Doctor Q Autumn 2020 by AMA Queensland

Doctor Q is free to AMA Queensland Members

AUTUMN 2020

C O V I D-1 9: A N AT I O N A L H E A LT H E M E R G E N C Y QUEENSLAND DOCTORSâ&#x20AC;&#x2122; COMMUNITY: MEMBERS DRIVING THE AGENDA PHARMACY PRESCRIBING PUTS P R O F I T S A H E A D O F PAT I E N T S

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CONTENTS

REPORTS

F E AT U R E S

Editor’s desk

Obesity Awareness Week

President’s report

Pharmacy prescribing

CEO’s report

Council of Doctors in Training update

Queensland Doctors’ Community - members driving the agenda

AGM and Election Notice

AMA Queensland Foundation: doctors doing good

CURRENT ISSUES

BUSINESS TOOLS 42

Lending - finding the jewel in a crowded marketplace

Alignment is a must

Off-label prescribing

Scammers target the ill

PEOPLE & EVENTS

LIFESTYLE

COVID-19: a national health emergency

Member profile: Assistant Professor Laurence McEntee

Gardens of the world

Budget submission

Obituary: Dr Dan Hart

Restaurant review: Polpetta

Junior lawyer case: paying well doesn’t mean you can overwork

Obituary: Dr Michael McDonnell

All About You

Dendy Cinemas

ASMOFQ fighting for you

Events calendar

The wisdom of avocation

Could real time prescription monitoring ease opioid pain?

Local Medical Associations round up

Dr Matt Young: The lady with the lamp

Rising from the ashes

InPrint: ThinSanity

Research round up

Junior Doctor Conference speaker profile: Associate Professor Munjed Al Muderis

AMA Queensland Annual Conference in Lisbon, Portugal

OBESITY AWARENESS WEEK - TACKLING OBESITY HEAD ON

NEW CDT CHAIR DR M ADDISON TAYLOR

MEMBER PROFILE: ASSISTANT PROFESSOR LAURENCE MCENTEE

Doctor Q Autumn

BOARD OF DIRECTORS

Editor’s Desk Welcome to our Autumn edition of Doctor Q. Queensland Doctors’ Community has certainly changed the way AMA Queensland communicates with members, as well as changing the way members are able to communicate with each other. It’s not all talk though - those conversations have fed directly into our advocacy work. Check out the feature on p14 and get in on it at https://community.amaq.com.au.

A U S T R A L I A D AY H O N O U R S Congratulations to the following members who received honours on Australia Day: Associate Professor Paul Eliadis received an AM for significant service to medicine as a clinical haematologist, and to charitable initiatives. Dr Neil R Wetzig and Gwen Wetzig received AOs for distinguished service to the international community of the Democratic Republic of Congo through medical support, teaching and training programs. Dr Vedella Hinckley received an AM for significant service to medicine as a plastic and reconstructive surgeon. Dr Donald Campbell received an OAM for service to trauma medicine.

OBITUARIES The following AMA Queensland members have recently passed away. Our sincere condolences to their families. Dr Stanley Michael MCDONNELL General Practitioner Late of Pelican Waters Member for 58 years Dr Daniel Roberts Lloyd HART AMA Queensland Past President 1977-78 Life member Ophthalmologist Late of Clayfield Member for 76 years

Dr Morris WILLIAMS General Practitioner Late of Ashgrove Member for 52 years Dr Mark Leith CRAIG General Practitioner Late of South Brisbane Member for 39 years Dr Ian UPTON General Practitioner Late of Manly Member for 46 years

F O L LO W U S :

Associate Professor Chris Perry Vice President

Dr Eleanor Chew OAM Casual Appointed Director Dr Sarah Coll Member Appointed Director

Ann Fordyce Skills Based Director Dr Bav Manoharan Member Appointed Director Dr Peter Isdale AM Skills Based Director

COUNCIL Dr Hashim Abdeen Doctors in Training Representative

Dr Sarah Coll Specialist Craft Group

Dr Fatima Ashrafi Specialist Craft Group

Dr Hasthika Ellepola International Medical Graduate Representative

Dr Sanjeev Bandi Capricornia Area Representative Dr Kimberley Bondeson Greater Brisbane Area Representative Dr Maria Boulton Greater Brisbane Area Representative Dr Bill Boyd Immediate Past President Zoe Byrne Medical Student Representative Dr Marianne Cannon Greater Brisbane Area Representative Dr Michael Clements North Area Representative

Dr (Deborah) Erica Gannon Part-time Medical Practitioner Craft Group Dr Marco Giussppin Downs and West Area Representative Associate Professor Geoffrey Hawson Retired Doctors Representative Dr Wayne Herdy North Coast Area Representative Dr Scott Horsburgh General Practitioner Craft Group Dr John de Laat Greater Brisbane Area Representative

Dr Bav Manoharan Greater Brisbane Area Representative Dr Katrina McLean Gold Coast Area Representative Dr Nikola Ognyenovits Specialist Craft Group Dr Rachael O’Rourke Greater Brisbane Area Representative Dr Fiona Raciti General Practitioner Craft Group Dr Siva Senthuran Full-time Salaried Medical Practitioner Craft Group Dr David Shepherd Far North Area Representive Dr Nicholas Yim General Practitioner Craft Group

A M A Q U E E N S L A N D S E C R E TA R I AT Jane Schmitt Chief Executive Officer

Filomena Ferlan General Manager Corporate Services

Katherine Gonzalez-Cork General Manager - Member Relations and Communications

Editor: Michelle Ford Russ

Doctor Q is published by AMA Queensland

Graphic Designer: Aleisha Coffey

Phone:

Journalist: Chiara Lesevre

(07) 3872 2222

Address: PO Box 123, Red Hill QLD 4059 Email:

amaq@amaq.com.au

Print Post Approved PP100007532

WHERE YOU DRIVE THE AGENDA

4 Doctor Q Autumn

Dr Dilip Dhupelia President, Chair of Board and Council

Disclaimer – All material in Doctor Q remains the copyright of AMA Queensland and may not be reproduced or transmitted in any form without permission. While every care is taken to provide accurate information in this publication, the material within Doctor Q is for general information and guidance only and is not intended as advice. Readers are advised to make their own enquiries and/or seek professional advice as to the accuracy of the content of such articles and/or their applicability to any particular circumstances. AMA Queensland, its servants and agents exclude, to the maximum extent permitted by law, any liability which may arise as a result of the use of the material in Doctor Q.

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President’s report DR DILIP DHUPELIA

As I write my final Doctor Q Presidential article, never in my wildest dream could I have imagined that the world would be in so much more turmoil than two years ago when I was elected, and where our highly skilled doctors and nurses and other frontline health workers have heeded the call of duty to look after our sick during a pandemic. I thought it appropriate to reflect on the wide and varied issues that AMA Queensland has been involved in during this time in our advocacy, representation and leadership: Improving the performance of the Office of the Health Ombudsman Raising the bar (slightly) in the Mandatory Reporting Legislation Opposing expanded scope of practice and role substitution Real-Time Prescription Monitoring System and tackling opioid misuse Abortion laws moving from Criminal code to the Health code Rural Maternity Services Taskforce Relaying clinician concerns on the roll-out of iEMR The establishment of Health and Wellbeing Queensland Water fluoridation campaign Improving Government and Queensland Health relations and access Campaigning against new medical schools or more medical students Advocating for a statewide Palliative Care Strategy Parliamentary representation on Voluntary Assisted Dying legislation

6 Doctor Q Autumn

Ensuring conversion therapy legislation protects clinicians working in the field of gender dysphoria Expanding prevention and support services for Mental Health Addressing poor state of oral health and palliative care services for our First Nations people A significantly deliberate and increased media presence Advocating for environmental sustainability in healthcare Resident Medical Officers Hospital Health Check survey Reinvigorating Local Medical Associations across the State, where possible Advocating for funding for Hepatitis C eradication through the Kombi Van Launching AMA Queensland’s inaugural Obesity Awareness Week Launching the Queensland Doctors’ Community real-time, peer-to-peer member platform Advocating for retired doctors Developing a skill-based board with a purposeful strategic direction A diverse and vibrant AMA Queensland Council with improved functionality and policy output In addition, what has been personally pleasing to me is how well the States and Federal AMA are operating in tandem on a number of issues and have recently signed off on a Memorandum of Understanding and also approved an external review of the collective operations of AMA Secretariats. This will result in positive aspects, such as nationwide policy advocacy campaigns and nationally

networked policy management and media management. The new Secretary General has outlined his vision for future policy directions and campaign priorities for the future, all of which I am sure you will soon be hearing about. I remain overwhelmed by the influential power and role of the AMA! During these two years, I have encountered amazingly dedicated colleagues and secretariat staff who live and breathe the AMA across the nation. Yes, there has been criticism regarding a drop in membership in recent years, a trend that is now hopefully once again being reversed. However, I can assure you the AMA remains a significant force in the eyes of governments and stakeholders. No matter what position we take on the numerous issues we deal with daily, some members will be pleased whilst others won’t. Such is the diversity of our membership. We must not get distracted, disillusioned or divided by single issues, because all things considered, no other organisation does so much for ALL Doctors. It will be remiss of me not to thank the Board Directors and Councillors who have supported me so eagerly, the hard working and dedicated Secretariat of AMA Queensland who amaze me, and the wisdom that I often tapped on and obtained from Past Presidents and members of our association. The forthcoming AMA Queensland elections will establish a new leadership team and I am very confident that we have the right formula for them to take us forth, provided we continue our support! I thank you for the opportunity of being your President.

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Doctors, Eligible Midwives, Healthcare Companies, Medical Students

CEO’s report JANE SCHMITT

COVID-19 As the global COVID-19 outbreak continues to unfold, we recognise the effort all in the medical profession are currently applying to responding to the outbreak and we are here to support members during these challenging times. Given the evolving situation in Australia and across the world, AMA Queensland has taken a number of precautionary measures in relation to our team to support them and their families, including implementing working from home arrangements to ensure key functions are continued offsite as we continue to support and advocate for our members. We are also currently planning and reviewing our work priorities and events for the year. We will continue to monitor the situation closely and will provide members with ongoing updates on the status of our conferences and events. The Australian Government has introduced a number of stimulus assistance for businesses that may help your practice through this uncertain time. Eligible small to medium businesses with a turnover of less than $50million that employ staff could receive up to $25,000 available tax free. Our corporate partner, William Buck, has provided the following link to update you on the support provided: https://bit.ly/33wjYsN.

MEMBERS INVOLVED IN KEY DECISION - MAKING We thank AMA Queensland members for providing ongoing feedback on the response to COVID-19 via Queensland Doctors’ Community (QDC). All feedback is viewed and acted upon. Your concerns are being collated and escalated to the relevant Departments and Ministers’ offices. The Australian Government has put $2.4billion towards 100 pop-up fever clinics, a $30million advertising campaign and a Medicare item for telehealth consultations. The national triage phone line will therefore be expanded to operate 24/7 to provide advice to patients. The government will establish dedicated Medicare-funded and bulk-billed pathology test for COVID-19 and influenza. Read more here: https://bit.ly/39TVN9H and here: https://bit.ly/2TWuEhb. I encourage members to continue to raise COVID-19 issues via QDC or by emailing covid19@amaq.com.au over the coming months so that AMA Queensland can continue to advocate on your behalf.

8 Doctor Q Autumn

AMA Queensland will continue to provide ongoing updates and frontline advice on COVID-19 to members via Queensland Doctors’ Community (QDC), email and our website, as information becomes available. RETIRED DOCTORS TO THE RESCUE AMA Queensland calls on retired Queensland doctors to register their interest in helping to flatten the infection curve, which is expected to peak during winter months. We have been liaising with Chief Medical Officer Dr Jeannette Young on the best way for retired doctors to assist Queensland Health during the outbreak. Retired Queensland doctors are needed to assist with contact tracing and 13 HEALTH hotline advice to help manage the COVID-19 outbreak. Retired doctors can register to help by emailing covid19@amaq.com.au or phoning AMA Queensland on (07) 3872 2222.

A M A Q U E E N S L A N D O B E S IT YAWA R E N E S S W E E K In March, AMA Queensland staged its inaugural Obesity Awareness Week (OAW), a grassroots public awareness campaign aimed at encouraging obese and overweight people to take small steps towards a healthier future and to contact their GP for help in adopting healthier habits. Run from 2-6 March, in partnership with Screen-Free Week, the campaign was timed to coincide with World Obesity Day on 4 March and challenged Queenslanders to make one small change to their diet or exercise regime each day of the week. This ranged from moving more to drinking less sugary beverages, or reducing the amount of screen time. AMA Queensland was delighted to provide AMA Federal and all the other State and Territory AMAs marketing resources, templates and social media collateral to raise awareness in their own communities and participate in the campaign. GPs received information kits to assist in discussing obesity-related health issues with patients and to seek their participation in our efforts to help curb the scourge of obesity at the grassroots level. Response to OAW has been overwhelmingly positive. A short survey of GPs on their obese and overweight patients yielded insights that made newsworthy content for numerous media outlets, including several Queensland television and radio stations, almost every metropolitan daily newspaper in the country as well as The Australian. Nominated AMA Queensland media spokespeople across the state ensured the OAW campaign was covered in local and regional news outlets and we received emails and letters of support from a number of Queensland Health and Education Queensland leaders. While AMA Queensland took the lead on OAW, we look forward to the campaign becoming a bigger, even more successful annual national initiative in coming years.

2020 AMA QUEENSLAND ELECTIONS Nominations will open at 12noon on 30 March for the positions of President, Vice President, Board and Council members. More information about the new positions and the election process is available on page 29. The election results will be announced at our Annual General Meeting on 22 May 2020.

I N N O VAT I O N I S K E Y Queensland Doctorsâ&#x20AC;&#x2122; Community (QDC) has changed the way AMA Queensland communicates with members, by helping us communicate more dynamically with you, respond more quickly to your needs and receive your input on critical issues. Read more on page 18. We recently launched new QDC features as part of your AMA Queensland membership benefits, including live Q&A webinars with key stakeholders and three new Junior Doctor, Medical Student and Retired Doctor QDC Discussion Forums to allow these groups to have peer-to-peer discussions on issues that are uniquely relevant to them. In the coming months, we will also be launching the new AMA app where you will be able to access QDC, update your membership profile, register for events, access membership benefits and discounts, renew your membership, and more. We will keep members abreast of progress on the development of the new app.

Doctor Q Autumn

COVID-19: a national public health emergency WORLDWIDE On 31 December, 2019, China reported a cluster of cases of pneumonia in people associated with a seafood market in Wuhan, Hubei Province and by 7 January, Chinese health authorities confirmed the cluster was associated with a novel coronavirus or COVID-19. By 30 January, almost 10,000 cases have been reported in 21 countries, including Australia. By 11 March, we had 112 confirmed cases in Australia and three deaths. On 12 March, the World Health Organisation (WHO) declared COVID-19 a pandemic, with more than 18,000 cases in 114 countries and 4,291 deaths. This is the first pandemic virus caused by a coronavirus. WHO’s Director General Dr Tedros Adhanom Ghebreyesus said that all countries can still change the course of this pandemic. “If countries detect, test, treat, isolate, trace, and mobilise their people in the response, those with a handful of cases can prevent those cases becoming clusters, and those clusters becoming community transmission. Even those countries with community transmission or large clusters can turn the tide on this virus. Several countries have demonstrated that this virus can be suppressed and controlled,” he said.

AUSTRALIA Australians started panic buying in March, purchasing pasta, powdered milk, but mostly toilet paper. Large scale events were cancelled, conferences and meetings were conducted via teleconference rather than face-to-face. Personal protective equipment has been very hard to get, particularly the correct masks, even for health professionals. Prime Minister Scott Morrison addressed the nation and warned of greater uncertainty to come but unveiled a $17.6 billion aimed at softening the blow from the outbreak.

QUEENSLAND AMA Queensland’s online platform, Queensland Doctors’ Community, has provided a direct line to and from members, which has been particularly valuable in the midst of the virus. AMA Queensland hosted a question and answer session with Chief Health Officer Dr Jeannette Young to provide an update on COVID-19 in February. We have been providing daily updates from Dr Roger Halliwell, our primary care representative on the State Health Emergency Coordination Centre (SHECC). Members were able to discuss their concerns, ideas and experiences through the platform and much of this information was escalated to AMA Federal and to the Queensland Chief Health Officer Dr Jeannette Young. AMA Queensland was able to communicate information to members as it came to hand, with updates from Queensland Health, the SHECC, the World Health Organisation and Australia’s Chief Health Officer. AMA Queensland will continue to share all information at hand and continue to coordinate efforts to help doctors work together during this crisis.

T E L E H E A LT H As part of the package outlined by the Australian Government, $2.4 billion was set aside for health. The money will go towards 100 new pop-up fever clinics, a $30 million advertising campaign and a Medicare item for telehealth consultations. The aim of the pop-up clinics is to divert patients away from hospital emergency departments and GP clinics to reduce the risk of the virus spreading. Staff at these clinics are expected to see 75 patients a day over six months. Severe cases will still present at hospitals. The AMA will work with Primary Health Networks (PHNs) and other groups to identify the most appropriate properly resourced sites. The AMA is also seeking more information about the extent to which these new telehealth items will be available to all members of the medical profession at the forefront of guarding against coronavirus.

10 Doctor Q Autumn

Where should the money go? AMA Queensland provides an annual budget submission to the Queensland Government to suggest how health funding should be spent. This year, we have asked the government to specifically review its approach to palliative care in Queensland, to ensure fair access to all patients in need, both rural and metropolitan. Our budget submission focused on the following health priorities and solutions.

1. P A L L I A T I V E C A R E AMA Queensland is calling on the Queensland Government to provide more funding to palliative care services and to fund the new base and outreach program which help address the unmet need in palliative care in rural and remote communities.

2. M E N T A L H E A LT H

Medical practitioners play an important role in the diagnosis and management of mental health across the continuum of care. Working with the Queensland Government and the Queensland Mental Health Commission, AMA Queensland is focused on achieving good mental health and wellbeing of Queenslanders, no matter where they reside.

3. O P I O I D M I S U S E

AMA Queensland calls for additional training positions in addiction medicine, an improved training pathway for medical practitioners, and a practice incentive to allow medical practitioners to provide comprehensive care for patients addicted to opioids.

4. I N D I G E N O U S H E A LT H

AMA Queensland recommends the Queensland Government focus on three health issues for Aboriginal and Torres Strait Islander Queenslanders which need urgent attention: palliative care services; addressing the poor state of oral health and improving access to equitable, safe and culturally appropriate health services.

5. H E A LT H Y MEDICAL WORKPLACES

Doctors, like all workers in Queensland, need a safe and healthy hospital workplace which allows them to provide the best possible care without the threat of bullying, sexual harassment and fatigue.

6. O B E S I T Y

AMA Queensland believes doctors play an integral role in overcoming and preventing obesity in Queensland adults and children by helping the patient develop and maintain healthy habits. AMA Queensland also believes that doctors will play an important role in the Queensland component of AMAâ&#x20AC;&#x2122;s 2020 Obesity Awareness Week and is calling on the Queensland Government to support this new initiative.

7. E N V I R O N M E N T A L SUSTAIN ABILITY I N H E A LT H C A R E

The health care sector is responsible for at least seven per cent of emissions, with GP clinics contributing four per cent and hospitals contributing 44 per cent of total emissions. AMA Queensland considers that environmental sustainability in healthcare can be worked towards through a consistent approach to sustainability mitigation activities and the setting of benchmarks and targets in all public hospitals and health care settings.

Doctor Q Autumn 11

Obesity Awareness Week Earlier this month, AMA Queensland hosted its first Obesity Awareness Week, a public education and awareness campaign aimed at battling obesity, curbing chronic disease rates and promoting healthy lifestyles. AMA Queensland distributed a range of practical tips and tricks to help Queenslanders become more active and make healthier choice. A partnership with the Screen-Free Week organisation helped highlight the link between screen addiction and lack of exercise. Thank you to our members for helping us spread the word through digital, social and traditional media channels. These resources are available at www.ama.com.au/owa. We challenged adults and children to take the Screen-Free Week Pledge and get together with friends to take on more activities. Obesity Awareness Week started a conversation about making healthier choices: moving more; doing a digital detox; freshening up with fresh fruits and vegetables and home made food; recognising World Obesity Day and swapping sugary drinks.

KEY MESSAGES AMA Queensland embarked on the campaign to get the message out that two in three adults and one in four children are obese or overweight in Australia. The message was donâ&#x20AC;&#x2122;t weight! Get help from your GP. AMA Queensland called on Queenslanders to make one small change each day towards a healthier future.

12 Doctor Q Autumn

AMA QUEENSLAND COMPILED A LIST OF SIMPLE CHALLENGES FOR PEOPLE IN WORKPLACES, SCHOOLS, HOUSEHOLDS AND OTHER FORUMS:

Monday - move more

Initiate incidental exercise such as stand up assemblies, a group run and organised physical activities at schools such as lunch-time walk/run or ride-to-school day.

Tuesday - Digital detox

Encourage Queenslanders to spend a screen-free lunch break. Turn off TVs and other screens in lunch rooms from 12-2pm. Challenge students to a screen-free day with no TV, computer games or other devices.

Wednesday world obesity DAY

Spread the word about the inaugural World Obesity Day.

THURSDAY - FRESHEN UP

Encourage Queenslanders to replace processed, convenience snack foods with fresh fruits, vegetables and nuts.

Friday Think before you drink Urge water instead of soft drink, alcohol and other sugary alternatives.

Doctor Q Autumn 13

Paying well doesn’t mean you can overwork staff The national law firm accountable for advising Woolworths on its $300 million underpayment scandal has been underpaying their own graduate lawyers. Ashurst has undertaken a 10-year review to determine whether their graduate lawyers were compensated for their hours worked on an $80,000 annual salary. As a result of this review, in some cases the graduate lawyers were not paid minimum award rates as a result of working excessive overtime. It’s a reminder to all employers that there is a need to look at how employees are engaged and conduct a review to ensure underpayments aren’t occurring. It is worth noting that employees have six years to lodge a claim for a back payment of wages. It is essential that you are aware of your employment obligations and are compliant.

P R I VAT E P R A C T I C E C O N S I D E R AT I O N S - SALARY CONTRACTS NOT PERMITTED It is extremely rare that an employee in a private medical practice would not be covered by a modern award. There are two awards which cover support staff, health professionals (other than doctors) and nurses; the Health Professionals and Support Services (HPSS) Award and the Nurses Award. Both of these awards do not permit the use of a salaried contractual arrangement. In saying this, there are instances where it is okay to pay an above the award hourly rate and absorb certain statutory entitlements using a ‘better off overall’ test. However, this needs to be done strictly in accordance with the individual flexibility arrangements (IFA) clause, found at Clause 7 in both the HPSS and Nurses Awards. Without an IFA, there is no ability to offset above award payments with the purpose of absorbing entitlements. Even with an IFA, Clause 7 is restrictive and allows for only particular listed entitlements to be absorbed. Further, an employer needs to be able to demonstrate how the

employee is better off, which often involves a process of completing calculations based on a predictive and regular working pattern. This is why an IFA is not relevant for a casual employee. When an employee is being paid above the award, it is also important to monitor any increases to their applicable pay rate. Whether this is as a result of the yearly CPI increase or as a result of moving up in levels, age increases for junior staff, and/or pay points in relation to their classification under the award. The AMA Queensland Workplace Relations Team can provide advice around this issue and also draft employment contracts and IFAs for members. Please don’t hesitate to contact the team on (07) 3872 2222 or wradvisor@amaq.com.au.

DID

Resident Medical Officers (RMOs) and Senior Medical Officers (SMOs) employed by Queensland Health are able to claim overtime for performance of additional hours of duty in excess of the ordinary hours of duty. The Australian Salaried Medical Officers’ Federation Queensland (ASMOFQ) regularly receives feedback from members, particularly RMOs, that overtime is either not being claimed or when claimed, is denied. The 2019 Resident Hospital Health Check confirmed this, revealing 27 per cent of RMOs responded that they believed claiming overtime would lead to a negative assessment. While the culture is slowly changing allowing RMOs and SMOs to be more confident in exercising their rights to claim, it is important that members continue to seek advice from ASMOFQ.

GET PAID

The ASMOFQ Team can assist with all elements of overtime. Contact the team on (07) 3872 2222 or asmofq@amaq.com.au for a confidential discussion.

G0T PAID

14 Doctor Q Autumn

NOT

for claimed overtime

13%

G0T

PAID SOME

of the claimed overtime

80%

ALL

the overtime they claimed

Being appropriately paid for unrostered overtime

PUBLIC PRACTICE - EMPLOYEE C O N S I D E R AT I O N S

Why Queensland Sleep? • Australia’s largest physician-owned, state-wide fully accredited sleep service. • Medicare item number changes requiring greater sleep physician involvement and pre-test assessment. • Queensland Sleep is now a trusted source of equipment hire and sales through our retail arm – Sleep Healthcare Australia. Name: MRS GAYLE BEARD • Patient 11 Sleep/Respiratory physician’s facilitating consultation, diagnostic and treatment pathways. ID: Reference ID: ROCKY 4 100685 Date of Birth: 13 July 1952 Report prepared by: QLDSLEEP on 30/09/2019 at 2:18 PM

Face-to face (metro centres) Sleep Physician

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9/2019

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Medicare changes to referring criteria from November 2018 requiring greater Sleep Physician supervision.

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Locations: Brisbane, Rockhampton, Townsville, Cairns, Mount Isa, Hervey Bay, Lismore, Bundaberg, Mackay.

Name: MRS GAYLE BEARD Uninsured Patient ID: and insured patients catered Reference ID: ROCKY 4 100685 for inDate allof locations. Birth: 13 July 1952 Report prepared by: QLDSLEEP on 30/09/2019 at 2:18 PM

Statistics 27/09/2019 - 29/09/2019 Device Settings Therapy Mode: AutoSet EPR Enable: ON Ramp Time: 30.0 minutes Minimum Pressure: 7.0 cmH2O Pressure - cmH2O Median: 16.2 Leak - L/min Median: 0.0 Respiratory Indices - events/hr Apnea index: 2.2 Obstructive: 2.2 RERA Index: 14.2 Total Usage Used Days >= 4 hrs : 3 Days not used: 0 Median daily usage: 7:10

Device: AirSense 10 AutoSet (S/N: 22151912007) EPR: FULL_TIME EPR Patient Enable: ON Essentials: PLUS Maximum Pressure: 20.0 cmH2O

EPR Level: 2.0 cmH2O Ramp Enable: RAMP_ON Response: SOFT

95th Percentile: 18.1

Maximum: 19.2

95th Percentile: 1.2

Maximum: 2.4

Hypopnea index: 7.6 Central: 0.0 % Time in CSR: 0.0

AHI: 9.8 Unknown: 0.0

Used Days < 4 hrs : 0 Total days: 3 Average daily usage: 7:03

% Used Days >= 4 hrs : 100 Total hours used: 21:09

Oximetry Statistics 27/09/2019 SpO2 - % Minimum: 61 SpO2 was less than 90%: 05:02:17 Pulse Rate - bpm Minimum: 70 ODI ODI for the session: 56

Device: AirSense 10 AutoSet (S/N: 22151912007) Median: 84 SpO2 was less than 80%: 01:18:36

Maximum: 97 SpO2 was less than 70%: 00:08:43

Median: 94

Maximum: 140

28/09/2019

Device: AirSense 10 AutoSet (S/N: 22151912007)

SpO2 - % Median: 84 Maximum: 94 Minimum: 58 SpO2 was less than 90%: 07:10:06 SpO2 was less than 80%: 01:46:47 SpO2 was less than 70%: 00:12:29 Pulse Rate - bpm Device: AirSense 10 AutoSet (S/N: 22151912007) Median: 95 Maximum: 136 Minimum: 76 Need referral pads or more information? Contact us today. ODI ODI for the session: 51

Tel: 1300 559 116 • Fax: 07 3217 2523 29/09/2019 AirSense 10 AutoSet (S/N: 22151912007) www.queenslandsleep.com.au •Device: clinical@qsdu.com.au SpO2 - % Median: 88 Maximum: 97 Minimum: 65 Referrals can be90%: sent05:09:57 via Genie, Objects, Best Practice or less Medical Director. SpO2 was less than SpO2Medical was less than 80%: 00:30:15 SpO2 was than 70%: 00:01:26 Templates are available in the practice software or for download at our website. Pulse Rate - bpm Minimum: 64 ODI ODI for the session: 36

Median: 84

Maximum: 136

THE IMPORTANCE OF OXIMETRY IN CPAP/APAP Diagnosis: 68 year old female with no history of lung disease, diagnosed with severe OSA (AHI = 118/hr, nadir Sa02 = 55%). Results of APAP Trial: Excellent control of respiratory events (AHI = 9.8/hr, AI = 2.2/hr), however persistent and sustained oxygen desaturation was recorded (nadir Sa02 = 61%). Treatment: Referral to Sleep/ Respiratory Physician to investigate. Conclusion: Patients who exhibit severe oxygen desaturations in their diagnostic study should always have subsequent oximetry measurements prior to any APAP/ CPAP trial.

Government announces pharmacy prescribing on International Women’s Day Despite dire warnings from AMA Queensland, the Royal Australian College of General Practitioners (RACGP) and the Pharmacy Board of Australia, the Queensland Government has gone ahead with allowing pharmacists to prescribe the oral contraceptive pill and urinary tract infections (UTI) medications over the counter. Premier Annastacia Palaszczuk has written to Prime Minister Scott Morrison to ask the Federal Government to support the down-schedule of the oral contraceptive pill so women can get it more regularly from pharmacies without having to renew their initial prescription. In the meantime, the Premier announced, on International Women’s Day, that they would make changes which would allow women to obtain an interim supply if their prescription had expired. The Premier commented in her media statement: “Most women who take the pill have done so since they were teenagers and are used to managing their reproductive health.” This statement ignores the need for other investigations that could occur in a standard doctor’s appointment, as well as the need to provide newer or updated medications from which the patient could benefit. She also commented that GP waiting rooms would be freed up and that women would not be burdened by the time and cost of visiting a doctor. AMA Queensland countered these arguments by stating that the Queensland Government shouldn’t be putting convenience ahead of health.

AMA Queensland President Dr Dilip Dhupelia argued these changes are more about bowing to pressure for profits from the pharmacy sector than improving women’s health care, adding that it was irresponsible of the State Government to allow pharmacies to provide antibiotics when the rise of antibiotic-resistant super germs was one of the greatest public health threats of our time. “This move works against all the national strategies that have been put in place in recent years to help control the growing threat of antibiotic-resistant superbugs. More than 700,000 people die every year around the world because of infections that are resistant to antibiotics. We need people taking less antibiotics, not more,” said Dr Dhuplia. Dr Dhupelia said Queensland’s changes disregarded national pharmacy considerations underway by the Australian Health Protection Principal Committee (AHPCC) and a recommendation of the Therapeutic Goods Administrations Independent Advisory Committee on Scheduling. “GPs are right to be concerned. We must never place politics ahead of public health.” Since this issue arose in October 2018, AMA Queensland has argued that the plan: does not separate the time-honoured principle that prescribing and dispensing must be separate; is in violation of nationally agreed and developed processes; is a clear conflict of interest for pharmacists; means a loss of preventative and opportunistic care; and encounters difficulties when it comes to the right to examine.

16 Doctor Q Autumn

Pharmacy prescribing puts politics above patients Pharmacy prescribing is a disturbing trend that may herald the further degradation of quality health care in the future. Substituting core roles of our highly trained medical workforce to other healthcare professionals, not specifically trained in the area, seems to be a favourite way for government to try and cut costs. Unfortunately, it devalues primary care, disturbs the continuity and totality of care provided by our general practitioners and further lessons the opportunity for preventative health care which is repeatedly quoted by all levels of government as being vital to not only improve the health of all Australians, but manage costs by intervening early and decreasing the need for in-hospital treatment. We have seen government substitute nurse practitioners for doctors to perform surgical procedures, pharmacists with commercial vested interests deliver immunisations and there is talk of non-medically trained personnel giving anaesthetics. Queensland Health Minister Steven Miles, supported by Premier Anastacia Palaszczuk, has now enabled pharmacists to prescribe and dispense the oral contraceptive pill for women already using this method of contraception, without having to be seen, assessed and evaluated by their general practitioner or gynaecologist. This is a clear departure for pharmacists in their role and is one for which they are inadequately prepared and trained. While pharmacists are a valued and important part of our health system, they are experts in understanding drugs. Whether it be how a drug works, how best to deliver or take the drug and what interactions a particular medication may have with other treatments that a patient is already on, a pharmacist is an expert in this field. They are not however, trained in how to diagnose or treat a particular

medical condition. Moreover, they are unable to clinically examine the patient or request the appropriate investigations that lead to a definitive diagnosis being made prior to undertaking any therapeutic options. Pharmacist prescribing has been extensively marketed by politicians as having a significant convenience factor for women who are described as time-poor and finding it difficult to schedule regular appointments to see their general practitioner to manage their contraceptive needs.

A/PROF GINO PECORARO Chair Federal AMA Board; President National Association Specialist Obstetricians and Gynaecologists; Obstetrician and Gynaecologist

A standard pill pack contains four monthsâ&#x20AC;&#x2122; worth of medication and with two repeats able to be given, it means a woman need only see a doctor once a year to manage her contraceptive needs. The World Health Organisation (WHO) is already on the record as saying that Australians are far too reliant on oral contraceptives and that these older methods should be replaced by newer long-acting reversible contraceptives (LARCs) such as implants and intrauterine devices. Importantly, LARCs are cheap! A single implant can last between three and 10 years, is covered by the PBS and does not require yearly review. In addition, they are associated with a significantly lower rate of unplanned pregnancies and method failures meaning fewer abortions. In this election year, any government wanting to help women with their contraceptive options and save both individuals and the health system significant amounts of money would do well to encourage them to see their GP or gynaecologist to discuss and update their contraceptive choice. Instead of having medically untrained pharmacists continue to dole out old fashioned treatment without review, perhaps we could look at government funding for contraceptive clinics being reintroduced or allowing gynaecology outpatient departments to see women again for contraceptive advice.

Doctor Q Autumn 17

Members driving the agenda

WHERE YOU DRIVE THE AGENDA

Since Queensland Doctors’ Community was launched in November last year, a number of robust discussions have taken place that have been driving our policy agenda at AMA Queensland.

COVID-19

AMA Queensland hosted a question and answer session with Chief Health Officer Dr Jeannette Young to provide an update on COVID-19 in February. Within the platform, members were able to ask about triaging, quarantining and caring for patients who may have COVID-19. AMA Queensland has been providing daily updates from Dr Roger Halliwell, our primary care representative on the State Health Emergency Coordination Centre (SHECC). Many GPs were concerned about advice for patients who thought they might have COVID-19 to make a faceto-face appointment with their GP. Within the conversation, Dr Michael Gattas suggested a special Medicare item be introduced to enable GPs to assess the patient via videoconference. Currently, this is restricted to nonurban locations. This request was immediately escalated to Queensland Chief Health Officer Dr Jeannette Young and Federal AMA and was discussed at the Health Ministers’ Council of Australian Governments in late February.

L I V E I N C O N V E R S AT I O N SESSIONS

AMA Queensland has organised a number of live in conversation sessions with notable figures. In February, members were able to ask questions of AMA President Dr Tony Bartone and AMA Vice President Dr Chris Zappala. Drs Bartone and Zappala discussed a range of health policy issues and future directions. Queensland Health DirectorGeneral Dr John Wakefield has been rescheduled for 23 March.

18 Doctor Q Autumn

VOLUNTARY ASSISTED DYING

An op-ed from AMA Queensland President Dr Dilip Dhupelia in The Courier Mail called So much focus on death, what about life left? focused on greater support for palliative care services before conversations about voluntary assisted dying (VAD). On QDC, members argued the ethics of VAD and what the process should look like. Following this discussion, AMA Queensland formed a new Aged Care, End of Life and Palliative Care, and VAD Working Group. The primary purpose of this working group is to develop policies, position statement and information which relate to end of life issues, including VAD. Additionally, this working group will develop recommendations which will be made to the AMA Queensland Council. However, in saying that, AMA Queensland has placed its primary focus on improving palliative care services in Queensland, which is consistent with the interests of the majority of our members. AMA Queensland believes investing more money into palliative care services would negate the need for the introduction of VAD in Queensland.

C O M M U N I C AT I O N BETWEEN HOSPITALS AND GPS

Members discussed the frustration at not being formally notified of a patient’s death by hospital staff and agreed that it may be one of the advantages of My Health Record. Another discussion post talked about Queensland Health’s Viewer, My Health Record and the integrated electronic health record (iEMR) and discussed what was needed from these systems and how they could better function.

C L I M AT E C H A N G E

There was an incredibly robust debate about AMA declaring a Climate Change Emergency Declaration in September 2019, with concern that AMA Queensland had not done enough to survey members on their beliefs. Some members argued that the evidence was well documented. One member commented “our colleagues in many of our colleges, as well as overseas medical associations, see this as a settled issue. I think we should do the same and get on with the job of addressing it.” Another member pointed out that AMA has had a similar position statement since 2004, but media attention has obviously made this a topical and contentious issue.

OBESITY AWARENESS WEEK

Ahead of AMA Queensland’s inaugural Obesity Awareness Week, there were several polls, surveys and discussions to gather information on members’ experience and observations on obesity in Queensland. These were then used to inform the Obesity Awareness campaign.

EXTRA STUDY

A junior doctor asked if masters qualifications were worth it and several members who had, and had not, completed extra study were helpful. Others looked at the enormous amount of study and debt already on junior doctors and questioned why a junior doctor needed so much extra study, on top of their MBBS, to get ahead.

GENDER DYSPHORIA

Gender dysphoria was one of the first issues raised on Queensland Doctors’ Community. In January 2020, AMA Queensland made a submission to the Health, Communities, Disability Services and Domestic and Family Protection Committee regarding the new Health Legislation Amendment Bill 2019. This bill sought to have conversion therapy outlawed in Queensland with any health service providers who are suspected of conducting conversion therapy guilty of an indictable offence. The drafting of the legislation could result in doctors working in this area (psychologists, endocrinologists, paediatricians, surgeons and general practitioners) inadvertently falling foul of the legislation. In response to this, AMA Queensland listened to members’ feedback and advocated for a specific change in the definition of conversion therapy which would eliminate any unintended consequences for doctors providing evidence-based practice for children and adolescents presenting with gender dysphoria. AMA Queensland also argued there were insufficient grounds nor evidence for offences contained within the Bill to be prosecuted under the Criminal Code. The Committee handed down its latest report prior to the public hearing. The report shows support for the definition to be changed to be less ambiguous. AMA Queensland will provide further comment on the amendments to the Bill as it progresses through Parliament.

PHARMACY PRESCRIBING

AMA Queensland has put significant resources into blocking a proposal for Queensland pharmacists to be able to prescribe antibiotics for urinary tract infections and the contraceptive pill. Most members agree the current trial would be fraught with danger, citing the long-held view that dispensing and prescribing should always be kept separate. So, discussion on Queensland Doctors’ Community has centred around how to show patients that a consultation with a doctor is always necessary. Conversation on social media with the hashtag #notjustascript looked at what else is offered with a doctor consultation. Dr Chris Zappala commented “It should never be the case that patients see it as acceptable, safe or appropriate to ever not see their GP/GP practice about a health concern”.

MEDICINAL CANNABIS

AMA Queensland President Dr Dilip Dhupelia called for comments to the Senate Community Affairs References Committee conducting an inquiry into the current barriers to patient access to medicinal cannabis in Australia. He noted that the committee would be examining the appropriateness of the current regulatory regime, the suitability of the Pharmaceutical Benefits Scheme for subsidising access to products and the training and education of doctors in relation to treatments. Members were able to provide feedback about their concerns.

BIRTHING UNITS

A rural doctor had concerns about his hospital wanting to establish midwifeled birthing units and wanted to ensure there was sufficient medical input into the decision. Two senior obstetricians were able to comment and advise him on how to take action.

AMA Queensland remains opposed to expanding the scope of practice for pharmacists, despite the Health Minister’s support of non-medical health practitioners being given authority to prescribe (thus far pharmacists and physiotherapists). AMA Queensland stands by the fact that if non-medical health practitioners are given the authority to prescribe, the result will be fragmented care and reduced patient safety. AMA Queensland will continue to lobby the Queensland Government to stop the introduction of pharmacists prescribing.

RESOURCES Media clips - Each workday, the media clips are uploaded for all members to peruse. The clips include any mention of health in Queensland in any Australian media and often spark conversation on the topics included within. Member directory - Every AMA Queensland member is on the directory, so members can look up a colleague, see if they are a member and also contact them through direct email through QDC. Library - AMA Queensland staff and members regularly upload relevant documents to the Queensland Doctors’ Community library to share information or start a discussion.

NOT ON QDC?

Jump on now at https://community.amaq.com.au with your member ID. If you’re unsure of this login, please contact us at (07) 3872 2222 or email membership@amaq.com.au. Doctor Q Autumn 19

ASMOFQ fighting for you In our last edition of Doctor Q, we ran a story on how, after two and half years of negotiation, the Australian Salaried Medical Officers’ Federation Queensland Branch (ASMOFQB) is in the final stages of the Royal Flying Doctors’ Service Queensland’s (RFDS Queensland) first enterprise bargaining agreement (EBA). RFDS Queensland doctors were initially on individual contracts on a terms and conditions-style agreement, while RFDS Queensland nurses, pilots and administrative officers were all on an enterprise agreement. RFDS doctors in other states are also on an enterprise agreement. The style of contract the RFDS Queensland doctors were on left them vulnerable to change and, while the contract was negotiated every two to three years, there were few wage increases and those would happen on a case-by-case basis, rather than being extended to all RFDSQ doctors. The overwhelming majority of employees have now voted the agreement up. From here, the agreement must be lodged with the Fair Work Commission within 14 days of the vote. ASMOFQB will provide submissions to the Fair Work Commission as part of the certification process. ASMOFQB State Secretary Dr Jim Finn said the agreement was an important landmark for RFDS doctors. “Importantly, this is the first Enterprise Agreement to cover Medical Officers employed by the RFDS Queensland Section and we want to ensure members are treated fairly and provided with the protections that come with being employed under an Enterprise Agreement. The agreement is also negotiated every three years to ensure the conditions for RFDS doctors are continually improved.

MAJOR WINS Professional Development Allowance increasing from $7,000 to $10,000 per annum Professional Development Allowance paid as a fortnightly allowance as opposed to a reimbursement Wage increases as per the Wage Price Index (Year one – 2.3%) Backpay from July 2019 25% loading for Primary Health Care Doctors performing work on weekends

M AT E R U P D AT E ASMOF Queensland Branch (ASMOFQB) wrote to Mater last year regarding renegotiation of the SMO and VMO Agreements along with an administrative wage increase for SMOs and VMOs. Mater provided SMOs and VMOs with a two per cent administrative wage increase and an intent to begin negotiations in March 2020.

20 Doctor Q Autumn

Since this time, ASMOFQB has met with a number of Mater doctors regarding the negotiation process, log of claims and nomination of bargaining representatives. The major claims will be centred around the Right of Private Practice (ROPP) and the Motor Vehicle Allowance (MVA) being contained within the

Agreement, as well as the Professional Development Allowance. ASMOFQB will also be seeking for SMOs and VMOs to be included within the same agreement and a view for other Mater facilities to be covered by this Agreement. This will allow significant organising opportunities for ASMOFQB.

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Doctor DoctorQQAutumn Spring 21

on page 34

AMA QUEENSLAND COUNCIL OF DOCTORS IN TRAINING

out JDC2020

Update

A new chair has been selected for 2020 and the selection of the remaining executive members will be finalised in the coming fortnight. Dr Maddison Taylor is currently PGY 3 and a medical registrar at Townsville Hospital. She has been in the role of representative advocacy for a number of years including with the Australian Medical Students’ Association (AMSA) and Townsville Medical Staff Society. “I have been lucky to be given the opportunities to represent my colleagues over the last five years. I am looking forward to working with the AMA Queensland Council of Doctors in Training (CDT) executive this year and creating some excellent initiatives and instituting changes to help make the working lives of all Queensland Doctors in Training better,” Dr Taylor said. Dr Taylor welcomes any and all feedback from DiT members, and if there is an issue you would like fixed, please let CDT know about it. Keep an eye out on email and social media this year as we are aiming to increase the number of DITs on working groups, so there will be opportunities to get involved throughout the year.

JUNIOR DOCTOR CONFERENCE AND CAREER EXPO AMA Queensland’s Junior Doctor Conference and Careers Expo will be held on the 27 - 28 June. The two-day program will be packed with unique content including key note speaker Dr Munjed Al Muderis, several breakout practical skills sessions, and engaging panels about the real issues for DITs today. There is also plenty of opportunities to get your research noticed with our poster competition and oral presentations. Now in its seventh successful year, the JDC Team know how to throw a cocktail party and the Saturday night festivities will be sure not to disappoint! Get your tickets at an early bird rate now. Visit www.amaq.com.au/events.

TRAINEE FORUM On the weekend 22 - 23 February the Federal Council of Doctors in Training met to discuss our advocacy priorities for 2020 and liaised with trainee representatives from each of the Colleges to discuss common issues for junior doctors. We covered a lot of ground and discussed strategies to advocate for change in the areas around part-time training and parental leave, lack of training opportunities in rural centres as well as concerns for the unaccredited registrars and frequently changing College entry criteria. We will continue to meet regularly throughout the year to continue chasing down solutions to these issues for trainees.

N AT I O N A L M E D I C A L W O R K F O R C E S T R AT E G Y Over the last few years the Department of Health has been developing a National Medical Workforce Strategy to address the increasing numbers of medical graduates, saturation of specialists in metropolitan areas and rural workforce shortage. This strategy will have profound impacts on the working arrangements and training pathways for junior doctors. Both state and federal CDT members have been actively involved in providing feedback from the junior doctor perspective to ensure that the strategy not only meets workforce demands but maintains a quality training experience for all junior doctors. 22 Doctor Q Autumn

Read more ab

EXECUTIVE ELECTIONS FOR 2020

MEDICAL TRAINING SURVEY Last year the Medical Training Survey was conducted by the Medical Board of Australia and almost 10,000 trainees contributed. The survey has produced an important data set that can continue being added to annually. Results show the majority of trainees are happy with their current training program and workplace. Significant areas of concern are reflected in the statistics specific to Queensland doctors in training below: 50% find their workload heavy or very heavy Only 48% of trainees feel their college seeks their feedback on training Only a third of trainees are getting feedback about performance in their exams At least a quarter of us have experienced bullying or harassment and a further third have witnessed it 27% of doctors in training feel their wellbeing is affected by their workload always or most of the time 25% are working unpaid overtime most of the time or always 50% of trainees rate their workload as heavy or very heavy These survey results reveal there is still a long way to go for the medical profession when it comes to making sure junior doctors are safe and well at work. These survey results along with your continued feedback through the Resident Hospital Health Check will shape our advocacy this year.

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Doctor Q Autumn 23

The wisdom of ‘avocation’ Sir William Osler left a legacy of wisdom for the medical profession. A Canadian physician who held many posts including Regius Professor of Medicine at Oxford, he helped craft of the ‘modern physician’ that emerged at the end of the 19th Century as scientific discoveries forged a new approach to medicine. Osler advocated strongly for humanism in medicine and emphasised the value of teaching at the bedside. His many famous aphorisms have helped the global community of medicine to better articulate their experiences at the clinical coalface. He championed compassion in the delivery of patient care. “A good physician treats the disease; the great physician treats the patient who has the disease.” While he was immersed in the excitement of the science of the day, he reminded us that “variability is the law of life and as no two faces are the same, so no two bodies are alike, and no two individuals react alike and behave alike under the abnormal conditions which we know as disease.” He also recognised that “one of the first duties of the physician is to educate the masses not to take medicine.” This resonates strongly with our need for preventive health

messages and reminds us that Osler also said “The philosophies of one age become the absurdities of the next, and the foolishness of yesterday has become the wisdom of tomorrow.” As an educator, Osler was focused on the importance of the broader definition of learning that extended well beyond the ‘medical arena’ of performance. He extolled the virtues of reading and offered a reading list for the bedside library to support the half hour of reading he recommended before retiring. There is much to learn from this. As a senior physician, he was clearly encouraging doctors to pursue a life beyond medicine, recognising that time spent stepping back from the work of the day was a necessary part of busy medical practice.

DR MARGARET KAY General Practitioner, Senior Lecturer, University of Queensland, Medical Director of the Queensland Doctors’ Health Programme

Similarly, Osler recommended that “The young doctor should look about early for an avocation, a pastime, that will take him away from patients, pills, and potions…”. While medicine is a vocation, it cannot be allowed to swallow our entire identity. An ‘avocation’ enables us time for selfreflection. For many doctors, this ‘avocation’ may include the pursuit of creative activities such as visual arts, creative writing. For others, it is an opportunity to maintain our fitness, foster our friendships. Whatever we choose, our ‘avocation’ is important for ensuring that we maintain sight of who we are, beyond our crafting of our ‘physician persona’. Osler’s words provide us with the challenge to pursue our ‘avocation’. He also reminds clinician leaders of the duty we have in encouraging those we teach, enabling their pursuit of a wellbalanced medical career. When did we last do this with our team members?

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24 Doctor Q Autumn

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Doctor DoctorQQAutumn Spring 25

Could ‘real time’ prescription monitoring ease opioid pain? Twenty-twenty has the potential to be a turning point in the battle against opioid misuse and overuse in Queensland. When the state’s real-time prescription monitoring system, QScript, goes live in the second half of the year, prescribers will be able to see their patient’s prescription history. The system will flag potential risks, which will help guide clinical decision-making and give prescribers the opportunity to discuss the risks of dependency with their patient. Pharmacists will be further supported if they elect not to dispense a drug if the system alerts them of potential dependency.

DR ALEX MARKWELL Chair, Queensland Clinical Senate; and Emergency Physician, Royal Brisbane and Women’s Hospital

Once rolled out across the state, QScript – which will link into the Commonwealth’s National Data Exchange - should help to reduce drug seeking and avoidable deaths, and minimise the risk of unintended harm from opioids and other high-risk medicines. It is anticipated that the system will monitor all schedule 8 substances and some schedule 4 medications such as benzodiazepines and codeine. At a time when deaths from pharmaceutical opioids exceed those from heroin nationally, and prescription opioid and benzodiazepine overdose are at record levels, clinicians are anticipating the system’s rollout later this year. Early results from jurisdictions in which real-time prescription monitoring is already in use are promising. While QScript is expected to have a major impact on the state’s opioid problem, other initiatives to compliment real time monitoring are being pursued in parallel. In 2018, the Queensland Clinical Senate made a number of recommendations to support prescribers and consumers in the use of opioids and other high-risk medications. The priority was the implementation of a statewide stewardship program, underpinned by education, with a broad focus on pain management and high-risk medications (not just opioids) so that medications continue to be available to appropriate patients under the supervision and care of their doctor.

OPIOID STEWARDSHIP TRIAL

PAT I E N T G U I D E

A stewardship trial is now underway at 18 Queensland Health emergency departments (EDs). EDs involved in the trial are supported to examine their prescribing practices and develop a local program that encourages the clinicians to prescribe opioids tailored to the individual patient’s needs and to improve clinical handover.

Late last year, Choosing Wisely Australia launched its ‘Managing Pain and opioid medicines’ patient guide.

The overarching aim of the program is to ensure that we take a patient-centred approach in finding the balance between pain management and avoiding unintended harm. The trial uses an Opioid Prescribing Toolkit (OPT) developed by Royal Brisbane and Women’s Hospital Pharmacist Ms Champika Pattullo. Early results have shown a significant shift towards tailored prescribing of opioids and the quantity supplied, as well as improved quality and quantity of medical handover to GPs. To read the opioid meeting report and full list of recommendations visit: https://clinicalexcellence.qld. gov.au/ priority-areas/clinical-engagement/queenslandclinical-senate

26 Doctor Q Autumn

The guide aims to enable better conversations between clinicians and consumers about opioid medicines so consumers know what the medicine is, what they can expect from it and whether there are other treatment options available. The guide outlines a number of questions patients who have been prescribed opioids can ask their clinicians before they leave hospital. A key element of the guide is to assist patients develop a personal pain management plan with their doctor. There are plans for development of a guide to assist these conversations with patients and clinicians in community settings. The patient guide is a really important step in supporting and empowering patients and healthcare providers to discuss what care is needed based on what matters to the patient and their family. You can download the guide from www.choosingwisely.org.au.

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FRA N SMI TH PRA CTIC E COO RDI NAT OR

Research round up Research Review Australia is an independent publishing organisation that puts together clinical research updates for Australian health professionals across more than 50 clinical areas. Every month the publications feature a local expert’s chosen ten research papers from global journals with their commentary on the impact to everyday practice. We have handpicked some key research articles from recent editions that are a ‘must see’ for those working in various clinical areas.

F U N C T I O N A L S Y M P T O M S I N D E R M AT O LO G Y Dermatology Research Review Issue 67 Reviewer: Dr Warren Weightman These two articles review functional symptoms seen in dermatology and are worthwhile reading. They are both available on open access from Clin Exp Dermatol. The symptoms include pain, pruritus and mucocutaneous pain syndromes such as vulvodynia. In these patients, there is a tendency to focus on excluding organic pathology with subsequent reassurance, but patients are often not reassured by this. Telling them that ‘nothing is wrong’ is often perceived by the patient as being dismissed. Continued investigations can cause anxiety and they often fail to be reassured by negative results. It is important to communicate the diagnosis honestly to the patient; i.e. tell them what they have, as well as explain their negative results. The authors suggest it may be helpful to explain that there is “not a problem with the structure of your body, but with its functioning”. For patients where clear explanation and reassurance is insufficient, antidepressant therapy and/or psychological therapies can be beneficial.

DEPRESSED DOCTORS MAKE MISTAKES GP Research Review Issue 83 Reviewer: Professor Gerard Gill There has been considerable controversy about the Australian Medical Board’s mandatory reporting of sick or impaired doctors. Some have felt that this may have a significant impact on doctors with mental health problems seeking appropriate medical care. This systematic review suggests that those doctors with depressive symptoms are more likely to make errors in patient care. This adds further credence to the opinion that there should be limited barriers for doctors accessing appropriate medical care.

Current and back issues of Research Reviews can be found at www.researchreview.com.au. Australian health professionals can sign in and download copies.

28 Doctor Q Autumn

Annual general meeting and Election Notice 2020 ANNUAL GENERAL MEETING 2020 The Annual General Meeting of the Members of The Queensland Branch of Australian Medical Association Limited will be held at: Time:

6.30pm

Date:

Friday 22 May 2020

Venue: AMA Queensland 88 Lâ&#x20AC;&#x2122;Estrange Terrace Kelvin Grove, Queensland

Business

Proxy Notice

The business of the Meeting will be:

A member who is entitled to attend and register one vote at the Annual General Meeting is also entitled to appoint another member as a proxy to attend and vote in his or her place. Proxy forms can be downloaded from the AMA Queensland website (https://qld.ama.com.au/election) from 3 April 2020 or by phoning AMA Queensland on (07) 3872 2222 and must be received by 6.30pm 20 May 2020.

1. To receive and consider the accounts, balance sheets and reports of: (i) The Board; (ii) Any committees instructed to report to the meeting; and (iii) The Auditors. 2. The declaration of the results from the election of: (i) The President, Vice President, Chair, Member Appointed Director and Council members. 3. The appointment of the Auditors and approval of the remuneration (if any) to be paid to the Auditors; 4. To deal with all business which any statute, the Constitution, or the By-laws requires.

Annual Report *The 2019 Annual Report will be available online from 3 April 2020 at https://qld.ama.com.au/about-us

Election Notice 2020 TIME FRAMES 30 March 2020, 12noon: 13 April 2020, 12noon: 14 April 2020, 12noon: 6 May 2020, 12noon: 20 May 2020, 12noon: 22 May 2020, 6.30pm:

Nominations open Final changes to register of members Nominations close Ballot opens Ballot closes Annual General Meeting

If you need to make changes to your craft group, geographical area or other position in the register of members for the purpose of the election this must be done by 12noon Monday 13 April 2020. Return completed nomination forms by 12noon Tuesday 14 April 2020 to the Returning Officer. Further nomination forms can be obtained at https://qld.ama.com.au/election from 12noon Monday 30 March 2020. Following receipt of nominations, if required a ballot will be held and will close at 12noon 20 May.

NOMINATIONS CLOSE 12NOON TUESDAY 14 APRIL 2020

Election notice 2020 (contâ&#x20AC;&#x2122;d) The Returning Officer invites nominations and will hold an election for the positions of President, Vice President, Chair, Member Appointed Director and Council of The Queensland Branch of Australian Medical Association Limited.

PRESIDENT AND VICE PRESIDENT 2020-2021

COUNCILLOR POSITIONS 2020-2022

For election as President or Vice President of the The Queensland Branch of Australian Medical Association Limited, one representative for each position is required.

Nominations must be in writing and signed by the nominee, and two (2) nominators. All persons must be ordinary financial members of the The Queensland Branch of Australian Medical Association Limited. Any two (2) ordinary financial or honorary members may nominate another member provided all members belong to and are registered in the same Geographical Area, Craft Group or other position.

A nominee must be an ordinary financial or honorary member;

Any two (2) ordinary financial or honorary members may nominate the nominee.

Candidates for President or Vice President may submit with their Nomination Form:

A short statement of no more than 250 words. Any words in excess will be discarded;

A brief CV of no more than 250 words. Any words in excess will be discarded;

Both Statement and CV must be in Word format with no graphics and have basic formatting i.e bold and dot points only; A passport-sized head and shoulder photograph; and

A video statement of no more than three minutes. The candidates may elect to have their video statement filmed at AMA Queensland. Film in excess of three minutes will be discarded.

CHAIR AND MEMBER APPOINTED DIRECTOR 2020-2022 For election as Chair and Member Appointed Director of The Queensland Branch of Australian Medical Association Limited.

One (1) representative for Chair is required; and

One (1) representative for Member Appointed Director role is required

Candidates for Member Appointed Director may submit with their Nomination Form: A short statement of no more than 250 words (any excess words will be discarded) that sets out their governance/ directorial experience and qualifications, including but not limited to strategy, financial performance, risk and compliance oversight, corporate governance and executive management and stakeholder engagement;

A brief CV of no more than 250 words. Any words in excess will be discarded;

Both Statement and CV must be in Word format with no graphics and have basic formatting i.e bold and dot points only; A passport-sized head and shoulder photograph;

A nominee must be an ordinary financial or honorary member; and

Any two (2) ordinary financial or honorary members may nominate the nominee.

Candidates can only apply for one position of President, Vice President or Member Appointed Director on the Board.

Craft Group Representatives required:

One (1) General Practitioner Craft Group Representative 2020-2022;

One (1) Specialist Craft Group Representative 2020-2022.

Other Positions required:

One (1) Doctor in Training Representative 2020-2022;

One (1) Retired Doctors Representative 2020-2022.

Geographical Area Representatives required:

Three (3) Greater Brisbane Area Representatives Postcodes 4000 - 4199, 4300 - 4349, 4500 - 4513, 4514 - 4549 inclusive;

One (1) Gold Coast Area Representative Postcodes 4200-4299 inclusive;

One (1) North Area Representative Postcodes 4799-4850 inclusive;

One (1) North Coast Area Representative Postcodes 4550-4601, 4619-4675 inclusive.

Candidates for Council may submit with their Nomination Form: A short statement of no more than 250 words. Any words in excess will be discarded; A brief CV of no more than 250 words. Any words in excess will be discarded; Both Statement and CV must be in Word format with no graphics and have basic formatting i.e bold and dot points only; and A passport-sized head and shoulder photograph.

What is required of a Councillor?

Availability to attend Council meetings, and relevant AMA Queensland events/functions such as the Dinner for the Profession;

Actively contribute to setting policy for the Association; Actively support membership retention and growth strategies; Provide a written report (template provided) for council meetings; and Availability to attend and contribute to AMA Queensland Committees.

Nomination form

NOMINATIONS CLOSE 12NOON TUESDAY 14 APRIL 2020

Nomination forms are to be returned to the Returning Officer, Andrew Vivian, by fax, email or post by 12noon, Tuesday 14 April 2020. Phone: (07) 3232 2900

Email: nominations@priestleyspfn.com.au

Fax: (07) 3891 9292

Post:

The Returning Officer, PO BOX 1770, COORPAROO DC QLD 4151

We nominate

(full name)

as a candidate for the position/s* of

NOMINEEâ&#x20AC;&#x2122;S DETAILS: I consent to this nomination. Full name: Date of birth:

Craft/Area/Other Position: Member number:

Telephone number:

Primary practice address: Residential address: Signature:

NOMINATORâ&#x20AC;&#x2122;S DETAILS X 2: Full name 1:

Full name 2:

Craft/Area/Other Position:

Telephone number:

Residential address:

Signature:

*Please Note

If nominating for President, Vice President, Chair or a Member Appointed Director you can only nominate for one of these positions; If nominating for a Member Appointed Director position, you can also apply, if eligible, for a Council position.

If nominating for a council position, your nominators must be registered in the same representative Council category for which you are nominating; and You cannot represent a category on Council at the same time as you are President, Vice President, Immediate Past President or Chair of Council.

Access this nomination form and the position description for the role of President, Vice President, Chair and Member Appointed Director at https://qld.ama.com.au/election from 12noon Monday 30 March 2020.

THE QUEENSLAND BRANCH OF AUSTRALIAN MEDICAL ASSOCIATION LIMITED | ACN: 009 660 280 | ABN: 17 009 660 280

MEMBER PROFILE

Assistant Professor Laurence McEntee Born and raised in Hawkes Bay, New Zealand, Assistant Professor Laurence McEntee graduated from Auckland Medical School in 2002 and worked as a junior doctor before moving into orthopaedic surgery. He finished his specialist training in 2011 and completed a post-graduate spinal fellowship in 2012 at Gold Coast Spine, where he has remained working as a spine surgeon in private practice for the past seven years.

W H AT M A D E Y O U D E C I D E O N O RT H O PA E D I C S U R G E RY ? I’ve always been a hands-on person and enjoy the practical side of medicine. Orthopaedic surgery allows me to combine clinical decision making with technical expertise to achieve the best possible outcomes for patients. It’s very fulfilling to be able to operate on someone and make an immediate difference to their life.

I S T H E R E A PA RT I C U L A R C O N D I T I O N/P R O C E D U R E T H AT YOU SPECIALISE IN? I treat all conditions of the spine. In particular, I specialise in disc replacement surgery, both in the cervical and lumbar spine. Disc replacement has a number of advantages over fusion surgery. The spine needs mobility as well as stability to function properly.

HOW HAVE YOU DONE THINGS D I F F E R E N T LY ? W H AT I S Y O U R A P P R O A C H? I am a big proponent of collecting and analysing patient reported outcomes. It’s fine to have a nice looking x-ray, but did the surgery achieve the outcome the patient was looking for? It’s very important to have a conversation with patients before surgery about the improvements they can expect from the operation. Our practice works closely with Bond University to analyse and publish patient reported outcomes after spine surgery.

WHY ARE YOU AN AMA MEMBER?

32 Doctor Q Autumn

In recent times, there seems to be more and more doctor bashing, mostly by groups and organisations that prioritise profits and cost minimisation over patient welfare. The AMA does an excellent job of getting doctors’ points of view into the public arena and exposing the hidden agendas of profitfocused organisations. The AMA who has the best interests of both doctors and patients at heart. I think that’s really worth supporting.

Thank you

For being a member

REFER A MEMBER AND RECEIVE A DISCOUNT ON YOUR M E M B E R S H I P RAT E S

Often in these busy times it is rare to have someone thank you. AMA Queensland would like to thank you for being a member. Your membership with AMA Queensland shows your commitment to shaping a better, healthier future â&#x20AC;&#x201C; not just for patients and yourself as a doctor, but Queensland as a whole.

SAVE

25%

OFF YOUR 2020 MEMBERSHIP FEE

42% of our new members are member referrals. AMA Queensland has a very active membership base with members recruiting non-members to help make our association stronger. The AMA Queensland Member-Get-A-Member campaign provides the ideal opportunity to encourage your nonmember colleagues to join. Growing AMA Queensland means greater recognition for the medical profession, more resources and support for members, and a louder voice in Queensland. To take advantage of this offer, ensure the member you refer puts your full name in the Member-Get-A-Member comment section of the membership application so that you get the 25% discount.

REFER 1 MEMBER

REFER 2 MEMBERS

REFER 3 MEMBERS

REFER 4 MEMBERS

25% discount off your membership

50% discount off your membership

75% discount off your membership

No membership fee for one year

N O N - M E M B E R S C A N J O I N AT A M A . C O M . A U A N D M E M B E R S H I P I S TA X- D E D UQCAutumn T I B L E .33 Doctor

OBITUARY

Dr Daniel Roberts Lloyd Hart MBBS DO FRCS FRACS F R A C O FA M A

15 October 1920 – 26 December 2019 Member for 76 years AMA Queensland Past President 1977 - 1978 Born in Clayfield, Dr Dan Hart attended school at Ascot and secondary school at Brisbane’s Church of England Grammar School (Churchie). Dr Hart studied medicine at the University of Queensland before enlisting in WWII as a Medical Officer with the rank of Captain in the Australian Imperial Force (AIF) in 1944. He served six months as a medical officer at Wallangarra and six months in an army general hospital. He boarded the troopship to an active campaign in Bougainville, west of New Guinea, but before he got there, the atom bomb ended the war. He ran an Australian Army jungle tent to treat warweary Japanese prisoners of war. During 1946 and 1947, Dr Hart volunteered to serve in the occupation throughout Japan as medical officer with the 65th Australian Infantry Battalion, providing medical treatment and controlling disease outbreaks. A highlight of his time in Tokyo was attending the Japanese war trials in April 1946, where he exchanged a long stare with Japan’s former Prime Minister Hideki Tojo who sat expressionless in the dock and was later hung for war crimes. Dr Hart travelled to England to qualify as an ophthalmologist with the Royal College of Surgeons and married 23-year-old physiotherapist Margaret Smith. He had a year’s residence in the Bristol Eye Hospital before heading home with Margaret and their first son to share rooms with his brother Jim, a partnership that lasted 26 years. Dr Hart became an active member of the Ophthalmological Society of Australia (OSA) and was appointed to the board of the Ophthalmic Research Institute of Australia (ORIA). The OSA disbanded and became the Australian College of Ophthalmologists (ACO), a single body regulating all ophthalmology training and education across Australia. His time with these groups was during a time of “considerable tensions with optometry”. He became the second ever President of the ACO in 1969 and called on the Australian Medical Association (AMA) for better support, before serving as AMA Queensland President in 1977. During his time as President, the controversial Czech-born cancer therapist, Dr Milan Brych, sought to establish a practice in Queensland. Dr Hart represented the AMA in discussions with Queensland Premier Joh Bjelke-Petersen and in the media frenzy accompanying

34 Doctor Q Autumn

Dr Brych’s 1978 Brisbane visit. In a panel discussion televised by Channel 7, Dr Hart politely but to no avail challenged Dr Brych to reveal his cures for the benefit of cancer patients the world over. Dr Brych thought better of his Queenslnad move and relocated his practice to Los Angeles. Dr Hart’s son David wrote of his father “We all know what drove him – a genuine deep curiosity to know as much as possible about each person he meets, especially about the good in them, and to always be looking for new people to meet, and to learn of the things they are passionate about.” Dr Hart died on Boxing Day 2019 at 99 years of age and was survived by his children, grandchildren and great-grandchildren. Dr Bill Glasson AO, wrote of Dr Hart: Dr Dan Hart was a trailblazer in the establishment of the College of Ophthalmology and the practice of the profession in this country. A friend and mentor to countless ophthalmologists and the broader medical family, and a man who constantly gave of himself as a clinician, mentor and teacher. Always a gentleman, loved by his patients. Lifelong friend Dr Frank Sullivan once said of Dr Hart: “It’s men like these who have set the standards we follow”.

OBITUARY

Dr Stanley Michael McDonnell M B B S F R S M F A C R R M

23 February 1936 – 26 December 2019 Member for 58 years Dr Stanley Michael McDonnell was the youngest child of Dr Stanley Augustine and Harriet McDonnell of St George, Queensland. Michael’s father, Dr SA McDonnell, spent 37 years in medical practice in St George having moved there in 1920 after returning from WWI, an experience which deeply affected him. He also subsequently served with distinction in the WWII. He was the sole medical presence in a large area of Queensland’s south west and had an impressive medical and obstetric record and reputation. His obitu-ary of December 12, 1970 published in the Medical Journal of Australia is fascinating reading. Following a primary education in St George, Michael became a boarding student at Churchie in Brisbane where he enjoyed success at cricket and tennis, then matriculated to the University of Queensland and its medical school. Michael enjoyed the boarding experience and established lifelong friendships, including many who joined him in medicine, as well as a sincere appreciation of his teachers. At UQ, he continued his sporting interests in cricket and rugby reaching first grade teams in both sports. Michael was proud of the fact he was selected in the Australian Universities Baseball team. Coping with these sporting distractions, he graduated MBBS in 1960 and commenced his medical career at the then Brisbane General Hospital, now the Royal Brisbane and Women’s Hospital. With an eye on his anticipated future practice, he managed to obtain a wide-ranging experience at the RBWH, including in the various branches of surgery, medicine and intensive care, then in its infancy.

In September 1965, he was appointed the part-time Medical Superintendent at the St George Hospital with the right to private practice. This position he held for 18 years and was able to utilise the knowledge he had gained at the RBWH for the benefits of rural patients. St George had become a centre for the medical care of a large area with a growing population. Michael combined with Drs Bill and Betty Rimmer who had purchased the St George practice in 1957. Michael’s commitment to his patients was legendary and there are many stories of great results from his medical care in this isolated area of Queensland. Whilst Medical Superintendent, he was never averse to opposing even the highest political pressure when he considered it detrimental to the interests of rural patients and doctors. Michael was interested and involved in the politics of rural healthcare and had been Chair of the Western Queensland Superintendents Association which was absorbed into the Rural Doctors Association. Like his father before him, Michael also served on the local Shire Council. In 1983 Michael moved to general practice in Toowoomba, there partnering with Dr John Kibble. In that year he became a Fellow of the Royal Society of Medicine. He continued his advocacy for rural healthcare and was elected to the AMA Queensland Council. This involved a regular commute from Toowoomba to Brisbane for AMA meetings and activities. In Toowoomba he developed another interest and became the Medical Risk Manager of St Vincents Hospital from 1995 - 2004. He was recognised by the University of Queensland as a Senior Lecturer

in Country Health; a role which he enjoyed and appreciated. An attempt at retirement started in 2006 but Michael spent much of the next eight years doing relief locums for rural general practitioners and this role was greatly appreciated by a new generation of rural doctors. Eventually he was persuaded to slow down and enjoy. Unfortunately, his terminal disease soon manifested itself. Michael had a wonderful wife and family. In the role he occupied in the life of a small town, such support was essential. He and Rosemary raised four children: Christopher, Sarah, Anne and Ben. All have become model citizens with lots of love and respect for their parents, especially for the care Rosemary gave to Michael in the last years. The family grows with now seven grandchildren. Following the news of Michael’s death, the social media in St George registered a very high number of tributes to his professionalism and his empathetic manner, especially in relationship to those who resided in rural Australia. Colleagues whom he treated over the years have spoken of their gratitude of his professional and kindly approach. This tribute to the life of an individual doctor who was capable, confident, caring and committed to his patients and his town, and who followed his father’s professional footsteps, is another example of a unique contribution to society and country. Supplied by Dr John Holmes Doctor Q Autumn 35

Events Calendar Advice for now

AMA QUEENSLAND PRESENTS

#qjdc2020

Private practice webinar training series 2020

JUNIOR DOCTOR CONFERENCE AND CAREER EXPO

P R I VAT E P R A C T I C E W E B I N A R TRAINING SERIES

DATE: Saturday 27 and Sunday 28 June 2020 LOCATION: Brisbane Convention and Exhibition Centre

DATES: Friday 15 May: Revisiting Privacy Obligations Friday 17 July: Policy Essentials Friday 11 September: Performance management - speaking with staff Friday 13 November: Customer Service 101 - Learning from Retail and Hospitality

The Junior Doctor Conference encourages junior doctors to engage and be inspired, and has grown in reputation as a must-attend event for junior doctors and medical students. The theme this year is Advice for Now, where each session and presenter will provide something of value for you to take away from the conference and put to use in your life now. The Careers Expo will again be part of JDC 2020 following the resounding success of 2019. Join leading medical colleges, career experts and healthcare organisations to delve into your career pathways and options for now and beyond.

Are you interested in brushing up on your workplace relations knowledge from the comfort of your own desk? Join AMA Queenslandâ&#x20AC;&#x2122;s Workplace Relations Advisor Jaaden Morrall for an indepth insight into current topical workplace relations matters via live webinar. If the webinar dates do not suit your schedule, you can register to receive a recording of the webinar/s to view in your own time.

2020 Events

Visit www.amaq.com.au/events for more information or to register for our events.

36 Doctor Q Autumn

PRIVATE PRACTICE CONFERENCE Date: Friday 28 August Location: Brisbane Convention and Exhibition Centre

DINNER FOR THE PROFESSION Date: Friday 28 August Location: Boulevard Room, Brisbane Convention and Exhibition Centre

MEDICO - LEGAL CONFERENCE Date: Saturday 29 August Location: Brisbane Convention and Exhibition Centre

AMA QUEENSLAND ANNUAL CONFERENCE Date: Sunday 20 September Saturday 26 September Location: Lisbon, Portugal

WOMEN IN MEDICINE BREAKFAST Date: Thursday 15 October Location: Victoria Park Golf Park

Local Medical Association round up Redcliffe District Local Medical Association (RDLMA)

Mackay Local Medical Association (MLMA)

Toowoomba and Darling Downs Local Medical Association (TDDLMA)

Contact:

Contact: Phone:

Contacts: Dr Sally Sojan, President; Dr Peter Schindler, Treasurer Web: www.tddlma.org.au Email: info@tddlma.org.au Phone: (07) 4633 1939 Wilsonton Medical Centre (Dr Peter Hopson)

Dr Kimberley Bondeson, President Web: www.redcliffedoctors medicalassociation.org.au Phone: (07) 3049 4444 Meetings: 25 March 28 April 27 May

Sunshine Coast Local Medical Association (SCLMA) Contact: Web: Email: Phone: Meetings:

Jo Bourke, Secretariat www.sclma.com.au jobo@squirrel.com.au (07) 5479 3979 27 March 30 April 28 May

Gold Coast Medical Association (GCMA) Contact: Web: Email: Phone: Meetings:

Professor Philip Morris www.gcma.org.au info@gcma.org.au 0419 780 505 19 March

Dr Bill Boyd 0419 676 660

Ipswich & West Moreton Medical Association (IWMMA) Contacts: Dr David Morgan, President; Dr David Careless Vice President; Dr Thomas McEniery, Treasurer Phone: (07) 3281 1177

Brisbane Local Medical Association (NLMA) Contact:

Dr Robert (Bob) Brown, President WebL: www.northsidelocal medical.wordpress.com Phone: (07) 3265 3111 Meetings: 14 April 9 June

Fraser Coast Local Medical Association (FCLMA) Contact: Email: Phone:

Dr Nicholas Yim, Secretary frasercoastlma@gmail.com 0421 659 892

Cairns Local Medical Association (CLMA) Contact: Phone:

Dr David Shepherd (07) 4031 8400

Central Queensland Local Medical Association (CQLMA) Contact: Phone:

Dr Michael Donohue 0419 715 658

CANâ&#x20AC;&#x2122;T FIND YOUR LOCAL AREA? If your Local Medical Association does not appear or your details are incorrect, please email amaq@amaq.com.au.

Doctor Q Autumn 37

JUNIOR DOCTOR CONFERENCE SPEAKER PROFILE:

Associate Professor Munjed Al Muderis Associate Professor Munjed Al Muderis is an Orthopaedic Surgeon at the Norwest Private Hospital, Sydney Adventist Hospital and Macquarie University Hospital; a Squadron Leader in the Australian Air Force Reserve; a Clinical Lecturer at Macquarie University and the Australian School of Advanced Medicine; an Adjunct Clinical Associate Professor at the University of Notre Dame Australia; Chair of the Osseointegration Group of Australia; and a Fellow of the Royal Australasian College of Surgeons and Australian Orthopaedic Association. In 1999, A/Prof Al Muderis was a young surgical resident working in Baghdad when a squad of military police marched into the operating theatre and ordered the surgical team to mutilate the ears of three busloads of army deserters. When the head of surgery refused, he was executed in front of his staff. A/Prof Al Muderis’ choices were stark - comply and breach the medical oath ‘do no harm’; refuse and face certain death; or flee. He escaped to Indonesia, where he boarded a filthy, overcrowded refugee boat, bound for Australia. Like his fellow passengers, he hoped for a new life, free from fear and oppression, but for ten months he was incarcerated in what became known as the worst of the refugee camps, Curtin Detention Centre in Western Australia. There he was known only by a number, locked in solitary confinement and repeatedly told to go back to Iraq.

Keynote speaker

On his release in 2000, he secured a job at the Mildura Base Hospital as an emergency unit and orthopaedic resident after sending out more than 100 resumes. In 2004, he joined the Australian Orthopaedic Training Program and attained his surgical fellowship with the Royal Australasian College of Surgeons in 2008. He completed post specialisation fellowships around the world before commencing private practice in 2010. He specialises in hip, knee, trauma and osseointegration surgery, focusing in hip arthroscopy, resurfacing, arthroplasty, knee arthroplasty and reconstruction of recurrent patellar dislocations. He is now one of the world’s leading osseointegration surgeons, transforming the lives of amputees with a pioneering technique that allows them to walk again. He implants titanium rods into the human skeleton and attaches robotic limbs, allowing patients genuine, effective and permanent mobility. A/Prof Al Muderis has performed this operation on hundreds of Australian civilians, wounded British soldiers who’ve lost legs in Iraq and Afghanistan, and a survivor of the Christchurch earthquake in New Zealand. Eighteen years after fleeing Iraq, the Iraqi Government invited A/Prof Al Muderis back to operate on soldiers, police and civilian amputees wounded in the horrific war against ISIS. A/Prof Al Muderis has been recognised by Queen Elizabeth II for his work and has met with Prince Harry, introducing him to some of the amputees he has helped. Prince Harry remarked that the life changing surgery is “the way forward for single amputees or double amputees above the knee”. The British Ministry of Defence paid for A/Prof Al Muderis to train five British surgeons to treat 20 amputees and monitor their progress. A similar project is in the works for Canada and Houston, Texas.

#qjdc2020 38 Doctor Q Autumn

A/Prof Al Muderis was named 2020 NSW Australian of the Year for his humanitarian work and contribution to medicine.

27-28

June 2020

Brisbane Convention and Exhibition Centre

Whatâ&#x20AC;&#x2122;s on offer Partake in the clinical or obstetrics and gynaecology skills hands-on workshops Learn how to address the growing epidemic of suicide and the aftercare that follows Hear the Junior Doctor live issues panel - voice your issues and be part of innovative solutions Enjoy the JDC by Night Cocktail party

JDC 2020 calls for

Abstract submissions

This year, there will be poster presentations, and the top nine oral research abstracts will be invited to present at the conference, thereby giving you a great opportunity to practice for the near future and to further build your CV. Submissions close 24 April 2020

Advice for now

JDC Careers Expo - network with prospective employers and colleges, also, hear from a live panel of career experts

Visit the www.amaq.com.au/events for guidelines and submission form

Contact For more information or to register online visit www.amaq.com.au/events. Register and general event enquires email registrations@amaq.com.au or call (07) 3872 2222

Member tes early-bird ra

Wednesday who register by AMA members te will the early-bird ra 1 April 2020 for . save up to $100

Doctor DoctorQQAutumn Spring 39

AMA Queensland Annual Conference 2020

Bringing a healthy tomorrow 20 - 26 SE PT EM BE R 2020

This year we are looking forward to celebrating the 20th AMA Queensland Annual Conference in Lisbon and the academic program is in the final stages of planning. We have been very fortunate in getting tremendous assistance from the Australian Ambassador and the Portuguese Medical Association and we already have very high calibre international and Queensland speakers in what is turning out to be an inspiring program. Key topics include: doctorsâ&#x20AC;&#x2122; health and wellbeing: challenges and solutions; emerging technology: artificial intelligence in medicine; how sustainability can transform healthcare; the ageing population and the increasing effects on healthcare;

40 Doctor Q Autumn

improving health services in rural and remote Australia; social media stress: effects on doctors, patients and todayâ&#x20AC;&#x2122;s youth; drugs, alcohol and mental health; and solving obesity â&#x20AC;&#x201C; a global problem.

CBRE HP

THE CHAMPALIMAUD FOUNDATION

The Champalimaud Foundation focuses on cutting-edge research and strives to stimulate new discoveries and knowledge which can improve the health and well-being of people around the world. The Champalimaud Centre for the Unknown, based in Lisbon, Portugal, hosts the Foundationâ&#x20AC;&#x2122;s activities in the fields of neuroscience and oncology by means of research programs and the provision of clinical care of excellence. The fight against blindness is also supported through a focused outreach programme. In seeking to achieve significant advances in biomedical science, the Champalimaud Foundation has adopted a translational methodology, which establishes a direct link between research carried out in the laboratory and the diagnosis and treatment offered in the clinic. This connection and interdependency is at the core of the Foundationâ&#x20AC;&#x2122;s mission to bring the benefits of biomedical science to those most in need. The program will feature speakers from the Champalimaud Foundation, but we are organising a tour of the architecturally acclaimed facility as well.

LISBON

Portugal

Lisbon is one of the most charismatic and vibrant cities of Europe that effortlessly blends traditional heritage, striking modernism and progressive thinking. The capital city of Portugal has a rich and varied history on display, such as the imposing Sao Jorge Castle and Belem Tower. The view of the old city encompasses the pastel coloured buildings, Tagus Estuary and Ponte 25 de Abril suspension bridge. Within a very short distance from the city is a string of Atlantic beaches, from Cascais to Estoril. Lisbon is blessed with a spectacular range of eateries, a buzzing nightlife and glorious September weather. For more information, visit www.amaq.com.au/events.

Doctor DoctorQQAutumn Spring 41

Lending - finding the jewel in a crowded marketplace The non-traditional banking revolution began almost a decade ago; however, many consumers remain tied to having their finance needs met by their primary bank. In addition to the banks, there are a fair few lenders competing for the attention of medical professionals. Given the demand for agility and speed, and of course the best offers, how do you satisfy those needs? People need banks – or so they think. They keep our money safe, loan us money for big purchases and support our payment networks; yet in many cases customer-centricity and innovation are not top of mind. Now this may sound controversial, but think about it, has your bank become complacent, have you become complacent and are you accepting it? The current landscape is definitely one where many professionals just don’t know what they don’t know. How could you?

SIMON MOORE

Finance Specialist credabl.com.au/amaq Live chat at www.credabl.com.au P: 1300 27 33 22 E: simon.moore@ credabl.com.au

Enter the independent and alternative options. With so many options for finance, instead of always being drawn to the major banks, what would you get if you took your needs elsewhere? A few things come to mind, including: approvals that take a few days, instead up to four weeks; the best service – your text will always be responded to, and you can chat online at any time; a dedicated team of experts that are passionate about

their offering, not just making money; early adoption of new trends such as open banking; and more options and greater transparency.

It is fair to say our wish lists are long these days, and in most situations, no one bank or lender has the best of everything anymore. Credabl is proud to exist as a lean, tech-centric finance solution for the medical community that listens to the exact needs of our clients and delivers precise solutions that speak to your specific businesses. We’ve worked to make our services even more holistic and convenient by including the ability to submit your application online in just moments and by providing a wider range of loan offerings than ever before. Credabl is not owned by a bank. Our independence means we are able to share all the solutions the market has to offer with you. You may still be OK, but what are you missing out on? Surely having a full view can help you avoid possible complications and produce the best outcomes! This includes home loans, equipment loans, car loans, commercial property loans and more. So, whether you’re looking to build a new practice, buy an existing one, or finance a new car to get there, Credabl will be there to make sure it happens. And that may even include recommending you stick with the deal you’ve got, if it’s the best solution for you. It’s about doing what’s right for each individual.

42 Doctor Q Autumn

Hundreds of experts. Thousands of topics. Fiercely independent, evidence-based and up-to-date treatment guidelines designed for health care professionals working at the point of care. Researched and written by hundreds of Australiaâ&#x20AC;&#x2122;s leading experts. Funded only by subscribers.

tg.org.au

Alignment is a must Leading on from our last Doctor Q article on strategic planning, part of setting up for success is to consider an alignment exercise with the prospective partners prior to entering into business with them. Owning a practice with a number of people is very much like a marriage and you need to ensure you have similar vision and goals in order to maximise the changes of success and minimise disputes in the long run. It helps to define beforehand a culture that will empower the staff and enable the practice to thrive. It is common for doctors to come together as a group where you have a particular area of specialty, are friends or where you are clinically aligned consider starting your own practice. Whether you are thinking of starting your own practice with other doctors (whether GP or specialist) or you are an existing part owner of a practice and looking to take on new doctors to the business structure, you need to consider the business alignment of yourself with your potential business partners.

ONS K E Y C O N S I D E R AT I INCLUDE:

s practice? setting up or running thi Do you know you are staff? s to each other? To the Have you articulated thi contribute you wish to (or able to) How much money do nture? to the new business ve u wish to work? How many hours do yo be ed, and should spouses What staff do you ne ? employed in the business risks are lling to take (and what What risks are you wi you not willing to take)? me? sh the practice to beco How large do you wi Multiple sites? n? take the marketing pla Where do you want to n? Is there a marketing pla who is accountable and Have you articulated aspects of the business responsible for various liance? â&#x20AC;&#x201C; staff, marketing, comp er to ensure check-ins with each oth Do you have regular d still aligned? that you are on track an ss of the k like (that is the succe What does winning loo will it practice feel like? What practice)? What does the be celebrating?

44 Doctor Q Autumn

ANGELA JEFFREY

Business Advisory Director, William Buck Accountants P: (07) 3229 5100 E: angela.jeffrey@ williambuck.com

Already in business with others? An alignment exercise is still a worthwhile consideration to ensure continued cohesive business practices and the ability to be aligned during growth phases. Take caution! This is not an exercise you should attempt alone. William Buck have developed an alignment exercise that will take you through the fundamental business items to consider prior to deciding whether to start or continue into business together. If this sounds like something worthwhile to you, please feel free to contact your trusted William Buck advisor to hear further how we can assist you.

SPECIALIST

ADVISORS TO THE MEDICAL

INDUSTRY WITH A DEDICATED HEALTHCARE PRACTICE, WILLIAM BUCK CAN HELP YOU STRUCTURE YOUR PERSONAL INVESTMENTS TO ACHIEVE THE AFTER-HOURS LIFE THAT YOU WANT. William Buck is experienced at structuring personal investments such as property or self managed superannuation funds, and can assist you with the following: — Advice on setting up appropriate investment structures — Comprehensive assistance with your personal taxation affairs — Develop strategies to help you make the most out of your superannuation and investments, including assessing the taxation consequences — Securing your financial freedom with business and retirement planning CONTACT PAUL COPELAND FOR A CONFIDENTIAL & COMPLIMENTARY CONSULTATION

Phone: + 61 (7) 3229 5100 Paul.Copeland@williambuck.com

Off-label prescribing W H AT Y O U N E E D TO K N O W

A patient or specialist asks you to prescribe a medicine in a way that is not indicated in the drug’s product information – how would you handle this situation? Off-label prescribing is the prescription of a registered medicine for a use that is not included in the Therapeutic Goods Administration (TGA)-approved Product Information. A medicine can be legally prescribed off-label, and many drugs are routinely used in this way.

CASE STUDIES 1. A psychiatrist assesses a 22-year-old student by video link and diagnosed him with bipolar disorder. She wrote to the patient’s GP and recommends treatment with topiramate. The GP was concerned that the medication was not listed in the therapeutic guidelines for use in bipolar disorder. 2. A young mother consults her GP with concerns about her breastmilk supply and asks for domperidone to boost her supply.

MARIKA DAVIES Medico-legal Advisor, MDA National

A QUESTION OF CLINICAL JUDGEMENT The TGA recognises that off-label prescribing may be clinically appropriate in some circumstances but advises doctors to use caution when considering it. In general, off-label use of a medicine should only be considered when the TGA-approved use of a registered medicine does not address the clinical needs of a patient. The decision to prescribe off-label must take into account the risks and benefits to the patient, and the evidence supporting the safety and efficacy of the proposed treatment. Clearly communicate the potential risks and benefits with your patient so they can provide informed consent, and answer their questions about the proposed treatment. Keep a clear record of the medications prescribed and your reasons for prescribing an off-label medicine, especially if you are not following common practice.

FOLLOW UP IS ESSENTIAL Ensure that the patient is appropriately monitored and followed up. The TGA encourages doctors to report any adverse events that occur during off-label use. Guidance published by the Council of Australian Therapeutic Advisory Groups says that, in the event of harm to the patient, “if the off-label use of the medicine in a particular situation is accepted by the practitioner’s peers as constituting competent professional practice, and the patient has given informed consent for its use, then prescribing offlabel should not imply negligence.”

IN SUMMARY The Council of Australian Therapeutic Advisory Groups sets out guidance for doctors in public hospitals considering the use of an off-label medicine: Only consider an off-label use of a medicine when all other options are unavailable, exhausted, not tolerated or unsuitable. Use high-quality evidence to determine the drug’s appropriateness. Involve the patient/carer in shared decision-making so that they may provide informed consent. Consult the Drug and Therapeutics Committee (except when off-label use of a medicine is considered routine). Ensure appropriate information is available at all steps of the medicines management pathway. Monitor outcomes, effectiveness and adverse events. 46 Doctor Q Autumn

Scammers target the ill As the world has shifted to become more digitally enabled, the unintended consequence has been a significant rise in scams and fraud. We’re seeing this trend first-hand in the banking industry, with more and more of our customers being the target of sophisticated fraudsters who are trying to manipulate and deceive for their own financial gain. Like financial services, unfortunately the health industry is a prime target for scammers, not only because of the level of personal information and data you possess, but because some of your patients tend to visit you when they’re facing a big life event, like an illness, injury, pregnancy, or surgery. At Suncorp, we have been doing a lot of work in this space and joined forces with QUT’s School of Justice and Chair in Digital Economy - who are academic experts in scams - to not only better understand why scams happen, but to explore new ways to address the issue. We ran a study which found scammers target people experiencing a big life event such as divorce, illness, moving to a new house, or retirement, because they are more vulnerable.

If you’re ending a long-term relationship or going through divorce you might be more likely to fall for a romance scam, or planning to retire you might be at greater risk of an investment scam, and if you’re faced with a health concern, either personally or a loved one, you might fall victim to a health and medical product scams. This is when scammers portray themselves as medical professional with a low-price, medical miracle. According to ACCC Scam Watch research, in 2019 there were 858 reports of health and medical product scams (in 2018 there were 1,038), but as we know, not all scams are reported. Suncorp’s behavioural economist, Phil Slade talks to the fact that scammers play on a person’s inability to process information in a rational way. He says “Change, both positive and negative, reduces a person’s ability to digest information in a rational way because we are focusing our energy on navigating the change. Scammers play on this vulnerability, by positioning themselves as an easy avenue to solve a problem or make life easier,”

BRUCE RUSH

EGM Deposits and Payments, Suncorp

Everyone has a role to play in combatting this rise of scams. Here some ways to better protect your business and your patients against this threat. Scammers are hunting for data, and medical practitioners are sitting on a gold mine. Consider what security and data protection software program you have installed to keep your own (and thereby your patients) data protected. Be clear with your patients about the type of communication they can expect from you – for example, you will never email them with request for personal information or payments. If your patient wants to make medical purchases online, remind them that legitimate pharmacies will list their full contact details and will require a valid doctor’s prescription. Be aware of the conversations happening in your office – patients disclosing their personal details over the counter in a busy waiting room could be opening themselves up to an ID takeover. Be suspicious of uninvited emails or pop-up boxes offering you unbelievable deals (for example, medical cures). Do not open suspicious or spam emails, and do not click on or open any files attached to them: delete them. Remember, anyone can become a victim of a scam, irrelevant of age, background or financial capability.

48 Doctor Q Autumn

Gardens of the world If you look after your backyard like the Hanging Gardens of Babylon – then get inspired by the great outdoors on your next holiday. While you get to know a region’s history through its museums and galleries – you will really see where it all started by getting up close with its native flora. So put the lawnmower and secateurs away – it is time to discover cherry blossom in Japan or ancestral gardens in London … or perhaps somewhere a bit more unusual.

eenslan vel - AMA Qu Orbit World Tra ovider: pr l ve tra preferred 885 P: 1300 262 aq.com.au E: travel@am .au orldtravel.com itw rb s.o ay holid

KEW GARDENS, LONDON

Housing the largest and most diverse botanical collections in the world. Once the playground of royalty and just 30 minutes from central London, the 130 hectares of peaceful retreat opened in 1759. Explore the garden’s Great Broad Walk Borders, the recently reopened Temperate House and Kew Palace, the smallest of all the British royal palaces.

M O N E T ’ S G A R D E N , G I V E R N Y, FRANCE

K E U K E N H O F, NETHERLANDS

Covering 32 hectares and seven million flowering plants, Keukenhof is the largest flower garden in the world. It is known as the Garden of Europe. Only open from late March to late May when millions of tulips, bluebells, hyacinths and daffodils are in full bloom – what a beautiful sight that would be.

LOST GARDENS OF HELIGAN, CORNWALL, UK

Twenty-nine years ago, Heligan’s historic gardens were unknown and unseen; lost to the brambles of time since the outbreak of WW1. It was only the chance discovery of a door in the ruins that led to the restoration of this once great estate. Today, the Lost Gardens have been put back where they belong: in pride of place among the finest gardens in England. These gardens include popular mud sculptures of the Mud Maid and Giant’s Head (seen left).

SOME OTHER NOTABLE GARDENS:

Gardens by the Bay, Singapore

Monet, the father of impressionism’s garden inspired his iconic series of water lily paintings. The pond, along with the gorgeous flower gardens have been beautifully preserved by the not-for-profit foundation, which now looks after the grounds. Never mind the art buffs; thanks to every in-vogue plant, from peonies to cherry blossoms and carpets of forget-me-nots, this garden is an Instagram snapper’s dream.

BUTCHART GARDENS, VANCOUVER I S L A N D, CANADA

These gardens were designed by Robert Pim Butchart and his wife Jennie Butchart and were once a quarry. When it closed in 1909, they decided to turn the land into a beautiful garden. They spent 12 years designing this garden. From 1921 onward, they’ve welcomed visitors to their beautiful garden. This world-famous garden contains theme gardens, exotic flowering plants and ponds and is also home to thousands of peacocks and other birds.

KENROKUEN, KANAZAWA, J A PA N

According to Chinese landscape theory, there are six essential attributes that make up a perfect garden: spaciousness, seclusion, artificiality, antiquity, abundant water and broad views. Kenrokuen literally means ‘garden of the six sublimities’. The spacious grounds were once the outer garden of Kanazawa Castle and were constructed over a period of almost 200 years. Opened to the public in 1871, Kenrouken features a variety of flowering trees, which provide the garden with a different look each season.

Doctor Q Autumn 49

RESTAURANT REVIEW

Australian art deco meets traditional Italian fare Located in the recently revitalised Howard Smith Wharves precinct, Polpetta encompasses the best elements of Italian dining – think robust flavours and generous servings, in a beautiful yet relaxed dining atmosphere. Inspired by the streets of Rome, Polpetta promises authenticity and personality, which they appear to effortlessly achieve. Set against the backdrop of the stunning art series The Fantuzzo hotel, it really is a feast for all the senses. To start your dining experience, it would be remiss not to start with an aperitivo of sorts. While it’s easy to start with a classic negroni or Aperol Spritz, the outstanding cocktail menu is worthy of attention. The ‘Pink koala’ with eucalyptus vodka and Cointreau is a refreshingly light and delightfully Australian take on a French martini; while the ‘Basil smash’ is an absolute must for gin lovers, a wonderfully sweet and sour combination of fresh herbs with lemon and a touch of sugar which takes your average G&T to a whole new level. For the health conscious or designated drivers, they have the single best selection of mocktails I’ve seen in Brisbane so far, based on the nonalcoholic Seedlip botanical spirits range. The ‘Seedlip south’ is the clear winner here, served with lime, sugar and mint in a martini glass with a floating dehydrated blood orange. It tastes just as impressive as it looks, a punchy mixture of florals and citrus flavours that will honestly make you wonder how on earth they’ve done it. The days of ‘mocktails’ being made

50 Doctor Q Autumn

exclusively of sickly sweet fruit juice and soft drinks are thankfully over, and credit to their bartenders who are clearly experts in their field.

showstopper of an entrée.

Make yourself comfortable, because the menu at Polpetta is made to be enjoyed slowly. Start with antipasti like cured salmon with crème fraiche, artisan salumi, a hearty lump of Burrata or their namesake, the veal and pork polpetta (meatballs). The

Casarecci comes with house ground pork and smoked scarmorza cheese, and orecchiette with market fish accompanied by saffron, mussels and a white wine butter sauce. You could be convinced that the rigatoni with braised beef, red wine and pecorino came straight from Nonna’s kitchen; but it’s hard to overlook the fettucini with zucchini flowers, buffalo ricotta and pistachio pesto. Don’t be distracted by the almost fluorescent green colour of the sauce, as the nutty, herby and slightly salty pesto is balanced beautifully by the light and neutral ricotta. The only issue you’ll have is finishing the dish,

extremely moreish arancini hero the local Noosa mushroom peppered with a hint of sage, and come perfectly crunchy on the outside with a side of parmesan aioli. The grilled octopus is also an absolute must, cooked in traditional Italian style. The octopus appears to have been poached before grilling, which leaves it tender enough to cut with a fork, which served alongside the most creamy potato mouselline, a hint of basil and spicy ndjua sausage on the side make for a

For secondi, choose from a selection of pasta or their traditional Italian mains.

as even a hungry and well-seasoned foodie like myself seriously struggled with the portion size. If pasta isn’t your forte, then consider

the market fish with cannellini bean and lemon puree, the pork cutlet with fennel or the roast chicken with poricini and broccolini. The black onxy beef is clearly a crowd favourite here – shoulder tenderloins of beef come as a tender medium rare on the inside, with a caramelised crunch on the outside, served with medallions of Kipfler potatoes smothered in salsa verde with chianti butter and pieces of pancetta. A brilliant dish that’ll make you want to recreate it at home, the potatoes in particular have a rich and slightly sweet quality to them – think flavours like maple syrup with bacon, except far more luxurious.

Just when you think you’re overbrimming with food, the dessert menu appears. The orange pannacotta, affogato or tiramisu are safe options here, but for the wicked at heart it’s almost impossible to overlook the delectably luxe chocolate tart. Perfectly flaky pastry, thick chocolate ganache, marscapone icecream and fresh berries make for decadently rich dessert which is best shared and worthy of a sugar induced food coma thereafter.

D R K AT G R I D L E Y Advanced Emergency Medicine Trainee, Royal Brisbane and Women’s Hospital

Polpetta embraces everything we consider special about Italian dining – genuine flavours, served generously, to be thoroughly enjoyed at a leisurely pace. Just don’t forget to wear your best stretchy pants.

Open for lunch 12-3pm and dinner 5.30pm - 9.30pm, you can find them on the ground floor of The Fantuzzo hotel at 5 Boundary Street, Brisbane City.

Doctor Q Autumn 51

A M A Q U E E N S L A N D F O U N D AT I O N

Doctors doing good The Foundation has now completed its 19th year of operation, with the generous support of donors and corporate partners allowing the Foundation to continue its vital work and achieve a number of positive outcomes. In 2019, the Foundation approved 29 x $1,000 grants to assist 29 families affected by the Far North Queensland floods get back on their feet. This involved AMA Queensland members and other local doctors assisting by identifying families in need which highlights our motto of doctors doing good. Also in 2019, the Foundation pledged $25,000 to the MND & Me Foundation to support patients diagnosed with motor neurone disease (MND) and their families. The MND and Me Foundation delivers support programs, including equipment loan initiatives, to families affected by MND. They also fund research into treatments and a cure for MND. In 2019, the AMA Queensland Foundation supported five patients with MND, providing equipment such as a modified bed, replacement mobility scooter batteries, and home and car modifications.

ensland Foundation One of the patients that the AMA Que 50-year old father supported in 2019 was William â&#x20AC;&#x201C; a diagnosed with was iam Will who lives at Woody Point. the disease, he of ion ress MND in 2018, and due to prog house. William sought relies on a wheelchair to leave his Foundation for two assistance from the AMA Queensland scooter so that he replacement batteries in his mobility roved quality of life. can access the community for imp g replaced in his bein s erie William says that the batt to visit his favourite him bled scooter has once again ena ing again. beach and most importantly go fish

If you have a patient who needs financial support for their medical condition, the Foundation welcomes funding applications for patients in need. If you can help or would like more information, please contact the Foundation on (07) 3872 2222 or at amaqfoundation@amaq.com.au.

52 Doctor Q Autumn

The AMA Queensland Foundation committed funding for five patients to be involved in a breast cancer research project looking at improving treatments for brain metastases through advanced imaging. In addition, the foundation donated to the go fund me page for Dr Chris Del Mar, a doctor who sustained a high level spinal cord injury in 2019 during an early morning surf on the Gold Coast. The funding will help Dr Del Mar with home modifications and equipment so he can return home from hospital. An update on the Hep C Kombi Clinic team â&#x20AC;&#x201C; after successfully securing government funding for a three-year period, they have been busy delivering outreach clinics throughout South East Queensland with five each month in 2019. This includes visiting drug rehab centres, homeless shelters, rough sleeping locations, community centres and large public events. To date, the Kombi Clinic team have screened over 1,000 people, and provided hundreds of patients with medications to cure their Hep C virus.

Scholarship winners The AMA Queensland Foundation is pleased to announce the winners of this year’s scholarships: Kayla Scully and Shaun Muggleton. Kayla is in her third year of medicine at Griffith University and has a passion for pathology and teaching through which she hopes she can motivate others to become the best versions of themselves. Shaun is in his final year of medicine at Griffith University and hopes to enter the Rural Generalist Pathway in order to address the medical skill shortages in rural Australia. We wish Shaun and Kayla all the very best with their studies and look forward to updating you on their progress later this year.

MEDICAL STUDENT SCHOLARSHIPS Since 2004 through the generosity of the AMA Queensland Foundation supporters we have now been able to provide close to $450,000 in financial assistance to 24 medical students studying in Queensland. Last week AMA Queensland Foundation President Dr Steve Hambleton had the pleasure of calling the 2020

scholarship recipients Kayla Scully and Shaun Muggleton to inform them of their application success.

only supporting James Cook students. The aim of the Scholarship Program is to ensure those students struggling to keep up with their studies due to monetary issues have access to much needed financial assistance.

The AMA Queensland Foundation Scholarship Program started in 2004 to address losing talented medical students due to financial hardship. The program has now been open to all Queensland universities after originally

Yes, I want to give with my tax-deductible gift PERSONAL DETAILS

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Thank you for your support! Doctor Q Autumn 53

All about you TV: JUSTIFIED Starting up with some Gangstagrass (country rap) opening credits, Justified is a modern day Western set in rural Kentucky. Timothy Olyphant plays super cool US Marshal Raylan Givens, who’s forced to return to his hometown and all that goes with it: his ex-wife, his outlaw father and knowledge of everyone in town and how they operate. He’s a quick draw and racks up the body count on the right side of the law, as well as going up against childhood buddies on the other side.

BOOK: THE SECRETS OF STRANGERS

There’s a number of simple swaps you can make to create less waste in 2020:

Despite the plastic bag ban in Queensland, you can

still take home a lot of plastic bags with fruit and vegetables and from retail stores. Take some reusable bags for ALL the shopping, not just for groceries.

Swap take away cups for a reusable cup/bottle – not just for tea and coffee but for cold water and soft drink as well.

Swap your plastic toothbrush for a bamboo

toothbrush. It’s estimated you’ll use 300 toothbrushes in a lifetime – that’s an awful lot of plastic.

Swap plastic straws for a steel straw, or just don’t use a straw at all!

A compelling, tense and heartfelt drama from the bestselling writer of See You in September, shortlisted for Best Crime Novel in the 2018 Ngaio Marsh Awards for Crime Fiction.

Swap gladwrap for beeswax wraps or use some

Name:

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of your existing plastic/glass containers to seal your food.

Swap liquid soap for a bar of soap at home – you can

even buy shampoo and conditioner in bars too so you don’t have so many plastic bottles in the bathroom.

Fill out the form and fax it to (07) 3856 4727 or email competitions@amaq.com.au. Entries close 10 April

Thanks to Allen&Unwin

W IN this book!

A regular weekday morning veers drastically off-course for a group of strangers whose paths cross in a London cafe their lives never to be the same again when an apparently crazed gunman holds them hostage. But there is more to the situation than first meets the eye and as the captives grapple with their own inner demons, the line between right and wrong starts to blur. Will the secrets they keep stop them from escaping with their lives?

GO GREEN: SUSTAINABILITY SWAP

Doctor Q Summer 54

UPCOMING FILMS Please note upcoming film are subject to change

2 April It Must Be Heaven Onward

IN SEARCH OF H AYDN

16 April Bellbird

29 March 2pm | 30 March 2pm Documentary

17 April David Attenborough: A Life on Our Planet

In his lifetime, Haydn achieved a degree of fame that easily surpassed that of Mozart and Beethoven. In Search of Haydn is an intricate portrait of Haydn’s life told through performances and interviews from today’s most admired classical musicians.

30 April Black Widow Hearts and Bones The Very Exellent Mr Dundee

THE GERSHWINS’ PORGY AND BESS 4 April 2.15pm | 5 April 2.15pm | 8 April 10am

WIN

The Met Opera The Gershwins’ modern American masterpiece has its first Met performances in almost three decades, starring bass-baritone Eric Owens and soprano Angel Blue in the title roles. Director James Robinson’s stylish production transports audiences to Catfish Row, a setting vibrant with the music, dancing, emotion, and heartbreak of its inhabitants.

EASTER IN ART

movie ticket s for two! Name:

7 April 10am | 11 April 2.30pm | 12 April 2.30pm Exhibition on screen Shot in Jerusalem, United States and throughout Europe, the film explores the different ways artists have depicted the Easter story through the ages. From the triumphant to the savage, the ethereal to the tactile, some of western civilization’s greatest artworks focus on the story of Christ’s death and resurrection.

CYRANO DE BERGERAC

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Telephone:

18 April 1pm | 19 April 1pm 21 April 6pm | 22 April 1pm The National Theatre Live James McAvoy (X-Men, Atonement) returns to the stage in an inventive new adaptation of Cyrano de Bergerac, filmed live for cinemas. Fierce with a pen and notorious in combat, Cyrano almost has it all - if only he could win the heart of true love Roxane. There’s just one big problem: he has a nose as huge as his heart. Will a society engulfed by narcissism get the better of Cyrano - or can his mastery of language set Roxane’s world alight?

Fill out the form and fax it to (07) 3856 4727 or email competitions@amaq.com.au. Entries close 10 April Portside Wharf, Remora Road, Hamilton P: (07) 3137 6000 W: www.dendy.com.au

Doctor Q Autumn 55

new linen and shirts were supplied for patients. Soap and baths, towels and basins were requisitioned. She pioneered arranging patients into wards to separate diseases. Orthopaedic patients were D R M AT T Y O U N G grouped together and General Practitioner, so too infectious disease Inala Medical Centre patients were isolated. It took Florence to put shields up to hide the operating theatre from those patients awaiting surgery. Hearing the auditory horrors of surgery must have been a terrifying ordeal for those awaiting the scalpel.

The lady with the lamp After my recent column on Hippocrates, I got to thinking about how much in common he had with the immortal matriarch of nursing, the legendary Florence Nightingale. Both were born into well to do families. Both could have settled for a comfortable life living off their families’ wealth but both were infected with an altruistic fervour to care for the less fortunate. While Hippocrates set up his shingle on the western side of the Aegean, in Greece, Florence’s greatest pioneering work occurred on the eastern side of the Aegean, in Turkey. After her basic nursing training was completed, she led a team of 38 nurses from London to Istanbul in 1854. Those rascally Russians were looking to expand their influence in Europe and the British and French took exception, hence the Crimea War. Florence set up in a rustic hospital in Scutari (in Istanbul) where the death rate for injured and sick soldiers was a staggering 42.7 per cent, with more men dying from infectious diseases caught in hospital than from their wounds. By the time she left Turkey two years later, the death rate had plummeted to 2.2 per cent. Florence’s miraculous feat was achieved by innovation and dedication, compassion and commitment. She paid attention to basic hygiene. She laundered the sheets to kill the lice, fleas and bed bugs. Filthy walls and floors were scrubbed, 56 Doctor Q Autumn

She probably pioneered holistic care, too. She used aromatherapy, music, pets and relaxation therapy to heal her patients. She had them exercising, eating nutritiously and even employed teachers to educate the recuperating troops to stimulate their minds. She ensured patients’ beds were well ventilated, bathed in natural light and they had scenery and views to look at as they recovered. She recommended talking to the patients to make them feel special. How revolutionary! Perhaps her quaintest quirk was insisting that patients had regular cups of tea. Afterall she was a proud daughter of the glorious British Empire. Understandably, upon her return to England in 1856, Florence was lauded as a heroine. 30 songs were written, the London Times edified her and poet Henry Wordsworth Longfellow penned his tribute, Lady with the Lamp to commemorate her extraordinary achievements that had contributed so tangibly to the British war effort. But Florence hosed down the adulation, preferring to focus on the men she had seen suffer so tragically. Her altruism succinctly stated, “I stand at the altar of murdered men and while I live, I fight for their cause”. Perhaps her greatest innovation was her propensity for statistical analysis. She recorded statistics obsessively during her time in Scutari. Her work forged all modern morbidity and mortality figures. She analysed what worked and what did not. She pioneered evidence-based principles. In recognition, the London Statistical Society inducted her as its first female member for her incredible work. Her next goal was to establish thorough training for future nurses. She revolutionised nursing training with her seminal 1859 book Notes on Nursing: What it is and what it is not and soon her inaugural nursing school was established at St Thomas’s Hospital in London. By the time she died in 1910, over 1,000 similar nursing schools had been established across the world. Her legacy is vast. She transformed her profession as drastically as Hippocrates transformed ours. She was truly a remarkable lady and I wish I’d have had the chance to have a cuppa with her. At the very least I will spare her a thought on the next International Nurses Day. It’s 12 May her birthday.

PHIL MANSER Wine Direct

P: 1800 649 463 E: philmanser@ winedirect.com.au

Rising from the ashes You might be clever, but I’m in charge! That’s the message I got loud and clear from Mother Nature after attending the fires on Kangaroo Island and the Adelaide Hills. In my other life I’m an Army Reservist and was part of the early January call out to help the emergency services and other authorities deal with the havoc wreaked by bushfires across South Australia and other parts of the country. There are confronting images I’ll take with me the rest of my life but I’d like to focus on my colleagues in the Adelaide Hills who bore the full brunt. In the fog of news, fake news and hysteria, it’s easy to lose focus on the facts and one of the biggest concerns I’ll address first is smoke taint. Globally, extensive research has been conducted into smoke taint in a relatively short period of time (and without drilling into too much detail) one of the most important factors

when considering potential taint is when in the season it happens. So, regarding smoke and its possible impact on vintage 2020? While the Hills have suffered the loss of around 30 per cent of their vineyards, one small blessing for all Hills producers is that the fires raged prior to veraison. Veraison refers to the onset of ripening when small, hard green berries expand and change colour and the skins become much softer. This means that there is an excellent chance that the remaining fruit picked in the 2020 vintage will still be superb and free of the aromas and flavours of smoke. As for the damage to the vines? I’ve seen with my own eyes how resilient vines can be and in many cases surviving vines are being cut back to stumps and watered vigorously with a view to training new shoots up to the cordon wire and restarting their

journey as productive vines. In other instances, growers will be replanting new vines along with re-installing all of the infrastructure (poly-pipe etc) which is where the generosity of other growers and suppliers has been of great help. Wine Direct has also been very generous too in donating the lion’s share of the proceeds of the sale of several mixed packs to this effort where growers on the ground are receiving these proceeds direct. In the meantime, you the drinker can do your bit by buying real wine, from real Adelaide Hills producers, just look at the back of the label and make sure the address is Adelaide Hills or visit www.adelaidehillswine.com.au for a full list of genuine wineries. For more info regarding Wine Direct’s bushfire fundraising packs contact me at phil.manser@winedirect.com.au.

Doctor Q Autumn 57

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Thinsanity Glenn Mackintosh Glenn Mackintosh is a psychologist who is incredibly passionate about eating, physical movement, weight and body image, and is the founder of Weight Management Psychology. He enjoys spreading compassionate, evidence-based and innovative messages. He is the Queensland representative for the Australian Psychological Society Psychology of Eating, Weight and Body Image Interest Group, and has researched and lectured in health psychology, the psychology of eating, and sport and exercise psychology at the University of Queensland and several other top universities. His first book, Thinsanity, aims to transform the way patients approach weight management of the body by starting with the mind.

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GREATER SPRINGFIELD MEDICAL & OFFICE SUITES Mater applauds Springﬁeld City Group for the establishment of the specialist suites adjacent to Mater Private Hospital Springﬁeld. The hospital is looking forward to productive conversation and partnerships with doctors who move into this facility. Justin Greenwell Director, Mater Private Hospital Springfield

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Be part of Australia’s largest integrated health and wellness precinct. Purchase or lease your own medical suite in the heart of Health City in Springfield Central at the new Greater Springfield Specialist and Office Suites. Now open, this brand new facility is directly adjacent to the Mater Private Hospital Springfield, AVEO Springfield, Quest Apartments and childcare.

With areas from 34m2 to whole floors of 474m2 over five levels (above ground floor retail and car parking), don’t miss this unique opportunity to grow your patient base in the heart of South East Queensland’s growth corridor. To book an inspection or to request a brochure contact Uma Ranchigoda on 0412 470 882 or visit gssuites.com.au

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