SEPTEMBER 2011 . Vol 74
THIS ISSUE: Hendra virus - medicine and the media
HIV and the law: 30 years on Interview with the Hon Michael Kirby AC CMG
bad timing for mental health cuts
medical handovers and patient outcomes
FREE TO AMA QUEENSLAND MEMBERS
AROUND THE REGIONS: AMA QUEENSLANDâ€™S NEW E-CONNECT
In this issue Current issues 10 letter from the premier 15 new branch council members 16 bad timing for mental health cuts 20 beyond wellbeing - revisiting doctors’ health 22 MEDICAL RECEPTIONISTS: THE FRONT LINE IN PRACTICES 24 media silence on suicide broken 18 hendra virus: medicine and the media
26 26 HIV/AIDS and the law: 30 years on. Our interview with the Hon. Michael Kirby AC CGM
AROUND THE REGIONS 23 corr: medical handovers and patient outcomes
32 Local medical association round up
48 do i have enough to retire?
33 RDAQ: leaders in training
49 road test: lexus ct 200h f sport
17 foundation news
50 Peru: magic, tradition and adventure 51 why decant?
56 Dendy cinemas
36 general member news
39 obituaries: dr peter schmidt oam and dr ron todd
58 In Print
40 member profile: DR jules black
4 FROM THE EDITOR’S DESK
42 insurance you cannot afford to do without
6 PRESIDENT’S REPORT
44 estate planning
8 CEO’S REPORT
46 dreams can still come true
12 in brief 14 AMA Queensland news
people & events 34 calendar 52 men in medicine 54 social photos
55 DoctorQ SEPTEMBER 2011
Michelle Ford Russ Doctor Q Editor With the annual ES Meyers lecture coming up this month, we had a chat to this year’s speaker, the Hon Michael Kirby AC CMG about HIV/AIDS and the law. The still terrifying Grim Reaper campaign, while criticised in retrospect, set a world standard in making people sit up and pay attention. Read the feature on p26. It’s been a very interesting time for health media over the past few months: changes to reporting on suicide (p24) and a media circus on Hendra virus (p18). A mere six months on from Queensland’s disasters, we look at why cuts to GP mental health plans couldn’t come at a worse time (p16). On a lighter note, we have some photos from the first Men in Medicine breakfast (p52) and from our farewell to Joy Moric, our receptionist for the past 44 years on p55. Enjoy, Michelle Ford Russ
Cover: Grim Reaper image used by permission of the Australian Government.
Five top stories over July/August period 1. Queensland Health payroll overpayments – This announcement by Queensland Health to begin retrieving ‘overpayments’ from employees sparked huge media interest. Despite the Premier stepping in to halt this process, AMA Queensland continued to seek clarification on the process to achieve the least harm and suffering to members and the community. 2. Student dies of Meningococcal in Townsville – Dr Kidd conducted many interviews clarifying the disease, symptoms to look out for and action to take if someone believes they have meningococcal. 3. National Health Agreement signed on 2 August 2011 – While it was positive to see an agreement reached between all states and territories, it is still a long way before patients will start seeing any of the promised funds. 4. Hendra Virus outbreak caused concern and attracted enormous media interest. AMA Queensland remained focused on delivering the facts about the virus. 5. Influenza spike – The number of influenza notifications was significantly higher in July 2011 compared with the same time last year. This prompted AMA Queensland to reinforce the importance of being vaccinated and staying away from work to avoid the spread of germs.
Disclaimer – All material in Doctor Q remains the copyright of AMA Queensland andmay 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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Board of Directors Dr Richard Kidd President and General Practitioner Craft Group Dr Alex Markwell President-Elect Dr Sharon Kelly Chairperson Dr Larry Gahan Treasurer
Dr Sharmila Biswas Honorary Secretary Professor Philip Morris Elected Member Dr Kirsten Price Elected Member Dr Christian Rowan Elected Member
Branch Council Dr David Alcorn Greater Brisbane Area Dr Sharmila Biswas Far North Area Dr Kimberley Bondeson Greater Brisbane Area Dr John W Cox Downs and West Area Dr Larry Gahan General Practitioner Craft Group Dr Noel Hayman Greater Brisbane Area Dr Wayne Herdy North Coast Area Dr Sharon Kelly Specialist Craft Group Mr Bavahuna Manoharan Medical Student Group Dr Deborah Mills Part Time Medical Practitioner Craft Group Professor Philip Morris Gold Coast Area Dr Stephen Morrison Specialist Craft Group Dr John F. Murray Full Time Salaried Medical Practitioner Craft Group
Dr Gino Pecoraro Immediate Past President Dr Kirsten Price Greater Brisbane Area Mr Matthew Roberts Medical Student Observer Dr Christian Rowan Greater Brisbane Area Dr Shaun Rudd General Practitioner Craft Group Dr Anil Sharma Capricorn Area Dr Jonathon Shirley Greater Brisbane Area Dr Mason Stevenson General Practitioner Craft Group Dr Jen Williams Residents and Registrars Craft Group Dr Chris Zappala Greater Brisbane Area
AMA Queensland Secretariat Jane Schmitt Chief Executive Officer Filomena Ferlan General Manager Corporate Services Neil Mackintosh Manager - AMAQ Foundation
Karen Fitzgibbons General Manager Member Relations & Communications Andrew Turner Manager - Member Services
Editor: Michelle Ford Russ Journalist: Stephanie Shield Graphic Designer: Rebecca Nathan Advertising: Rebecca Byrnes Doctor Q is published by AMA Queensland Contact Phone: (07) 3872 2222 Postal Address: PO Box 123, Red Hill QLD 4059 Print Post Approved PP490927/00049 Email: firstname.lastname@example.org
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n 2 August 2011 Julia Gillard announced a historic day for health as the national health reform agreement between the Commonwealth and states and territories of Australia was signed. There is no doubt that health reform is needed in Australia if we are to continue to achieve health outcomes and enjoy health care that is amongst the best in the world.
Dr Richard Kidd President AMA Queensland
While it is positive to see an agreement reached between all states and territories, it is an overstatement to be calling it a historic day especially since it is still a long way before patients will start seeing any of the promised funds. The true success of the health reform will be if the agreement and extra investment results in increased health outcomes and improves delivery of care to our patients. The reforms agreed to by COAG in February will mean an investment of an extra $16.4 billion in public hospitals over the 2014-2015 to 2019-20 period, rising to a total $175 billion to 2029-30. It remains unclear how much of the promised funds will actually be distributed to Queensland and whether the funding will be enough to meet the health needs of patients. Despite the agreement being finalised, there will be further levels of bureaucracy, such as the National Health Performance Authority (NHPA) which will inevitably lead to more inefficiency and waste in a system that is already severely underfunded.
budgeting and resource allocation decisions made by any Local Hospital Network governing council’. Another key section of the submission focused on the relationship that Local Health and Hospital Networks will have with Primary Healthcare Organisations (Medicare Locals). At the moment this relationship remains unclear. In order for Medicare Locals to work effectively, they need to preserve and support the role of GPs through strong GP engagement and focus on areas of unmet need. In the submission AMA Queensland requested further clarification regarding how an appropriate balance of rights and responsibilities will be apportioned to both Local Health and Hospital Networks and Medicare Locals, particularly when considering that geographical boundaries of each body are not concurrent. The way these two bodies effectively engage will be critical in assessing whether ‘real’ reform in the health system has taken place.
During the end of August, early September I would have completed my first regional tour since becoming AMA Queensland President. At the time of writing this report we will have travelled to Mackay, Rockhampton and Emerald as well as Dalby, Toowoomba and Warwick. By the end of this tour I hope to have had fruitful conversations with members, non-members and other key people to identify serious issues of concern in these areas. More on the outcomes from this tour will be included in the next edition.
Media silence on suicide to break
Even if all this money was spent today, it would not meet the current needs of patients. Over a further 10 years of population growth, it clearly won’t be enough. Right now we know Queensland needs 1200 extra beds. Over the next 10 years, this extra investment from the Federal Government might only amount to enough money to build one or two hospitals such as the new Sunshine Coast University Hospital which will cost about $1.97 billion and will start with only 450 beds. Even if all this money was spent today, it would not meet the current needs of patients. Over a further 10 years of population growth, it clearly won’t be enough.
Submission on the Health and Hospitals Network Bill 2011
AMA Queensland completed a submission to Queensland Health regarding the Health and Hospitals Network Bill 2011. The promise for clinician engagement at a local level remains a sticking point for AMA Queensland and we stressed in the submission that ‘a local practicing doctor with expertise in clinical issues as well as governance will make a valuable contribution to strategic, 6
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On a final note I am pleased to see the Australian Press Council is being proactive when it comes to responsible reporting on suicide. See the story on page 24. It is important that the issue of suicide prevention is discussed more widely and constructively in the context of initiating better support and resources for mental health services in this country. Q
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AMA Queensland E-Connect – A new member service particularly for members in rural and regional Queensland
During September, we will be trialing a new member service called AMA Queensland E-Connect. AMA Queensland E-Connect has been set up to ensure that no matter where our members reside, they have access to support and advice from us. So how does it work? Jane Schmitt Chief Executive Officer AMA Queensland
Log onto our website and click on the AMA Queensland E-Connect icon Book a meeting time with the person or AMA Queensland department you wish to speak with. This might be our President, a member of our Council, or our membership, workplace relations or business support services teams You can also upload documents you wish us to peruse or refer to during our meeting with you Once you have booked an appointment time, you will receive an email to confirm the time and to tee up your preference of either a face-to-face meeting via Skype or teleconference. We have initiated this meeting option, to ensure that if you live outside the South East corner, you have quick, easy and regular access to the support and advice services AMA Queensland offers. Of course, members who live or work in Brisbane and surrounding areas, are most welcome to save travel time and time away from your workplace, by utilising this service too. We encourage you to take a look at AMA Queensland E-Connect and welcome your feedback.
Queensland Health Payroll Overpayments
Towards the end of June, many Queensland Health employees received correspondence from their employer regarding alleged payroll overpayments and the repayment process. On 11 July, after Queensland Premier Anna Bligh has announced: A temporary moratorium on the overpayment recovery process. A focus on ensuring under-payments are rectified as a priority. The appointment of an external workplace ombudsman to handle complaints and to determine the length of the moratorium. Provision of more support for line managers and better recognition for payroll staff. The trialing of new pay cycle arrangements at a number of sites. 8
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We know this issue continues to place unnecessary stress and frustration on many AMA Queensland members who have been swept up into this ongoing debacle. Our Workplace Relations team has assisted many of you and will continue to do so. We encourage you to refer to our website for updates and answers to frequently asked questions. Recently, we received a letter from Premier Anna Bligh apologising to members for the distress and inconvenience the payroll debacle has caused. This letter can be viewed on page 10.
National Disability Insurance Scheme
In August, the Federal Government announced its commitment to a Commonwealth-run, no-fault National Disability Insurance Scheme following recommendations from the Productivity Commission. The Productivity Commission’s final model calls for a full federal takeover of disability care and support from the states with the creation of a single agency called the National Disability Insurance Agency. AMA Queensland supports the principles of a National Disability Insurance Scheme which proposes to cover all Australians with funding support in the event of a significant disability. The immediate past President of the AMA, Dr Andrew Pesce, has been a passionate campaigner for a longterm care scheme in Australia for around a decade. He has described the introduction of the scheme as “a defining moment in social equity in Australia”, further stating, “For too long, support for people with disabilities has come from a hotchpotch of programs and schemes that have rarely provided comprehensive and necessary support. At the moment there has been wide-spread criticism that the government has failed to move more quickly on delivering the scheme, with the current preparation time close to seven years. This length of time to wait is disappointing for families who continue to struggle every day and are in desperate need for more disability care and support. Certainly there is a lot more detail to come and we will monitor it closely. Q
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AMA QuEENSLAND NEWS
letter from the premier Following a meeting with Premier Anna Bligh, AMA Queensland received the following letter regarding Queensland Healthâ€™s payroll issues.
SEPTEMBER 2011 DoctorQ
DoctorQ SEPTEMBER 2011
in brief Young people in the dark about sexual health Young Australians are showing worrying signs of ignorance about their sexual health. A survey of more than one-thousand 18-to-35 year olds has found many are in the dark about Pap smears, sexually transmitted infections and how the contraceptive pill works. One in 10 men believe the pill protects a woman against sexually transmitted infections, like gonorrhoea and chlamydia. One in five don’t know that STIs can affect their fertility. Nearly half of all those surveyed wrongly believe Pap smears for cervical cancer can also pick up sexually transmitted infections. The survey was carried out in July for private health insurer Bupa, and also found four in 10 young Australians don’t know when a woman is most likely to fall pregnant. Q
review recommends better medicare arrangements in aged care
dr bill coote acting director of professional services review
The AMA has welcomed recommendations for a review into GPs visiting elderly patients in aged care facilities and their own homes to ensure the Medicare rebate covers the cost of providing the service.
AMA President, Dr Steve Hambleton, welcomes the appointment of Dr Bill Coote as the Acting Director of the Professional Services Review (PSR) for a three-month period. Dr Hambleton said that the PSR performs an important function and it is crucial that it has strong leadership that is respected by health practitioners. “Dr Coote is a senior, respected member of the medical profession with considerable experience in medical practice and in medical education,” Dr Hambleton said. “His high standing in the medical community sends a strong signal that the PSR will be in safe hands.” Q
Dr Hambleton said that the AMA has been calling for improved Medicare arrangements in aged care for many years. “Ensuring access to ongoing medical care is the most cost effective way of providing quality long-term care and prevents the unnecessary cost of older people being admitted to hospital. “It is important to know that residents of aged care facilities are getting the medical care they need. Up until now, there has been no way to monitor this ,” Dr Hambleton said. “We will now be urging the Government to accept the Commission’s recommendations on the Medicare rebate for aged care services,” Dr Hambleton said. In order to properly cater to the medical care needs of residents, the AMA believes residential aged care providers will need: Specific financial support to enter into arrangements with medical practitioners, underpinned by a retainer, to ensure residents can access ongoing medical care; Government support to ensure that there are adequately equipped clinical treatment areas in aged care facilities that afford patient privacy; Government support to provide information technology to enable access to medical records and to improve medication management; and Sufficient numbers of registered nurses to monitor, assess, and care for residents and liaise with doctors. Q
stop the rot to fight rural classifications The Rural Doctors Association of Australia (RDAA) has launched a national Stop the Rot! virtual roadshow to highlight mounting evidence that the new Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) system is making it significantly more difficult for small rural towns to attract doctors. The ASGC-RA is used to determine the extent of relocation and retention incentives that doctors receive based on their location. However, it places many smaller rural towns in the same category as larger regional centres and even Hobart, meaning doctors can receive the same incentive payments whether they practise in the smaller towns or larger centres. This substantially reduces the incentive for doctors to move to or stay in the smaller towns. “The irony is that, in many towns, more remote classification levels apply less than two kilometres—and even just five metres—from the town limits. If five metres out of town is considered ‘very remote’ then why is the town itself not considered ‘very remote’ too?” said RDAA President Dr Paul Mara. Q
SEPTEMBER 2011 DoctorQ
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AMA QuEENSLAND NEWS
health and hospitals network bill submission
MA Queensland has reinforced the importance of clinician control and attaining effective clinician engagement in its submissions regarding the Health and Hospitals Network Bill 2011.
The reforms appear to introduce considerable new levels of bureaucracy and AMA Queensland has expressed its concerns about the potential for an increase in the levels of bureaucracy and associated costs that may be a ramification of the reforms.
AMA Queensland has requested to see further details and explanations about how the new bureaucratic levels will operate and have made it clear that there exists a very real need for increased clinician engagement if real reform is to take place. Q
AMAQ FOUNDATIOn donates $30K to see the signs campaign
he AMAQ Foundation has donated $30,000 to the AMA Queensland See the Signs campaign, which raises awareness about mental health symptoms after Queenslanders continue to clean up after a devastating summer of natural disasters.
to rebuild their homes and their lives,” said Dr Hambleton.
See the Signs is a state-wide public awareness campaign urging friends and family to look out for each other.
As part of the campaign, Dr Gino Pecoraro filmed a YouTube clip entitled See the Signs for a healthy mind discussing those most at risk of experiencing mental illness following a natural disaster and the signs to look for in friends and family. To access the YouTube clip either visit the AMA Queensland website or visit www.youtube.com and search for “See the Signs for a healthy mind”.
The aim of this initiative is to help Queenslanders recognise if someone isn’t coping by providing a practical checklist of common symptoms. We also want to make sure people know their GP is there to help. AMAQ Foundation President Dr Steve Hambleton said that while the cyclone and floods might be a distant memory for some, the Foundation was moved to donate the money for the people who are still very much affected. “Six months on from the disasters that ravaged Queensland, people are still struggling
“A campaign that encourages Queenslanders to see the red flags amongst friends and family that signal anxiety or depression is well worth the investment,” he said.
AMA Queensland has also developed an A4 poster outlining the seven signs which can be downloaded at www.amaq.com.au. To find out more about the campaign please contact AMA Queensland on (07) 3872 2209 or email firstname.lastname@example.org. Q
like us on facebook
MA Queensland has taken the plunge and joined the world of Facebook.
Facebook creates an excellent forum to connect with members online, increase that sense of community and enable us to be more accessible to our members, especially our junior doctors and medical students. We hope to encourage discussion online about anything from the hot topics surrounding the medical world to feedback on how we can better service you, our members. Next time you are on Facebook check out our page, ‘like’ it and share your thoughts on our wall. Q
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Complaints of continued poor sleep with ongoing nightmares. Observations a person is easily overwhelmed, tearful or fragile. The use of drugs or alcohol to suppress intense emotions or to try and achieve sleep. A pattern of withdrawing from family and friends and not engaging in day to day discussions that generally allow people to slowly debrief. Problems performing at work such as struggling to concentrate on the job at hand. Startling easily and declining invitations for social engagements and other usually pleasurable activities. Increased or unreasonable irritability with family, workmates or friends.
AMA QuEENSLAND NEWS
new B ranch C o u nc i l M E M B E R S Dr noel hayman
Greater Brisbane Specialty: Public Health and General Practice Background: Dr Hayman was one of the first two Indigenous medical students to graduate from the University of Queensland in 1990. He has subsequently completed his Masters in Public Health, and received his Fellowship of the Australasian Faculty of Public Health Medicine in 2000. He is an Associate Professor, at the University of Queensland School of Medicine. His current position is Clinical Director of the Inala Indigenous Health Service in Brisbane. He sits on numerous National and State Committees including being the current Chair of the Royal Australasian College of Physician’s Aboriginal and Torres Strait Islander Health Expert Advisory Group. He is also on the Board of the Australian Indigenous Doctors’ Association (AIDA) as Secretary. Intention: “Indigenous health. I believe we can do so much better in this area if we all work together. I would love to see more Indigenous students studying medicine – if I can do it, anyone can.”
Dr jonathon shirley
Greater Brisbane Specialty: Anaesthetist Background: Dr Shirley works in clinical practice as an anaesthetist in Brisbane. As a locally trained graduate, he has had significant exposure to both public and private sector medicine over the last two decades. He has also contributed in his role as an aerial retrieval specialist for the Royal Flying Doctor Service and Emergency Management Queensland helicopter. Intention: “As an anaesthetist one has a unique advantage to observe the patients’ clinical experience across a wide range of specialties and also the interaction between them. I strongly believe doctors need a committed representative on council. My concern for the future of health care at both state and federal levels centred around sustainable clinical service delivery for patients and the apparent governmental inaction to the ongoing education and training needs of junior doctors right across the board. It is absolutely imperative that the medical profession as a whole take control and leadership of these issues before we as future patients become victims of a system that has been neglected. As a member of council, I will take an active role in ensuring the highest quality and professional standards for our colleagues.
Dr shaun rudd
General Practitioner Craft Group Specialty: General Practitioner Background: Dr Rudd has been practising as a GP for 24 years and is currently based in Hervey Bay. He enjoys all areas of General Practice and has been a representative on AMA Queensland Branch Council for the past six years, followed by a recent short break. He has also served as the AMA Queensland Honorary Secretary from 2007-08; and Chair of the AMA Queensland International Medical Graduates Committee. Intention: “I aim to promote General Practice and the preservation of the autonomy of the doctor patient relationship, the biggest threat to which is voluntary registration attached to fund holding for diseases.”
dr anil sharma
Capricornia Area Specialty: Consultant Ophthalmologist - cataract surgery, diseases and surgery of the retina, age-related Macular Degeneration, Ocular Trauma Background: Dr Sharma has been practicing Ophthalmology for the past twenty years and is currently based in Rockhampton at the Mater Misericordiae Hospital. He received his FRANZCO in 2005 and has been practicing general ophthalmology work in Rockhampton, initially at the Rockhampton Base Hospital as a staff specialist commencing in 2003, then as a VMO, and now as a private practitioner at the Mater Hospital. Dr Sharma has a Retinal Fellowship from the Sydney Eye Hospital and the Royal Adelaide Hospital and is currently Senior Lecturer in Ophthalmology at the Queensland University Rural Division based in Rockhampton. He is also involved locally with the Rockhampton Lions Club and participates in various community projects. He is also on the board of the Central Queensland Nepalese Association. lntention: “l aim to undertake more educational activities and address health issues of the public in the Capricorn Region, thus promoting the AMA in Rockhampton and the Capricornia.”
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DoctorQ SEPTEMBER 2011
Six months on from Queensland’s flood and cyclone disasters, Policy Advisor Zoe Levendel points out why cuts to GP mental health services could not come at a worse time.
he See the Signs campaign was launched in May this year in response to concerns for the mental health of Queenslanders after the devastating floods that occurred earlier in the year. The campaign is a state-wide public awareness campaign to urge friends and family to look out for each other and additionally AMA Queensland also wanted to ensure people were aware their GP was there to help. The AMA are concerned about changes made to the Medicare Benefits Schedule announced in the 2011/12 Federal Budget, which will effectively reduce the level of Medicare rebates payable to patients who require GP mental health services. AMA has launched an online petition to urge the government to restore funding for GP mental health services and it highlighted the Better Access Program that has been independently reviewed by the Centre for Health Policy and Programs. This review demonstrated the program has: improved patient access to mental health services; achieved positive outcomes for patients with mental illness; and provided affordable access to GP mental health services, with little or no out-of-pocket costs.
The same review also found the program was cost effective, so it is difficult to comprehend why the Government has cut the funding for GP mental health services. The cuts to mental health funding also come at a time when Queenslanders will require more support. It is well documented that a number of mental health issues arise post disaster. They can span across a spectrum of mental health issues from difficulty concentrating, relationship problems and including post traumatic stress syndrome, indicating various signs that the body is experiencing psychological stress. A recent AMA Queensland survey found half of the doctors surveyed think most Queenslanders would not know where to turn for help if they were suffering mental health difficulties and this is a worrying proposition. Clearly education about what constitutes mental health issues is required and this is one of the many issues GPs can address during their consultations with patients. A concerned AMA Queensland member also stated they see on average two to three patients daily experiencing mental health issues
and wanted to highlight it was not only the devastation caused by the floods that was having an impact on Queenslanders, but it was also financial strain placing a significant burden on many people leading to conditions such as anxiety and depression. AMA Queensland recognises doctor-to-patient, face-to-face consultations are always the best option to be taken, as GPs can open the doors to the appropriate support services and referrals systems. However, a number of factors can prevent patients suffering from mental health issues from seeking treatment. Challenges to providing mental health services and support include aspects, such as not having enough time to get away from work, limited or no access to support services, particularly those in regional or remote areas, or the general stigma felt by some people regarding the need to seek mental health treatment. Another initiative available, OnTrack, created by a team of psychologists at Queensland University of Technology with sponsorship from the Queensland Government to help fill the gap. Specifically the OnTrack Flood and Storm Recovery program was funded by Queensland Health as part of its disaster recovery response. The program is available at www.ontrack.org.au/floodandstormrecovery and guides people towards identifying their strengths, coping resources and support mechanisms to help them think about how to move forward and where to start. Importantly, this is a free service. Dr Dawn Proctor, from QUT’s Institute of Health and Biomedical Innovation stated “in the first phase of disaster recovery the emphasis should be on helping people to work through practical problems, put together a plan to rebuild their lives and make use of their available support networks.” The website is interactive and provides a number of quizzes, so people can check how they are doing from a psychological perspective and get feedback. This may direct some people to a page called ‘Get Help’ which details important support services. The website offers a range of sources to seek support in an easy and user-friendly format and provides another level of armory in addressing access to mental health support services for the community. Q
AMA Queensland President Dr Richard Kidd:
“AMA Queensland would like to reiterate our deep concerns regarding funding cuts to patient rebates for GP mental health services and urge members to sign the petition located on the Federal AMA website. We would also like to acknowledge that it is the worst time to make such cuts to mental health services as Queensland doctors are expecting an increase in the number of patients (adults and children) presenting with mental health conditions after the disasters. Arguably, if these are dealt with in a timely manner by experienced GPs, psychologists and other mental health professionals it is likely this support will assist to prevent the progression to more severe disease and other ramifications such as a loss of personal income and a general loss of productivity and costs to the Queensland economy.”
SEPTEMBER 2011 DoctorQ
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DoctorQ SEPTEMBER 2011
AMA Queensland Media and Communications Officer Stephanie Shield discusses why a health issue that needs time and careful attention to the facts is likely to suffer in the world of ‘click-through’ journalism.
evelopments in technology and the internet have caused the media to evolve at a rapid rate, the demands by society for immediacy has also played its part in increasing the need for news to be delivered quickly and in the most exciting and sensational format. But how is this demand for immediacy impacting on the content quality? From a doctor’s perspective you can be forgiven for sometimes being frustrated by the reporting of a disease or illness that either leaves out the important facts, reports the facts incorrectly or creates unnecessary hysteria by not putting a story in context. One such example is the recent reporting of the Hendra Virus outbreaks over the last two months. The Hendra Virus by all accounts is still an emerging disease and has many unknowns to be researched and considered like the specifics surrounding the transmission of the disease. Headlines such as the one below however focus more on creating hysteria with little regard for factual truth. “Hendra causing panic!” “FRASER COAST families are living in fear of flying foxes after a Hendra virus outbreak” To date, there is no evidence of the Hendra Virus spreading from bat-to-human that would suggest the next time a flying fox is spotted overhead you should dive for cover for fear of contracting the virus. So far, humans have only become infected from handling infected horses (both before and after they develop clinical signs, as well as during autopsies). “Kill flying foxes to stop Hendra”
AS E fam R CO A li i of ving lies a ST fl i r ter 18ying n fea e fo r a s H xe SEPTEMBER 2011 DoctorQ
“We would carry out mass culling to protect the health of Queenslanders, amid a new cluster of Hendra cases killing horses in Queensland and NSW” Despite these claims, authorities have quite clearly indicated that culling flying foxes is not an effective way to reduce the Hendra virus risk because: Flying foxes are widespread in Australia and are highly mobile so it is not feasible to cull them and; Culling or dispersing flying foxes in one location could simply transfer the issue to another location History shows there have been seven cases of human infection recorded, of which four have resulted in death. While any loss of human life is devastating for family and friends, these four deaths is a far cry from a “Killer outbreak!” as one newspaper headline exclaimed. News organisations can review what stories received the most ‘hits’ or ‘click throughs’ online to assist them in deciding what the public are interested in reading and what generates most discussion or debate. It is generally the eye-catching headline and sensationalist story that makes the general public click through and read, forward to a friend or re-post on Twitter. Don’t believe it? A snapshot of the top most read stories of the day include headlines such as: Cockpit sex photos - airline to investigate She could kill Nazis with her bare hands Prison guards get intimate with inmates Bat vigilantes on the rampage Vulgar jokes: Websites mock dead babies Flu outbreak grips Australia Parents who smack ‘may face court’ If this is what the top most read stories of the day entail, is it any surprise that news organisations continue to repost similar stories online? In our demand for more immediate news delivery it has, for better or worse, created tighter deadlines for journalists and reporters meaning less time to research and shorter articles being churned out every five minutes.
l a c l l u c t Ba
In the world of media one of the golden rules is to simplify an issue to its basic core so the general public can understand and relate. This is where medical journalism is falling down because medicine, more often than not, can not be simplified. The result - a Hendra Virus scare campaign providing very little factual information because there
is simply not enough understanding, time or word limit to portray the issue in its entirety. Back to the Hendra virus story, there have been many interesting headlines which make it appear like every bat in Queensland must be annihilated or that Hendra virus is in every horse paddock across the State. Bats targeted as Hendra virus fear grows Better protection needed against hendra virus Bat cull call Experts hunt for Hendra in other species Horse owners boycott Ekka over hendra virus fears Ekka Hendra virus worry Flying foxes rule as Hendra virus fears rise amid calls for culling LNP wants to chase bats out of urban areas with smoke bombs, choppers While there has always been talk back radio and letters to the editor, the two-way nature of media has never been so immediate and unmodified.
more ‘citizen journalism’ to take place. While this can present an alternative viewpoint from mass media, readers may not always question the source’s credibility. There is no doubt we will continue to see further developments in technology that will impact on the way media evolves and generate new ways to interact, share and engage with audiences. No matter what the future holds for the media and the delivery of news, AMA Queensland will continue to assist journalists to understand a health issue entirely and will communicate complex health and medical concepts in a easy to understand format, without losing the important facts. Q
Health generates a lot of emotion and discussion which is why, the more controversial the topic, the more likely people are to read and make comments. A recent story headlined Smoking reduces need for joint replacement received 158 comments within two hours of it being posted online. While the public have always and will always make up their own mind about a story, they’ve never had the chance to do it so publicly. A conversation that might have been had around the kitchen table is now accessible for the world to read. It often leads to uninformed, insensitive, discriminatory and downright incorrect facts up for discussion.
URRENT ISSUES Twitter, blogs and other social media have allowed
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DoctorQ SEPTEMBER 2011
Dr Margaret Kay from the Doctors’ Health Advisory Service outlines why it is so important for doctors to sit down and have a chat with a regular GP.
octors’ health is not just a mental health issue. The focus on mental health often distracts the profession from the broader issues of doctors’ health. The medical literature tells us that doctors suffer with the same types of illnesses as the general community – physical and mental health issues - and over 40 per cent of doctors have a long term health problem1. Despite their health knowledge, doctors are no better than the general population at having their preventive health checks, their immunisation rates are sub-optimal.1 Rates of depression and substance abuse are also similar to the general population.2 Overall doctors have a lower standard mortality rate. This is partly because doctors are health literate and from a higher socio-economic background, but perhaps mostly because few doctors smoke.3 Doctors do have a higher suicide rate.3 This has been repeatedly documented since Sir William Ogle presented his findings to the Royal College of Physicians in 1886.4 Male and female physicians have the same rate of suicide (very different to the general community).2 However it is important to remember that suicide is associated with physical health problems as well as mental health issues.2 It is also well documented that doctors have difficulty accessing health care for themselves.5 In response to this, it has been recommended for some years now that doctors should have their own general practitioner (GP).6 Although more doctors report having a GP, it is not clear how many doctors have an independent GP and, just as importantly, how many have an established therapeutic relationship with their GP.7 It appears that doctors find it difficult to know when to go to the doctor, who they should see, why they should bother going to the doctor (because they are healthy) and how to be a patient when they get there. There has been little research into how doctors decide to access their health care. In particular, there are very few qualitative studies investigating this issue and most of these studies have focused on seriously ill doctors rather than the ‘average’ doctor.5 Determining the ‘right time’ to go to the doctor can be especially difficult. It can be difficult to decide which symptoms are significant enough. Doctors often hesitate to attend for less serious illness wishing to avoid bothering their doctor unnecessarily. They often wait for that ‘red flag’ symptom; yet often there is no ‘right time’. Although the literature criticises doctors for delaying formal care by self-prescribing, the narratives of doctors’ health suggest that observing an illness is a more common trap, and determining when to access care is a complex process that is rarely discussed.8 When doctors talk to their peers informally about their health problems, they rarely encourage each other to see their GP. Instead the discussion can drift into an intellectual discourse about the potential differential diagnoses - a far more comfortable conversation. Although this advice may be academically correct, this failure to trigger the seeking of formal health care can cause significant delay in the seeking of care. Even when a doctor finally goes to a doctor, specialist care is often sought and the GP may be bypassed. The opportunity for the doctor-patient to establish rapport with their GP is lost again. 20
SEPTEMBER 2011 DoctorQ
When a patient does seek care, the treating-doctor may be uncomfortable when the doctor is a patient.9 Reassuring the doctor-patient that they will be treated like a normal patient is usually a good place to start. Expectations should be plainly stated (and assumptions avoided). Confidentiality is essential and the doctor-patient should feel free to be honest about their self-treatment so that future care is managed safely. The treating-doctor should recognise the doctor-patient’s health literacy, engage the patient in shared decision-making and ensure adequate follow-up is arranged. Finally, when revisiting doctors’ health, it is necessary to recognise the complex weave of cultural issues that continue to sustain the poor health behaviours of doctors. Cultural bravado often counters positive messages about maintaining wellbeing. Doctors often compare stories about how they kept working when they were very sick, very tired or even jet-lagged. These cultural narratives are quickly absorbed by junior doctors and students. Meanwhile the medical literature often presents the ‘sick doctor’ negatively. It is not a surprise to find that doctors continue to struggle to accept the ‘sick role’ when this term is regularly used interchangeably with ‘impaired doctor’ or ‘problem doctor’. Cultural change is necessary before many of these health issues can be addressed. It is our profession and our responsibility to provide the positive messages that will enable cultural change. Doctors need to be proactive about maintaining their personal health (including the food we eat and the hours we keep) and sometimes this will involve becoming a patient. Providing overt, positive role-modeling of these healthy behaviours to our peers is one way to initiate the cultural change. Q
References: 1. Kay M, Mitchell G, Del Mar C. Doctors do not adequately look after their own physical health. Medical Journal of Australia 2004;181(7):368-370. 2. Centre C, Davis M, Detre T, Ford D, Hansbrough W, Hendin H, et al. Confronting depression and suicide in physicians: a consensus statement. JAMA 2003;289(23):3161-3166. 3. Schlicht SM, Gordon IR, Ball JR, Christie DG. Suicide and related deaths in Victorian doctors. Med J Aust 1990;153(9):518-21. 4. Woods R. Physician, Heal Thyself: the Health and Mortality of Victorian Doctors. The Society for the Social History of Medicine 1996;9:1-30. 5. Kay M, Mitchell G, Clavarino A, Doust J. Doctors as Patients: a systematic review of doctors’ health access and the barriers they experience. British Journal of General Practice 2008;58(552):501-508. 6. Australian Medical Association. AMA Code of Ethics. 2004. In. Canberra: Australian Medical Association; 2004. 7. McCall L, Maher T, Piterman L. Preventive health behaviour among general practitioners in Victoria. Aust Fam Physician 1999;28(8):854-7. 8. Mandell H, Spiro H. When Doctors Get Sick. First ed. New York: Plenium Medical Book Company; 1987. 9. Kay M, Mitchell G, Clavarino A. What doctors want? A consultation method when the patient is a doctor. Australian Journal of Primary Health 2010;16:5259.
Mater Health Services invites you to join your colleagues for an inspiring education weekend at the stunning Hyatt Regency Sanctuary Cove. Mater’s Women’s Health Conference program for 2011 features some of Queensland’s leading women’s health specialists, delivering exciting, interactive and informative presentations that will engage you, inspire excellence and provide practical techniques for you to perform in your practice. Not only will you be one of the first doctors educated in ground breaking medical advancements, Mater’s key specialists will provide hints, tips and advice for you to improve patient care.
REDCLIFFE MEDICAL PRACTICE FOR LEASE • Redcliffe Parade, Redcliffe
FEES: Full Delegate Registration $400 inc GST. • Two days conference registration (Saturday and Sunday) - Conference lunch on Saturday and Sunday, morning and afternoon tea on Saturday and morning tea on Sunday for delegate • One night accommodation in a Hyatt Guest Room, choice of one king or two double beds • Breakfast for two on Sunday • Conference cocktail party for two on Saturday night. Day delegate registrations are also available.
REGISTRATION: To register please visit Mater’s online registration portal located at materonline.org.au and click on Events. INFORMATION: For further information please contact Sara McDonald on 07 3163 1036 or email email@example.com
Department of Veterans’ Affairs
More choice for GPs when referring veterans for mental health services
• 30kms north of Brisbane CBD
GPs can now refer DVA clients to mental health professionals registered with Medicare Australia.
• Custom built furnished rooms
These include clinical psychologists, psychologists, mental health social workers and mental health occupational therapists.
• Suitable for up to four doctors
Mental health professionals no longer need to contract separately with DVA.
• Adjacent to a long established pharmacy
For more information visit: www.dva.gov.au/service_providers For information about veteran mental health issues go to www.at-ease.dva.gov.au and click on the Resources for Health Professionals tab.
• Spacious car park
Enquiries please call John:
Phone 07 3203 7734
DoctorQ SEPTEMBER 2011
AMA Queensland Workplace Relations, Training and Policy Manager Andrew Turner discusses how important the role of the medical receptionist can be as a conduit between doctor and patient.
hile medical training is increasingly incorporating empathy and communication in any skills assessment, there is an all pervading ignorance about the role of receptionists. With GPs and Specialists working under more and more time pressures, and support staff required to perform more tasks to ensure the clinicâ€™s smooth operation and compliance requirements, the role that empathy plays in this can be neglected.
Patients largely view receptionists as hostile barriers blocking access to their doctors, and this may explain how tense situations are created. The position of medical receptionist has been traditionally under-researched, and consequently their role has been downplayed. The tasks required of the receptionist as the initial point-of-contact frequently involves the management of patients, some of whom are emotional, anxious or aggressive. They are a vital part of the health care relationship, and as such, the idea of triangulation between doctor patient and receptionist needs to be understood. Itâ€™s often not until a valued staff member retires, is away on holidays or is absent with sickness that the integral role they play becomes evident. Their capacity to
soothe, calm and engage with patients is fundamental to the operation of a clinic. In May 2011, the Journal Social Science and Medicine published a major study regarding the role of medical receptionists. Dr Jenna Ward at the York School of Management observed 30 receptionists over the course of three years. The study found that a receptionist handles 70 queries in any day: involving death, birth and everything in between. Their responsibility is to empathise with these patients in a professional capacity, which is a skill that can only be developed through time and training. Not all receptionists have the same skill level. This major study contains some surprising results: patients largely view receptionists as hostile barriers blocking access to their doctors, and this may explain how tense situations are created: if patients perceive that their health concern is not being urgently attended to, they feel threatened. The anger and frustration that results is due to their concern that they will not get the attention they consider their condition warrants. The role of empathy in this exchange cannot be overstated. If the receptionist can communicate with the patient, then a potentially heated exchange can be neutralised. Even routine tasks that one staff member performs on a regular basis can become arduous by an unskilled staff member. A common misconception is some tasks appear easy: in making an initial assessment of the patient over the telephone or in person; providing elementary health care and scheduling appointments. There were two observations which are fundamental to the running of your clinic: the larger the clinic becomes, the more rigid the policies are, which unfortunately, results in greater hostility towards reception staff. Secondly, young adults and parents with children are often more quick to temper and are the most likely to be combative in their approach. Dr Ward concluded the most successful receptionists were able to change their emotions to replicate the patients: whether it related to speaking to grieving family members or congratulating a new parent. Further Dr Ward notes that specific training should be provided to all staff concerning management of patientsâ€™ expectations. Seeing as though receptionists are on the front line of the patient relationship, they require the tools to do their job, just as much as a doctor, nurse or other health practitioner. Q
SEPTEMBER 2011 DoctorQ
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You can refer a patient to Return to work assist by calling 1300 023 969 or by completing the referral form on our website at www.qcomp.com.au
DoctorQ SEPTEMBER 2011
With the Australian Press Council releasing new standards for reporting on suicide, Editor Michelle Ford Russ discusses how the changes will open the door for far more coverage on the topic.
or many within the media industry, suicide has been a taboo topic with very real fears of copycat suicides by people considered vulnerable because of age or mental health. Others have tread onto sensational ground by dismissing important guidelines in place to prevent those vulnerable from ‘getting ideas’.
that’s actually contributed very much to the continuance of ignorance and taboo around the issue,” he added.
Numerous celebrity suicides have been linked with increased national suicide rates. After Marilyn Monroe took a sleeping pill overdose in 1962, researchers pointed to her death as a trigger for a 12 per cent rise in people in the US taking their own lives during the following month.
“In the past that anxiety around those issues has resulted in the whole issue not being covered at all,” he said.
In comparison, when singer Kurt Cobain died by suicide in 1994, there was not an overall increase in suicides rates in his home town of Seattle, believed to be because reporting differentiated strongly between the brilliance of his life achievements and the wastefulness of his death. Another contributing factor may also be because the media coverage discussed risk factors and identified sources of help for people experiencing suicidal feelings. Until the recent changes, organisations such as Mindframe actively discouraged media from reporting on suicides by suggesting the amount of stories on suicide be reduced and recommended less prominent placement.
Others have tread onto sensational ground by dismissing important guidelines in place to prevent those vulnerable from ‘getting ideas’. The new standards, which have been welcomed by counselling services, mental health groups and advocates, encourage journalists to report on suicide and suggest that the increase could “be of substantial public benefit”. Australian Press Council Chair Professor Julian Disney said there should not be a taboo on reporting of this kind. “It can help to improve public understanding of causes and warning signs, have a deterrent effect on people contemplating suicide, bring comfort to affected relatives or friends, or promote further public or private action to prevent suicide,” said Professor Disney. Mental health advocate Professor Patrick McGorry supported the new guidelines. “The problem has always been this idea among media outlets that they aren’t able to report suicide. And 24
SEPTEMBER 2011 DoctorQ
Professor McGorry said there was no reason not to report cases of suicide, provided caution was exercised around several specific issues.
Examples around the world have shown that opinion on reporting on suicide can differ greatly, even between like-minded organisations. When 17 young people took their own lives in a space of 13 months in the Wales town of Bridgend in 2007-08, grieving parents blamed sensationalist reporting for glamorising suicide. Following the deaths, Anne Parry, the Chairwoman from the UK’s young suicide prevention charity Papyrus, commented: “We are seriously concerned any more media coverage would exacerbate the current state of affairs with disastrous results. At worst it could lead to further suicide attempts. We are asking media please do not draw further attention to this situation.” However, emotional support group service Samaritans disagreed. “We need responsible reporting rather than no reporting,” a spokesperson said. Although some reporting had been insensitive and sensationalist, there had been positive benefits, she said. “Putting suicide in the spotlight helps focus attention and resources on it, and greater understanding of its complexity helps to destigmatise it.” So, while the new Australian guidelines welcome responsible reporting and discussion, they also include restrictions on naming people who have died by suicide. Research shows that copycat victims tend to come from similar backgrounds and are at greatest risk if they know other victims. Journalists are discouraged from providing details about methods or locations of suicide, giving details of a suicide note and using inappropriate language, such as ‘successful/unsuccessful suicide’, ‘committing suicide,’ or ‘cry for help’. In Australia, journalists are encouraged to provide contact details about 24-hour crisis counselling services on any stories relating to suicide or mental health problems. For help or information on suicide, visit www.beyondblue.org. au, or call Lifeline on 131 114. Q
Persistent Pain Management Services
Dear Colleagues, The Queensland Government is investing in improving Persistent Pain Management Services across the state. Immediate efforts are focused on expanding existing services in Townsville, Sunshine Coast, Metro South and Gold Coast Health Service Districts to address the biomedical, psychological and social aspects of pain problems within evidence-based, multidisciplinary service delivery models. There will be a phased approach to increasing the capacity of these services, however it is anticipated they will be fully operational within their expanded models by January 2012. In the meantime, existing services will be maintained as the Persistent Pain Management Services transition into these expanded models. For rural and remote patients across the state, it is acknowledged that practical pain management steps pose significant challenges in terms of access and equity of service delivery, and as a result, Townsville, Sunshine Coast and Gold Coast Persistent Pain Management Services and the pain management service at the Royal Brisbane and Womenâ€™s Hospital are examining the use of telehealth and outreach programs within their service delivery models, and will be liaising with primary and secondary services inside their catchment areas to address this issue. Queensland Health and the Persistent Pain Management Services are committed to involving the primary care sector, in particular the General Practitioner (GP) community, in both the planning and implementation aspects of this phased approach. Each of the Persistent Pain Management Services has sought involvement from GPs and GP Liaison Officers within the GP Divisions / Medicare Locals in their relevant catchment areas and are working closely to develop a truly integrated model. A statewide Persistent Pain GP Advisory Group has also been established, with representation from AMAQ, GPQ, RACGP, ACCRM and relevant GP Divisions / Medicare Locals to provide a forum to address challenges and opportunities within this statewide network. Another aspect of improving persistent pain services is the development of patient educational resources to support you and your patients with ongoing persistent pain management. In addition, training and continuing education of medical, nursing and allied health staff in both acute, community and primary care settings is necessary to allow for sustainable service provision and improved health outcomes. Persistent Pain Management Services will be developing strategies to address these patient education and training needs. There is a Screening and Referral Guide for Persistent Pain Management Services available to assist you to determine referral suitability and provide sufficient information to allow services to accurately prioritise referrals. It is important to note that Persistent Pain Management Services are consultative and time-limited and that â€˜indefiniteâ€™ referrals will not be accepted. Persistent Pain Management Services will work with you and your patient, and other local community services where available to help them develop the skills required to better understand and self-manage their pain. As you know, as many as one in five Australians live with persistent pain, therefore it is realistic to acknowledge that expansion of these services may only provide a part of the solution in terms of addressing persistent pain in Queensland. There are other existing public services in some regional areas and practitioners and programs in the private sector that may also be a suitable source of information, advice and service provision. For a copy of the Screening and Referral Guide and information for patients you may be interested in referring to a Persistent Pain Management Service, please visit the website: www.health.qld.gov.au/persistentpain/ Thank you, and we look forward to working with you.
FEATURE FEATURESTORY STORY
With the Honourable Michael Kirby AC CMG delivering this year’s annual ES Meyers lecture, he reflects on Australia’s response to one of the world’s deadliest afflictions and how law and medicine worked together to become a world leader in HIV awareness and policy.
ike a holocaust, AIDS is a disease of tragic proportions with 60 million people infected since its discovery 30 years ago. On 5 June 1981 the United States’ Centres for Disease Control reported an unusual form of pneumonia in Los Angeles and New York. A few weeks later a similar cluster of rare cancer called Kaposi’s sarcoma was noted in San Francisco. This was the beginning of AIDS and they were a harbinger of the onslaught to come.
Grim Reaper Prevention is the Only Cure used by permission of the Australian Government.
As Michael Kirby recalls “At the beginning of the epidemic in the mid1980s, I became involved both personally and institutionally. As a gay man, I began to lose friends, dropping to infection at a time when there were few useful medical interventions. Because my sexuality was already an ‘open secret’, I was invited to take part in national AIDS conferences, the work of the AIDS Trust and, eventually, the Global Commission on AIDS of the World Health Organisation (WHO). I had the privilege of working with those great international civil servants and epidemiologists, Jonathan Mann and Peter Piot who led the global struggle against AIDS.”
The first case was diagnosed in Australia in 1985 however, the Federal Government was ready and was both vigilant and aggressive in ensuring that infection was contained. Left in its wake, was widespread community stigmatisation of intravenous drug users and homosexuals. And while this has abetted over time, it illustrates that a successful public policy campaign can be developed with the intersection of medicine and law, and serve as an example to future public health campaigns. Grim Reaper used by permission of the Australian Government.
“We have made many mistakes in the past 30 years. But we have also revolutionised the strategies for a global pandemic. And we have changed forever the relationship between law and medicine in fighting an epidemic”, Kirby says. “Suddenly, social science has become critical to this endeavour and lawyers and doctors now recognise this. In Australia, we were braver than most, thanks to the leadership of two influential and enlightened politicians: Neal Blewett (ALP Minister for Health in the Hawke Government) and Peter Baume (Coalition Spokesman). How lucky we were to have them when AIDS came along”. While he acknowledges that some governments’ approaches were and continue to be preferable to others, Kirby believes that the history has borne out the decisions made 30 years ago, “ On the whole, I believe that the policy response of Australian governments, Federal, Territory and State, were pretty well integrated in an astonishingly short time. Compare this with the usual difficulty we have in securing legal and social integration on any topic in Australia, even the time of day”.
The UK’s ad campaign Don’t Die of Ignorance aired in 1987.
SEPTEMBER 2011 DoctorQ
The medical community’s response was integral: and Australia’s
response was identified as a world leader in harm minimisation. Political decisions were also made to ensure widespread community engagement. This is evidenced by the decision to appoint Ita Buttrose, then editor of Australian Womens’ Weekly Magazine as Chair of the National Advisory Committee of AIDS (NACAIDS) from 1984 -1988. By engaging Buttrose, there was a deliberate campaign not to limit this educational campaign to drug users and homosexuals, but to get families to understand that nobody was immune. Buttrose fronted an ad campaign to explain that donating blood did not pose a risk of contagion after stocks dropped precipitously. However, in some respects, the campaigns were almost too successful, and the stigma that was then attached to the disease was truly frightening.
the grim reaper ad campaign
The cover image for this edition, the grim reaper is taken from the infamous 1987 advertisement. This public hysteria was truly petrifying as its creator Siimon Reynolds now acknowledges. He says the campaign did not clarify how to minimise harm, it only paralysed everyone into inaction; considering themselves at risk of exposure. Moreover Mr Reynolds says it unfortunately perpetrated homophobia as it manifested the fear the community was feeling towards ‘the gay plague’. This fear was personified in the character of the grim reaper, who was assumed to be a diseased homosexual man. While the campaign didn’t contain misinformation, nor was it constructive in reducing the stigma that permiated HIV/AIDS. Mr Reynolds was overwhelmed by the reaction to the ad, as he acknowledged to the ABC in 2008, “I think there was also a bit of a political fear that there’ll be a backlash against gays if everybody thinks it’s some kind of gay plague. But, you know, other countries had failed in their AIDS education because heterosexuals weren’t listening. We really had to wake people up. There was a lot of information about how to stop AIDS out there, but no-one was reading it”.
French organisation AIDES created a campaign using superheroes to remind the public that even the strongest amongst us can still be affected by HIV .
“We have made many mistakes in the past 30 years, but we have also revolutionised the strategies for a global pandemic. We have changed forever the relationship between law and medicine in fighting an epidemic.”
In recalling this stigmatisation, Dr Wendall Rosevear OAM, a General Practitioner at the Stonewall Medical Centre at Windsor in Brisbane’s north, recalls a rumoured proposal by the Bjelke-Petersen Goverment to re-open Peel Island in Moreton Bay, which was previously a leper colony as a destination to send infected HIV-positive patients. While critical of the state response, Dr Rosevear considers the Hawke response “to be crucial in establishing Australia as world leader in the harm-minimisation approach”. Surprisingly, a supporter has also been found within the church, particularly the Sisters of Mercy who, in 1985, lent a house in Wooloongabba to establish a palliative care facility. Dr Rosevear also notes the Sisters of Mercy were again on the front lines with Sydney’s first safe injecting rooms, despite heavy internal institutional pressures. Rosevear says this support was fundamental in erasing the stigma that had calcified over time. Michael Kirby concurs, “Even very sensitive subjects, such as sterile needle exchange and the establishment of the injecting centre at Kings Cross in Sydney, were accomplished against huge political odds and significant opposition from powerful interest groups. Of course, in retrospect, we could have done some things better. But the “Grim Reaper” campaign in the mid 1980s informed everyone about the dangers. Use of condoms became standard in the gay community. The injecting community embraced sterile needle exchange. Sex workers became condom educators. Laws were reformed”. In the face of such overwhelming public fear and uncertainty, this substantial law reform, however incremental, cannot be ignored. “On the whole, I believe HIV prevention campaigns were highly
Grim Reaper Sharing Needles used by permission of the Australian Government. DoctorQ SEPTEMBER 2011
FEATURE FEATURESTORY STORY successful in the early days of the epidemic. Correctly, for Australia, they targeted specifically the gay community and groups specially at risk. Ironically, this engagement, and the dramatic challenges of the time, enlivened courage and demands for respect and equality amongst gay Australians. Sadly, it took so much death and suffering to bring people out of the closet. And that includes me”. “Within Australia, we still have laws that need to be changed. They include anti-discrimination laws which do not uniformly protect sexual minorities and sex workers and people living with HIV and AIDS. But there are still in place criminal laws affecting drug possession and use that are increasingly recognised as ineffective and counter-productive. It is past time for Australia and the global community to reconsider the prohibitionist model of dealing with drug use. In the context of HIV, that model can often serve as part of the problem, rather than of the solution”. “In recent times, we have seen variations in STI rates in different states of Australia. The reasons are complex. But it does appear to vary with expenditures by state governments on AIDS councils and targeting at risk populations. Generally speaking, New South Wales has done better than most states because its successive governments have worked closely with ACON (AIDS Council of New South Wales). In other states, the degree of co-operation has been variable. And in the early days, Queensland was rather prudish or even hostile about involvement of the gay community. Even to this day, there are provisions of the Criminal Code of Queensland that discriminate against homosexual citizens in the state. Experience teaches us the best strategy for prevention is a non-discriminatory engagement with the at-risk groups. Helping them to face the crisis, we help ourselves – all of us. In this, we, in Australia and New Zealand, have a lot to teach the world.”
searching for a cure
Four years ago, a HIV-positive man, Timothy Brown underwent an innovative procedure in Germany which involved stem cell transplant for leukemia. Since then test after test has revealed there is no remains of the virus in his body. The bigger miracle is this might be the beginning of a cure for AIDS. For sceptics who used to say the money was there but the science wasn’t; it turns out it was the other way around. In 2008 he underwent a second transplant and the cancer appears to have stayed away. This man who had both cancer and AIDS, now has neither, and the scientists are trying to determine how. This transplant procedure costs a prohibitively expensive $250,000 and complications can arise resulting in death. And while this procedure raises many questions, a cure is still “decades away”, according to Daria Hazuda, an American Based vice-president of Merek. A recent study determined that early anti-retroviral therapy decreases patients’ infectiousness by 96 per cent. Today, most people on antiretroviral drugs achieve an undetectable viral load - there is virtually no HIV circulating in their blood. Big Pharma has a roll to play in the research and development and also distribution of any anti-retroviral therapy , “The issue of pharmaceutical patents is a hotly contested one which is under the study of the UNDP Global Commission on HIV and the Law. Obviously, patents which provide a time limited monopoly for those who share inventive secrets with the community can be justified to encourage the development of new drugs and vaccines to counteract HIV,” Kirby says . “The mistake which the international community and national governments have made has been to apply legal regimes that were
SEPTEMBER 2011 DoctorQ
developed in the age of steam engines to the rapidly changing technology of informatics, biotechnology and nuclear science. A different global regime was needed that also took into account universal human rights to the best available standards of health care. Most unfortunately, the United Nations failed to give proper leadership on this issue of balancing inventiveness and human rights. Instead, the development of new patent laws fell into the hands of the World Trade Organisation, which is not a United Nations agency at all. It is an organisation largely controlled by rich developing countries which, through WTO and the increasing network of free trade agreements, has stymied the development of a human rights respecting patent regime. Michael Kirby’s involvement is with developing countries, where money is scarce and science is tainted with religious ideology, “More recently, I have been appointed to the UNAIDS Reference Panel on HIV and Human Rights (2002) and the new UNDP Global Commission on HIV and the Law (2010). As well, my work in the Eminent Persons Group, looking at the future of the Commonwealth of Nations, has required me, and the Group, to examine the special problem of HIV/ AIDS for Commonwealth countries where the laws are often an impediment to prevention strategies. Our report has been completed. It will be considered at the Perth CHOGM meeting 28-30 October 2011. It recommends new initiatives to tackle HIV in Commonwealth countries”. Access to quality drugs and ideology-free information is still an issue in contention, and there seems to a two tier approach separating develop and developing countries, as Kirby says, “there is an urgent epidemic. Michael Kirby is a survivor, and he brings this stoicism and reliance to his work at the UN, “ Who will win in this struggle? Some say the international pharmaceutical corporations are invincible. Certainly they have a big financial kitty to play with. It is important to recognise universal human rights in the Universal Declaration of Human Rights 1948, expressly acknowledges the human right to protection of scientific inventiveness. But at the same time, universal human rights acknowledge the right to protection of life itself and to access to essential health care. Because the major impact of HIV/AIDS has fallen on poor developing countries and because the largest pharmaceutical corporations are in rich developed countries, the imbalance of power in the path of reform is plainly apparent. “In the end, I believe, and certainly hope, that humanity will triumph. It would be a shocking indictment of current generations if the availability of essential life-saving drugs was closed off because of the unavailability of generic drugs and the operation of intellectual property law, including ACTA. We must make sure this does not happen. But this will require not only recommendations in the report of a body such as the UNDP Global Commission. It will require strong action on the part of enlightened countries, and particularly countries like our own, Australia. In the three decades of HIV/AIDS, we have been a good exemplar of what can be done to reduce the epidemic at home. And what should be done to support prevention, care and treatment abroad. Australians have good credentials on HIV/AIDS. Not perfect, it is true. But good by the world’s standards. We must lift our voices to maintain the energy necessary to challenge the cost crises that lie ahead in HIV/AIDS. And we must learn from the ways in which this epidemic has been faced for the challenges to public health in other fields where the global community has so far only scratched the surface of essential reforms”. Q
DoctorQ SEPTEMBER 2011
In the lead-up to MOCA negotiations, AMA Queensland is investigating factors around safe working hours and fatigue management, including the quality of medical handovers. Council of Residents and Registrars Chair Dr Jen Williams explains.
he importance of effective handover has never been so high, due to decreased hours of work and a concomitant increase in shift change overs and due to ever increasing pressure on the hospital system to do more with less. Transmission of patient-related information from doctor to doctor may be distorted for reasons including time pressure, fatigue, frequent interruptions or lack of personal contact with the patient. Good handover requires input from a variety of caregivers. Handover safety can be improved by measures including: cross-over of shifts, allowing adequate dedicated time in a suitable location, clear leadership, provision of appropriate information technology and support from all levels of the medical team. In response to the belief that clinical handover can be better taught and practised, the AMA in 2007 developed a guide for Safe handover: Safe Patients. This document was to provide guidance to doctors on best practice in handover and provide examples of good models of handover from which doctors and managers can learn. Effective communication is necessary to allow for pertinent information to be exchanged and to ensure patient safety, so that clinically unstable patients are known to senior and covering clinicians, junior members are adequately advised of concerns from previous shifts and tasks not yet completed are understood by the incoming team. These systems, based on a generic model, must be adapted to local needs.
The key to the handover system is continuity of care based on continuity of information (in lieu of continuity of personnel), to protect patient safety. Handover is of little value unless tasks are prioritised, appropriate actions taken and plans for further care put in place in a timely manner. The Australian Commission on Safety and Quality in Health Care came into operation on 1 July 2011. It has been established as an independent, statutory authority under the National Health and Hospitals Network Act 2011. Its role is to lead and coordinate improvements in safety and quality in health care across Australia, to achieve safer, more effective and more responsive care for consumers. They have a focus on research and engagement with patients, consumers and their carers. Clinical handover will undoubtedly be one target area. AMA Queensland would be interested in hearing about your experience of clinical handover. We encourage you to think about procedures in place at your hospital, and to ensure the safety of your patients through optimised handover processes. Q
CoRR is the peak organising group for Residents and Registrars in Queensland. Chair
Dr Jen Williams firstname.lastname@example.org
Dr Saul Felber email@example.com
Education Dr Matt Palmer firstname.lastname@example.org
SEPTEMBER 2011 DoctorQ
Dr Vanessa Palmer email@example.com
Regional and Rural
Dr Alex Kippin firstname.lastname@example.org
CHARITY GOLF DAY T H U R S D AY 3 N O V E M B E R 2 0 1 1 • I N D O O R O O P I L LY G O L F C L U B
Contact Neil Mackintosh on (07) 3872 2267 or email email@example.com
Sullivan Nicolaides Pathology visit
MAQ Foundation President, Dr Steve Hambleton, visited Sullivan and Nicolaides Pathology’s head office at Taringa in Brisbane recently to personally thank their General Manager Dr Michael Harrison for the continuation of the company’s wonderful support to the Foundation. Sullivan Nicolaides Pathology became a supporter of the Foundation during its establishment year in 2000 and has been a generous donor ever since and is the Foundation’s largest corporate supporter.
Sullivan Nicolaides Pathology CEO Dr Michael Harrison, AMAQ Foundation President Dr Steve Hambleton and Genetic Pathologist Dr James Harraway.
During the visit Dr Hambleton took a quick tour of the laboratory and was fortunate to meet Dr James Harraway, one the few Genetic Pathologists in Australia. His team are internationally renowned and are offering microarray comparative genomic hybridisation right here in Brisbane. The techinques used in this laboratory can detect deletions and duplications of genetic material at an order of magnitude higher than conventional karyotype. These techniques using thousands of oligonucleotide DNA probes on each sample are proving clinically useful in the characterisation and inheritance issues related to intellectual disability, developmental delay, autism and congenital abnormalities. One can see the microarray testing device in the background of the top picture with world leading research being done right here in this lab. There is no doubt microgenetic analysis is going to be a big part of the future of medical care in this century. Q
AMAQ Foundation President Dr Steve Hambleton thanks Sullivan Nicolaides Pathology CEO Dr Michael Harrison for their tremendous support. DoctorQ SEPTEMBER 2011
AROUND THE REGIONS
Stay connected with colleagues and up to date with the latest health news and issues affecting your local area. Donâ€™t stand on the sidelines - join your Local Medical Association today and make a difference.
Monthly dinner meetings are generally held on the fourth Thursday of each month.
Members and non members can keep an eye out on the website for details on upcoming events and meetings or contact the Association on firstname.lastname@example.org.
Venue: Maroochydore Surf Club Function Room, Alexandra Parade, Cotton Tree Time: 6.30pm for 7pm Convenor: Jo Bourke Phone: (07) 5479 3979 Fax: (07) 5479 3995 Email: email@example.com For further information or to join visit www.sclma.com.au
Fraser Coast For information on meeting dates and how to join, contact Fraser Coast Local Medical Association President Dr Shaun Rudd. Address: PO Box 1347, Hervey Bay, Qld , 4655 Phone: (07) 4128 3644 Fax: (07) 4124 0660
Gold Coast You will find all the latest news and information on the Gold Coast Medical Association (GCMA) at www.gcma.org.au. To join, simply visit the website and download an application. You can contact the GCMA on: Phone: (07) 5575 7054 Fax: (07) 5575 7551 Email: firstname.lastname@example.org 2011 Meeting Dates 15 September
Membership of the Toowoomba and Darling Downs Local Medical Association is just $50. To join go to tddlma.org.au/ membership.html and download an application form.
Redcliffe & District For information on upcoming meetings please contact Tracey Jewell, Meeting Convener on (07) 3049 4429, 0411 223 073 or email email@example.com. Venue (for all but the last meeting): Renoir Room at the Ox, 330 Oxley Ave, Margate. Time: 7pm for 7.30 pm 2011 Meeting Dates 13 September 26 October 25 November - End of Year Networking Function
Brisbane Northside Local Medical Association For upcoming meeting information or to join, please contact: Shirley Briscoe Meeting Convenor Phone: (07) 3121 4456 Email: firstname.lastname@example.org Website: http://northsidelocalmedical.wordpress.com 2011 Meeting Dates 11 October 13 December
If your Local Medical Association does not appear above or your details are incorrect, please email Kathleen Bertini at email@example.com with corrections, contact details, how to join, web address, dates for upcoming meetings and who to contact for further information. This will be published in upcoming editions of Doctor Q in 2011. 32
SEPTEMBER 2011 DoctorQ
AROUND THE REGIONS
New Rural Doctors’ Association Queensland President Dr Ewen McPhee explains how the centralising process has left regional and rural areas with restricted services.
wenty-four years ago, as a second year I arrived in Charleville to the most intense learning experience that I had had to date. Charleville is a small rural community seven hours from Brisbane.
Queensland is experiencing massive investments in the resources sector, while the wider community continues to suffer a lack of infrastructure investment and workforce shortage.
At the time Dr Louis Ariotti was the resident surgeon. Under his guidance the next two years saw me exposed to an enormous variety of surgical conditions.
Whether you are a GP or a Specialist we all know the demands on our time often exceed what is safe or sustainable.
With the assistance of the Medical Superintendent Dr Mike Muscio and Procedural GP Chester Wilson I performed over 500 anaesthetics, learnt appendectomy, cholecystectomy, hernia repairs and caesarean section.
It seems we are as much responsible for our clinical work as funding health services through our own provider numbers.
Unfortunately that learning experience is largely non-existent in rural practice today. It is true to say policy decisions to centralise expertise have seen even regional hospitals lose their ability to provide some less common procedures. Clinical service frameworks have been used to define standards, and become an excuse to restrict service. The challenge should be to raise equipment and facility levels in regional centers so that a wider breadth of medical services, and Registrar Training, can be offered in rural and regional facilities.
Rural Doctors’ Association Queensland update
RDAQ dared to dream at the 2011 conference held in sun-soaked Cairns over the Queen’s Birthday long weekend of 10-12 June. This year the conference enjoyed a record number of delegates and students and a high standard of professional speakers. Following RDAQ’s AGM in Cairns, Dr Ewen McPhee is newly appointed President of RDAQ. Dr McPhee has lived in Emerald since 1989 and has been a medical superintendent, GP Supervisor and the only remaining procedural GP in Emerald. He is well aware of the challenges ahead for rural health. Not least of these is that health infrastructure in rural areas is struggling.
With all the above in mind I look towards the cohort of doctors in training. You have a big task ahead. I was told recently there is only one doctor in a team, and the doctor continues to be seen, in the eyes of the law at least, as the single point of accountability. Young doctors have to be leaders, reformers and the rational voice in the challenges ahead. Close cooperation with AMA Queensland, RDAQ and other medical interest groups can nurture those goals and I implore our future leaders to become engaged and informed. Q
“Massive growth in my own town of Emerald, driven by the mining industry, is placing excessive strain on the public and private health workforce,” said Dr McPhee. “Why is it that measures of health equality consistently see rural people lag behind their city cousins?” Dr McPhee says he supports Queensland Health’s Rural Generalist Training Program, but also champions the independence and challenge of general practice. “Country Queensland needs a steady supply of doctors with procedural and office-based skills to protect the health of our communities,” Dr McPhee said.
RDAQ President Dr Ewen McPhee in discussion with Deputy Director-General Queensland Health Dr Michael Cleary and Assoc Prof Bruce Chater at RDAQ 2011 Conference Daring to Dream.
Dr McPhee on the go.
DoctorQ SEPTEMBER 2011
PEOPLE & EVENTS
Bancroft Oration 7 September – 6.30pm
Paddington, Brisbane This year we are honoured to have Associate Professor Daryl Wall keynote. The address will relate to Queensland’s impact on international surgical advances over the past 40 years. Register: www.amaq.com.au/events or Rebecca Byrnes (07) 3872 2269 or firstname.lastname@example.org
Bridge to Brisbane - AMA Queensland team 11 September
South Bank, Brisbane Run, jog or walk 5kms with President-Elect Dr Alex Markwell at The Sunday Mail Suncorp Bridge to Brisbane. Members, friends and family are invited to register for the AMA Queensland team that will raise money for the AMAQ Foundation. Register: Visit www.bridgetobrisbane.com.au and quote team name AMA Queensland and team number 33413.
University of Queensland Medical Society’s 54th E.S. Meyers Memorial Lecture 27 September – 5.30pm for a 6pm start
UQ Centre, St Lucia The Honourable Michael Kirby AC CMG, former Justice of the High Court of Australia and Commissioner of the UNDP Global Commission on HIV and the law will speak about HIV/AIDS and Law Reform: Desperate Need to Move Mountains. Register: www.uqms.org/esmeyers2011
AMAQ Foundation Charity Golf Day • 3 November Indooroopilly Golf Club
The event will be played as a Four Ball Ambrose. Players can enter a team of four ($440) or as an individual ($110). This includes a light lunch, golf cart and presentation cocktails. Register: Contact Neil Mackintosh for further information on (07) 3872 2267 or email email@example.com
SEPTEMBER 2011 DoctorQ
CONFERENCE PEOPLE & EVENTS sponsor profile: TressCox Lawyers
ressCox is a specialist law firm which has been operating since 1897. We provide an integrated range of commercial legal services through offices in Brisbane, Sydney, Melbourne, and through our national and international alliance with ALFA International. As well as providing market leading expertise in Health and Aged Care, TressCox offers clients expertise in Banking and Financial Services, Biotechnology and Life Sciences, Building and Construction, Competition and Trade Practices, Corporate and Commercial, Mergers and Acquisitions, Employment and Industrial Relations, Energy and Resources, Estate Planning, Trusts and Estate Litigation, Government, Probity, Infrastructure, Insolvency, Insurance and Corporate Risk, Intellectual Property, International Business, Litigation and Dispute Resolution, Media and Entertainment, Property and Planning, Tax and Revenue, Technology, Water, and Wealth Planning.
Contracting with health insurers and suppliers, including contractual principles and compliance with all necessary legislative requirements and confidentiality principles. Business conduct as it relates to competition and regulation, corporate governance, liability insurance, and ethics. Clinical and legal risk management. Employment and workplace relations including occupational health and safety, privacy and accreditation, and VMO appointment documentation and contracts. Wealth management, estates, tax and revenue law advice, and the establishment of charitable foundations and trusts, discretionary and hybrid trusts and self-managed superannuation schemes. Contractual arrangements for the development, financing, construction and operation of major healthcare infrastructure.
Our Health Services Group is one of the most experienced in Australia. When professional, ethical and commercial issues compete, our legal advice is sensitive to every nuance and reality for one particular reason: our health team has specialist expertise gained through long term relationships with the industry. We regularly advise health industry clients on: Developing and operating a commercially viable business that complies with the health industryâ€™s unique and ever changing regulatory environment.
Katharine Philp - Partner, Brisbane Phone (07) 3004 3536 Email: firstname.lastname@example.org
Establishing the right business structure, including partnerships, incorporated associations and trusts.
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The Wesley Hospital
8-9 October 2011
A weekend of clinical education focusing on maternity and the future trends, treatments and new technology in surgery at the Wesley Hospital, Queenslandâ€™s premier choice in healthcare.
Leading Learning through
Visit www.wesley.com.au for more information
DoctorQ SEPTEMBER 2011
Directory of Members 2012
Do we have your correct employment details?
The production of the Directory of Members 2012 will begin shortly. Keep an eye out for your verification form to confirm your address details for next year’s Directory. Our annual Directory of Members publication is due for release in January 2012.
AMA Queensland represents members across a diverse range of disciplines and stages of career and recognises that each discipline experiences varying individual issues.
Please contact Karen Fitzgibbons on (07) 3872 2248 for any further information relating to the 2012 Directory.
Get 25 per cent off your 2012 membership subscription renewal Simply refer one of your colleagues to join AMA Queensland, and receive 25 per cent off your subscription for each member you refer! Start referring today and save next year. Please forward any referrals to the membership team. Email firstname.lastname@example.org or phone (07) 3872 2222.
Real Estate classifieds The AMA Queensland website now offers classifieds for: Medical practice or room sales Residential sales Commercial sales Medical practice and rooms for lease Residential real estate for rent/holiday/share Commercial real estate for lease. Special member rate of $100 ex GST available (standard price is $150 ex GST). Please visit www.amaq.com.au/realestate to view classifieds.
Issues often arise that affect a specific discipline and AMA plays an essential and significant role in keeping our members informed on these issues. To ensure the right member receives the correct information, we ask that you update your employment details should they change. AMA records information on members’: Discipline eg. general practice, pathology etc Employment status eg. private, public and VMO Practising status e.g. retired, academic, full time etc General practice information eg contact numbers and address If any of your employment details have changed, please contact the membership team on (07) 3872 2222 or email email@example.com and we will update your details.
eVENTS+Training e-newsletter AMA Queensland successfully launched the eVENTS+Training e- newsletter this year to update and inform members on the fantastic events, seminars, training and workshops that we hold throughout the year. The eVENTS+Training is delivered to our members’ inbox every three weeks, and we would like to extend this free e-newsletter to anyone that works in the medical profession, for instance medical receptionists, practice managers and nurses.
For more information and to book, please contact Rebecca Byrnes on (07) 3872 2269 or email firstname.lastname@example.org Should you wish to add an employee, colleague or friend to the mailing list, please email their name, email address and contact number to email@example.com or phone (07) 3872 2201.
SEPTEMBER 2011 DoctorQ
Get more value from your membership
For a full list log into the members only page on our website to download all contact details and specials for these benefits or contact the Membership Team on (07) 3872 2222 or firstname.lastname@example.org
Advocacy, representation and support
Adventure and recreation activities
Member support, services, policy and workplace relations
travel lounge Advertising car discounts doctor recruitment
Doctorsâ€™ Health Advisory Service
AMAQ Foundation supporting rural medicine
after hours Medical support
Council of Residents and Registrars supporting DITs
professional training and development
assisting impaired medical professionals
personal health insurance administrative support
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PROFESSIONAL TRAINING and DEVELOPMENT courses
ABCs OF HEALTHY LIVING
community aid for children
manuals, fact sheets and Publications for your practice
credit card and merchant facilities taxation, Accountancy and business advisory services financing investment life insurance
Events and conferences AMA Queensland organises and designs events to satisfy educational and professional development needs as well as social networking opportunities among your peers. events + training newsletter
Publications and medical resources Directory of Members AMA List of Medical Services and Fees
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IPHONE APP AND WEBSITE
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DoctorQ SEPTEMBER 2011
Congratulations to the following doctors who are now elected members of AMA Queensland June Doctors-in-Training
Dr Su-Lin Leong
Dr Erin Wilson
Dr Mohammad Hossain
Dr Lachlan Marshall
Dr Vladislav Matic
Dr Thomas Arthur
Dr Leslie Dhaniram
Dr Kate Wallace
Dr Prabash Gardiyehewa
Dr Faroogh Jafari Mousavi
Dr Luke Notley
Dr Leanne Ryan
Dr Glen Pearse
Dr Alexandra Greenaway
Dr Yee (Richard) Ong Dr Chee Chong Dr Randal Pittelli Dr Antony Attokaran Dr Sharon Dâ€™Arcy Dr Kathryn Hebble Dr Melvin Malte Dr Rasika Wijedeera Dr Alison Winning Dr Samar Pandhem Dr John Quayle Dr Amol Deshmukh Dr Shona Mair
Dr Michelle Parameswaran
Dr Moira Perumal
Dr Sandra K Peters Dr Ka-Kiu Cheung Dr Haseena Mohamed Dr Jennifer B Power Dr Joseph Thomsen Dr Chang-han Liu
Dr Graham Rice
Dr Elizabeth Smart
Dr Lastitia De Villiers
Dr Rajan Payyappilly
Dr Daniel Timperley
Dr Susan C Philbrook
Dr Warrick Smith
Dr Ziena Al-Obaidi
Dr Glenn Sterling Dr Dylan Wilson Dr Thomas Hess Dr Christopher BM Tracey Dr Jonathan Shirley Dr Tanya Wood Dr Tal Jacobson
Salaried Practitioners Dr Kim Latendresse Dr Trevor Gervais Dr Vesna Markovic Dr Gregory Parker
Over Seventy and Practising
Dr Kenny Low
Dr Patrick SC Lee
Dr Tess Higgins
Dr Anura Andarawewa
Dr Kylie Bown
Dr Jessica Merlo
Dr Steven Kane-Toddhall
Dr Stacey A Waugh
Dr Andrew Ramage
Dr Hayley Skidmore Dr Jeannine McManus Dr Ameen Shaikh Dr Alec Dearden Dr Andrew Finch Dr Nathanael Sheehan Dr Asoka Ranasinghe
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Dr Julie Towett
Dr Piksi Singh
Dr Animesh Mishra Dr Kristin M Kerr Dr Christopher J Vertullo Dr David Melsom
Dr Biddy Fitch
Dr Matthew Hope
MBBS (Qld), FRACGP 29 December 1922 - 18 June 2011 Peter Schmidt boarded at Nudgee College where he won a University Open Scholarship before proceeding to the University of Queensland for his medical studies and graduated in 1945. After graduation he worked at the Mater Hospital, first as an RMO, then as Senior Resident and later as a Clinical Assistant in Medicine. He entered private practice at Greenslopes in 1948 and became involved in many activities of the RACGP Queensland Faculty, including Chairmanship of the Accreditation Committee, and in 1984 became Provost of
the Faculty Board. He was appointed Director of the University of Queensland Post Graduate Medical Education Committee for Queensland from 1975 to 1989 with the major focus on continuing education for country doctors, and later became Chairman. In 1984 he was awarded Fellowship of the AMA, and in 1993 the Medal of the Order of Australia. Contributed by Dr Humphry Cramond
MBBS (Qld) FRACS FRCS FACS BA BSc Dip Obst RCOG Dip Gemmology Dip Ag Sc 16 January 1922 - 16 June 2011 After secondary school studies at Churchie, Ron proceeded to medical studies at the University of Queensland, graduating in 1948. An active athlete in his student days, he continued involvement after graduation. He was a member of the BMA/AMA from graduation until his death.
of his popularity as a surgeon, he found time to develop his hobbies of horse and cattle breeding and gemmology.
After his initial postgraduate terms at the Brisbane Hospital he spent more time in Australian hospitals and the proceeded overseas to the United Kingdom and the United States.
His younger brother, the late Dr Brian Todd, was President of AMA Queensland in 1983-84.
For the greater part of his life he practised as a general surgeon in Ipswich, where in spite
When he retired from active surgery he became involved as a medical officer in the prison services, a role he filled with great kindness.
Contributed by Dr Humphry Cramond
DoctorQ SEPTEMBER 2011
and Chinese. It was a pleasure for me to observe as the early, probably pretty penniless Vietnamese migrants progressed and integrated as I saw them progress and as their lifestyle changed with successive pregnancies. Near the end of my innings, I saw some of their daughters now grown up and fertile. I lectured residents, registrars and also GPs going for their DRANZCOG. I’m pleased to say I always got the top rating in their feedback.
I still maintain that there are more people out there with sexual difficulties than say lupus or pre-eclampsia for example. Q: How did you become involved in sexology?
From childhood onwards I grew up observing the angst this subject caused among parents and other adults alike. That only served to fan the flames of my curiosity even more. Medical school failed to address sexuality in any significant way contrary to my expectations, hence I embarked upon a course of self-education initially. I ended up realising that this was quite an untapped field and dovetailed I thought, (but not by most of my colleagues), with obstetrics and gynaecology. I still maintain that there are more people out there with sexual difficulties than say lupus or pre-eclampsia for example.
DR jules black dr jules black has always argued that if there is no sexual function, there is no Obstetrics and Gynaecology. australia’s foremost gynaecological sexologist let us in on his fascinating and pioneering career. Q: What is your current position?
Semi-retired obstetrician and gynaecologist. I only do rural obstetrics and gynaecology locums now and have so far been to over 30 individual hospitals in four states, some on several occasions.
Q: What are the other roles you have held?
In my obstetrics and gynaecology mode I was principally in private practice but for 25 years I also ran a busy public antenatal clinic at KGV, now Prince Alfred Hospital for Mothers and Babies. I loved that clinic. I called it ‘Vietnamese morning’ as that was the principal migrant group who came on that day and therefore a Viet interpreter was always present as well as interpreters for other groups such as Turkish, Lebanese
SEPTEMBER 2011 DoctorQ
Q: You’ve commented that you’ve battled ignorance regarding your chosen field, even unkindly being nicknamed ‘Dr Filth’. Do you think this attitude has changed in modern medicine?
I’d like to think so, but I still sense an awkwardness about sexuality among the doctors and nursing staff I’ve worked with these past five or so years.
Q: Early in your career, you worked for the infamous Harry Bailey. Can you tell us a bit about him?
The late Harry Bailey was one of the most intelligent people I’ve ever met. He was a psychiatrist, but in his private life he was extremely well-read, had studied industrial chemistry, played the flute, was a superior carpenter and draftsman among other things, and used to give me good advice about HiFi systems and other such technicalities. I was a registrar for three years at the Women’s Hospital (Crown Street) in Sydney, and he was our principal consultant psychiatrist. That was the context in which I knew him, and in my time at what was then Australia’s largest maternity hospital, he set up the Department of Gynaecological Psychiatry that dealt with the assessment of women seeking terminations of pregnancy, as well as managing the emotional problems of women at the various epochs in their lives. This in turn meant dealing with their sexuality and thus sprang up Australia’s very first sex therapy clinic, and I was fortunate enough to sit in with him for about two years.
At the same time he owned a private hospital, the ultimately notorious Chelmsford Private Hospital on Sydney’s North Shore where he practised deep sleep therapy for depression plus other ills. This form of therapy was discredited because of not having any value over other modalities of psychotherapy, and because of its significant morbidity and death rates. But Harry kept using it and ultimately he was the subject of a judicial enquiry and found guilty of professional misconduct. This once very proud and powerful man, (earlier in his career at Callan Park Psychiatric Hospital in Sydney, he saw to the pulling down of the perimeter walls, and the unlocking of wards where patients had been incarcerated for years), was found dead in his car, pills and alcohol by his side.
Q: What are the highlights of your career to date?
Convincing my Professor of Obstetrics and Gynaecology, the late Rodney Shearman, that sexuality was important and that the only way one could get students to learn about it was if it was examinable. For my sins he got me to construct the first multiple-choice questions for the Med. finals and then participate in giving a Sexuality course together with the late Prof. Derek Llewellyn-Jones. He honoured me further when our College’s Advanced Scientific Courses commenced by asking me to construct a whole session on Sexuality. Twice more did I present at an Advanced Course. I think that was unheard of back then — for one person to present at more than one such course. For several years I was on the Board of two major international sexology associations, The Society for the Scientific Study of Sexuality (SSSS), and The World Association for Sexual Health (WAS), where apart from being a Board member, I was also Secretary-General/Treasurer for four years. I was considered Australia’s foremost gynæcological sexologist. In March of this year I donated my entire collection of Sexology books, journals, papers etc that I had amassed over almost 50 years, to the Curtin School of Public Health in Perth. They are but one of only two or three Australian universities that run courses in Human Sexuality. They honoured me by naming it the Jules Black Sexology Collection, and they brought me over for the opening ceremony. (john.curtin.edu.au/julesblack)
designer and she conceded that this perfume was very similar to one of Calvin Klein’s. She came into my office, sat down and then said, “Doctor Black, I’m wearing Calvin Klein underwear and I wondered how on earth you knew!”
Q: What do you get up to outside of work?
I love practically every kind of music and have a large, very eclectic collection that I started age seven. The only musical instrument I play is the CD machine. Currently I am taking lessons at our local community FM station. I’m being groomed to become an announcer and be able to play my music. My wife and I like live performances and plays. Separately I am very much into film, go to lots of movies and have a large video and movie collection. I have branched out into Blu-ray and designed my own home theater with a 3m projection screen, 7.1 surround sound through a 140W per channel processor. I am pretty computer literate, and my next project is to edit all of my former 16mm silent and Super-8mm sound movies that I recently had converted to DVD. I used to be an avid reader and as I write this I glance over at my bookshelf and see there are four books lining up for me to read.
Q: Why do you think it’s important to belong to AMA Queensland?
It pays to belong I’ve always believed. I joined the AMA immediately upon graduation (1964). I must admit I did resign a few years after that on a matter of principle, when the AMA was not truly representative of NSW doctors, the RMOs. However, when I returned from my postgraduate work in England and set up in private practice, the birth of Medicare erupted around us, with all of its consequences. I saw that Government was only going to deal with one medical body and that was the AMA. Thus I saw the importance of the AMA being truly representative of the profession, and that could only be if the majority of us were members. As members then we could have an individual voice within our craft groups. So I rejoined and have been a member once more ever since. Q
Q: We’d love to hear an anecdote about something funny or bizarre that has happened to you along the way?
When you have specialised in women for as long as I have, I got to be able to identify a large number of perfumes my patients were wearing, and they would be impressed when I rattled off what it was. I see now it was an oblique way of showing I was observant and that I cared. On this particular day, my secretary brought in the card of a new gynæ patient. I read she was 19 and a law student. I came to the waiting room door to fetch her, and my olfactory apparatus swung into action. I exclaimed, “Calvin Klein”. I saw a physical ripple go through her body. She regained her composure and said it wasn’t, it was Issey Miyake of which I’d never heard at that stage. She explained he was a well-known Japanese dress
DoctorQ SEPTEMBER 2011
Damage to your business might not just be physical - the complex world of human relationships can just as quickly destroy your reputation and goodwill. Scott Stewart from AMA Queensland Insurance Solutions explains. Scott Stewart AMA Queensland Insurance Solutions 1300 883 059 email@example.com
unning a business is a complicated and time consuming exercise and it can be devastating to see what you have worked so hard to build go up in smoke due to fire, or be severely damaged in one of our frequent storm events - but it can be doubly disheartening to know that your business can be just as effectively destroyed by the actions of your staff and/ or fellow directors as it can from the actions of the elements. Whilst bricks and mortar can be replaced, loss of reputation and negative publicity brought about in litigation relating to employment practices, human resources, client handling and health and safety breeches, to name a few examples, can take a much longer time to repair. Actions as simple as misfiling a pathology report or accidently breeching privacy regulations can result in financial losses far in excess of the value of a practices physical assets alone - and in worst cases can result in not only the loss of your business but also your home and savings as well. Unrealistic you might say? Well consider that even if you are innocent you and your business still will have to payout potentially tens of thousands of dollars in defence and investigation costs to prove it- and these costs alone can be financially crippling for both you and your business.
Actions as simple as misfiling a pathology report or accidently breeching privacy regulations can result in financial losses far in excess of the value of a practices physical assets alone. So what can be done to help mitigate losses such as these? Luckily there are two covers available that can help protect the financial health of your business - these being Practice Indemnity and Management Liability insurance policies. Management Liability Insurance has been developed to protect the financial interest of a business as well as the personal assets of its directors and officers
from legal claims involving, but not limited to, errors and omissions on their part right through to claims for harassment, discrimination, wrongful termination, occupation health and safety breeches or even fraud and embezzlement. Even an innocent act, error or omission can be enough to generate a claim against an individual and/or against a company. Supervisors such as Practice Managers and senior administration personnel are particularly vulnerable to the types of lawsuits mentioned above and can benefit greatly from the cover offered by a management liability policy. Management Liability Insurance should be considered very seriously by any business employing staff or contractors - in fact there is really no excuse for not holding this cover seeing that it can help prevent a legal suit or statutory claim from turning into a financial calamity. Practice Indemnity insurance policies are designed to provide healthcare professionals with security against legal liability arising from the conduct of their practice and supporting staff. In the past the overwhelming majority of civil liability claims for compensation stemmed from clinical activities carried out by medical practitioners. Current trends however are for more non-clinical claims, such as breach of patient confidentiality, loss of records, billing errors, drug storage errors, employment practices and handling of complaints. A Practice Indemnity policy is designed to respond to events such as those listed above and help mitigate the financial costs of these events to the practice and insured staff. In short, Practice Indemnity insurance provides healthcare professionals with security against legal liability arising from the conduct of their practice or business. AMA Queensland Insurance Solutions has access to multiple providers who offer some of the most comprehensive Management Liability and Practice Indemnity policies on the market and we would welcome the opportunity to answer any questions you may have in regards to these covers and are happy to provide quotes at no obligation- remember the cost of a call can potentially save you hundreds of thousands! Q
AMA Queensland Insurance Solutions is a joint initiative of AMA Queensland and Insurance Advisernet Australia Pty Limited ABN 81 072 343 643 AFS Licence 240549. AMA Queensland Insurance Solutions is a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, Authorised Representative No: 320115. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.
SEPTEMBER 2011 DoctorQ
more ChoICe more freedom Let AMA Queensland Insurance Solutions take the hassle out of arranging insurance.
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AMA Queensland Insurance Solutions is a joint initiative of AMA Queensland and Insurance Advisernet Australia Pty Limitied ABN 81 072 343 643 AFS Licence 240549. AMA Queensland Insurance Solutions is a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, Authorised Representative No: 320115. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.
Phone: 1300 883 059
Julie Smith from William Buck explains some important points to consider when getting your affairs in order.
E Julie Smith William Buck (07) 3229 5100 firstname.lastname@example.org
state planning is not the most pleasant topic to discuss; however it is crucial to properly plan for you and your family’s future wellbeing. Estate planning solutions differ from person to person as it depends heavily on personal circumstances. We have outlined some of the basics of estate planning below but we strongly recommend you seek your own professional advice concerning your personal circumstances.
Get a will and review it regularly – we can’t stress this point enough. If you don’t have a will, your estate will be divided up according to the laws of intestacy and the result is often not what was intended. A professionally drafted will not only provides some certainty in relation to the various parties’ property rights, but it will also appoint an administrator (the executor/executrix) to make decisions and ensure your estate is distributed in accordance with your wishes. Whilst it is possible to prepare your own will using a will-kit, if your circumstances are even mildly complex (ie you have children, you own your own business or you hold significant investments etc) then we strongly recommend that the will be drawn up by a suitably qualified solicitor. It is important to bear in mind that marriage acts to revoke gifts/appointments to people other than the spouse and divorce acts to revoke gifts/
A professionally drafted will not only provides some certainty in relation to the various parties’ property rights, but it will also appoint an administrator to make decisions and ensure your estate is distributed in accordance with your wishes.
appointments to the (former) spouse. This means your will may be substantially, or entirely, made void as a result of marriage or divorce. Accordingly, it is critical that you review your will as soon as possible if either event happens to you. If you have complex family affairs (such as blended families) consider the likelihood of a dispute between beneficiaries upon your death. Remember, beneficiaries can contest a will if they believe they have not been adequately provided for, regardless of what your will states or how well they have been provided for during their lives.
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Are you in business with parties who are not related to you? If so, you may wish to consider putting a buy/ sell agreement in place with your business partners. Properly drafted, this type of arrangement can make the transfer of a business to the remaining business partner/s much simpler and will have considered the tax and financial issues in regard to the transaction so it is effective for all parties. If you are in a family business, you may wish to consider the benefits of using a testamentary trust to hold your business assets following your death. There are some tax benefits of using a testamentary trust, especially where there are minor children involved.
You may wish to consider putting a Binding Death Nomination (BDN) in place for any superannuation accounts you hold. A BDN is a legal document that compels the trustee of the superannuation fund to pay the death benefit to the person/s nominated in a BDN Form. These are only valid for three years and should be revisited following marriage or divorce. Reversionary Pensions within a superannuation fund allows a members pension to continue being paid to their dependant spouse. If a member has not commenced a pension, their super balance must be paid as a lump sum in accordance with the BDN or, if there is no BDN in place, in accordance with the superannuation trust deed rules. If a superannuation fund member has commenced a pension, and there is a dependant spouse, but a BDN isn’t in place, the executor of the estate may request that the superannuation fund trustee convert the pension into a reversionary pension for the spouse. The superannuation fund trustee is generally under no obligation to follow these instructions and they will decide what they feel is the best course of action. In the case that a superannuation fund member does not have a dependant spouse, any pensions being paid to that member will generally be converted to a lump sum then paid to the estate. It is generally more tax effective to leave superannuation benefits to a spouse and dependants. If a superannuation fund pays the balance of a deceased member’s account balance to a dependant, there will generally be no tax on this transfer. If a superannuation fund pays the balance to a non-dependant, the transfer will usually be subject to tax, up to a maximum of 31.5 per cent. Q
The information contained in this summary is general in nature and should not be applied or relied upon without seeking additional professional advice. William Buck has a dedicated team of superannuation and taxation experts who are happy to speak with you regarding your self managed superannuation fund or any other issues regarding superannuation you may have.
Feel like your accounting and finances are in a mess? We can help.
At William Buck, we have one simple goal - to simplify, clarify and systemise your finances and take the stress out of your life. Weâ€™re more than just a leading accounting and advisory firm. We become true partners with our clients and work hard to keep you one step ahead.
William Buck (Qld) GPO Box 563, Brisbane QLD 4001 Telephone:+61 7 3229 5100 Facsimile: +61 7 3221 6027
DoctorQ SEPTEMBER 2011 45 CHARTERED ACCOUNTANTS & ADVISORS
The Australian dream of buying your own home is getting harder as house affordability puts it out of reach. Andre Karney from Investec Medical Finance explains why dreams can still come true.
W Andre Karney National Sales Manager Investec Medical Finance 1300 131 141 www.investec.com.au/ medicalfinance
hen it comes to mortgages, escalating property prices has meant borrowers need to stump up more cash as a deposit. Many home buyers are forced to spend many years saving before they have a big enough deposit to buy their own home.
To avoid mortgage insurance, many banks require a buyer to pay a 20 per cent deposit plus another 5 per cent to cover costs. For the median house price of $600,000 this equates to $150,000, which is a lot of money.
To put this in perspective, say a home buyer plans to purchase a residential property at the median house price of $600,000. On top of a deposit, mortgage insurance and stamp duty can add another $20,000 to $40,000 to a property purchase of this value.
Some banks add the mortgage insurance to your loan if you don’t have the cash upfront. This is problematic because you end up paying more in interest over the life of the loan. To overcome this roadblock to home ownership, Investec Medical Finance has created innovative lending products, specifically designed for doctors and others in the medical professions. Unlike other banks, Investec recognises that doctors have a lower risk profile than the average borrower with a steady earning capacity across the economic cycle. During times of market turmoil, some lenders have been forced to tighten their lending criteria and decrease the amount they would lend against the value of the property, which means they require an even bigger deposit. As a specialist bank, Investec has the ability to maintain a consistent credit policy that doesn’t compromise our clients’ opportunity to borrow and create wealth - and invest in property. Investec continues to buck the trend, offering up to 100 per cent mortgage finance for qualified medical professionals intending to occupy the residence, and up to 95 per cent for a residential investment property – without Lender’s Mortgage Insurance. With steady interest rates and a slowing of property price growth, now might present an opportunity to put a plan in place to get your foot in the door. We have a range of financial options created especially for medical professionals. Contact us on 1300 131 141 to find out more or visit www.investec.com.au/medicalfinance Andre Karney is the National Sales Manager for Investec Medical Finance. At Investec, medical finance is all we do and as such have to ensure we do it particularly well and deliver the best finance solutions possible. Call 1300 131 141 to speak to one of Investec’s specialised finance consultants. Q
Disclaimer Investec Professional Finance is not offering financial or tax advice. You should obtain independent financial and tax advice, as appropriate, to consider whether Investec’s products are right for you. All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. We reserve the right to cease offering these products at any time without notice.
SEPTEMBER 2011 DoctorQ
That’s why when you switch to Commonwealth Bank, you’ll pay no joining fee and enjoy preferred rates on merchant services. For a little special treatment, contact our merchant team today. Call 1800 730 554. Commonwealth Bank of Australia ABN 48 123 123 124.
DoctorQ SEPTEMBER 2011
Ross Noye from Wilson HTM will show you how to calculate just how much you need in under two minutes.
Ross Noye Wilson HTM (07) 3212 1068 email@example.com
t’s official. We’re living longer, just ask the government actuary. Women now have an average life expectancy of 84 years and men 79 years – the reasons for the difference between the sexes I’ll leave you to ponder. The real significance in these ever-increasing numbers is that we now need to plan for at least 20 years in retirement! Most of us have high expectations of a ‘holiday lifestyle’ in retirement. For many this expectation is unlikely to be met because no plan has been implemented to achieve the goal. The holiday lifestyle goal is achievable for most; it simply takes some strategic investment planning and of course financial discipline. However, one of the biggest hurdles for many of us is working out how much we need to accumulate to fund our retirement lifestyle. One of the most asked questions by clients has always been “How much do I need to retire on?” In my view the helplessness felt by many investors on how to get a answer to this simple question has often been the reason that little or no thought has been given to implementing an investment plan to deliver the desired retirement lifestyle. It’s just been too hard.
We then divide your income goal by the real rate of return you discover you need $2 million of capital invested to provide. So there, you have your estimate of the capital you need to fund your retirement income – so now you can start developing and implementing your strategies to achieve your now clearly defined goal.
Of course, that’s not to say they haven’t tried! I have no doubt they have been exposed to the computer– generated, spreadsheet–moulded, mind-boggling projections indicating that they will need $4 million in 2020 to meet their retirement needs. All this after they have meticulously filled out a 3cm thick questionnaire with 756 questions on every detail of their finances and present and future lifestyle needs, only to get back a similar 12cm computer-generated report – which tells them on pages 1-40 how old they are along with all the other answers to the 756 questions! It’s just too hard – and what if a loaf of bread costs $2 million in 2012 anyway?
Remember to add back the three per cent inflation figure to arrive at your pre-tax, pre-inflation investment hurdle rate of return you require to hit your income target. The first thing you should notice is that your hurdle rate is bigger than the cash rate – so investing the money in cash will not give you the return you need. One way to make this easier is to reduce the tax you pay – and that’s easier than you think.
“How much do I need in retirement?” is a simple question and there is a simple way to get an answer in under two minutes.
If you are aiming for double the retirement income above you will need twice the capital invested. Over the last 27 years I have found that the main reason most people struggle with their retirement planning is that they did not take the time to work out what they are aiming for. So take the two minutes, it really could change your life.
STEP TWO: Guesstimate the annual retirement income you would like from today STEP THREE: Guesstimate what you believe is an achievable long-term investment return STEP FOUR: Guesstimate what you think the longterm annual inflation rate might be STEP FIVE: Subtract answer to step four from answer to step three to get your after-inflation after-tax investment return STEP SIX: Divide your desired annual income by your estimated Real Rate of Return ie your answer to step five
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The real rate of return simply makes sure that we are always talking in today’s dollars. To calculate your estimated long term real rate of return just subtract three per cent per annum from eight per cent per annum to get a net investment return of five per cent per annum.
Just to summarise, if you have $2 million invested and you achieve an after-tax and after-inflation return of five per cent per annum it will provide you with an annual income of $100,000 forever, while also maintaining your $2 million capital base. Obviously, if you don’t care whether you spend your capital you will need less.
STEP ONE: Assume you are retiring today
You may find working through an example helps. Let’s keep the numbers easy so we can focus on the process – we will assume you would like an annual after-tax income of $100,000 and that this income must have the same purchasing power in 20 years time as it does today. You believe that an eight per cent per annum investment return is achievable over the longer term and that the inflation rate will remain under control at around three per cent per annum (that’s steps one to four out of the way!)
Ross Noye is a stockbroker and financial adviser at Wilson HTM Investment Group and a licensed representative of Wilson HTM Ltd. Readers should seek their own advice. Q
Dr Larry Gahan roadtests the Lexus CT 200h F Sport, thanks to Lexus of Brisbane.
here’s a few reasons why I selected the small hybrid Lexus for AMA Queensland road test material:
1. With inappropriately high fuel prices despite the record high Aussie Dollar, we are all hurting at the fuel bowsers. 2. Although the Greens hold the balance of power in Australian Government, the V8s holds balance of real power in the Gahan Family Garage. What does 4.1L/100km mean in a car!!? 3. Iconic Lexus Service – At 4pm Thursday I enquired about a CT 200h to loan from David at Lexus Kedron; he phoned back at 4.10pm to say he would drop the car, an F sport version, at my surgery first thing Friday morning. 4. Curiosity – Lexus has had fuel efficient hybrids in its ranks since 2006, when it released the GS450h. The fuel consumption and performance figures that this car and the subsequent LS 600HL (luxury limo) Rx 400h and 450h (4WD) have been impressive to say the least. So, what are we to expect from the CT 200h luxury small hatchbacks, in hybrid only format. This vehicle has been designed for low fuel consumption with state of the art safety features, and of course has the legendary Lexus built quality, features, comfort and service.
From $39,990 CT 200h Prestige to $49,990 F sport to $55,990 sport luxury.
It was quiet and composed, though the whine of the generator activity in deceleration and braking is something to get used to. It may get tiring in long term use, but to me it reminded me that it was storing energy instead of just wearing out my brake pads and rotors. The interior room is more meant for luxo commuting than serious people bulk material carrying! When my daughter and her son of 10 months plus baby car seat plus eight bags of ‘essentials’ to last a fourhour round trip to the coast arrived, we struggled to fit everything in. Regardless, with its reclining rear seats and hatchback design it remains a useful town design. On a subsequent trip I could fit two pushbikes in after removing front wheels.
Claimed fuel consumption figures of 4.1L/100km (about 70 miles per gallon) are on a different planet to my other vehicles. The carbon dioxide output is a mere 95 grams per Km. The hybrid electric/petrol engine aspect certainly works here. Output figures need to be combined for the petrol engine 1.8 litres four cylinder VVTI DOHC Atkinson cycle 73Kw and 142Nm, and electric motor 60Kw and 207Nm. Many testers quote the petrol engine alone. Aerodynamic drag coefficient is 0.29, a quite impressive figure.
Features of the F sport
People ask about what is the warranty, how long they really last, and what is the environmental impact.
I sought out Dale O’Brien, 20+ year Toyota/Lexus parts veteran, to help us out. While the warranty for Lexus vehicles is four years/100,000km with the famous Encore program included (read pampering + special seats + free parking at Cultural Centre events + airport drop off + service ++), the batteries are warranted for eight years. There is only one reputed Lexus hybrid battery failure in Australia since their release in 2006. This was an operator error, caused by a taxi driver who tried to ‘jump start’ with reversed polarity – better to wait for the Lexus Encore Road Side assist! The batteries themselves are 96 per cent recyclable.
Plenty of buttons including cruise, GPS, Bluetooth, digital radio, 10 speaker stereo, six CD stacker, dual zone climate control, reversing camera and reverse parking sensors, daytime running LED lights, auto headlights and wipers, heated front seats, leather, 17” alloy wheels in graphite, Yokohama low profile 215/45 ZR17 tyres, body kit, sports pedals and no-cost option metallic paint. What really impressed is the Audio/Nav joystick on the centre console that would require serious dollars to obtain elsewhere. It is very intuitive and easy to use.
0-100 kph in 10 second bracket! Oh no, you say – most people who read Road Test reports have some petrol head aspect to their persona. To comment appropriately, we need to consider the raison d’être for this vehicle. It is never going to be a track day hero car like the HSV Clubsport, FPV GTP or BMW M3. This morning, my 25-minute journey to my surgery, I spent about 10 minutes stationary. In the CT 200h, every time you brake you regenerate energy which is stored for future use. When stationary, you use no power at all. It easily keeps up with city traffic. I never drive for economy (sorry carbon people) and I soon learned to drive with copious throttle, with sprightly results, and even slight chirp from the front tyres! My average fuel consumption was still 5.3L/100km, which may be the worst of Australian Road Tests.
I could easily live with a Lexus CT200h as the seventh vehicle in our household, to head out into the heavy traffic that is part of Brisbane these days. It was quiet, luxurious, packed with features, and economical. It is lively enough for commuting in rush hour traffic and covered by the Lexus seal of approval. The intense policing of our lowish speed limits make so many cars in Australia superfluous to the task at hand, and 0-100kph and 0-200kph times less relevant. Q
You can elect to drive in ECO for economy, normal or sport mode, in which case the ‘red mist’ literally descends on the instrument panel, (changing from blue backlighting to red and the eco VS power meter changes to a tachometer). DoctorQ SEPTEMBER 2011
With the ruins of Machu Picchu, remarkable wildlife, the sun festival and the Inca Trail, Peru should be high on your wish list.
eru is a country that nurtures some of the world’s most dramatic scenery – from the lush rainforests of the Peruvian Amazon, its serpentine rivers and barren deserts to the soaring Andean Mountains that slices through much of the South American continent. Then there is Peru’s rich Spanish and indigenous heritage, its gastronomy (Peru was voted the ‘gourmet capital of The Americas’), as well as it’s remarkable wildlife; from exotic birds, pumas and monkeys to reptiles and insects including vibrant butterflies. Peru has fast gained a new generation of sophisticated travellers looking to incorporate the magic and tradition of the country as well as its sense of adventure. The ruins of Machu Picchu, located high above the thunderous Urubama River, remains Peru’s most distinctive spellbinding attraction. Four hours from Cusco - once the centre of the Inca Empire that dominated much of South America until the Spanish invasion in the 16th century, Machu Picchu stands as a defiant bastion of the Old World as well as the gatekeeper to mystical Peru. Most arrive to the region by one-hour flight from Lima to the city of Cusco. Cusco provides visitors with a unique sampling of Peru’s vibrant colours, its Incan and Spanish culture and authentic ambiance. Also a perfect place to acclimatise to the high altitude, visitors can walk into Peru’s past along Cusco’s cobblestone streets which are brimming with cafés and marketplaces selling Andean rainbow-hued
Please contact Stephanie or Ros at AMA Travel Queensland for more information on this and other wonderful travel experiences.
PHONE: 1800 262 885 FAX: (07) 5556 7200 EMAIL: firstname.lastname@example.org WEB: www.amaq.worldtravel.com.au
SEPTEMBER 2011 DoctorQ
textiles, silver and crafts, as well as a host of museums, Spanish churches and ancient walls, which still stand as a living testimony to the Inca civilisation. Then there are the festivals and religious celebrations that give Cusco it’s pulse, most notably, Inti Raymi or Sun Party - a festival once deemed as a pagan ceremony and abolished by the Spanish antagonists - now hosted in the Valley of Ruins at Sacsayhuaman. Travelling on a spectacular 110 kilometre rail journey through the lush Sacred Valley, you then travel the Inca Trail, meandering through a wealth of villages and ruins before reaching Machu Picchu the mountaintop citadel that sat silent for four centuries as Peru’s lost city until it’s rediscovery in 1911. Those who are after a more adventurous journey can tackle the famous Inca Trail by foot. For those with reasonable fitness the trail is very achievable. Standing 2,407 metres above sea level in a misty veil of cloud and built on a steep, terraced slope that once featured a labyrinth of sophisticated dwellings, Machu Picchu was inhabited by noblemen, their servants and priests as well as the ceremonial virgins, who allegedly dedicated their lives to the Inca’s Sun God. Machu Picchu, and Cusco by default, appear on many a bucket list don’t leave it! Ensure it is included in any plans to visit this expansive continent.Q
Phil Manser from Premium Wines Direct explains how and why we should decant wine before drinking.
ecanting can be useful for a couple of reasons. Firstly it allows older red wines to be separated from any sediment that may have developed in bottle. Phil Manser Premium Wines Direct 0400 251 168 email@example.com
I find the easiest way to do this is by standing the bottle up for a day or so before drinking - to allow sediment to settle to the bottom of the bottle; opening and then pouring the wine slowly and smoothly into a jug, or glass decanter. As soon as you see sediment coming out of the bottle stop pouring. Removing sediment, which can be quite bitter - being a combination of tartrate crystals and tannin - allows you to enjoy all the mature flavours of the wine without any unwelcome intrusions Having decanted the wine, Iâ€™d advise giving the bottle a rinse with filtered water and pouring the wine back into the bottle and resealing it. This is because the process of decanting oxygenates the wine, which accelerates development. This process of decanting a wine and then putting it back into the bottle is called double decanting.
Older red wines, decanted and left to stand for hours, quickly lose much of their delicate aroma, which simply volatilises. This leaves us with not much to smell, and therefore little flavour. This is because our olfactory senseswhich begin in our nose, are the greatest contributor to our sense of taste. Double decanting older reds, just moments before drinking, will give them a bit of a kick along without destroying them. Typically with younger wines Iâ€™ll double decant them a few hours prior to drinking (if I can wait that long) and when the time comes to drink them, they have typically opened up substantially. In spite of being resealed, the wine still opens up and softens, thanks to oxygen trapped in solution. I reckon this is the most gentle and effective means of bringing out the best in your wine. Q
Wine for Decanting Turkey Flat Barossa Shiraz 2008 RRP $45
AMA member price September Only - $27 (or until sold out) 96/100 James Halliday, Five Star Winery
Excellent crimson-purple; a bouquet that has the same allure as a great pinot, drawing you back again repeatedly before you taste the wine; Turkey Flat nailed the â€˜08 vintage, capturing all of its luscious black fruits without a scintilla of jam or confection; the texture of the ripe tannins is perfect, as is the oak balance. Call Phil Manser at Wine Direct to order this wine on 1800 649463, or email your order to firstname.lastname@example.org
DoctorQ SEPTEMBER 2011
PEOPLE & EVENTS
Tuesday 12 july 2011
Victoria Park Golf Course
uests at the inaugural Men in Medicine breakfast in July enjoyed an inspiring morning communicating the importance of men’s health and engaging with other medical professionals. Rugby League legend Wally Lewis told his inspiring account of how he came to be the legend he is today, the battles he has faced with a serious medical condition and how he has triumphantly returned to the nation’s TV screens as an icon of men’s health issues, a leader and a hero.
Dr Michael Kennedy, Ross Noye and Matthew Roberts.
One lucky guest, Dr Paul Tesar (pictured on the page opposite) won the opportunity to have breakfast with Wally and other key medical professionals. The day was a huge success, thanks to the sponsors, Wally Lewis and guests. Q
Queensland Shadow Health Minister Mark McArdle, Federal Shadow Health Minister Peter Dutton and Dr Gino Pecoraro.
Wally Lewis was happy to sign autographs.
Dr David Pakchung, Harry McCay and Jonathan King-Christopher.
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PEOPLE & EVENTS
Prize winners MIPS set of stethoscope cufflinks Paul Copeland
XXXX Ale House BBQ and beer tour David Weber
MIPS set of stethoscope cufflinks Dr Jeffrey Hooper
XXXX Ale House BBQ and beer tour M. Neil
UQ 75 Years of Medicine Ball Steven Nance
MDA National $100 gift voucher Margaret Anderson
Mercedes-Benz for the weekend Harry McCay
Arbonne Men’s Care Pack T. Clarke
The event would not have been possible without the generous support of our sponsors
L- R: CEO Jane Schmitt, President Dr Richard Kidd, Wally Lewis, Carla Azzi (Doctors’ Health Fund) and Immediate Past President Dr Gino Pecoraro.
Dr Larry Gahan and Andrew Laing from Mercedes Benz.
Nicholas Gaffney, Justin LeGoullon and Dr Patrick Clancy.
Sandra Reed, Sean Jenkins and Dr Scott Ingram.
Dr Jim Houston, Sam Thompson and Luke Fraser.
Stephen Solly and Sean Launchbury.
Dr Jeff Hooper and Allan Hooper.
L- R: President Dr Richard Kidd, CEO Jane Schmitt, James Warwick (AMA Queensland Insurance Solutions), Wally Lewis, Scott Stewart (AMA Queensland Insurance Solutions) President-Elect Dr Alex Markwell and Immediate Past President Dr Gino Pecoraro.
L - R: President Dr Richard Kidd, Paul Copeland and Julie Smith (William Buck Queensland), Wally Lewis, CEO Jane Schmitt, Immediate Past President Dr Gino Pecoraro and PresidentElect Dr Alex Markwell. Steven Nance, Greg Burns and Greg Lovett.
Wally Lewis with early bird winner Dr Paul Tesar.
Photos: Jerry Liu 2011 www.jerry-liu.com DoctorQ SEPTEMBER 2011
PEOPLE & EVENTS
Drinks & DITS TOWNSVILLE, Wednesday 8 June cairns, Thursday 9 June herston, Thursday 23 June 2011
AMA Queenslandâ€™s Council of Residents and Registrars met with Doctors in Training in Brisbane, Cairns and Townsville for casual drinks and nibbles. The CoRR team gave guests an update on MOCA negotiations, working conditions and payroll issues. Above: President-Elect Dr Alex Markwell, Angela Lindner from William Buck, Simon Moore from Investec and Cristina Castro from Avant.
Starting and working in Private Practice FRIDAY 29 - SATURDAY 30 JULY 2011
On the 29 and 30 July, AMA Queensland successfully hosted its annual Starting and Working in Private Practice Conference. The comprehensive two-day program attracted a range of GPs, specialists and practice managers who were all excited to expand their knowledge of the complex process of establishing and operating a private practice. AMA Queensland President, Dr Richard Kidd joined key partners and sponsors to present individual education sessions and to discuss the hot topics currently affecting the profession with delegates. Everyone in attendance thoroughly enjoyed the conference and found the information sessions to be a valuable asset to their private practice ventures.
Dr Clyde Mackey, Dr Matthew Hocking and Awais Chaudhry.
Rebecca Byrnes and Patricia Cuthbert.
SEPTEMBER 2011 DoctorQ
Julie Smith from William Buck addresses the crowd.
Kylie Atwood, Dr Isabelle Jonsson-Lear, Dr Beres Wenck and Lucas Levy.
Terry Boyce with Dr Anita Holland and Julie Bydder.
Katharine Philp from TressCox Lawyers.
PEOPLE & EVENTS
Joy’s farewell friday 5 august 2011
AMA QUEENSLAND VERANDA, HERSTON
After 44 years of loyal service, AMA Queensland stalwart Joy Moric hung up her ear piece and retired. Long-time members, former staff and friends visited Hunstanton for a high tea to celebrate Joy’s move to the next phase of her life.
Dr Humphry Cramond (far left) with Joy and her husband Mike.
Past President Dr Bruce Biggs with Joy Adams (centre) with Joy.
No high tea would be complete without scones, finger sandwiches and sweet treats.
Joy with Dr Trevor Harris and Joy Adams.
Dr Peter Cassimatis.
AMA President Dr Steve Hambleton said a fond farewell.
Dr Frank Sullivan and his wife Colleen came along to say goodbye.
CEO Jane Schmitt presents Joy with a parting gift.
The string quartet added a little extra elegance to the high tea.
President Dr Richard Kidd raised a toast.
DoctorQ SEPTEMBER 2011
DENDY MOVIES One Day Opens: 1 September Cast: Anne Hathaway, Jim Sturgess, Patricia Clarkson After one day together - 15 July, 1988, their college graduation - Emma Morley (Anne Hathaway) and Dexter Mayhew (Jim Sturgess) begin a friendship that will last a lifetime. She is a working-class girl of principle and ambition who dreams of making the world a better place. He is a wealthy charmer who dreams that the world will be his playground. For the next two decades, key moments of their relationship are experienced over several July 15ths in their lives. Somewhere along their journey, these two people realise that what they are searching and hoping for has been there for them all along. As the true meaning of that one day back in 1988 is revealed, they come to terms with the nature of love and life itself.
Eye of the Storm
Crazy Stupid Love
Midnight in Paris
Opens: 15 September Cast: Geoffrey Rush, Judy Davis, Charlotte Rampling
Opens: 29 September Cast: Steve Carell, Ryan Gosling, Julianne Moore, Emma Stone, John Carroll Lynch, Marisa Tomei,, Kevin Bacon, Jonah Bobo, Analeigh Tipton, Josh Groban, Liza Lapira, Joey King
Opens: 20 October Cast: Kathy Bates, Adrien Brody, Carla Bruni, Marion Cotillard, Rachel McAdams, Michael Sheen, Owen Wilson
When Elizabeth Hunter (Rampling) has a stroke, her son (Rush) and daughter (Davis) fly across the world to be at her bedside, which raises all the family’s old frictions and resentments as they struggle to come to terms with who they are and what they mean to each other and how they can best survive one another. Based on the novel by Nobel Prize–winning author, Patrick White, The Eye of the Storm is a savage exploration of family relationships – and the sharp undercurrents of love and hate, comedy and tragedy, which define them.
When forty-something, straight-laced Cal Weaver (Steve Carell) learns that his wife, Emily (Julianne Moore), has cheated on him and wants a divorce, his ‘perfect’ life quickly unravels. Now spending his free evenings sulking alone at a local bar, the hapless Cal is taken on as wingman and protege to handsome, thirty-something player Jacob Palmer (Ryan Gosling). In an effort to help Cal get over his wife and start living his life, Jacob opens Cal’s eyes to the many options before him: flirty women, manly drinks and a sense of style. Despite Cal’s makeover and his many new conquests, the one thing that can’t be made over is his heart, which seems to keep leading him back to where he began.
This is a romantic comedy set in Paris about a family that goes there because of business, and two young people who are engaged to be married in the fall have experiences there that change their lives. It’s about a young man’s great love for a city, Paris, and the illusion people have that a life different from theirs would be much better.
WIN MOVIE TICKETS FOR TWO Name: Postal address: Portside Wharf, Remora Road, Hamilton Ph: (07) 3137 6000 www.dendy.com.au 56
SEPTEMBER 2011 DoctorQ
FAX BACK TO (07) 3856 4727 or email email@example.com by 30 September
culture Le Grand Cirque From 15 September, Lyric Theatre, QPAC Le Grand Cirque returns to QPAC with the jaw-dropping visual feast, Adrenaline - the most dangerous, entertaining and thrilling acts combined with physical comedy routines and feats of skill and agility. Extravagant and mesmerising, witness three daredevil motorbike riders race around inside the Globe of Death and marvel as identical twins bend their bodies in incredible exploits of physical plasticity. Watch in awe as the Giant Swing catapults performers into the vaulted ceiling while a group of fire breathers blow giant fireballs over the audience’s heads.
Kawai Piano Series 4 and 12 October, Reverse Mode, Concert Hall, QPAC Performed at The Ian Hanger Recital Hall and QPAC’s Concert Hall, experience the remarkable Kawai Piano Series and hear some of the twentieth century’s most exciting pianists perform live on stage. Featuring one of Australia’s most distinctive pianists, Stephanie McCallum invoking the glory of Italy, and piano due Liam Viney and Anna Grinberg performing a selection of modern pieces for piano, this is an intimate, hour-long recital that will inspire music lovers.
Spring Awakening 13 - 22 October, Cremorne Theatre, QPAC The winner of eight Tony Awards, including Best Musical, Spring Awakening explores the journey from adolescence to adulthood with poignancy and passion in an electrifying fusion of morality, sexuality and rock and roll. Join this group of late 19th century German students as they navigate teenage self-discovery and coming of age in a powerful celebration of youth and rebellion in the daring, remarkable Spring Awakening. Featuring a cast of Brisbane’s finest professional and emerging talent, this Spring Awakening will be one to remember.
QI Live 31 October – 2 November, Concert Hall, QPAC The world’s first live interpretation of ABC’s smash hit television show QI comes to Australia. Host Stephen Fry and Alan Davies, joined by a line-up of celebrity panellists, present QI Live in Brisbane. The buzzers, the theme tune and the QI set are all packed and on their way Down Under to take part in what we have come to know and love on television as QI, the world’s most impossible TV quiz!
WIN DOUBLE PASSES TO THE KAWAI PIANO SERIES
Name: Postal address:
FAX BACK TO (07) 3856 4727 or email firstname.lastname@example.org by 23 September DoctorQ SEPTEMBER 2011
current Diagnosis and Treatment: Emergency Medicine
Doctor Q has a copy of Current Diagnosis and Treatment: Emergency Medicine to give away.
the evaluation and treatment of specific disorders.
An easy-to-use guide to the diagnosis, treatment, and managemenet of the full range of clinical conditions seen in emergency medicine.
Current Diagnosis and Treatment: Emergency Medicine is published by McGraw-Hill and retails for $114. Q
This updated edition in the trusted CURRENT series is valuable to anyone practicing in an emergency department or acute-care setting. It emphasises immediate management of life threatening problems, then covers
To go in the draw to win a copy of this book, simply fill out your details in block letters on the form below and fax it back to Doctor Q on (07) 3856 4727.
FAX TO: (07) 3856 4727 or email email@example.com by 30 september
Competition winners DENDY WINNERS Double pass winners: 1. Dr Brian Wilson-Boyd 2. Dr Noel Saines 3. Dr Peta Margrie 4. Dr Jason McMillen 5. Dr Jennifer Cavanagh 6. Dr David Lynch 7. Dr Photene Weber 8. Dr Jen McAuliffe 9. Dr Karen Chau 10. Dr Ken Bowes
1. A Markwell 2. R Parsons 3. R Ramsay 4. A Fifoot 5. A Ellis 6. W Christie 7. C Weekes 8. L O’Keefe 9. T Pham 10. D Volling-Geoghegan
1. A Lim 2. K Black 3. A McKee 4. J Kynaston 5. G Pearse 6. S Luland 7. G Langerak 8. S Kevat 9. A Blond 10. A Cormican
CONSULTING ROOMS TO LET McCullough Specialist Centre Sunnybank Half day sessions, $100/session + GST PHONE (07) 3345 7117 FOR DETAILS 58
SEPTEMBER 2011 DoctorQ
Dr Brian Wilson-Boyd won a double pass to Ballet Revolución at QPAC.
Winners for the exclusive premiers for the eVENTS+Training newsletter:
11. P Dodd 12. G Hopkins 13. C Jackson 14. B Flegg 15. N Herbert
BOOK WINNER The winner of last edition’s In Print giveaway was Dr Robert Watson of Everton Park. Dr Watson won a copy of First Do No Harm: Being a Resilient Doctor in the 21st Century.
FOR RENT /LEASE Chermside Medical Complex Spacious specialist medical rooms (with balcony) available to share on either a full-time or session basis. Separate reception areas. Staffroom. Additional smaller consulting room (suitable for procedures/psychologist/dietician) also available. Secured car space. Other services in complex include Premion Radiotherapy, HOCA, Southern X-ray Clinics, S& N Pathology, Day surgery, General Practice and Pharmacy.
Contact: Therese 0414 854 793
Medical Practice for SALE
Professional On-site IT Support
39 GLADSTONE ROAD HIGHGATE HILL
• Initial practice set up and relocations • Repairs, upgrades and virus removal • Networking and remote access • Software upgrades and support
Southcity Family Medical Centre is a busy practice located in inner city West End. It sees both regular families, and is well known for its work with drug addicted patients which comprise 70% of its patient population. The centre has been operating for almost 20 years, and has a good reputation with both patients and other health care providers locally. It has good public transport systems and two tertiary hospitals nearby. Contact Stuart Reece on (07) 3844 4000
Dr Namrata Bajra MBBS, FRANZCOG
OBSTETRICIAN & GYNAECOLOGIST Dr Namrata Bajra runs her practice from her rooms at the North West Medical Centre, Everton Park and the Wesley Medical Centre, Auchenflower. Special interests: High risk obstetrics Colposcopy Complex pelvic surgery Laparoscopic surgery
Associations: RANZCOG ASUM AMA
A J Technology (Aust) Pty Ltd has extensive experience providing IT support to medical practitioners throughout the Greater Brisbane and Moreton areas. Find out more about AJ Technology at www.ajtech.biz or phone (07) 3888 6084
Previous Experience and Training Dr Bajra started her specialist training in 2003 at the Logan Hospital followed by a year at the Mater Mothers Hospital, South Brisbane and then a year at the Rockhampton Base Hospital completing her rural training. The final two years of her training Dr Bajra worked at the Royal Hobart Hospital followed by a year at the Royal Women’s Hospital, Melbourne gaining further skills in Advanced Gynaecological Surgery. Since completing her Specialist Training in 2008, Dr Bajra has worked as a Staff Specialist at the Mater Mothers Hospital, South Brisbane until August 2010.
Wesley Medical Centre Suite 30, Level 2 40 Chasely Street Auchenflower Qld 4066 North West Medical Centre 125 Flockton Street Everton Park Qld 4053 Telephone: (07) 3871 3317 Facsimile: (07) 3232 7585 After Hours: (07) 3836 3256
NEW FARM PRACTICE TO LEASE Prestigious suburb and building, densely populated area with no doctors nearby, dentist occupying next door, main corner opposite shopping centre precinct, new Mirvac site soon to be finished nearby. Beautiful grounds and entry, fitted out and ready to start. 90 sq meter area, three doctors’ rooms, waiting room, reception area, autoclaving room, plus storage and own toilet. Hours you can open are 7am – 9pm, 7 days a week – Council approval for a working week of 98 hours.
PLEASE RING SUE ON 0421 007 966 FOR AN INSPECTION
ROOMS IN BENOWA (GOLD COAST) Located across the road from Pindara Private Hospital, in the heart of one of the Gold Coast’s most established medical precincts, they are currently being used by an orthodontist and will become available from December 2011. Offering a central location and ample car parking, with easy access from all areas of the Gold Coast, the ground floor suite (75m2) is immaculately fitted with 2 treatment rooms, reception, consulting office, sterilizing and lab areas. PHONE: 07 5597 2100 during office hours, or 0416 046 721 AH
ONCE IN A
SPACE AVAILABLE FOR RENT • 30 to 130 square meters of ground ﬂoor retail in modern retail centre suitable for a doctors group. • Be the ONLY doctors surgery in Camira (growth area beside Springﬁeld) on busy road (20,000 cars/day) besides a service station with combined driveway. Mainly health professionals with Dentist, Chiropractor, Chemist, Massage Therapy, Yoga and Counselling • Cost $320/m2 + Outgoings ($9,600 - $41,600) Contact: Conrad Woolston M: 0400796935 E: Conrad@dataone.com.au
CAMIRA VILLAGE • 320 OLD LOGAN ROAD, CAMIRA, BRISBANE 4300
A one off opportunity, unlike most other properties this one would be very difficult to duplicate, location is one of the key aspects. 170m from the waters edge, of full level of Warwick’s Lake Leslie, literally fish, sail or water ski from your very own front yard. 180 degrees of lake views. Catch brunch, sit on the front verandah and enjoy the view. Second to the view is the home, made from solid sandstone boasting four extra large bedrooms, extra large living areas with two bay windows, take in the morning sun. You have to see the detail that has gone into the construction of this home to really appreciate it. Tasmanian Oak Kitchen, 10’ ceilings, tiled living areas, air conditioning and wood heater, sheds, enough to park 3 cars plus a large boat plus a large caravan all under cover all secure with an electric security gate on the house yard, 6m x 9m workshop plus the enclosed storage area for the mower etc, 40 acres of quality grazing country plus the opportunity to lease the water’s edge, perfect for horses, sheep or cattle. Unfortunately for the owner, illness has forced the sale of this home and with no comparison properties the owners are inviting offers. If you would like the opportunity to own this one off, never to be duplicated property, contact Brent Bowles Property Specialists Warwick (07) 4661 7443 or 0408 670 055.
DoctorQ SEPTEMBER 2011
$395 back in your pocket As a current AMA Queensland member you have the chance to save. Benefit from the AMA Queenslandâ€™s partner relationship with Investec Medical Finance when you take out a home loan or refinance your existing home loan. Not only will you get a competitive rate from 6.80%* but $395 back in your pocket! To find out more about this limited offer from Investec Medical Finance please contact AMA Queensland members services team on 07 3872 2205 or email firstname.lastname@example.org
Investec Professional Finance Pty Ltd ABN 94 110 704 464 (Investec Professional Finance) is a subsidiary of Investec Bank (Australia) Limited ABN 55 071 292 594 AFSL/ACL 234975. Residential loan through Adelaide Bank Limited. *Residential property finance interest rates are variable and subject to change without notification, rate based on 80% of property valuation and credit policy. Valid for loans greater than $250k at 80% LVR. Rate current as at 20 July 2011. Investec Professional Finance is not offering financial or tax advice. You should obtain independent advice as appropriate. All finance is subject to our credit approval criteria. Terms and Conditions, fees and charges apply. AMA gift of $395 goes directly back the member. All enquiries must be made via AMA and must quote member number. Valid for enquiries made throughout August and September (must settle before 31 October 2011). Gift issued by the end of November 2011.