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ISSUE 8 november 2010 3 5 7 8 10

RACGP welcomes new president A GP in Pakistan Helping the homeless General practice heads to Cairns for GP10 Maternal deaths on the decrease

A new kind of professional development In the next triennium QA&CPD will become QI&CPD. So what does the change mean for GPs and general practice teams?

In October 2010, the RACGP launched the new QI&CPD Program for the 2011–2013 triennium. Since 1987, when the first continuing professional development program began, the RACGP has been committed to continually evaluating and improving the program, and this new triennium builds upon the demonstrated successes of previous programs. The new program aims to assist Australian GPs to maintain and improve the quality of care they provide to patients and to promote care of the highest possible standard to the community. In the new triennium, the education framework and minimum requirements for GPs will remain the same: a minimum of 130 points for the triennium including two Category 1 activities and one basic cardiopulmonary resuscitation (CPR) course. (For further details on requirements, please see page 14.) RACGP President Professor Claire Jackson said that the College’s internationally recognised QI&CPD Program would not be as successful as it is currently without general practice playing a central role in the program’s design, development and ongoing review. “The QI&CPD program for the 2011–2013 triennium was created for our profession, by our profession,” Professor Jackson said. “As well as focusing on quality improvement activities this triennium, we have also streamlined the program administration for participants. In addition, as in the last triennium, all QI&CPD accredited activities are subject to a quality review process to ensure that the education delivered is of the highest quality.”

Continued page 3 www.racgp.org.au/goodpractice


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News

A new kind of professional development (continued)

The ongoing evaluation and development of the program led to the name change from quality assurance (QA) to quality improvement (QI). This change emphasises the role of quality improvement activities as a means to improve patient outcomes during the 2011–2013 triennium. Rural and remote GPs, part timers, locums and doctors practising in special interest areas have been considered in designing this program. So how do already time poor GPs fit in their CPD requirements? Dr Carolyn O’Shea, a GP in Greensborough, Victoria, said she tries to consider activities that already fit into her clinical work and are flexible from a time perspective. “As a GP, I look for opportunities to embed my learning into everyday practice,” she said. “There is also an increasing range of online learning activities if you find attending activities out of hours difficult.” Dr Caroline Johnson, a Melbourne GP, said that she makes a note of knowledge gaps at the end of a consulting day and consciously plans to address these gaps within a set time period. “Don’t wait for the next formal CPD event to come along, use one of the many web-based educational sites to learn what

All your QI&CPD needs at your fingertips The new online GP activity notification system for ‘plan, do, study, act’ cycles and individual GP active learning modules will make claiming CPD points easier, with less paperwork. As each GP, practice team and practice setting is different, so too are the learning needs and challenges faced within the primary care team. The GP online notification system enables learning and development specific to individual needs, as well as activities completed in daily practice, to be recognised for QI&CPD points – all without leaving your chair. There is also a new look website that comes with a number of improvements, including: • QI&CPD accredited activities calendar – all accredited activities will be listed in the calendar, so if you can’t see it, it’s not accredited • tools and resources – updated online support tools are available to help GPs and practices identify problems and collect data to improve quality of care

you need when you need it,” she said. “Another great way of keeping up-to-date is to get involved in teaching.” The new triennium will see a stronger emphasis on a whole of practice team approach to CPD and continuous quality improvement activities. The RACGP QI&CPD Program, the Australian Practice Nurses Association and the Australia Association of Practice Managers have been working together to ensure that practice managers and practice nurses who participate in RACGP accredited activities receive appropriate recognition within their own

professional CPD programs. As the general practice profession grows, so too will QI&CPD. Quality improvement activities lead to practices providing better care to patients, particularly when it involves a whole of practice team approach. The College is and will remain committed to providing GPs, allied health professionals and practice staff with the educational systems and tools to achieve quality in general practice.

How do you make time for QI&CPD? Let us know your thoughts by emailing goodpractice@racgp.org.au

RACGP welcomes new president at GP10 Professor Claire Jackson has taken over from Dr Chris Mitchell as President of the RACGP, with Dr Mitchell handing over leadership at the GP10 academic session. Professor Jackson is a GP and GP supervisor in Inala, Brisbane and is Professor in General Practice and Primary Health Care at the University of Queensland. She has previously been chair of the RACGP Council and the RACGP Queensland Faculty and has had significant involvement in health reform in many areas, serving on the National Primary Health Care Strategy External

Reference Group and providing a commissioned paper for the National Health and Hospitals Reform Commission. Outgoing RACGP President Dr Chris Mitchell said it was a privilege to hand over to Professor Jackson, knowing she will carry on the traditions of the College while offering a new and vibrant perspective. “There could have been no better president than Professor Jackson,” Dr Mitchell said. “She is smart, passionate and experienced. “She will make a wonderful president and has my full support.

Published by The Royal Australian College of General Practitioners 1 Palmerston Crescent, South Melbourne Victoria 3205 Telephone 03 8699 0414 Email goodpractice@racgp.org.au www.racgp.org.au/goodpractice ACN 000 223 807 ABN 34 000 223 807 ISSN 1837-7769

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This is a very important time for general practice and our College, and we need a skilful and engaging president – Professor Jackson has all the skills for the role.” Professor Jackson thanked Dr Mitchell for his exceptional service to the College during his time as RACGP President and spoke about her vision for the future of general practice. “I am committed to growing our discipline in reach and prominence over the next 2 years, and working towards access to international best practice standards in family care for all Australian communities,” she said.

New RACGP President Professor Claire Jackson with outgoing president Dr Chris Mitchell at the GP10 academic session

staff

Editorial notes

General Manager Mark Donato Managing Editor Denese Warmington Editor Nicole Kouros, Pete Nicholson Writers Melanie Fontolliet, Rael Martell, Jessica Warne Graphic Designers Jason Farrugia, Beverly Jongue Cover image © Jim Tsinganos

© The Royal Australian College of General Practitioners 2010 All rights reserved. Requests for permission to reprint articles must be made to the editor. The views contained herein are not necessarily the views of the RACGP, its council, its members or its staff. The content of any advertising or promotional material contained within Good Practice is not necessarily endorsed by the publisher.

Advertising enquiries Jonathon Tremain, Tremain Media Telephone 02 9499 4599 Email jonathon@tremedia.com.au

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Printing Offset Alpine Printing, Lidcombe NSW

Good Practice Issue 8 – November 2010

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GP10 award winners

The Rose-Hunt Award

GP Supervisor of the Year

Dr Eric Fisher was presented with the RACGP’s most prestigious honour: the Rose-Hunt Award. The Rose-Hunt Award is a medal named after two of the founding members of The Royal College of General Practitioners in the United Kingdom, Dr Fraser Rose and Dr John Hunt, and is a gift to the RACGP from the UK college. The Rose-Hunt Award is awarded to a person who has rendered outstanding service in the promotion of the aims and objectives of the RACGP. Dr Fisher has been an active member of the RACGP since 1967 and has worked tirelessly for the College in a range of roles, including serving as president in the 1980s. He has given his time freely to a wide range of College activities and committees with endless dedication and enthusiasm, including serving on the RACGP NSW Faculty Board and the Finance, Audit and Risk Management Committee, and chairing the Archive Committee. He has also acted as the RACGP representative on many different working parties and committees over the years. Dr Fisher is recognised and respected as a family GP, both in the local area in which he practices and in professional circles.

Dr James Best won the RACGP 2010 General Practice Supervisor of the Year award. This award recognises the dedication of GPs who train and mentor general practice registrars, their continuing commitment to general practice and their service to their patients, practice and community. Dr Best is strongly committed to giving back to general practice through educating and training junior doctors. He is generous with his time and actively seeks out opportunities to teach and train in evidence based medicine, the art of structuring consults and effective communication with patients.

GP of the Year The RACGP 2010 GP of the Year award was presented to Dr Patrick Byrnes. This award recognises an individual GP’s understanding of, and commitment to, general practice, service to community and involvement in ongoing training and continuing professional development. Dr Byrnes has been an important contributor to educational research and is widely recognised in Queensland for his research in clinical guidelines and the role of nurses and nurse practitioners in general practice. Dr Byrnes was the first GP in Queensland to employ a nurse practitioner, and has also been a pioneer in the field of chronic disease management inside general practice, establishing a full range of chronic disease clinics in his practice. Dr Byrnes has clocked up more than 30 years experience in general practice and has a passion for teaching the next generation of GPs.

National and NSW&ACT Practice of the Year The Practice, in western Sydney’s Blacktown, is the winner of the RACGP 2010 National and NSW&ACT General Practice of the Year award, which recognises the commitment of a practice to ongoing quality improvements, as well as the standard of facilities offered to patients and staff and the services offered to the local community. For nearly 30 years, The Practice has focused on working with families, with the practice team dealing with the day-to-day challenges of life, seeking to provide the best care for children and teenagers. A team care model has been developed by The Practice involving collaboration with local GP colleagues, community health and nongovernmental organisations and allied health practitioners.

Good Practice Issue 8 – November 2010

Dr Belinda Wozencroft has won the RACGP 2010 General Practice Registrar of the Year award, which recognises a general practice registrar’s commitment to general practice and learning and to serving patients, practice and community. Dr Wozencroft is constantly developing and refining her skills as a GP. These skills, along with her professionalism and compassion, have been highlighted by her supervisors as her strengths.

Brian Williams Award Dr Peter Joseph has won the RACGP 2010 Brian Williams Award. Created in 2006, this award is given by the RACGP National Rural Faculty to a member of the College who has made a significant contribution to the personal and professional welfare of rural doctors. Dr Joseph is a rural GP who maintained a hospital based procedural practice in the city. He is a past president of the RACGP and the South Australian branch Dr Kathryn Kirkpatrick, Dr Peter Joseph of the Australian Medical Association. and Dr Chris Mitchell During his RACGP presidency, Dr Joseph promoted the role of rural general practice and the need to value the work of rural GPs within the Australian healthcare system.

Standing Strong Together Award

Dr Simon Young

Two health teams, Dr Melania Scrace and Mr Frankie Deemal, and Dr Gillian Gould and Mr David Kennedy, have been jointly awarded the RACGP 2010 Standing Strong Together Award in Aboriginal and Torres Strait Islander health. The award recognises achievement by a Fellow or member of the RACGP and an Aboriginal or Torres Strait Islander person working in an effective partnership to produce substantial positive outcomes.

Dr Brad Murphy, Dr Mark Wenitong, Mr Frankie Deemal and Dr Melania Scrace

National Rural Faculty General Practice Registrar of the Year Dr Michael Fasher

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GP Registrar of the Year

Two registrars, Dr Aileen Traves and Dr Nicola Patching, have been jointly awarded the RACGP 2010 National Rural Faculty General Practice Registrar of the Year award. The award recognises the contributions of new and future doctors to rural general practice.

The Royal Australian College of General Practitioners

www.racgp.org.au/goodpractice


Issues

Aid in the face of adversity When floods overwhelmed Pakistan in late July this year, the country was quickly overwhelmed with a range of critical health problems. Dr Judith Findlay, a GP from Western Australia, was one of the healthcare workers who travelled to Pakistan to help. Dr Judith Findlay was in Tasmania surrounded by snow when the call came through to ask her if she was willing to go to Pakistan to help victims of the devastating floods affecting the country. “I said ‘yes’ immediately,” Dr Findlay says. After brief stops in Perth and Amberley, near Brisbane, Dr Findlay and a mixed group of nurses, doctors and paramedics were soon heading for Pakistan in a C17 Royal Australian Air Force transport plane. After a day in a transit camp, the group were taken by helicopter to Kot Addu in the Punjab region of central Pakistan. Working in disaster areas is not new to Dr Findlay, who spent time in Indonesia in the wake of the 2006 Javanese earthquake (see September 2007 GPREVIEW). Now, 4 years later, Dr Findlay and the other healthcare professionals on the ground faced one of the 21st century’s biggest natural disasters. The floods have left 20 million of the Pakistan population affected, including 8 million needing direct life saving assistance. Dr Findlay was working with Australian Medical Assistance Teams (AUSMAT), an Australia wide team that includes partners from Victoria, Western Australia, the Northern

Territory and Queensland. In Pakistan, Dr Findlay and her colleagues were housed in tent accommodation set up by the Australian Defence Force (ADF) on a soccer pitch. Pathology and X-ray services were also provided by the ADF, enabling Dr Findlay and her colleagues to check blood counts and kidney function. Dr Findlay was one of a team of health professionals that worked morning or afternoon shifts of 6 and a half hours each. “There were times when it was 45 degrees and very humid,” she says. “I did experience illness due to heat stress, but I soon got over it.” Dr Findlay says common presentations included hypertension, diabetes, diarrhoea, skin and chest infections and malaria. “Among children we also saw huge amounts of dehydration and malnourishment,” she says. Improvisation and adaptability were a key part of the work. A waiting area for those in need of healthcare was set up under a tree, and separate clinics were run for men and women in respect of their Muslim faith. Security for healthcare staff attending flood victims was monitored by the Pakistan military. “We stayed within the compound and we didn’t feel

in any danger at any time,” Dr Findlay says. “Neither did I see anyone die,” she adds, although she describes two occasions in which patients were ‘touch and go’. “I remember vividly two patients. One was a little boy aged 2 or 3. He was carried in by his mother; he was unable to walk, his eyes were rolling and he was very sick and dehydrated. I wasn’t sure if he would make it. “We managed his fever and rehydrated him and then sent him home with oral rehydration solution. I was seriously worried he may not make it; 2 or 3 days later he came back to the clinic, bouncing around and full of mischief. I didn’t recognise him. That was very rewarding.” Dr Findlay describes another close call with a teenage girl who was brought in by her family. “She couldn’t walk; she had very low blood pressure,” Dr Findlay says. “She had malaria and I gave her some intravenous antibiotics for any secondary infections she might have had. The next day she walked in and she was heaps better.”

Dr Findlay worked in Pakistan under AusAID, the Australian Government overseas aid organisation. For more information visit www.ausaid.gov.au

Money up your sleeve Owners of healthcare practices, like any business owners, sometimes need to borrow funds to take pressure off their cash flow. One finance solution for smaller, business expenses such as; insurance, software, stationery, association and professional development fees, is a line of credit.

Line of credit Borrowing money for unforeseen business expenses is a common way for practice owners to protect their personal cash reserves. If you are experiencing the pressure of a tight cash flow or want funds ready for surprise expenses, a line of credit is worth considering. Medfin offers a line of credit designed for busy practitioners – Med-e-credit. A Medfin Med-e-credit account is easy to set up – simply discuss the funds you wish to place at call with your Medfin Relationship Manager and after the funds are approved, your account is ready for use.

Dip into funds as needed Once your account is active you can dip into the funds as needed, up to the amount of your agreed limit. Funds do not need to be used all at once – they can be tapped into as required.

And you only pay interest on the amount of money you have drawn – not on the total limit that is at your future disposal. Because your Mede-credit account is for business purposes, interest payments are tax deductible.

It’s Easy Medfin helps make finance easy with: • Appointments at a time and place that suit you • Fast response • Minimum paperwork • Financial solutions designed for healthcare professionals

More information? Call your local Medfin Relationship Manager on 1300 361 122 or visit medfin.com.au/racgp to: • Request a quote • Book an appointment

Special $200 offer for GPs

$200 credit* with each car or practice loan. Use this credit to purchase any RACGP product or service.

The recent floods in Pakistan left 8 million of the country’s population in need of life saving assistance

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Dr Findlay with an infant patient

www.racgp.org.au/goodpractice

A tent from which Dr Findlay and her colleagues provided medical care

*Conditions apply. Visit www.racgp.org.au/memberbenefits/medfin or call the RACGP on 1800 331 626. Important Information: This document has been prepared without knowledge of your personal objectives, financial situation or needs. Before acting on any of the information you should seek independent financial advice. Eligible assets only. Approved customers only. Fees and charges apply. Interest rate is variable and subject to change. Ability to transfer funds is subject to your available limit. Medfin Australia Pty Limited ABN 89 070 811 148. A wholly owned subsidiary of National Australia Bank Limited and part of the NAB health specialist business (GP11/10)

The Royal Australian College of GeneralGood Practitioners Practice_November issue.ind1

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Good Practice Issue 8 – November 2010 5 18/10/2010 3:47:35 PM


Issues

Back to basics General practice involves being faced with an enormous range of symptoms that offten require truly holistic management in practice. How to communicate appropriately with a patient, conduct a thorough examination, conclude a differential diagnosis and propose the appropriate treatment strategies (all within a limited timeframe) is a routine challenge for GPs. You may have already developed your own approach to each clinical scenario – many GPs have – but there is always room for improvement to refine approach. It is believed that about 80% of diagnoses are made (or suspected) based on examination and history. This is despite the trend to conducting more investigations, tests and medical imaging to assist practitioners. It is even possible that more diagnoses are made from the history than from the physical examination and investigations combined. But looking at and studying the patient’s general appearance and demeanor is important. Your spot diagnosis needs to be supported by physical examination and history. The face can be a mirror of disease. Counselling and therapeutic skills are, of course, vital and can always be improved. Presenting at GP10, Professor John Murtagh reminded us all of the most basic and sensible diagnostic techniques, aide memoires and mnemonics – all common sense, and things that we as practitioners should never lose sight of. For example: SOCRATES – questions to ask about symptoms Site Onset Character and severity Radiation Aggravating and relieving factors Timing Exacerbating factors and associated symptoms Social aspects (effect of the symptom or illness). LINDOCARF – for describing pain Locations Intensity Nature Duration Occurrence Concurrence Aggravating factors Relieving factors Features (other associated features).

VINDICATES – for differential diagnosis Vascular Inflammatory Neoplastic Degenerative (wear and tear) Iatrogenic (caused by treatment such as medications) Congenital Autoimmune or atopic (allergy) Trauma or toxins Endocrine and/or metabolic Substance abuse or psychological. Not missing a serious or life threatening illness is, of course, the name of the game and of particular significance. Professor Murtagh suggests the following should be considered until proven otherwise: • neoplasia, especially malignancy • HIV infection/AIDS • asthma • severe infections • coronary disease • imminent or potential suicide • intracerebral lesions • ectopic pregnancy. Professor Murtagh also has a basic model of diagnosis for a presenting problem. There are five questions to be answered: 1. What is the probability diagnosis? 2. What serious disorder/s must not be missed? 3. What conditions are often missed? 4. Could this patient have one of the ‘masquerades’ in medical practice? 5. Is this patient trying to tell me something else? Finally, Professor Murtagh’s seven primary masquerades (common disorders in general practice which might be disguised in some fashion) are described as: • depression • diabetes mellitus • drugs (prescription, nonprescription, recreational and illicit) • anaemia • thyroid (and other endocrine problems) • spinal dysfunction • urinary infection (especially in the elderly). Should your diagnosis for a patient become difficult it is well worth remembering this helpful list and the wise words of the father of contemporary general practice in Australia.

Dr Rob Walters Medical Indemnity Protection Society and Hobart based GP

Older smokers favour GP advice for quitting New research suggests that older smokers are making use of GP assistance to quit. A survey by the Cancer Institute NSW of 1000 people who had recently quit smoking found that quitting cold turkey without the assistance of products such as nicotine replacement therapy is the preferred quitting option for most smokers. The next most popular methods are nicotine replacement therapy and cutting down and then stopping.

Good Practice Issue 8 – November 2010

The survey found younger quitters prefer the unassisted methods of quitting, while older people usually choose assisted methods such as GP advice. “Efforts to reduce the overall smoking rate in the Australian

For advice on quitting call 137 848 or visit www.quit.org.au

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MIPS – where members matter! Medical Indemnity Protection Society Ltd. Call 1800 061 113 www.mips.com.au DOCTORS FOR DOCTORS Medical Indemnity Protection Society Ltd (MIPS) is an Australian Financial Services Licensee (AFS Lic. 301912). MIPS Insurance Pty Ltd (MIPS Insurance) is a wholly owned subsidiary of MIPS and holds an authority issued by APRA to conduct general Insurance business and is an Australian Financial Services Licensee (AFS Lic. 247301). MIPS has a binding authority from MIPS Insurance to issue the MIPS Insurance medical indemnity policy. Any financial product advice is of a general nature and not personal or specific.

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Photo © istockphoto/Alex Kosev

community can be best served by continuing to motivate smokers to quit through antitobacco mass media campaigns and to support smokers choosing the ‘cold turkey’ and ‘cut down then quit’ approaches,” says lead author of the study Dr Wai Tak (Arthur) Hung. “We should also continue to assess the effectiveness and accessibility of other methods, to ensure a diversity of needs are met, such as [those of ] smokers from disadvantaged backgrounds or those that prefer assisted methods,” he said.

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5 minutes

Caring for homeless on their turf In 2007 GP Andrew Davies founded Mobile GP, a Perth based not for profit organisation that provides primary care services for homeless people in their own environment. What inspired you to found Mobile GP? I had a privileged upbringing. I am the last person you would expect to be one of the founders of an organisation that provides primary healthcare to homeless people. My interest in health disparities started in medical school when we were taught about the appalling health of Indigenous Australian people. No mention was made of the plight of homeless people. I tried a few training programs before realising that what I really wanted to do was care for the whole person and that general practice was the specialty for me. During my GP training program I was attached to a mentor who worked for the local division providing healthcare to underprivileged groups. She asked me if I was interested in doing some sessions with the service and from then on the healthcare of homeless people became my passion.

more than a decade less than that of Indigenous Australian people and almost half that of the average Australian.

What does Mobile GP do that other primary care services cannot? There is a lot of shame associated with being homeless. Access to bathing facilities and clean clothes is difficult and homeless people are embarrassed to show up to clean GP surgeries or hospitals. Unfortunately, when they do present they are often quickly judged, exacerbating their embarrassment and shame. Mobile GP is all about going out to where these people already feel safe and providing a nonjudgmental service. The factors leading to homelessness are complex, and many people end up in a cycle where being homeless exacerbates

What are the most common health problems you find in your work? Being homeless is not easy. Stress and boredom lead to psychological, psychiatric and drug use problems. Life is focused on immediate survival. Disease tends to present late and self management is often poor. Chronic illnesses such as diabetes and chronic obstructive airways disease are extremely common, as is domestic violence. Research shows that the average life expectancy of a homeless person is 45 years of age. That is

their medical problems, and their medical problems perpetuate their homelessness. Working together with social support agencies, we are able to improve the health of homeless people, increase their chances of finding long term housing and making the transition back into mainstream society. I believe that we are still missing a group of patients who do not access drop in centres and they are one of our next challenges.

How could services be improved? We desperately need more doctors. The need for our service is enormous and we are only just starting to scratch the surface. We can only do more with more staff on the ground and the most difficult group to recruit are doctors. I would love to expand on what we have, into working with youth and trying and divert them away from the homeless lifestyle. Australia also has a lot of catching up to do with researching our homeless population’s needs.

How would you respond to a GP saying ‘I’d love to provide this service but don’t have the time’?

Dr Andrew Davies on a Mobile GP round

It adds an extra 5 minutes to my day driving to one of the homeless shelters rather than my regular surgery, and the rewards are enormous. Many of the colleagues I speak to are under the impression that we spend the day dealing with unkempt ‘doctor shoppers’. There isn’t much we can do about patients being

Photo © istockphoto/rez-art

unkempt and, like all doctors’ surgeries, we have patients that try it on with drugs of dependence but we have a no benzodiazepine or opiate prescribing policy. This is largely respected among the homeless population. I spend the day dealing with complex biopsychosocial problems with a really supportive team around me.

What is a typical day like for you? Instead of driving to the surgery, I drive to a drop in centre. I have a fully computerised practice, work one-on-one with a nurse, have a psychiatric nurse available to assist with management when required and the staff of the drop in centre to help with social problems. When we arrive we make a list of patients to see, based on medical need, and then on a ‘first come first served’ basis we work through the list, spending as much time as required with each patient. The people we see have fascinating stories of survival. Lunchtime arrives, and I go off to work in my traditional general practice.

Does the philosophy of respecting the individual regardless of background need to be better embedded in training for GPs? I think we are doing a reasonable job of trying to instil this philosophy into our general practice trainees. Where it becomes difficult is in understanding the behaviour of someone who has been brought up not learning social norms, or having suffered from enormous abuse. I would love for every GP trainee to come out and see what we do, so that they can understand that a homeless person is exactly that – a person like the rest of us with the same needs and desires who often just needs help getting out of the situation they are stuck in.

Who has inspired you in your career? I think the greatest inspiration in my career would have to be my mother. If someone can go through medical school and become an obstetrician and gynaecologist while bringing up a family of five children then anything is possible.

For more on Mobile GP including how to contribute visit www.mobilegp.org.au

Better fertility advice needed for cancer survivors Australian research finds that the issue of fertility remains crucial to cancer survivors’ identity and psychosocial health. Fertility is an important issue for cancer survivors, new research has shown, and one that that is often not adequately addressed by healthcare workers. A team from Adelaide’s Flinders Medical

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Centre interviewed 25 cancer survivors, most of them women, and found that concerns about sexual function and fertility are increasing due to both the tendency for people to have children later and to improved cancer treatment outcomes. In particular, researchers found that fertility remained a concern even for women who already had a family, and who had no plans for more children. “This is important, as doctors may not raise these issues with

Fertility is important to a patient’s sense of identity and body image patients who claim not to have plans for further children,” Professor Bogda Koczwara, one of the researchers behind the study, told the European Society for Medical Oncology in Italy last month. Fertility, the researchers found, is important to a patient’s sense of identity and body image. For single people, changes in sexual function due to the effect

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of chemotherapy on reproductive organs may mean anxiety about entering into future relationships. “Many respondents accepted fertility loss but struggled with the ongoing impact of changes in sexual function and its impact on their relationships,” Professor Koczwara said. “There appears to be a need for raising awareness of these concerns among cancer professionals and providing them with information and training regarding these concerns.”

Professor Ian Olver, CEO of Cancer Council Australia, agreed, saying that there is a “need to provide the opportunity for patients to discuss these issues and then have the appropriate support to help in their resolution.”

Professor Bogda Koczwara’s paper was presented at the 35th Congress of the European Society for Medical Oncology in Milan last month. For more information visit www.esmo.org Good Practice Issue 8 – November 2010

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The RACGP Council procession at the academic session

The GP10 gala dinner was enjoyed by all who attended

Great vibe and spirit at GP10 The conference of the records This year, the RACGP teamed up with the Australian Association of Practice Managers (AAPM) to host GP10 – the conference for general practice, held from 6–9 October in Cairns. A very exciting program attracted a record number of delegates, with a strong focus on Aboriginal and Torres Strait Islander health, e-health, sports medicine, rural health, health promotion, the business of medicine, and practical tips for students and registrars. With more than 1000 people gathering at the Cairns Convention Centre over the 4 days, GP10 exceeded expectations and was the biggest conference the College has ever hosted. It was truly the conference of superlatives, with record numbers of delegates, GPs, students, sponsors and exhibitors attending, and a record number of abstracts submitted. The College couldn’t have asked for more and would like to thank everyone who joined the general practice family in Cairns.

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Good Practice Issue 8 – November 2010

community. Visit page 4 to see all this year’s award winners, including the winner of the RoseHunt Award and the GP of the Year, National General Practice of the Year, Supervisor of the Year, Registrar of the Year awards. During the academic session Professor Claire Jackson officially took over from Dr Chris Mitchell as RACGP President. (To read more about our new president, turn to page 3.) GP of the Year Dr Patrick Byrnes

The RACGP AGM and Convocation were held on Wednesday 6 October, followed by the academic session. At the session, the College recognised GPs who have made an outstanding commitment to improving the quality of general practice care, training, education and research to benefit the profession and the level of healthcare provided to the

The launch of the RACGP National Faculty of Aboriginal and Torres Strait Islander Health on Friday 8 October was another key event, with the Minister for Indigenous Health, The Hon Warren Snowdon, and the Aboriginal and Torres Strait Islander Social Justice Commissioner, Mick Gooda, speaking at the launch. The gala dinner on Saturday evening, held in an outdoor marquee along the Cairns esplanade, was a great end to a successful event. Delegates gathered to celebrate the

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Launch of the 4th edition of the RACGP Standards for general practices profession, to wine and dine and kick up their heels – anyone who says that doctors don’t know how to party has never been to an RACGP conference! GP10 convenor Dr Kathy Kirkpatrick and her hard working committees are to be congratulated for bringing us a wonderful conference that will

be remembered fondly by all who attended. The RACGP hopes that you will all be able to come and join us to build on this wonderful experience at GP11 in Hobart.

All GP10 information can be viewed at www.gp10.com.au

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New Fellows of the RACGP

William Arnold Connolly orator Dr Peter Doyle

The Hon Warren Snowdon, Minister for Indigenous Health, speaking at the Aboriginal and Torres Strait Islander health plenary session

Dr Chris Mitchell presenting Dr Eric Fisher with the RACGP 2010 Rose-Hunt Award

Aboriginal dancers perform at the Aboriginal and Torres Strait Islander health plenary session

Student Manik Mayadunne performs ‘I wanna be a GP’ at the NRF cocktail reception

Professor John Murtagh presenting to delegates

Delegates mingling in the trade and exhibition hall

Workshops gave delgates the opportunity to learn more

www.racgp.org.au/goodpractice

The RACGP booth was a popular exhibit to visit

The Royal Australian College of General Practitioners

Dr Chris Mitchell handing over as President of the RACGP to Professor Claire Jackson

Good Practice Issue 8 – November 2010

9


Business

Getting protected

The importance of personal insurance

$500 FREE credit for GPs* Proloan, Australia’s leading provider of residential and investment property loans to members of the medical profession, is offering a $500 RACGP credit to RACGP members and RACGP QA&CPD participants who complete a Proloan residential or investment property loan.* The $500 credit can be used for purchasing any RACGP products or services including membership, registration at the GP10 conference, RACGP assessment services, and hardcopy publications and guidelines.^ To find out more about this exciting benefits program and how Proloan can help you, talk to the participating Proloan office in your state today. * Available to RACGP members and RACGP QA&CPD participants within Australia only. Excludes medical students ^ The credit is not transferrable into cash, and cannot be used to pay for services for which a RACGP member or QA&CPD participant has requested a refund. The credit may take up to 60 days to be available from the time that your loan has been completed

10

PROLOAN – NATIONAL www.proloan.com.au Julie Bongiorno 03 9863 3306

BARTONS – SA www.bartons.com.au Adam McCann 08 8294 4744

BONGIORNO – VIC & TAS www.bongiorno.com.au Anthony Bongiorno 03 9863 3111

SMITH COFFEY – WA www.smithcoffey.com.au Mark Kynaston 08 9388 2833

BONGIORNO – NSW & ACT www.bongiorno.net.au Luigi Iacullo 02 9326 2788

THE CARTER GROUP – QLD www.thecartergroup.com.au Peter Sa 0433 141 750

Good Practice Issue 8 – November 2010

The Black Saturday bushfires of 7 February 2009 led to the deaths of 173 people. On a day of ‘record breaking weather conditions’, the fires were ‘of a scale and ferocity that tested human endurance’, according to the 2009 Victorian Bushfires Royal Commission Final Report. The tragedy has given rise to much public debate on issues ranging from the tactical response of highest management to the protections in place for the victims of the fires. In the past few months Smith Coffey has been looking into the bushfire commission from a strategic management perspective. In Appendix A of volume one of the report, the report’s authors look at the ‘Estimated cost of fires’, and, more specifically, the cost of ‘Death and injury’. The appendix goes into the ‘method of valuing life’ applied by the commission – a method accepted by both the Commonwealth and Victorian governments. This approach values the lives that were lost on Black Saturday at $645 million, an average of $3.7 million per person. Smith Coffey compared this ‘method of valuing life’ in the report to the total claims resulting from accident, illness or death paid out by the life insurance industry in 2009 – $2.78 billion,

according to the Risk Store, which publishes annual payout figures from the major life insurers. It was assumed that of the $2.78 billion paid out, a substantial amount would have resulted from the Victorian bushfires. However, according to the Investment and Financial Services Association, life

Having correct insurance for accident, illness or death can help victims of such tragedies and their loved ones deal with these most difficult of circumstances insurance companies paid only 30 death claims totalling $4.9 million and 10 income protection claims totalling $35 000 per month as a result of the Victorian bushfires. So what does this tell us? If we assume that three out of four people who died in the bushfires were under 65 years of age and should have had life insurance, this shows that: • based on the ‘method of valuing life’, these residents should have had $481 million of life insurance cover (ie. an average of $3.7 million multiplied by 130 lives)

• the $4.9 million paid by life insurance companies is a mere 1% of the above amount. From this information, we can conclude that 76% of the residents did not have life insurance. So is this just a problem with rural Victoria? Or rural areas in general? Underinsurance, unfortunately, is a problem nationwide and is not gender specific. The 67 recommendations in the Victorian Bushfire Royal Commission report focus on reducing damage from bushfires and the impact of such damage. However, there were no recommendations to address the underinsurance relating to accident, illness or death. While it is the human cost that is most difficult to deal with in such tragedies, having correct insurance for accident, illness or death can help victims of such tragedies and their loved ones deal with these most difficult circumstances. It is imperative to have your personal insurances reviewed each year – especially if your personal circumstances or financial position changes.

Jay Pintado Chief Executive Officer Smith Coffey

Maternal deaths decrease globally Study shows the number of women dying due to complications during pregnancy has dropped dramatically in the last two decades. A new report released by the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Population Fund and The World Bank has found that the number of women dying from complications during pregnancy and childbirth dropped 34% between 1990 and 2008. The report, entitled Trends in maternal mortality, shows 358 000 maternal deaths in 2008, compared to 546 000 in 1990. While a positive result, the annual rate of decline remains less than half of that required to meet the Millennium Development Goal target, which aims for a

The Royal Australian College of General Practitioners

75% reduction in the maternal mortality ratio by 2015. Dr Margaret Chan, DirectorGeneral of the WHO, says an increase in the training of midwives, and “strengthening hospitals and health centres to assist pregnant women” are among the factors responsible for the decline in deaths during pregnancy and childbirth. The main causes of death among pregnant women are severe bleeding after childbirth, infections, hypertensive disorders and unsafe abortion. The risk of a woman in a developing country dying from a pregnancy related cause during her lifetime is around 36 times

higher than that of a woman living in a developed country such as Australia. Executive Director of UNICEF, Anthony Lake, said: “To achieve our global goal of improving maternal health and to save women’s lives we need to do more to reach those who are most at risk. That means reaching women in rural areas and poorer households, women from ethnic minorities and indigenous groups, and women living with HIV and in conflict zones.”

The report is available to read at http://whqlibdoc.who.int/ publications/2010/9789241500265_ eng.pdf

www.racgp.org.au/goodpractice


Finance, travel and lifestyle The RACGP’s primary aim is to improve the health of all people in Australia, through quality general practice, equitable access to general practice care throughout Australia, forward thinking, and a welcoming and collegiate environment. We understand that our members have other important needs that may indirectly influence their professional roles. So we have developed a relationship with a range of corporate program partners that are designed to offer savings to members and make their lives easier. The RACGP receives a small commission from some of our larger corporate program partners when members choose to take up those offers. These commissions contribute toward enhancing and expanding the suite of services provided to members. Below is a snapshot of some of the benefits available to RACGP members through our corporate program partners.

Finance and insurance

Lifestyle and travel

Clinical guidelines

American Express credit cards

GP Support Program

Superior benefits and attractive financial savings with RACGP American Express Gold and Platinum credit cards.

A free and confidential counselling and coaching service to help RACGP members cope with life’s stressors. Face-to-face, telephone or online counselling during business hours are available, or a 24/7 service can be arranged for traumatic incidents. Available only to members who are Australian registered medical practitioners.

Through our corporate partner program, members can also access significant savings on quality RACGP approved clinical guidelines.

Proloan residential and investment property loans Receive a $500 credit with each Proloan residential and investment property loan, which you can use to purchase any RACGP products and/or services.* Medfin car, equipment and practice loans Receive a $200 credit with each Medfin car, equipment or practice loan which you can use to purchase any RACGP products and/ or services.* Terms and conditions, fees and charges apply. Approved applicants only

The Qantas Club Special discounts on Qantas Club membership, including the joining fee and renewal rates for 1 and 2 year memberships. Hertz car rental Save on your car rentals with Hertz including discounts off the best daily rate, periodic bonus offers and more. Travelscene

Australian Medicines Handbook Save up to 19% on all Australian Medicines Handbook (AMH) products, including AMH Online and mobile phone versions, which enable you to make informed prescribing choices at point-of-care. Therapeutic Guidelines Save 10% on the full range of Therapeutic Guidelines books as well as eTG complete, which offer clear, concise, independent and evidence based recommendations for patient management. To benefit from these offers or to find out more visit www.membership.org.au/ memberbenefits

Dedicated travel service with Travelscene American Express which provides access to special offers and premium service.

RACGP corporate partners

EMERGENCY RESPONSE KIT www.emergencyresponsekit.com.au

www.membership.org.au/memberbenefits * Available to RACGP members and RACGP QA&CPD participants within Australia only. Excludes medical students. The credit is not transferrable into cash, and cannot be used to pay for services for which a RACGP member or QA&CPD participant has requested a refund. If credited funds are not used within 24 months, the money will be donated to The RACGP Foundation. Offers valid to 31 August 2011


FacultyNews

WA WA’s GP researcher of the year One place you won’t find Dr Allan Walley, a Margaret River GP, is out surfing, which is odd given that he has just been awarded the 2010 WA GP Research Award in part for his investigative work on surfing injuries. But Dr Walley is not just a one trick pony: he has also conducted research into the prevalence of mosquitoes and possible causes of respiratory disease on Christmas Island. It was this breadth of research interests which excited the judging panel. A rural GP with over 31 years of experience, Dr Walley’s interest in research began during a 5 year sojourn on Christmas Island, during which he completed a Master in Public Health

and Tropical Medicine from James Cook University. Having completed his degree he set out to investigate the prevalence and location of mosquitoes on the island. At the time a large number of refugee boats were arriving on the island and there were concerns about the possible spread of mosquito-borne diseases such as malaria and dengue fever. His work in documenting the range of the insects enabled the island to prepare for any potential introduction. Returning to the mainland, Dr Walley eventually settled in the Margaret River/Augusta region of southwest WA. There, he was amazed to observe the number and severity of surfing injuries

Dr Allen Walley with RACGP WA Faculty Chair Dr Peter Maguire at the awards presention

QLD Is there a physician’s assistant in the house? In a state that has fewer medical practitioners per head of population than any other in Australia and a population growing faster than any other, having a physician’s assistant on a GP’s team might be one way to ease the pressure in the primary healthcare sector. The physician assistant role was developed in the United States and involves a medically trained clinician working under the supervision of a qualified medical practitioner. Queensland Health conducted the Queensland Physician’s Assistant Pilot for a 12 month period concluding in May 2010. During each evaluation phase of the pilot, the RACGP Queensland Faculty, as part of Queensland Health’s collaborative network,

The physician assistant role involves a medically trained clinician working under the supervision of a qualified medical practitioner provided feedback and comment on the integration of the role into clinical teams, the scope of practice and the importance of the quality framework ‘fit’ for these positions. The pilot was conducted on four sites, including one general practice – a clinic and local hospital in Normanton in far northwest Queensland. The evaluation of the pilot is now complete and the report released. The pilot demonstrated that within the participating sites the

physician assistants integrated well with their clinical teams, created distinct roles which complemented the existing nursing and medical roles and enhanced service delivery. The final evaluation report concluded that the strength of the physician assistant role lies in its flexibility. Because it is adaptable, the physician assistant role has the potential to suit a number of diverse clinical environments, providing there is appropriate medical supervision and role clarification to allow the development of a collaborative working relationship with healthcare team members.

A full copy of the evaluation report can be downloaded from www.health.qld.gov.au/ publications/pa_eval_final.pdf

General practice training places: a call to action The Queensland General Practice Advisory Council (GPAC) has called for action on how to expand the capacity of general practice to accommodate increasing numbers of general practice training places. The RACGP Queensland Faculty is a foundation member of the GPAC network. While welcoming the increase in training places, GPAC has identified several key issues which the organisation maintains need addressing before the

12

Good Practice Issue 8 – November 2010

initiative is implemented. Many general practices, for instance, lack the physical infrastructure to house and support trainees during their training in general practice. There is currently a lack of appropriate funding and incentives to support GP supervisors to train and mentor trainees, and there is concern about the impact that training and supervising trainees will have on the GP’s ability to maintain practice and delivery standards.

To alleviate these issues and allow general practice to build training capacity, GPAC recommends that resources and funding be allocated to create appropriate training environments and that funding models that recognise the time, resources and commitment required to provide high quality training in general practice be explored.

Contact the faculty on 07 3456 8944 email qld.faculty@racgp.org.au The Royal Australian College of General Practitioners

presenting at the local hospital. He was also struck by the general consensus that these injuries ‘came with the territory’. Unable to accept this, Dr Walley began to explore how to minimise the range of trauma being experienced by surfers – everything from laceration, compound fractures and eye injuries to death. With support from the University of Western Australia and Primary Health Care Research, Evaluation and Development (PHCRED) Western Australia, Dr Walley embarked on his project, ‘The incidence and severity of surfing accidents in the south-west’. Discussions with surfers and surfing doctors

resulted in a questionnaire which was then sent to hospitals and GPs in the area. Questions covered surfers’ experience, surfboard specifications, accident background and safety precautions and conditions. A year later, the data was collated and presented at a PHCRED conference and to Geraldton GPs. From here, among other things, Dr Walley will be working toward a paper on the findings with the long term aim of reducing the number of injuries in the surfing population.

Contact the faculty on 08 9489 9555 email wa.faculty@racgp.org.au

NSW&ACT GPs connect in the ACT This month, the RACGP will join forces with the Australian National University’s Rural Medical School, the Southern General Practice Network and the ACT Division of General Practice to present a stimulating weekend education conference. Under the banner GP Connect 2010, general practice and allied health professionals from the ACT and southeast NSW will have the opportunity to participate

Participants will examine the challenges of a geographically separated virtual team with different IT systems in a diverse range of workshops that will cover everything from the latest in e-health applications and becoming a teaching practice to more practical topics such as paediatric medicine and pain management. The program has been devised to offer clinical sessions for GPs, nurses and allied health professionals, as well as practice management and skill based sessions for general practice staff. A key address, ‘National health reform and general practice: achievements, challenges and future priorities’, will be delivered by RACGP President Dr Claire Jackson. A panel discussion on

the practicalities of delivering the integrated primary healthcare agenda, moderated by broadcaster and journalist Julie McCrossin, will follow the address. This plenary dovetails with a workshop, also involving Professor Jackson, on effective multidisciplinary teams and what the future will look like in the primary healthcare setting. Participants will examine the challenges of a geographically separated virtual team with different IT systems, compared with the advantages of a co-located team within a large centre offering a comprehensive range of services who all use the same communication platform. These are the realities primary healthcare practitioners will need to face if they are to embrace the future integration of services. GP Connect 2010, to be held in Canberra of the weekend of 12–14 November, provides the perfect opportunity to explore the options and strengthen existing partnerships.

For more information visit www.gpconnect.com.au

www.racgp.org.au/goodpractice


FacultyNews

VIC The 2010 Victoria General Practice of the Year award Westcare Medical Centre, Melton West has been named the winner of the RACGP 2010 Victoria General Practice of the Year award. Established in 1989, Westcare Medical Centre moved into its present purpose built premises in 2006. An exceptional, dynamic and innovative practice, it provides high level service to the community and is a true model for the future of patient focused primary healthcare. At Westcare, the values and personal touches of traditional general practice are coupled with

contemporary advances including well equipped consulting rooms, the latest computer based information and patient record systems, state-of-the-art clinical resources and a full range of co-located allied services. Health promotion and chronic disease management are central to the practice, with an increasing emphasis on preventive care and patient managed care plans formulated by GPs in partnership with patients. Data on patient outcomes is actively monitored, allowing nurse led chronic disease

clinics and a comprehensive recall and reminder system. Training general practice registrars and medical students has been a practice priority for over 12 years. Westcare Medical Centre provides a supportive clinical environment, fully integrating registrars into the running of the centre. This enhances the level of clinical care available, provides registrars with a broad case mix and offers them opportunities to develop special interests in areas such as dermatology and women’s and youth health. The learning culture of the practice also encompasses continued professional development of the GPs and nurses.

SA&NT Chandlers Hill Surgery wins SA 2010 General Practice of the Year award

The faculty comes to you Interested in the Victoria faculty visiting your practice? The Victoria faculty has embarked on a strategy to engage with members and nonmembers in the practice setting. The visits aim to provide an opportunity for practice staff to ask questions about the College and to offer suggestions on how the College can improve its support of practices and GPs. A visit will also give the faculty an opportunity

to update practice staff on recent College initiatives. Possible areas for discussion include: • an overview and demonstration of the new RACGP e-health products and initiatives including the PrimaryCare Sidebar®, PCS Clinical Audit ToolTM and Oxygen: Intelligence in Practice • how to meet the 2008–2010 triennium requirements and a summary of changes for the

2011–2013 triennium • the impact of proposed and current health reform policies • opportunities for engagement with the faculty and the College. The visits will be tailored to discuss areas of importance to your practice.

If your Victorian practice is interested in the faculty visiting, call 03 8699 0563 or email vic.events@racgp.org.au

TAS Tasmanian GPs win national awards Two Tasmanian GPs, Dr Frank Meumann and Dr Allison Turnock, have been recognised with national awards at the annual General Practice Education and Training (GPET) conference, which was held recently in Alice Springs. “These national awards are fitting tributes to the dedication and commitment of Dr Meumann and Dr Turnock to general practice,” RACGP Tasmania Faculty Manager Ms Jolanda De Jong said. Dr Frank Meumann, Director of Medical Training at General

Dr Frank Meumann Medical Educator of the Year

www.racgp.org.au/goodpractice

Practice Training Tasmania and a Tasmania faculty board member, was named Medical Educator of the Year for his inspired delivery of innovative quality medical training for registrars. ‘The sheer breadth of Frank’s medical education expertise, his scope of influence throughout Australia and his enduring enthusiasm and productivity over the past 20 years makes him an outstanding medical educator,’ states his award citation. Until recently a member of the

Dr Allison Turnock General Practice Registrar of the Year

RACGP Tasmania Faculty Board, Dr Allison Turnock was awarded the title of General Practice Registrar of the Year for her work as a registrar liaison officer. Described as a ‘quiet achiever’, Dr Turnock has been a strong registrar advocate, communicator and educator for general practice. Dr Turnock confessed that she was ‘surprised, but flattered’ to receive such an award. “Especially when you see the quality of the other nominees,” she said. “The Tasmania Faculty know Frank Meumann and Allison Turnock as active, dedicated RACGP members,” said Ms De Jong. “We congratulate them on their well deserved awards.” GPET manages the Australian General Practice Training Program on behalf of the Australian Government.

Contact the faculty on 03 6278 1644 email tas.admin@racgp.org.au

The Royal Australian College of General Practitioners

Chandlers Hill Surgery SA General Practice of the Year Chandlers Hill Surgery, in the Adelaide suburb of Happy Valley, is the winner of the RACGP 2010 South Australia General Practice of the Year award. The General Practice of the Year award recognises outstanding general practice, with commitment to ongoing quality improvement, as well as the standard of facilities offered to patients and staff and the services offered to the local community.

Chandlers Hill Surgery is a dynamic, innovative practice – a model for the future of patient focused primary healthcare “Chandlers Hill Surgery is a dynamic, innovative practice – a model for the future of patient focused primary healthcare,” said Professor Nigel Stocks, RACGP SA&NT Faculty Chair. Established 25 years ago, the practice has continued to grow and provides a superb example of how innovative technologies such as e-health programs can be used to provide better services to patients. The team at Chandlers Hill Surgery monitor specific health issues, such as smoking, across the practice population and use the information gathered to devise health promotion initiatives. The practice’s electronic reminder system ensures that patients with chronic diseases, such as diabetes

Chandlers Hill reception staff and asthma, are recalled when appropriate for reassessment and treatment. In addition, the practice was renovated and expanded recently to incorporate many allied health professionals and services, making it an easy access medical hub for patients. As an accredited training practice for registrars since 1990, Chandlers Hill Surgery regularly hosts medical students from both Adelaide and Flinders universities. “Chandlers Hill Surgery has an excellent reputation with patients and students alike for providing comprehensive, interdisciplinary primary healthcare and a very high level of service to the community,” said Professor Stocks. He congratulated the doctors and staff for their work in creating a model of outstanding general practice in the 21st century.

Contact the faculty on 08 8267 8310 or email sant.faculty@racgp.org.au

Good Practice Issue 8 – November 2010 13


QA&CPD

Quality improvement and continuing professional development for 2011–2013 triennium QA&CPD is shifting toward quality improvement in general practice, which has led to the name change for the next triennium. The QI&CPD Program launched its new look at GP10 in Cairns in October. While the education framework remains unchanged, the introduction of quality improvement in general practice will be a key feature in the years to come. Working towards quality improvement The RACGP is moving towards an aligned strategy, encouraging quality improvement (QI) initiatives in general practice. The RACGP Standards for general practices recommend ‘practices to engage in QI activities’. This approach is consistent with a shift in focus over previous triennia from a ‘person approach’ to a ‘systems approach’. Quality improvement – ‘get it right, for the right people every time’. The QI&CPD Program provides opportunities for GPs to improve individual skills and knowledge, and to review and improve their practice’s structures, systems and processes for improving quality of care and, ultimately, patient health outcomes. Quality improvement helps to identify and test what needs to change in general practice in

order to increase quality and safety for patients. General practitioners, practice team members and other healthcare professionals can all influence quality improvement in general practice via individual or practice focus initiatives. Have you met your QA&CPD requirements for 2008–2010? To move forward into the 2011–2013 triennium, you must first have met all your QA&CPD requirements for 2008–2010. The QA&CPD Program has many tools to help you meet your requirements: • RACGP online calendar – features an extensive list of activities offered by the RACGP’s QA&CPD education providers. The calendar can be filtered and you can search by location, date, specific interest and categories (1 or 2) • individual active learning modules (ALMs) – various learning methods and activities are covered under the umbrella of individual ALMs. Unaccredited conferences, teaching medical students, supervising registrars and writing for peer reviewed journals are all activities that can be recognised for 40 Category 1 points • basic CPR is a requirement this triennium. If you have completed a basic CPR course

2011–2013 triennium QI&CPD Program requirements A minimum of 130 points for the triennium, including: • two Category 1 activities and • a basic CPR course

Category 1 options Quality improvement activities

• GP research (40 points)

• Clinical audit (40 points)

–– principal investigator

• Rapid PDSA cycles (40 points)

–– GP research participant

Other Category 1 options • Active learning module (40 points)

• Higher education relevant to general practice (Australian Qualifications Framework accredited) –– certificate courses (60 points)

–– individual GP ALM

–– diploma courses (90 points)

–– peer review journal ALM

–– masters degree (120 points)

–– examiner training ALM –– teaching medical students ALM –– supervising registrars/PGPPP ALM

–– PhD (150 points) • RACGP assessment (150 points)

–– accredited activity provider ALMs • Small group learning (40 points) • Evidence based medicine journal clubs (40 points)

–– FRACGP by examination –– FRACGP by practice based assessment –– FARGP

• Supervised clinical attachment (40 points)

Category 2 options • Basic CPR course (5 points) – must meet Australian Resuscitation Council guidelines; may be completed as part of a Category 1 activity • Accredited activity provider Category 2 activities (each activity is capped to a maximum of 30 points)

Self recorded activities for category 1 and 2 Capped at 20 points for the triennium and claimable when 10 hours of activities have been completed

please send the certificate to your state faculty QA&CPD unit. Basic CPR courses must follow the Australian Resuscitation Council guidelines.

The table above outlines the GP requirements for the 2011–2013 triennium. For further information, please contact your state faculty QA&CPD unit

Generation e-health Around 40 students from Melbourne’s La Trobe University recently visited the Model Healthcare Community (MHC), part of the RACGP’s e-health Futures interactive display. The Bachelor of Health Science and Master of Health Information students toured the MHC to discover how the Healthcare Identifiers (HI) Service works. The guided tour of the MHC takes participants through a patient’s health journey, showing them how e-referrals, e-prescribing, e-pathology and e-discharge summaries will improve the management and communication of health information for healthcare

14

Good Practice Issue 8 – November 2010

delivery, and how they will assist provider organisations to better identify and manage patient information. The service focuses on the importance of uniquely identifying everyone involved in a healthcare transaction, which is vital to a safe and secure e-health system.

Tours run for approximately 75 minutes on Tuesdays every fortnight. Monthly evening tours are available. To book, please visit www.racgp.org.au/ehealth/ehealthfutures

Students during a recent guided tour of the Model Healthcare Community

The Royal Australian College of General Practitioners

www.racgp.org.au/goodpractice


Listings

Check out events in your state at www.racgp.org.au

NOVEMBER

Men at Work – a workshop for men in general practice

Starting in private practice

RACGP members Christmas party

Saturday 13 November North Sydney, NSW

Friday 26 November College House North Adelaide, SA

CPR certification course

The interactive and practical Starting in Private Practice workshop provides participants with the knowledge and skills to prepare to set up their own private practice. Workshop covers models of business, financing the set up of your practice, understanding the role and importance of business planning and legal considerations. Designed as an ALM (40 Category 1 CPD points), this 1 day program will afford opportunities to learn from and ask questions of experts and GPs who have set up their own practices.

Tuesday 9 November Faculty offices , WA

Contact NSW&ACT Faculty tel 02 9886 4700 email nswact.events@racgp.org.au

Saturday to Sunday 6–7 November Diamond Island Resort Bicheno, TAS Developed in response to expressions of interest from our members, the faculty is pleased to announce the first in a series of workshops designed specifically for men in general practice.

Contact Joanna Rosewell tel 03 6278 1644 email joanna.rosewell@racgp.org.au

This course is designed to provide participants with the necessary CPR knowledge and skills as required by the 2008–2010 RACGP QA&CPD Program.

Contact Rachel Patterson tel 08 9489 9555 email rachel.patterson@racgp.org.au

PHCRED conference: partnerships in practice Friday 12 November The University Club Crawley, WA The three PHCRED WA units – the Combined University Centre for Rural Health, the University of Western Australia and the University of Notre Dame Australia – are joining together with the RACGP and invite you to be part of this annual research conference. This premier annual event is a must for anyone with an interest in primary healthcare research.

Contact Abby Roberts tel 08 9489 9555 email abby.roberts@racgp.org.au

International Medical Graduate Forum Friday to Saturday 12–13 November Bardon Conference Centre, QLD The IMG Forum explores a number of issues relevant to overseas trained doctors seeking to work in Australian general practice or attain RACGP Fellowship, such as patient-doctor communication, pathways to Fellowship, hints and tips to help pass the exams, medicolegal case scenarios, and information on Medicare and the Medical Board of Australia. The first 50 delegates to register will receive a free copy of John Murtagh’s General Practice series on USB (valued at $250).

Contact Georgina Scriha tel 07 3456 8941 email georgina.scriha@racgp.org.au

www.racgp.org.au/goodpractice

RACGP Fellowship ceremony Sunday 14 November The Great Hall, Sydney University, NSW This celebration includes presentations to new Fellows, life members and other award recipients, followed by cocktails and canapés in the adjacent main quadrangle. Children are welcome and kids entertainment will be provided at the cocktail party after the ceremony. All new Fellows ratified in the last year, recent life members and award recipients will have received a letter and invitation by now.

If you haven’t received an invitation or would like more information contact William McCrea or Sharon Fung tel 02 9886 4700 email nswact. events@racgp.org.au

RACGP facilitation skills training workshops

An enjoyable evening for RACGP members to celebrate a fantastic year of hard work and achievement with their families and colleagues.

Contact SA&NT faculty tel 08 8267 8310 email sant.faculty@racgp.org.au

Victoria Faculty Fellowship and awards ceremony Sunday 28 November The Members’ Dining Room Melbourne Cricket Ground, VIC The ceremony is an opportunity to welcome new Fellows to general practice and acknowledge our life members and other award winners and the contribution they have made to the profession.

Contact Victoria Faculty tel 03 8699 0563 email vic.events@racgp.org.au DECEMBER

Contact tel 03 9597 0363 email mail@acnem.org visit www.acnem.org

• M anagement tools: for increased decision making support. • Improved patient safety and care.

Wednesday and Thursday 8–9 December Faculty offices, WA

Contact the Zedmed Sales Team on 03 9284 3300. www.zedmed.com.au

e-health futures is a walkthrough experience with simulations and demonstrations of how e-health information will work among healthcare professionals and between healthcare settings. Visitors can book to complete this guided tour, which will operate four times daily over the 2 day period.

PowereD by:

CPR Certification Course

The ACNEM Primary Course in Nutritional and Environmental Medicine is a practical, evidence based foundation program in NEM for GPs and other graduate health professionals that attracts 40 Category 1 QA&CPD points.

• Efficient: cost and time effective record management.

• Better productivity, improved bottom line.

Learn how to facilitate meetings, events and education activities successfully.

Thursday to Sunday 18–21 November The Vibe, North Sydney, NSW

Doctor benefits:

e-health futures guided tours

Contact Abby Roberts tel 08 9489 9555 email abby.roberts@racgp.org.au

ACNEM Primary Course in Nutritional and Environmental Medicine

The new generation of clinical medical software

• Convenience: information where and when you need it.

Thursday 18 November North Sydney, NSW

Contact Angelique Tere tel 02 9886 4712 to book or for information contact Christine Owen on 02 9886 4711 email christine.owen@racgp.org.au

Zedmed Medical Software Solutions

Saturday 11 December WA faculty office, WA This course is designed to provide participants with the necessary CPR knowledge and skills as required by the 2008–2010 RACGP QA&CPD Program.

Contact Rachel Patterson tel 08 9489 9555 email rachel.patterson@racgp.org.au

e-health futures self guided tours 13 December to 25 February Faculty offices, WA Available between December and February, these e-health futures tours are self guided.

Medical Record eXchange Now GP’s can process patient medical information requests easily, quickly and securely online • Make life easier in 3 simple steps. • E nsure a safe and secure transfer of patient’s medical information. • Compatible with major medical software packages. • D eveloped to NEHTA and Standards Australia eHealth guidelines. • Secure, encrypted and privacy compliant.

Contact the Zedmed Team on 1300 933 833 www.zedmed.com.au or www.medicalrecordexchange.com.au PowereD by:

Contact Abby Roberts tel 08 9489 9555 email abby.roberts@racgp.org.au

The Royal Australian College of General Practitioners 10403 MKL Zedmed GP_ad_FA.indd

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Good Practice Issue 8 – November 20109/14/10 15

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Good Practice Issue 8, November 2010  

The November issue of Good Practice reveals the launch of the new Quality Improvement and Continuing Professional Development (QI&CPD) Progr...

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