be released in five parts, the first part of the Health Vision will examine public health and generational disadvantage. This is an appropriate place to start examining what a future, healthier Queensland might look like as it is of vital importance in ensuring Queenslanders
DELIVERING EFFECTIVE PREVENTION PROFESSOR VICTOR NOSSAR IS THE PROGRAM LEADER IN CHILD AND YOUTH HEATH IN THE NORTHERN TERRITORY. HE WAS A SPEAKER AT LAST YEAR’S AMA NATIONAL CONFERENCE AND HERE ARGUES FOR THE IMPORTANCE OF A HEALTHY FOUNDATION IN LIFE TO SUPPORT LIFELONG HEALTH.
For decades it has been known that social factors are important in determining the health of people throughout their lives. This has often lead to the social determinants of health being misunderstood as mainly about the health needs of poor people – due to the perception that poor people have poorer lifestyles and inadequate healthcare. Seminal research lead by Prof Marmot in UK clearly revealed that in reality the impact of social factors on health outcomes is distributed across the social spectrum along a gradient – there being a consistent relationship between socioeconomic status and health, with the more affluent or more privileged generally being healthier; and those less affluent or less privileged being less healthy. Even when health behaviours and access to healthcare were accounted for, the socially derived health gradient largely remained (1, 2). Until recently, the issue of how disadvantage causes poorer health has been a matter of debate. Studies have shown that it is during the earliest years
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of life when social disadvantage ‘gets under the skin’ of a person, becoming incorporated into their physiology and then eventually into their epigenome (3). It is now clear that it is the care that infants experience during those earliest years of life that modifies the expression of key genes, as well as the architecture of the developing brain, creating developmental, neurological and physiological templates that remain for the rest of their lives. Adversity experienced in the early care environment has been shown to impact on many aspects of a person’s life including health and development in childhood (4); educational progress at school, during adolescence (including early initiation of smoking, early initiation of sexual activity, illicit drug use, adolescent pregnancies, and suicide attempts); as well as many chronic diseases of adulthood such as coronary vascular disease, metabolic syndrome, diabetes type 2, and hypertension (5). Current research suggests that these associations between early childhood disadvantage and these adult disease states may even be immune-mediated (6).
It is well understood that infants simply require consistent loving care and positive life experiences to grow and develop optimally. Thankfully there is also high quality research demonstrating that a number of specific early childhood development support programs delivered during pregnancy and the early years of life are able to significantly reduce the impact of early life adversity and to deliver measurably improved health and life outcomes for children and into adulthood. Programs such as the Nurse Family Partnership Program (7), which is sustained home visiting carried out by specially trained nurses, the Abecedarian Project (8), which is an intensive early childhood development program, and the High/Scope Perry Preschool early childhood development program (9) have each shown in randomised controlled studies, with long follow up, that they can deliver significant improvements in outcomes in childhood and adolescence – outcomes that have that been sustained over decades (10). Importantly, those same studies have clearly demonstrated that program fidelity has been an essential prerequisite to delivering the improved outcomes. Surprisingly, while the strongest research is clear about what interventions can (or cannot) deliver improved health,
CURRENT health vision ISSUES live healthy, productive lives. Sadly, growing health inequality and unhealthy lifestyles in both Queensland and Australia, especially in children, and an ageing population are increasing problems that are jeopardising the ability of our health care system to provide adequate care for Queenslanders. It will examine how both AMA Queensland and the Government can work together to
development and life outcomes for vulnerable children, few of these proven early childhood development support programs have been implemented on a large scale. Conversely, unproven early childhood development programs continue to proliferate with little evidence that those programs have ever delivered any significant improvement in outcomes for children (11). How we understand the terms ‘evidencebased’ and ‘what works’ needs to be rethought. Many of the programs currently described as ‘evidence-based’ bear little relationship to the effective early childhood development programs that are so often quoted by early years proponents. Indeed, many children’s services in Australia would benefit from the wider adoption in Australia of a more rigorous framework to assist the selection of more effective programs – such a framework is used by the Coalition for Evidence-Based Policy in US which seeks to increase government effectiveness through the use of more rigorous evidence about what works (12).
ensure that no matter where you live, you will be able to get the same standard of care as other Queenslanders. It will explore the concept of generational disadvantage (in which poor health outcomes can be ‘inherited’ due to past generations of your family being economically disadvantaged), a concept which segues into AMA Queensland’s upcoming Annual Conference theme of Health has a Postcode.
This is only the first chapter of the Health Vision. Subsequent chapters will examine how to ameliorate the health sectors significant workforce and training issues, how to reprioritise care in response to demand, and the important subject of end of life care.
To improve outcomes for children and reduce future risk of significant chronic diseases in adults, the challenge is to incorporate more widely the strong evidence about the importance of the earliest years of life for children’s health and development, as well as for the health of adults. Then the
imperative must be to ensure that the early childhood development programs with strongest evidence of efficacy are implemented widely to reduce the impact of disadvantage on children’s lives across Australia. Q
Studies have shown that it is during the earliest years of life when social disadvantage ‘gets under the skin’ of a person...
If a program is said ‘to work’ its proponents need to be able to define the specific child outcomes that will be improved, by how much and with what level of certainty certainly before there is any consideration of wider implementation. The current vogue of focusing on how a program is implemented before the efficacy of the program is established can result in the better implementation of programs that may be ineffective – betraying the trust that communities place in their professionals. Without greater rigour in the selection of more effective programs, Australia will continue to see proliferation of early childhood development programs but little measurable improvement in health and developmental outcomes for vulnerable children.
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professional services
HOW TO SUCCESSFULLY REBRAND YOUR PRACTICE THERE ARE JUST AS MANY REASONS TO REBRAND A PRACTICE AS THERE ARE WAYS TO DO IT, JASON BORODY EXPLAINS THAT WHEN DONE CORRECTLY, REBRANDING CAN BUILD EXCITEMENT BOTH WITHIN YOUR PRACTICE AND WITHIN THE HEALTHCARE MARKET.
Jason Borody Director (07) 3282 2233 jason@vividus.com.au Vividus specialises in healthcare marketing for hospitals, medical centres, GP and specialist practices, and healthcare businesses.
Rebranding is a strategy that can revitalise your practice and improve patient relationships. Timely rebranding is not designed to improve your practice, but rather to have a positive impact on your current and prospective patients. WHY SHOULD YOU REBRAND YOUR PRACTICE? There are four main reasons why a practice should consider a rebrand. If you can see the opportunity to improve your relationship with your patients and the healthcare market in any of these areas, it may be time to seriously consider rebranding. Gain an Edge on the Competition: The economic climate changes, almost as quickly as the weather. Rebranding is one way to reflect the current market situation and gain a competitive advantage. When you revise your brand and your public message, you revitalise your market and increase your sales performance. Accelerate Growth: A rebrand cuts through the advertising clutter and attracts attention to your products and organisation. People naturally pay attention to new messages and advertising they haven’t seen or heard before. Rebranding helps you increase the impact of your practice’s message and promote sales growth. You can also take advantage of a rebrand to reduce your operational costs and create efficiencies in your processes. The result is increased profitability.
Timely rebranding is not designed to improve your practice, but rather to have a positive impact on your current and prospective patients. 38
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Expand Your Market: As your practice grows, your brand must often be adjusted to reflect an expanding market presence and higher level of sophistication. When you rebrand, you naturally expand your market by positioning yourself to attract attention in a larger field. Showcase Innovation: Rebranding is a natural way to showcase innovation within your practice. A carefully designed brand will capture the imagination of the public and position your practice as an innovative leader in the healthcare market.
REBRANDING DONE WELL A successful rebrand is more than a new logo or a revitalised ad campaign. It starts with a compelling vision developed by senior leadership and communicated throughout the organisation. This vision then flows into your marketing message and eventually out to your existing and potential patients. Rebranding starts at the top, engaging leadership from the beginning. The entire management team and Board of Directors must understand and embrace the new message. It’s helpful to find a phrase your team can rally around and a way to make it visual and memorable. The senior management, starting with the CEO, must drive the revised brand promise. Enlist the help of Human Resources; let them work with your marketing team to roll out the new message to the troops in a way that is interesting, engaging and fun. The process takes 6-18 months when done well (dependant on size and complexity). Communicate your new brand and those new key messages to your staff repeatedly during this time. Team lunches, competitions, and team building events are crucial to long-term acceptance of the brand. Even things like coffee mugs, signs, or desk toppers can keep the new brand image top of mind during the transition. Work closely with your sales team as you develop and launch the new brand. Engage them early and let them help you determine product positioning and fine-tune your brand message. The sales staff are able to identify patient needs and industry trends – useful information during the brand repositioning process. Measure and track your employee’s engagement with the rebrand and use that information to determine if your strategies are working or if adjustments are needed. Rebranding success is built on your internal team. If they believe in your brand and enthusiastically respond to it, your patients will react positively as well. Enthusiasm is infectious and rebranding success depends on it. Q
professional services
CYCLE GRINDS ONWARD AND UPWARD EQUITY MARKETS HAVE DELIVERED SOLID RETURNS IN THE PAST 24 MONTHS. MACQUARIE’S ROSS NOYE EXPLAINS THAT THE ECONOMIC AND EARNINGS CYCLE IS CONTINUING ITS LONG, GRINDING RECOVERY. 2013/14 financial year (FY14), with the ASX 20 increasing 12.7per cent, and the ASX 20 Accumulation Index rising 18.0per cent. Since 30 June 2013, all sectors in the ASX 200 posted gains and the US S&P 500 posted its fifth consecutive financial year of positive returns.
MAJOR ASSET CLASS RETURNS DURING FY14
AUSTRALIAN AND INTERNATIONAL EQUITIES Australian equities (S&P/ASX 200) returned +17.4per cent during the past 12 months, while international equities earned +24.1per cent. Although the S&P/ASX 200 Index remains 21.2per cent below its 2007 historical high, once dividends are accounted for, the Accumulation Index exceeded its 2007 high by 6.7per cent. Fixed income significantly underperformed equities for the second consecutive year. Corporate bonds outstripped government bonds as credit spreads continued to contract. A broad holding of Australian government and corporate bonds gained 6.1per cent and cash yielded 2.7per cent. Australian equities performed in line with global equities for the majority of the year, as a change in government and increasing house prices bolstered consumer confidence. However, a steep decline in the iron ore price and a tough federal budget delivered during May 2014 saw the ASX 200 underperform towards year-end. The Australian dollar proved resilient, finishing slightly higher at $0.94 ($A/$US), resulting in a drag on unhedged international positions. Within the Australian equities universe, we prefer companies with sound business models leveraged to the more attractive growth opportunities of the global economy. Sound business models should also be favoured domestically, with consumer
Macquarie Private Wealth (07) 3233 5805 0438 779 955 ross.noye@macquarie.com
ANOTHER YEAR OF DOUBLE DIGIT RETURNS Global equity markets delivered double-digit returns for the second year running as the US economic recovery took hold, interest rates remained low and equity valuations expanded. The US Federal Reserve’s (the Fed) scaling back of asset purchases did not hold equity markets back as many had feared it would, and monetary policy from Europe, Japan and the UK remained supportive. The combination of improving economic conditions and accommodative central bank policies resulted in the lowest levels of volatility since early 2007.
Ross Noye
Ross Noye is a stockbroker and financial advisor at Macquarie who specialises in investment and retirement planning.
demand likely to remain weak and many sectors undergoing significant structural change. We continue to favour the growth potential offered by international equities relative to that of Australian equities. Our preference is for cyclical exposures such as financials, industrials and technology companies. We recommend reducing exposure to defensive sectors such as utilities and REITs which have rallied due to low bond yields. EUROPEAN EQUITIES AND S&P 500 Investors in European equities fared particularly well as the region’s bonds rallied, reflecting renewed investor confidence. In Italy, a prime example, the Milan 30 Index returned 39.7per cent as the country’s 10-year bond yield dropped 40per cent to reach an all-time low of 2.7per cent. Equity markets in Spain, Germany and France were similarly upbeat, with returns of 40.7per cent, 23.5per cent and 18.3per cent respectively. US equities had another solid year with the S&P 500 (22.0per cent), Dow Jones Index (12.9per cent) and NASDAQ Composite (29.5per cent) all surging higher. China’s Shanghai Composite (3.5per cent) trailed global equities for the third year running, as questions remained over the country’s growth. DIVERSIFICATION IS KEY TO MANAGING PORTFOLIO RISK An appropriate mix of equities, fixed interest, property and cash, which matches the investor’s long-term investment and lifestyle needs, should be the foundation of any portfolio. Discussing these issues with your adviser should lead to the creation of an investment portfolio that is suited to your requirements. Q
An appropriate mix of equities, fixed interest, property and cash, which matches the investor’s longterm investment and lifestyle needs, should be the foundation of any portfolio.
IMPORTANT INFORMATION: This information is provided by Macquarie Equities Limited ABN 41 002 574 923 (MEL), participant of 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 advice you should consider whether it is appropriate to your situation. Past performance is not an indicator of future returns.Except for Macquarie Bank Limited (Australian Credit Licence 237502) ABN 46 008 583 542 (MBL), any Macquarie entity referred to on this page is not an authorised deposit-taking institution for the purposes of the Banking Act 1959 (Cth). That entity’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 entity, unless noted otherwise.
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professional services
THE POWER OF BENCHMARKING DO YOU KNOW HOW YOUR PRACTICE PERFORMS AGAINST OTHER PRACTICES? IS YOUR PRACTICE A STAND OUT PERFORMER OR JUST AN AVERAGE PERFORMER? JULIE SMITH FROM WILLIAM BUCK EXPLAINS HOW BENCHMARKING CAN PROVIDE YOU WITH THE INFORMATION YOU NEED TO TAKE THE NECESSARY STEPS TO IMPROVE OR MAINTAIN YOUR PRACTICE. 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.
BENCHMARKING – WHAT IS IT?
WHAT AREAS SHOULD BE BENCHMARKED?
Benchmarking is a process where key items of your practice are compared against other similar practices. The key to a successful benchmark is firstly to ensure that meaningful items are measured. What are the key things that worry you about your practice? Do you worry about your performance against your competitors? Are there areas that you think you may be able to improve upon? These are the items that you should talk about with your advisors to ensure they are covered in the benchmark.
There are two types of benchmarking that you can consider – clinical and financial.
Secondly, a benchmark is only as good as the database that is used to make the comparison. In general, it is very difficult to accurately benchmark a specialist practice, as there is simply not enough similar data to compare against – the practices are quite variable. By comparison, benchmarking can be very useful for general practices and in some cases, you can even benchmark by region to get a clearer picture of how your practice is performing. WHY IS IT USEFUL?
Think of it as a flashlight that you shine into the corners to find things that may be lurking unnoticed.
Many people perceive the primary role of benchmarking is to compare your practice against competitors. To do only this would miss the power of what benchmarking can do for your business. The real power of benchmarking is that it enables you to identify any issues in your practice before they develop into big problems. Think of it as a flashlight that you shine into the corners to find things that may be lurking unnoticed. Here are some of the key issues that can be identified, in particular, for a general practice: Are you generating as much revenue as you can? If not, why? Is it due to your pricing, your appointment mix, your policy on private billing, your use of item numbers etc? Are you paying doctors and staff within industry averages? Does this match with the perception in your practice? Are there any expenses that are much higher than they should be? What things are you doing better than your competitors?
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.
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From a financial perspective, the key areas to benchmark include: Number of available appointments Pricing schedules and opening hours Percentage of bulk vs private billing Patient fees generated vs patient fees capable of being generated Key expenditure such as medical supplies, wages, rent Doctor contract payments This will give you a broad range of results to help you to review your practice. HOW TO USE THE RESULTS If the real power of benchmarking is the identification of issues, make sure that you get advice on how to interpret the results. Ideally, it should lead to a discussion with your advisors on some key actions that you can implement into your practice to improve your results or address the issues that have come to light. The power is in this action plan, not the numbers that are generated. Q
Benchmarking Report for General Practices Get your business healthy for the new financial year with a free health check for your practice
Register to participate in William Buck’s Benchmarking Report for GP Practices. Email qld.marketing@williambuck.com to register your practice and receive a benchmarking report for the 2014 Financial Year.
professional services
HOSPITAL INDEMNIFIED – DO I STILL NEED MY OWN MEDICAL INDEMNITY? 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.
SO YOU’RE EMPLOYED BY QUEENSLAND HEALTH AND YOU ARE COVERED IF A PUBLIC PATIENT DECIDES TO SUE. WHY SHOULD YOU HAVE YOUR OWN MEDICAL INDEMNITY? CHRIS MARIANI FROM AMA QUEENSLAND INSURANCE SOLUTIONS SHOWS US THE TOP SEVEN REASONS.
1. MORE THAN JUST INSURANCE
6. PRIVATE SECTOR LOCUM WORK
When you take out a medical indemnity policy with one of the four medical indemnity insurers, you are also joining as a member. This will give you access to a range member benefits and services – such as risk management education and access to 24/7 medico-legal assistance (eg it’s 3am in the morning and the police arrive at the hospital requesting information about a patient – you’re the senior doctor on duty and there is nobody in the hospital to seek advice).
You may be a full time hospital medical officer but decide to do a weekend locum. By holding a policy you can simply ‘turn on’ the private sector billings to provide cover (usually just a simple phone call).
2. YOU’RE NOT A DOCTOR JUST 9 TO 5 When you leave for the day, your hospital indemnity does not cover you outside of hospital employment. Writing a script or referral for a family member, volunteering as the team doctor for the kids’ soccer team, writing a healthcare article in a magazine or other gratuitous activity can be covered by your own medical indemnity. 3. PROTECTION FOR YOUR REPUTATION Your hospital indemnity might also extend to cover you for the legal costs of a medical board investigation or other disciplinary matter, but even if it does, what happens where there is a conflict between your interests and the hospitals (given the hospital is paying the lawyer)? Having your own medical indemnity means your own lawyer on your side, looking after your interests. 4. HOSPITAL DISPUTES Again, having your own legal assistance and access to the resources of your medical defence organisation could be of enormous benefit should you face a dispute with the hospital (eg unfair dismissal or discrimination). 5. PRIVATE SECTOR TRAINING
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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For doctors in formal training programs, there are opportunities to undertake training (eg GP Registrars, surgical assisting) in a private practice. Some medical indemnity policies for doctors in training include cover for private sector training, and some policies start from around $100.
7. COMPLIANCE WITH THE MEDICAL BOARD OF AUSTRALIA’S PII REGISTRATION STANDARD Annually, as part of your registration, you are asked to declare you have held professional indemnity (medical indemnity) for all practice you have undertaken. It is important to understand the definition of ‘practice’ in the Standard is very broad, so having your own medical indemnity to cover anything you do outside of hospital indemnity is important. The PII Registration Standard can be viewed on the Medical Board website under Registration Standards. The definition of ‘Practice’ reads: Practice means any role, whether remunerated or not, in which the individual uses their skills and knowledge as a health practitioner in their profession. For the purposes of this registration standard, practice is not restricted to the provision of direct clinical care. It also includes using professional knowledge in a direct non-clinical relationship with clients, working in management, administration, education, research, advisory, regulatory or policy development roles, and any other roles that impact on safe, effective delivery of services in the profession.
SELECTING THE INDEMNITY POLICY
RIGHT
MEDICAL
The best policy will depend on your particular circumstances and future plans. For example, if you are currently in a training program and plan to go into private practice in the future, then an important consideration is not just the current cover and premium today, but you should also consider the cover for the future and what the premium will be when you first start private practice and then when you are paying a ‘mature’ premium on the top private billings bracket. You also need to understand the actual scope of cover as this varies between the insurers and again the best insurer will depend on your circumstances. 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
BECAUSE THEY’RE WORTH IT
WHY SHOULD YOU PAY YOUR EMPLOYEES PROPERLY? IT’S THE RIGHT THING TO DO, BUT IT’S ALSO GOOD BUSINESS SAVING A FEW DOLLARS NOW BY UNDERPAYING YOUR EMPLOYEES COULD END UP COSTING YOU TENS OF THOUSANDS OF DOLLARS IN THE FUTURE. AS TRESSCOX’S RACHEL DREW EXPLAINS.
Rachel Drew Partner (07) 3004 3527 Rachel_Drew@tresscox.com.au Rachel Drew has expertise in providing advice to employers and human resources professionals in relation to employee management and entitlements at TressCox Lawyers.
In late 2012, the Fair Work Ombudsman brought proceedings against a Sydney medical centre and the two doctors who were directors of the practice for underpaying a disabled staff member. Over a period of approximately two years, the employee was underpaid $20,847.94 and this resulted in the Court fining the practice $88,870. What’s more, the individual doctors were each personally fined $17,410. You don’t have to be an experienced business owner, or even a financially astute doctor to know those numbers are not good for business. The allegations in this case related to the underpayment of a visually disabled employee of the practice who started working for the practice for a trial period, during which she was not paid any wages at all.
The Court emphasised that at no point did the practice or the doctors take steps to inform themselves of the appropriate wage entitlements of the employee...
From February 2010, the employee was formally employed in a part-time role at a rate of $7 per hour, which rate later increased to $7.50 and then $8. Even at the $8 rate the employee was being paid significantly less than her position commanded under the relevant modern award. Seeking to improve her prospects, the employee began a traineeship in Business Administration through TAFE. Ironically, the practice then received a wage subsidy by way of the Disabled Australian Apprentice Wage Support. Despite this, her wage was not increased in line with the subsidy or with the modern award. The employee, who was obviously nobody’s fool, asked one of the doctors in mid-October 2011 that she be paid in line with the modern award. Remarkably, she was told that this would be reviewed only when her traineeship had ended and she was able to work unsupervised. Understandably, the employee stopped working with the practice on 31 January 2012 and she issued her proceedings later that year.
Register now for AMA Queensland’s second Medico-Legal Conference, featuring incoming Health Ombudsman Leon Atkinson-MacEwen. 44
SEPTEMBER 2014 DoctorQ
Visit www.amaq.com.au.
The proceedings in the Federal Circuit Court were largely uncontested, with the practice wisely deciding not to defend the indefensible. They accepted that the various contraventions of the Fair Work Act included: discrimination against the employee by not paying her during the ‘trial’ period and paying her less than other employees after she was formally given the position. This adverse action was due to the employee’s disability; underpaid the employee by failing to pay her the minimum rates of pay prescribed by the award relevant to each phase of her employment: Sunday overtime rates, Saturday and public holiday penalty rates, ordinary wages for hours spent training, annual leave entitlements upon termination, annual leave loading, and public holiday pay; and, failed to provide the employee with payslips. Even though the medical practice was incorporated, the doctors were personally liable for the contraventions and they accepted they were aware of the way in which the employee was paid and were therefore involved in the contravention. The Court emphasised that at no point did the practice or the doctors take steps to inform themselves of the appropriate wage entitlements of the employee, despite the fact they were receiving a disability apprentice subsidy and the underpayments had been brought to their attention. In what could be described as a generous interpretation, the Court found the actions of the practice were reckless, even though the doctors were not deliberately exploiting the employee. The Court found that the practice was profitable and, as such, the respondents had “the financial resources to obtain advice, including professional legal advice, in respect of their obligations to all their employees”. It is vital that doctors, as employers, are aware of employee entitlements and, in particular, the entitlements of employees with disabilities. That means getting good industrial advice and putting the necessary infrastructure in place to protect both you and your workers. That might cost a few dollars upfront, but it can save you thousands in the long run. Q
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“ , Partner
, Partner
, Partner
, Partner
, Partner
, Partner
, Partner
• Employment Contracts • • • IR & Workplace Safety • • Business structuring and contracts
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lifestyle
Heroes HALLIDAY’S
COMPETITION Enter our Winelover’s competition at competitions@amaq.com.au and go in the draw to win a Vintage Pack: a 12 month membership to James Halliday’s Wine Companion, the brand new 2015 Wine Companion Book and a 12 month Subscription to the James Halliday Wine Companion Magazine, valued at $109.
WITH THE MUCH ANTICIPATED RELEASE OF THE 2015 EDITION OF JAMES HALLIDAY’S AUSTRALIAN WINE COMPANION, THE TEAM AT WINES DIRECT HAVE BEEN KEPT BUSY WITH REQUESTS FOR THE TOP RATED WINES FROM WHAT MANY REGARD AS THE WINE BUYERS BIBLE.
There can be no doubting the excitement generated from Halliday’s latest ratings. Add to this that 95/100 is the new 90/100, we thought we’d highlight some of these for you.
2010 PIRRAMIMMA ‘WAR HORSE’ MCLAREN VALE SHIRAZ Score: 96/100 This is their flagship red sourced from an old contoured vineyard planted in the early 40s. Yields are often measured in kilograms rather than tons and this release has all the hallmarks of classic McLaren Vale shiraz with mocha, cherry and spice on the nose with firm tannins and cleverly integrated oak. This demands decanting now for at least an hour otherwise lose it in the cellar for 10+ years and enjoy the reward.
2011 LEEUWIN ESTATE ART SERIES CHARDONNAY Score: 98/100 I first saw the 1987 vintage of this wine and was blown away by its intensity, complexity and structure. This wine remains one of Australia’s finest chardonnays and this vintage only enhances this reputation. Tropical fruit, pear and citrus all manage to appear in harmony on the nose with the additional complexity of clever oak handling on the palate providing nuts and figs finished with their signature razor sharp acidity. Cellar this beyond 10 years or if drinking now serve with a gentle chill only.
2012 HAMILTON CENTURION SHIRAZ Score: 97/100 We saw this wine well before the Halliday ratings and knew it would pick up a top score. This is sourced from vines planted in 1892, and in true old vine style, give up very mean yields of top quality fruit. ‘Shiraz Concentrate’ is a term I often hear about this wine with black and blue fruits over a palate crafted with French oak and firm powdery tannins. Cellar for up to 20 years. Q
MEMBER DISCOUNT
Phil Manser Wine Direct 1800 649 463 phil.manser@winedirect.com.au
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AMA Queensland members receive 40% off all memberships and subscriptions to James Halliday’s Wine Companion – visit www.winecompanion.com.au/become-amember and enter promo code ‘amaq’ at the check out to apply the discount.
07 3833 2500 07 3833 2511 www.brizbrain.com.au
More than just a neurosurgery and spinal surgery practice, BrizBrain & Spine has partnerships with various organisations to help provide the best patient care possible. Our partners
BrizBrain & Spine’s partner clinic on the Sunshine Coast, and our first stand alone regional clinic. scbrainandspine.com.au
Our surgeons
Our locations
Dr Francis Tomlinson
OPERATING HOSPITALS
NEUROSURGEON & SPINAL SURGEON
The Wesley Hospital Auchenflower
Dr Terry Coyne NEUROSURGEON & SPINAL SURGEON
Dr Geoff Askin Health Group The Fortus Health Group provide executive management, business advice, accounting, marketing and IT services to the health industry.
Newro FOUNDATION New Ideas New Research New Hope
BrizBrain & Spine is committed to undertaking and supporting research to better treatment and post-operative care to patients with brain and spine conditions. We are proud supporters of the Newro Foundation. newrofoundation.com.au
Holy Spirit Northside Chermside St Andrew’s Hospital Spring Hill
PAEDIATRIC & ADULT SPINAL SURGEON
Mater Private Hospital South Brisbane
Dr Richard Kahler
Mater Children’s Private Hospital South Brisbane
NEUROSURGEON & SPINAL SURGEON
Mater Children’s Hospital South Brisbane
Dr David Walker NEUROSURGEON & SPINAL SURGEON
CLINIC LOCATIONS
Dr Michael Bryant
Auchenflower
Rockhampton
NEUROSURGEON & SPINAL SURGEON
Spring Hill
Ipswich
Chermside
Toowoomba
North Lakes
Lismore
South Brisbane
Mackay
Dr Steven Yang PAEDIATRIC & ADULT SPINAL & HAND SURGEON
Sunshine Coast
lifestyle
Shanghai FEEL LIKE VISITING THE BIGGEST CITY IN THE WORLD? MORE THAN 25 MILLION PEOPLE LIVE IN EXOTIC, BUSTLING SHANGHAI. ROS BULAT FROM AMA TRAVEL GIVES US A TASTE TO WHET OUR APPETITES.
Shanghai is a bustling port with a pronounced European flavour that lingers from its heyday earlier this century as one of the world’s great maritime crossroads. A walk through Shanghai’s neighbourhoods reveals a surprising mix of European architecture and old Chinese facades. Located on the coast of the East China Sea, 14 miles from the Yangtze River, Shanghai is the largest city in China with a population of over 14 million. It is one of the few municipalities under the direct control of the central government. Shanghai began as a tiny fishing village in the tenth century. By the middle of the thirteenth century a town was established. This developed into a flourishing port, as Shanghai became the largest export centre in China, thriving on silk, tea and opium. In the nineteenth century, Shanghai lured the world’s great houses of finance; international entrepreneurs descended on the city, erecting grand palaces of plenty and creating communities resembling the grand capitals of Europe. Shanghai was reduced to a paradise for adventurers. The city became known as the Paris of the Orient with its mixture of gamblers, dandies, tycoons, missionaries, adventurers and a few unsavoury types.
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The character of Shanghai underwent a major change after the founding of the People’s Republic of China. Over the years the negative traits were eliminated - a tremendous achievement. Since 1990 the central government has channelled large-scale investments into Shanghai’s burgeoning economy. The changes have been quite staggering, particularly noticeable in the monumental modern building projects. Some highlights are: The Bund (Embankment), where 240 banks flourished in style between the mid-nineteenth and mid-twentieth centuries. The Yu Yuan Gardens and Old Town are among Shanghai’s premier sights; Pudong New Area, larger than Shanghai itself, with its bustling economic activity; Frenchtown, the former French Concession, is a shopper’s paradise… a glittering alternative to Nanjing Road. Shanghai really is a cultural mixing pot and offers all travellers a special something. Q
For more in AMA Tra formation call o r email R vel Quee os at nsland.
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
CHINA
ocker doctor
TEACHING IS A TWO-WAY STREET
DR MATT YOUNG EXPLAINS HOW TEACHING MEDICAL STUDENTS MIGHT BRING SOME UNEXPECTED BENEFITS.
DR MATT YOUNG General Practitioner
Teaching. Hippocrates directly mentions it in his oath, attesting to its importance. ‘Docere’, the Latin root meaning ‘to teach’, gives rise to the most obvious title in our profession. And besides all the ancient historical allusions, it is generally extremely rewarding and almost universally a lot of fun. Some colleagues don’t seem that fussed on the idea and their biggest reservation is primarily that it slows them down during their busy days. They may have a point but I have always found the positives greatly outweigh the drawbacks. An infusion of medical students’ youthful wide eyed enthusiasm and passion for medicine keeps me young and has rekindled my love of medicine frequently over many years as the stresses of general practice have tried to leach me dry. They remind me that cynicism has no place in my working life. Their altruism reminds me of why I pursued my medical career in the first place and what a grand adventure it can be as it takes me on a roller coaster of emotions every day. Medical students provide a tremendous social outlet during my day. It is wonderful to share a laugh or even a shake of the head after the bizarre cases have left the room. I have made some tremendous friends by taking on medical students. The best man at my wedding, my opening batting partner for the Ned Flanders Cricket Club and some of my favourite travel mates have all been medical students that I have mentored before we became great friends. Some medical students are even great for business. I remember having a pair of especially pretty female medical students and I reckon the young male demographic of my patient load went through the roof for the whole two months they were with me. Fit, young, healthy blokes were coming in every couple of days just to have themselves checked out. On the other side, one glamour girl accompanied me to do my stint as South Rugby Union club doctor. Just about every bloke on the paddock went down at some stage during the match, all aching to be helped by my student. It was
amazing how quickly they recovered when it was me that ran out to help them and how much detailed attention they required when it was her. There is no end to the practical uses for medical students. Being significantly technologically ignorant (I don’t even own a mobile phone), it is essential for me to have young people around to fix the computer when it seizes up. From switching the ON/OFF button to solving more complex problems, it is awesome to have a medical student or two with their usual techno savvy, close at hand. Another incident illustrated the tremendous benefits of teaching. After I politely declined a fairly baseless request by a young woman for a narcotic script, some trouble broke out in the waiting room. She was busy on her phone mustering up her significantly burly boyfriend and his equally bulked up brother. Her brief for them was to dish out some corporal punishment to the non-compliant GP. Luckily my overseas medical student at the time had packed into a lot of scrums as a prop for his national under 21 rugby team and he was good enough to provide the threat of some hired muscle as he escorted me back to my car that afternoon.
Teaching a young medico a few practical skills is one of the highlights for me. They never forget their first excision or their first stitches. The smiles on their faces as they learn these procedures really is something at which to marvel. I recently had one of my old medical students return to my practice as part of his ENT training requirements. The nervous young bloke who had done his very first minor operations with me six years before was now performing hemicolectomies on his own. (Not at my practice though, at least not while I was watching). It was a humbling experience for me to see how much he had learnt. Teaching medical students has so many benefits. The social aspects, the humour, the technological genius of their generation and the pride I see in their eyes when they learn and perfect a new skill. I love to hear how their careers are panning out and what amazing things some of them have achieved. But perhaps the most important aspect of training the next generation of doctors is that they will be the ones looking after me as I get old and decrepit. I want to make sure they know what they are doing! Q
An infusion of medical students’ youthful wide eyed enthusiasm and passion for medicine keeps me young and has rekindled my love of medicine...
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lifestyle
MEDEA
NATIONAL THEATRE LIVE 4 - 5 Oct 1pm, 6 Oct 6pm Helen McCrory (Harry Potter, The Queen) takes the title role in Euripides’ powerful tragedy. Medea is a wife and a mother. For the sake of her husband, Jason, she’s left her home and borne two sons in exile. But when he abandons his family for a new life, Medea faces banishment and separation from her children. Cornered, she begs for one day’s grace. It’s time enough. She exacts an appalling revenge and destroys everything she holds dear.
ORE FOR M ISIT INFO VOM.AU .C DENDY
THE ENCHANTED ISLAND
ROMEO ET JULIETTE
13 Sept at 10.30am, 14 Sept at 1pm, 18 Sept at 10am
11 Oct at 10.30am, 12 Oct at 1pm, 16 Oct at 10am
In one extraordinary new work, lovers of Baroque opera have it all: the world’s best singers, glorious music of the Baroque masters, and a story drawn from Shakespeare. In The Enchanted Island, the lovers from Shakespeare’s A Midsummer Night’s Dream are shipwrecked on his otherworldly island of The Tempest. Inspired by the musical pastiches and masques of the 1700s, the work showcases arias and ensembles by Handel, Vivaldi, Rameau and others, and a new libretto by Jeremy Sams.
The world’s most famous love story comes to operatic life with superstars Anna Netrebko and Roberto Alagna as the star-crossed young couple. Their performances brought audiences to their feet in both the opera house and in movie theaters. Gounod’s ultrasensual interpretation of Shakespeare also ENJOY features Nathan FREE Gunn as Mercutio and UNDERCOVER PARKING AT Plácido Domingo on DENDY! the podium.
Met Opera
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 and Publicity Manager Jenny Sonter on jennys@ dendy.com.au for a free quote.
COMING FILMS 11 September The Giver Tarzan Step Up - All In 18 September Wish You were Here Boxtrolls Sin City – Dame to Die for Planes – Fire and Rescue 25 September Little Death Land of the Bears (3D) 2 October
Gone Girl Dracula Untold
9 October
The Judge
16 October
Before I Go to Sleep
Our exciting new movie and TV service is up and running. We’ve handpicked quality movies and TV shows for you to watch on any device, anywhere you like. Visit www. dendy.com.au to find out more.
WIN MOVIE TICKETS FOR TWO Name:
Member No:
Postal address: Portside Wharf, Remora Road, Hamilton Ph: (07) 3137 6000 www.dendy.com.au 50
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Phone:
FAX BACK TO (07) 3856 4727 or email competitions@amaq.com.au by 30 Sept
NEW!
HOLD YOUR FUNCTION OR BIRTHDAY PARTY AT DENDY!
Met Opera
CULTURE
AMERICAN BALLET THEATRE 28 Aug - 7 Sept, Lyric Theatre, QPAC
Direct from New York and for the very first time in Australia, American Ballet Theatre brings two programs for this exclusive season. The imperishable classic Swan Lake and a triple bill showcasing three masterpieces entitled Three Masterpieces. Surrounding these major programs is a multitude of Insight Events from movies, backstage tours, exhibitions and more.
AMERICAN MUSIC CLUB
E MOR FOR ATION RM INFO COM.AU . C QPA 36 246 OR 1
15 - 27 Sept, Cascade Court, QPAC
Mingle. Dance. Play. Party into the night and hang out with the artists as QPAC’s Cascade Court comes alive as one of Brisbane Festival’s favourite after-show destinations. This year we celebrate the stunning diversity of American music genres including swing, jazz, blues, R&B and musical theatre with a jam packed selection of free live music.
WUTHERING HEIGHTS 1 - 18 Oct, Cremorne Theatre, QPAC
Brontë’s gothic masterpiece Wuthering Heights storms into QPAC in a new adaptation from the company behind the critically acclaimed productions of George Orwell’s Animal Farm and 1984. Featuring a breathtaking design and a stellar cast including Australian star of stage and screen Gerry Connolly, shake & stir invites you to drop by the Heights and settle in for this classic story, retold.
Name:
WIN TICKETS TO WUTHERING HEIGHTS
BLACK DIGGERS 24 September - 12 October, Playhouse, QPAC Shunned and downtrodden in their own country - and in fact banned by their own government from serving in the military - Aboriginal men stepped up to enlist. Undaunted, these bold souls took up arms to defend the free world in its time of greatest need. For them, facing the horror of war on a Gallipoli beach was an escape from the shackles of racism at home, at a time when Aboriginal people stood by, segregated, unable to vote, unable to act as their children were ripped from them. When the survivors came back from the war, there was no heroes’ welcome – just a shrug, and a return to drudgery and oppression. Black Diggers is the story of these men - a story of honour and sacrifice that has been covered up and almost forgotten. Directed by Wesley Enoch and written by Tom Wright, Black Diggers is the culmination of painstaking research into the lives and deaths of the thousand or so Indigenous soldiers who fought for the British Commonwealth in World War I. Young men will step from the blank pages of history to share their compelling stories – and after the curtain falls, we will finally remember them.
Member No:
Postal address:
Phone:
FAX BACK TO (07) 3856 4727 or email competitions@amaq.com.au by 30 Sept DoctorQ SEPTEMBER 2014
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all about you APP SNAP - FIND MY IPHONE If you misplace your iPhone, iPad, iPod touch, or Mac, the Find My iPhone app will let you use another iOS device to find it and protect your data. Find My iPhone will help you locate your missing device on a map, remotely lock it, play a sound, display a message, or erase all the data on it. If your device is running iOS 6 or later, Find My iPhone also includes ‘Lost Mode’, which locks your missing device with a passcode and can display a custom message and contact phone number on the lock screen. Q
Signs of the social networking times.
BOOKLOVERS
CLUB
LOOKING FOR A NEW READ?
Put that work down for a minute and check out these great titles. Q
THE RAINBOW TROOPS
AVOCADO AND BASIL BREAKFAST BRUSCHETTA
FICTION
ANDREA HIRATA
INGREDIENTS 1 large firm ripe avocado, stone removed, peeled, diced 250g cherry tomatoes, halved ¼ cup fresh basil leaves, torn 2 tsp olive oil 1 tsp lemon juice 4 large slices sour dough bread Lemon wedges, to serve
1. Place avocado, tomatoes, basil, olive oil and lemon juice in a medium size bowl. 2. Season with sea salt and freshly ground black pepper. Gently stir to combine. 3. Toast or grill bread until golden. 4. To serve, spoon ¼ of the avocado mixture over each slice of bread. Serve with a wedge of lemon. Q Photograph credit: Andrew Young/News Life Media
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MY MUM’S MY FOE DR KEVIN NAICKER (AMA QUEENSLAND
FICTION
METHOD
Ikal is a student at Muhammadiyah Elementary, on the Indonesian island of Belitong, where graduating from sixth grade is considered a major achievement. Ikal and his friends - a group called The Rainbow Troops - face threats from every angle: pessimistic, corrupt government officials; deepening poverty and crumbling infrastructure; and faltering self-confidence. But in the form of two extraordinary teachers, they also have hope, and Ikal’s education is an uplifting one, in and out of the classroom.
MEMBER)
A child’s pledge to his dying father leads him to a world of hurt and misery. A world-renowned widowed mum struggles to love her one and only child, who is pursued by another mum. Through a tangled web of deceit, abuse of power, endless heartbreaks, emotional turmoil, unjustified use of medical and military knowledge, the young boy has to mature into a sporting hero and a medical super specialist. This medical suspense thriller will have you guessing to the end.
IN PRINT
PHYSICAL ILLNESS AND DRUGS OF ABUSE: A REVIEW OF THE EVIDENCE The timely recognition of physical health problems in patients with severe mental disorders is emerging as an important priority in the medical health field. Although it is well known that persons with addictions to illicit substances often develop a variety of mental health and physical health conditions, the epidemiological associations between physical illness and addiction to illicit substances are poorly understood. This book comprehensively surveys recent literature to critically review the relationships between physical illness and drugs of abuse, describing the association between each of the principal classes of illicit drugs
(cocaine, marijuana, opioids, and common hallucinogens and stimulants) and the major categories of physical illness. Clear summary tables accompany detailed discussions, providing the reader with a quick reference guide. Physical Illness and Drugs of Abuse will be essential reading for all health professionals, students, practising clinicians and policy makers with interests in mental health, public health and epidemiology. Physical Illness and Drugs of Abuse: A Review of the Evidence is published by Cambridge University Press and retails for $92.00. Q
WIN THIS BOOK! Name:
Doctor Q has a copy of Physical Illness and Drugs of Abuse: A Review of the Evidence to give away. Simply fill out your details in block letters on the form and fax it to (07) 3856 4727 or email competitions@amaq.com.au.
Entries close 30 Sept
Postal Address:
DENDY WINNERS
QPAC WINNERS
BOOK WINNER
DOUBLE PASS WINNERS
Dr Chris Cuneen and Dr David Liessmann won double passes to The Red Shoes at QPAC.
Dr Margaret Oziemski won a copy of Psychodermatology, provided by Cambridge University Press.
1. Dr Mitesh Gandhi 2. Dr Bruce Jones 3. Dr Alison McColl 4. Dr Michael Lutz 5. Dr Emily Mackenzie 6. Dr Tim Briggs 7. Dr John O’Sullivan 8. Dr PM Johnson 9. Dr Glen Pearse 10. Dr Photene Weber
COMPETITION WINNERS
Telephone: Member No:
CHECK FOR YOUR NAME!
DoctorQ SEPTEMBER 2014
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lifestyle member news
SUPPLEMENTARY LISTING AND CORRECTIONS
2014/2015 DIRECTORY OF MEMBERS SPECIALISTS – CARDIOLOGY Page 42 of Directory Update to contact phone number for phone, fax and after-hours for Northside Cardiology Services at Caboolture.Removal of listed Bribie Island practice address MCLARAN, DR CHRIS Peninsula Specialist Centre Suite 9 George Street, KIPPA RING QLD 4021 P: 07 3283 4046 F: 07 3889 3333 A/H: 07 3883 7777 SI: Echocardiography, Cardiology, Arrhythmias Northside Cardiology Services 17 Haskings Street CABOOLTURE QLD 4507 P: 07 3283 4046 F: 07 3889 3333 A/H: 07 3883 7777 SPECIALIST – CARDIO-THORACIC SURGERY Page 46 of Directory TESAR, DR PETER Suite 303, Level 2, St Andrew’s Place 33 North Street SPRING HILL QLD 4000 P: 07 3309 3000 F : 07 3839 3044 E: petertesar@bigpond.com SPECIALIST – CARDIO - THORACIC SURGERY Advertisement omitted from Page 46 of Directory VRTIK, DR MAROSH Consulting at: North West Private Hospital, Everton Park Mater Medical Centre, South Brisbane St Vincents Hospital, Toowoomba Operating at: Mater Private Hospital South Brisbane, At Andrews War Memorial Hospital Spring Hill, Holy Spirit Northside Hospital Chermside P: (07) 3353 5942 F: (07) 3353 9357 SI: Thoracic Surgery, Thoracic Surgical Oncology (lung cancer, mediastinal tumours, chest wall tumours, metastectomy, pleurodesis, mediastinoscopy), Video Assisted Thoracic Surgery (VATS) SPECIALISTS – DERMATOLOGY Page 52 of Directory Correction of phone number and removal of email address MCLARAN, DR PETA Peninsula Specialist Centre Suite 9 George Street, KIPPA RING QLD 4021 P: 07 3283 4046 F: 07 3889 3333 A/H: 07 3883 7777 SPECIALIST – ENT HEAD AND NECK SURGERY Updated email address on Page 73 of Directory SLEE, DR NICOLA ANNE Taylor Medical Centre Suite 15A, Level 2 40 Annerley Road WOOLLOONGABBA QLD 4102 P: 07 3169 0368 F: 07 3169 0367 A/H: 07 3261 9570 E: enquiries@sleemedical.com.au
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CUT OUT AND KEEP!
Please find a list below of AMA Queensland members who were mistakenly omitted from or whose entries contained errors within the initial 2014/2015 Directory of Members. Additionally, we have listed any member records that we have since been advised have changed after the date of Directory printing. AMA Queensland extends its sincere apologies and would ask that you kindly note and cut out these changes and staple into your Directory copy on the relevant page listed. If you have any further questions regarding the 2014/2015 Directory of Members, please contact the Membership team on (07) 3872 2222 or email membership@amaq.com.au Q
SI: Paediatric Otolaryngology, Head & Neck Surgery, Endoscopic Sinus Surgery, Otology SPECIALIST – ENT HEAD AND NECK SURGERY Special interests missing from entry on Page 73 of Directory QUE HEE, DR CHRISTOPHER Watkins Medical Centre Level 10, 225 Wickham Terrace BRISBANE QLD 4000 P: 07 3831 4400 F: 07 3831 4411 E: reception@eardoctor.com.au SI: Cochlear Implants, Implantable Hearing Devices, Ear Surgery, Cholesteatoma, Paediatric ENT Bayside ENT Suites 8 & 9 16 Weippen Street CLEVELAND QLD 4163 P: 07 3831 4400 F: 07 3831 4411 SPECIALIST - GASTROENTEROLOGY Entry omitted from Page 78 of Directory PASCOE, DR ANDREW LAURENCE Suite 9, Level 9,Evan Thomson Building 24 Chasely St AUCHENFLOWER QLD 4066 P: 07 3871 3826 F: 07 3870 4434 E: Andrew.Pascoe@wesley.com.au SI: Colonoscopy, liver disease, nutrition SPECIALIST – GASTROENTEROLOGY AND INTERNAL MEDICINE SECTIONS Entry omitted from Directory Page 78 of (Gastroenterology) and Page 176 (Internal Medicine) MITCHELL, DR KEITH Buderim Gastroenterology Centre Suite 5, 102 Wises Road MAROOCHYDORE QLD 4558 P: 07 5475 4464 F: 07 5430 0444 E: enquire@buderimgastro.com.au SPECIALIST – GENERAL SURGERY Entry omitted from Page 152 of Directory CLARSON, DR MARA Sunshine Coast University Private Hospital 3 Doherty Street BIRTINYA QLD 4575 P: 07 5390 6000 E: mara@scgensurg.com.au SI: Endocrine, breast and trauma surgery SPECIALIST – GENERAL SURGERY Entry omitted from Page 157 of Directory MARKEY, DR STEPHEN Stephen Markey Surgical Suite 31012, Level 10 Southport Central Tower 3 9 Lawson Street SOUTHPORT QLD 4215 PO Box 2586, Southport BC QLD 4215 P: 07 5528 2628 F: 07 5528 6928 M: 0414 627 539 A/H: 0414 627 539 E: reception@markeysurgical.net.au SI: General Surgery, Hernia Repair, Laparoscopic Surgery, Gastrointestinal Surgery, Hepato Biliary Pancreatic Surgery, Vasectomy, HAL RAR and Haemorrhoidectomy, Skin cancers and skin grafts, Wound Care
SPECIALIST – GENERAL SURGERY
Reconstructive Surgery
Correction to practice address and phone and fax numbers on Page 159 of Directory
SPECIALIST - PAEDIATRICS
SECOMBE, DR EMMA Hinterland Specialist Centre Selangor Private Hospital 62 Netherton Street NAMBOUR QLD 4560 P: 07 5441 1804 F: 07 5476 0744 E: hinterlandsurgicalcentre@gmail.com SI: Breast surgery, Endocrine surgery, General surgery, Laparoscopic surgery, Diagnostic Endoscopy SPECIALIST – INTERNAL MEDICINE Page 171 of Directory Incorrect special interest listed CAMPBELL, DR ROBERT Watkins Medical Centre 225 Wickham Terrace BRISBANE QLD 4000 P:07 3831 5205 F:07 3832 7058 Beaudesert Medical Centre 47 William Street BEAUDESERT QLD 4285 P: 07 5541 1422 F: 07 5541 3677 The Gap Village Medical Centre 1000 Waterworks Road THE GAP QLD 4061 P: 07 3300 1744 F: 07 3300 5329 SPECIALIST – OPTHAMOLOGY Page 211 of Directory Update to practice address and email JAMNADAS, DR GIRISH Ipswich Eye Centre Ipswich City Church Multiplex Unit 3, 1-3 Pring Street IPSWICH QLD 4305 P: 07 3812 3022 F: 07 3812 7011 M: 0422 870 330 A/H: 07 3376 2211 E: reception_iec@yahoo.com SPECIALIST – OPTHAMOLOGY Page 212 of Directory Update to email address KERT, DR GILDA St Andrew’s Medical Centre Suite 43, 280 North Street TOOWOOMBA QLD 4350 P: 07 4633 4111 F: 07 4633 4133 M: 0412 630 389 A/H: 0412 630 389 E: enquiries@darlingdownseye.com.au SI: Cataract Surgery, Diabetic Eye Diseases SPECIALIST – ORTHOPAEDIC SURGERY Page 227 of Directory Phone number correction and previous Strathpine address removed MALISANO, DR LAWRENCE Brisbane Orthopaedic and Sports Medicine Centre, Level 5, Specialist Centre 259 Wickham Terrace BRISBANE QLD 4000 P: 07 3834 6680 F: 07 3834 6637 A/H: 07 3833 4130 E: drmalisano@osteon.com.au SI: Adult Hip & Knee, Sports injuries and
Page 240 of Directory Update to practice address and email address ROYLE, DR SUZANNE The Prince Charles Hospital Paediatric Services Rode Road CHERMSIDE QLD 4032 P: 07 3139 4000 F: 07 3139 6478 M: 0417 781 900 E: suzanne.royle@health.qld.gov.au Lang: French SI: General Paediatrics, Respiratory Medicine, Medical Education SPECIALIST – PSYCHIATRY Page 253 of Directory Corrected address BELL, DR TOM Athol Place 303 Wickham Terrace P: 07 3832 4796 F: 07 3832 7169 E: admin@tombellmedical.com.au SI: Medico-Legal, Occupational Psychiatry SPECIALIST – RESPIRATORY MEDICINE Page 274 of Directory No longer works in Rockhampton and additionally corrected phone number for Healthpoint Mackay* EDWARDS, DR ROBERT LESLIE Wesley Medical Centre Level 2, 26 Chasely Street AUCHENFLOWER QLD 4066 P: 07 3870 4511 F: 07 3371 3677 E: bob.edwards@wesley.com.au 15 Hasking Street, CABOOLTURE QLD 4510 P: 07 5495 2077 F: 07 5498 9618 Healthpoint Precinct 93 – 101 Willets Road NORTH MACKAY QLD 4720 P: 07 4965 4640 SPECIALIST – RESPIRATORY MEDICINE AND SLEEP MEDICINE Specialty missing (Bronchoscopy), fax number updated, email and web address updated – Page 277. Entry omitted from Sleep Medicine section, Page 280 of Directory THOMPSON, DR MICHAEL The Lung Centre 144 Ashmore Road BUNDALL QLD 4217 P: 07 5564 7775 F: 07 5564 7776 E: admin@lungfunction.com.au W: www.lungfunction.com.au SI: Sleep Disorders, COPD, Interstitial Lung Disease, Bronchoscopy GENERAL PRACTICE Page 89 of Directory Update to phone number and special interest BROWN, DR CHRIS Life Member PO Box 63 CLAYFIELD QLD 4011 P: 07 3862 3477 M: 0417 770 817 SI: Asthma, Medico-Legal, preventive medicine
CLASSIFIEDS
Dr Stephen Markey MBBS(Q) FRACS
07 5528 2628
reception@markeysurgical.net.au
Specialist Laparoscopic and General Surgeon Dr Markey offers Routine and Acute Laparoscopic and General Surgical Care and is well known for his outstanding patient attention including his out-ofhours service. Dr Markey has a passion for minimally invasive surgery and was the first Surgeon in private practice in the Southport region to be fully trained in the Laparoscopic Era.
07 5528 6928
Surgical Services: Laparoscopic Cholecystectomy, Appendicetomy, Inguinal and Ventral Hernia repair, Adhesive Bowel Disease, Bowel Cancer Resections, Diagnostic Laparoscopy etc. Also attends to Vasectomy, HAL RAR and Haemorrhoidectomy, Skin Cancers, Skin Grafts, Wound Care etc.
NEW ADDRESS: Southport Central Towers Hub, Level 10, Suite 31012, Red Tower 3, 9 Lawson St, Southport QLD 4215
Dr Marosh Vrtik
Consulting at:
Specialising in: • Thoracic Surgery • Thoracic Surgical Oncology (lung cancer, mediastinal tumours, chest wall tumours, metastatectomy, pleurodesis, mediastinoscopy)
North West Private Hospital, Everton Park Mater Medical Centre, South Brisbane St Vincents Hospital, Toowoomba
Operating at:
• Video Assisted Thoracic Surgery (VATS) For appointments phone: 07 3353 5942 | Fax: 07 3353 9357
Mater Private Hospital, South Brisbane Saint Andrews War Memorial Hospital, Spring Hill Holy Spirit Northside Hospital, Chermside
Available Positions - General Practitioners 7Springs Medical Practice is currently seeking experienced General Practitioners for our modern, purpose built facilities. Excellent career opportunities. 7Springs Medical is a: • Mixed billing practice • Flexible and family friendly • Limited after hours (on roster with all doctors) • Teaching Practice
• Multiple experienced GP supports • Allied Health on site • Excellent facilities • Nice practice manager • Location - RA2
Phone: 07 4529 2777 Email: employment@ sevensprings.com.au 881 Ruthven Street Toowoomba Q 4350 www.sevensprings.com.au
Unique Medical Rooms “On the Terrace” in Brisbane CBD are now available LOCATION: 79 Wickham Terrace, Brisbane QLD 4000
PLEASE CONTACT:
AVAILABILITY: A range of Heritage Rooms in various combinations are available to suit the needs of a modern medical practice. Varying in size and up to two or three rooms that adjoin if you require.
BRISBANE CLINIC
WEBSITE: www.brisbaneclinic.com.au/rooms-for-lease
E: administrator@brisbaneclinic.com.au
Leanne Winter P: (07) 3270 4551 or 0402 822 924
DoctorQ SEPTEMBER 2014
55
Our name has changed but we’re still the same Investec Bank (Australia) Limited has been sold to BOQ and, from 1 August 2014, the name on the door will change to BOQ Specialist. Our clients will be dealing with the same people they have come to know so well and can expect the same high levels of expertise and personal service. With over 20 years’ experience, we will continue to deliver a distinctive suite of lending and banking products to professionals for their personal and business needs. Visit us at boqspecialist.com.au
Equipment and fit-out finance / Credit cards / Home loans / Commercial property finance / Car finance / SMSF lending and deposits Transactional banking and overdrafts / Savings and deposits / Foreign exchange Financial products and services are provided by BOQ Specialist Bank Limited ABN 55 071 292 594 (BOQ Specialist). BOQ Specialist is a wholly owned subsidiary of Bank of Queensland Limited ABN 32 009 656 740 (BOQ). BOQ and BOQ Specialist are both authorised deposit taking institutions in their own right. Neither BOQ nor BOQ Specialist guarantees or otherwise supports the obligations or performance of each other or of each other’s products.