Doctor Q Summer 2020

Doctor Q is free to AMA Queensland members

SUMMER 2020

N E W C E O AT TH E H E L M DR BRETT DALE

SH APING VOLUNTA RY ASSIS TED DYING L E GISL ATION R ESID ENT HOS P ITA L HEALTH C HEC K PATIENT DIS C H A R G E SUM M ARIES

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CONTENTS

REPORTS 4

Editor’s desk

6

President’s report

8

EGM’s report

48 AMA Queensland Foundation update

F E AT U R E S

BUSINESS TOOLS

14 Introducing AMA Queensland’s new CEO, Dr Brett Dale

39 Risky business – how safe is your inheritance?

16 Now is the time to renew

40 Budget insights for health

18 Doctors can help fulfil election promises

42 Mandatory reporting – what’s new?

20 Resident Hospital Health Check 2020

46 The big internship – survival tips

44 Medical practice website compliance

24 Labor fast-tracking VAD legislation

CURRENT ISSUES 22 Senior Doctor Craft Group 26 Navigate your future in medicine 28 Improving communication between hospitals and GPs

PEOPLE & EVENTS 10 Annual Conference: Northern Territory 12 Women in Medicine wrap up

LIFESTYLE 50 Restaurant review: Eterna 52 All About You 53 Reef, rainforest, outback and more 54 Greenock Creek – where big is beautiful

30 GP fellowship examination the latest blow to junior doctors

56 Dr Matt Young: Perhaps sport is the answer

32 Essentially connected – art and medicine

58 InPrint: Dermatologic Surgery and Cosmetic Procedures in Primary Care Practice

34 Clinician engagement vital to response 36 Research round up

Renew now

YOU R 2021 A M A QU E E NSL A N D M E M BE R SHIP NO INCREASE TO YOUR MEMBERSHIP FEES FOR 2021

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2 0 2 1 A N N UA L CO N F ER E N C E: N O RTH E R N TER R ITO RY

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W O MEN IN MEDICINE WRAP U P

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IT’ S TIME TO RENEW

Doctor Q Summer

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BOARD OF DIRECTORS Prof Chris Perry President

Editor’s Desk We welcomed our new Chief Executive Officer, Dr Brett Dale, on 30 November. He comes to us with a PhD in entrepreneurship and change leadership, as well as management experience in health, education and government relations.

We’re excited to see in a new era, as well as seeing the end of 2020!

Have a wonderful Christmas and New Year!

Dr Bav Manoharan Vice President Dr Eleanor Chew OAM Chair of Board and Council

Dr Kimberley Bondeson Greater Brisbane Area Representative

Dr Dilip Dhupelia Immediate Past President

Dr Chris Perry President

Zoe Byrne Medical Student Representative Dr Marianne Cannon Greater Brisbane Area Representative Dr Eleanor Chew OAM Chair of Board and Council

Dr Hasthika Ellepola International Medical Graduate Representative Dr Erica Gannon Part-time Medical Practitioner Representative Dr Marco Giuseppin Downs and West Area Representative Associate Professor Geoffrey Hawson Retired Doctors Representative Dr Bav Manoharan Vice President

Dr Michael Clements North Area Representative

Dr Cornelius (Kees) Nydam North Coast Area Representative

Dr Sarah Coll Specialist Representative

Dr Nikola Ognyenovits Specialist Representative

Dr Fiona Raciti General Practitioner Representative Dr Tony Rahman Specialist Representative Dr Louise Robinson Gold Coast Area Representative Dr Siva Senthuran Full-time Salaried Medical Practitioner Craft Group Dr David Shepherd Far North Area Representative Dr Maddison Taylor Doctor in Training Representative Dr Ian Williams General Practitioner Craft Group Representative Dr Nicholas Yim General Practitioner Craft Group

AMA QUEENSLAND SECRETARIAT

OBITUARIES The following AMA Queensland members have recently passed away. Our sincere condolences to their families.

Dr Maxwell John WEST Psychiatrist Late of Redlynch Member for 63 years

Dr Nicholas Yim Member Appointed Director

Dr Rachael O’Rourke Greater Brisbane Area Representative

Dr Paul Bryan Greater Brisbane Area Representative

The AMA Queensland office will close at 4pm on Wednesday 23 December and reopen Monday 4 January 2021. We wish all our members a happy and safe festive season.

Ann Fordyce Skills Based Director

Lachlan Crawford Medical Student Observer

WHAT’S HAPPENING ON QDC?

CHRISTMAS CLOSURE

Dr Mellissa Naidoo Member Appointed Director

Dr Sanjeev Bandi Capricornia Area Representative

Dr Maria Boulton Greater Brisbane Area Representative

Vigorous discussion continues on: recording patient consultations; medical complaints; voluntary assisted dying; and protection against patients seeking restricted medications.

Dr Peter Isdale AM Skills Based Director

COUNCIL

Michelle

Queensland Doctors’ Community (QDC) is AMA Queensland’s member-only, real-time online platform where members drive the agenda. Visit https://community.amaq.com.au or access via the AMA Community app.

Dr Sarah Coll Member Appointed Director

Dr David CILENTO General Practitioner Late of Newstead Member for 55 years

Dr Kevin Walter VANDELEUR Ophthalmologist Late of Highgate Hill Member for 69 years

Dr Brett Dale 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: Cathy Ball

Phone:

(07) 3872 2222

Address: PO Box 123,

Red Hill QLD 4059 Email:

amaq@amaq.com.au

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AMA CO M M U N I TY APP

WHERE YOU DRIVE THE AGENDA

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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Private health insurance products are issued by The Doctors’ Health Fund Pty Limited, ABN 68 001 417 527 (Doctors’ Health Fund), a member of the Avant Mutual Group. Cover is subject to the terms and conditions (including waiting periods, limitations and exclusions) of the individual policy.

President’s report PROF CHRIS PERRY

ELECTION CAMPAIGN COVID-19 has taken everyone’s plans for 2020 and dragged them through a hedge backwards. The pandemic has also shown the true value of our medical professionals, as well as showing some cracks in the system.

Prior to the State Election on 31 October, we released our 11-point Action Plan which outlined how doctors would like to best see the health budget spent. Ultimately, we’d like to see doctors and frontline clinicians leading the decision-making process about the delivery of care to patients.

RESIDENT HOSPITAL HE ALTH CHECK FINDINGS In October, we released our annual Resident Hospital Health Check survey findings which showed nearly half of Queensland’s trainee doctors are worried they will make a clinical mistake because they are exhausted from working excessively long hours.

More than 730 interns, house officers and other junior doctors completed the survey, which compares employment conditions at public hospitals across Queensland. Read more about the Resident Hospital Health Check on p20.

With the Labor Government re-elected, we thank Steven Miles for his hard work in the role of Health Minister, and welcome the State Member for Redcliffe Yvette D’ath, as Queensland’s new Minister for Health and Ambulance Services.

RENEWALS REMINDER

VOLUNTARY ASSISTED DYING

We are counting on your continued support, and your membership investment helps us to help you and your patients.

While AMA Queensland stands firm on our original position that doctors should not be involved in patients choosing to die, the Labor Government plans to implement Voluntary Assisted Dying legislation in February 2021. We remain involved in upholding doctors’ interests in drafting the legislation and sent a survey to all members at the start of November asking for their opinion to shape the proposed legislation.

It’s time to renew your membership so that AMA Queensland can continue to advocate for doctors in the health landscape. You will have received a letter with the details to easily renew for 2021.

For any queries, please contact the Membership Team on (07) 3872 2222 or email membership@amaq.com.au.

NEW CEO Finally, a warm welcome to our new CEO, Dr Brett Dale, who will have started by the time you read this. Brett comes highly qualified to lead AMA Queensland with 20 years’ leadership experience in health, education and government relations and comes to AMA Queensland from MTA Queensland, a member-based organisation representing 15,500 businesses.

Prior to this, he served as Chief Executive of the Northern Territory GP Education and Primary Health Workforce Programs, responsible for GP training and workforce distribution of primary health care for the NT. He has over 15 years in clinical and educational roles with the Australian Defence Force across pre-hospital, primary and secondary care, health operations and workforce planning. He holds graduate and post-graduate qualifications in business including a doctorate specialising in entrepreneurship and change leadership.

Brett’s wide ranging experience in health, education and government relations will provide a solid foundation for his role as AMA Queensland CEO. Read more about Brett on p14.

We will keep members informed through our variety of channels on how this legislation is being introduced. Read more on p24.

D R BAV M A N O H A R A N, PR E MIE R A N N A S TACI A PA L A S ZC ZU K, A N D PRO F CH RIS PE R RY AT O PE NIN G O F PA R LI A M E N T IN N OV E M B E R

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Educating, inspiring and preparing the next generation of GPs

www.gptq.qld.edu.au

What kind of GP would you like to be?

HOLISTIC

Dr Sean Mitchell, Gold Coast Recently Fellowed GP, working at an Aboriginal Medical Service

“Coming from a hospital background, I needed to make the transition from an acute medicine mentality to being a GP who is looking after someone for their whole life. GPTQ was instrumental in helping me become a better communicator with a holistic health outlook.”

CONNECTION

CONNECTION Dr Kat Abeykoon, Ipswich 3rd year GP Registrar, working at a not-for-profit community health clinic

“General Practice feeds my love of connecting with patients and feeling like I can make a tangible difference in their lives. I’m exactly where I want to be.”

IMPACT

CONTINUITY Dr Tammy Maxwell, Dalby Rural Generalist, Obstetrician

“I love the continuity of care you get to provide in a rural setting—being able to care for a woman through the full journey of her pregnancy, then often being a part of that baby’s care through childhood.”

Dr Ricky James, Warwick

“You can either pick a skill that you love and want to have as a feature of your job, or you pick a community that you want to be a part of and decide on an advanced skill based on what that community needs.”

“I enjoy teaching and working collaboratively with GPs in the community and am passionate about refugee health. I discovered all of this through my GPTQ training experience.”

When you choose General Practice training with GPTQ we’re with you every step of the way.

COMMUNITY 2nd year Rural GP Registrar, pursuing advanced skills training in Obstetrics

Dr Rebecca Farley, Brisbane Working as a Clinical Lead in refugee health and a Director of Clinical Training

VARIETY

Dr Annabelle Hughes, Toowoomba 1st year Rural Generalist

“I like that there is a lot of variety in rural General Practice and that you really have to be a Jack of all trades.”

We provide the support and training experiences that help GP Registrars discover their niche in primary care.

Learn more about a career in General Practice with GPTQ https://www.gptq.qld.edu.au/our-program/training-options/

EGM’s report

DR BAV M ANOH ARAN

I write this column on my last day in the seat as Executive General Manager of AMA Queensland knowing that by the time you read this, you would have been introduced to Dr Brett Dale, our new CEO. Brett is an impressive character and you can read more about him on p14.

As a doctor first and foremost, it has been quite a challenge for me to fill in the role of the CEO of our professional organisation for the last four months.

Whilst I have had the benefit of nearly seven years on the AMA Queensland Board and 11 years on Council, I never fully appreciated the crucial and essential role the staff behind the scenes at the AMA Queensland office play.

All the wins that we have had over the years for our members, the leadership and strength in advocacy and policy that we have been able to demonstrate, the corporate deals that were organised, the dinners, galas, conferences, seminars and workshops… none of it would have been possible without the commitment, determination and loyalty of the staff in the AMA Queensland offices, some of whom have been with us for decades.

Most of you are unlikely to meet them, perhaps fleetingly at an event as they keep things running behind the scenes, or maybe over the phone or email.

So I would like to take this opportunity to thank them, on behalf of us, the members. They’ve worked tirelessly for our members, supporting, promoting and advocating for the medical profession in Queensland. And this year, it has never been more critical.

2020 would have been a significantly worse year for the AMA Queensland and the medical profession in Queensland if it was not for our dedicated team. My last few months would have been impossible without them supporting me.

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POLICY AND ADVOCACY 2020, despite its challenges, has presented us with many opportunities as well. The AMA Queensland policy and advocacy machine has been working hard this year. We did not back down on the attempts by corporate pharmacy interests to jeopardise the primacy of general practice and put the public at harm, we pushed hard against their attempts to move to antibiotic and contraceptive prescribing and dispensing, to move into vaccinations without training and COVID-19 testing.

We will continue to fights this scope creep, as well as the other instances our members have been describing to us, including nurse endoscopy, risky midwifery practices, and physiotherapists prescribing S4 and S8 pain medications amongst others.

Coming into this role in the lead up to a state election was daunting, but the way our Council and Policy Team formulated the 11-point election plan in the lead up to the election was exceptional. It enabled our President Professor Chris Perry and I in our advocacy to all sides of politics and the public through media on these issues. We continue to use this platform, post-election, and have communicated with our Premier

and new Health Minister about the intent of AMA Queensland to continue advocating publicly for these core issues.

VOLUNTARY ASSISTED DYING We just completed the single most engaging policy surveys of our member’s thoughts on Voluntary Assisted Dying.

Over 1,250 responses, and a richness of data that we have used to inform our submission to the Queensland Law Reform Commission (QLRC). This is a complex and emotive issue and we know that the final AMA Queensland position will not please everyone, however we primarily will be advocating to support and protect you, our doctor members, and your patients. You will see a lot more of Professor Perry and me in the media and various parliamentary hearings over the coming months prosecuting your collective views and opinions.

COVID -19 With the pall of COVID-19 hanging over every aspect of our lives, our profession has been at the forefront of protecting our community and saving lives. And with this heightened focus and responsibility comes new pressures and pain points, tensions and issues that we must address to continue to advance and protect our profession and the benefit Queenslanders. It is true we committed a great deal of our focus to COVID-19 issues such as improved PPE clarity, supply chain, fit and testing. Also mental health, testing protocols and safeguards, and we have a keen eye turned to the roll out of vaccines in 2021.

Next year will be a significant challenge for all of us and our association. I hope you will continue to support us as we advocate for you in the years to come.

D R BAV M A N O H A R A N, QU E E N S L A N D’S N E W MINIS T E R FO R H E A LT H A N D A M BU L A N CE S E RV ICE S Y V E T T E D’AT H, A N D PRO F CH RIS PE R RY AT O PE NIN G O F PA R LI A M E N T IN N OV E M B E R

Sleep Physician Consultations and Sleep Investigations IMPORTANT INFORMATION FOR REFERRING DOCTORS Queensland Sleep has recommenced in-hospital and ambulatory (home) diagnostic and titration studies, aligning with current Department of Health guidelines to relax the restrictions on elective surgery which were released on 21 April 2020. All patients will be screened pre-study and testing will be postponed if symptomatic, pending further medical investigation.

• Pre-test screening will include:

• Increased PPE and distancing:

– Pre-test temperature screening.

– Questioning to identify any fever, cough, sore throat, SOB , recent international travel or contact with someone diagnosed with or suspected of having coronavirus.

Sleep Physician and Teleconsultations • Available via telehealth and telephone in line with the new MBS item numbers.

• Referrals for consultations and/or sleep investigations should be faxed to 3217 2523 or sent via Medical Objects, Medical Director, Best Practice or Genie templates.

– In-lab sleep investigations performed in private rooms with bathroom.

– Portable (home) studies performed in the patient’s home by sleep technicians.

– 4m2 rule per person strictly adhered to.

Equipment Rental and Purchase • Queensland Sleep can facilitate the hire and sale of CPAP equipment via its retail arm Sleep Healthcare Australia.

– Equipment and pressures will be supplied in line with the prescription and without modification.

• Sleep Healthcare Australia is an authorised equipment supplier to DVA patients.

• Continuous treatment monitoring by Sleep Scientists via 4G enabled rental equipment.

– Usage and compliance data is uploaded to the cloud daily and can be accessed via a secure password protected site.

– Compliance monitoring and 4G access is at no additional cost to the patient.

More Information?

1800 717 566 @clinical@qsdu.com.au

www.queenslandsleep.com.au

AM A QUEENSL AND ANNUAL CONFERENCE

Northern Territory 19 – 25 SEPTEMBER 2021 Doctors, practice managers, registered nurses and other medical industry professionals from around Australia are invited to attend the AMA Queensland Annual Conference in the Northern Territory from 19-25 September 2021.

The program will feature high-profile Australian speakers on a range of medical leadership and clinical topics in an exciting and unique location.

To find out more about the Annual Conference or to register, please contact AMA Queensland on (07) 3872 2222 or email events@amaq.com.au.

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Qantas Business Rewards Members and Qantas Frequent Flyer Members will earn 1 Qantas Point for every eligible $1 spent (GST exclusive) on payments to MIGA for Eligible Products. Eligible Products are Insurance for Doctors: Medical Indemnity Insurance Policy, Eligible Midwives in Private Practice: Professional Indemnity Insurance Policy, Healthcare Companies: Professional Indemnity Insurance Policy. Eligible spend with MIGA is calculated on the total of the base premium and membership fee (where applicable) and after any government rebate, subsidies and risk management discount, excluding charges such as GST, Stamp Duty and ROCS. Qantas Points will be credited to the relevant Qantas account after receipt of payment for an Eligible Product and in any event within 30 days of payment by You. Any claims in relation to Qantas Points under this offer must be made directly to MIGA by calling National Free Call 1800 777 156 or emailing clientservices@miga.com.au  Insurance policies available through MIGA are underwritten by Medical Insurance Australia Pty Ltd (AFSL 255906). Membership services are provided by Medical Defence Association of South Australia Ltd. Before you make any decisions about any of our policies, please read our Product Disclosure Statement and Policy Wording and consider if it is appropriate for you. Call MIGA for a copy or visit our website at www.miga.com.au © MIGA March 2019

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Doctors, Eligible Midwives, Healthcare Companies, Medical Students

Women in Medicine BREAKFAST

At our first face-to-face event for 2020, 145 members and guests were allowed to converge in the Marquee at Victoria Park for this year’s Women in Medicine Breakfast, with a focus on mental health.

CHAIR: VICKY DAWES

DR JEANNETTE YOUNG

QUEENSLAND DOCTORS’ HEALTH PROGRAMME’S EDUCATION OFFICER AND COUNSELLOR

QUEENSLAND CHIEF HEALTH OFFICER

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Speakers on the panel included Queensland Mental Health Commission Interim Executive Director Bretine Curtis, Queensland Chief Health Officer Dr Jeannette Young, Queensland Doctors’ Health Programme’s Education Officer and Counsellor Vicky Dawes and RPAVirtual Hospital Balmain General Dr Owen Hutchings (on screen).

The panel discussed the impact of COVID-19 on the community’s mental health, particularly in children and young adults.

Dr Jeannette Young talked about the impact of COVID-19 on Queenslanders’ health, and also talked about her own way of coping with the world’s biggest healthcare crisis in 100 years.

Guests at the breakfast had an incredible array of prizes to win from our generous sponsors: Audi Australia, Belle Property, Credabl, Doctors’ Health Fund, Holding Redlich, MDA National and William Buck.

BRETINE CURTIS QUEENSLAND MENTAL HEALTH COMMISSION INTERIM EXECUTIVE DIRECTOR

DR OWEN HUTCHINGS RPAVIRTUAL HOSPITAL’S CLINICAL DIRECTOR

NADJA MATHEWSON

DRS ANNABELLE CHALK AND SOPHIE MANOY

DR MINJAE LAH AND MARY JOB

DRS PETA MCLARAN AND AMANDA TAYLOR

JANE CROMBIE AND DR ELEANOR CHEW

DRS ISABELLA PANET TIERE AND MARIA BOULTON

NICOLE TREACEY AND DR PAULINE JOUBERT

DRS SARAH GILLMAN, CARMEN MAIN, NATALIE BOWRING, WENDY HARVEY AND MARY ASIC- KOBE

BRETINE CURTIS, VICKY DAWES AND DR JEANNETTE YOUNG

ANASTASIA MORAHAN AND ISABELLA VUONG

KIM PITTARD AND SAM CLARK

Doctor Q Summer 13

INTRODUCING AM A QUEENSL AND’S NEW CEO

Dr Brett Dale AMA Queensland’s new CEO believes there is no greater purpose than changing health outcomes for Australians.

Dr Brett Dale’s decades of leadership and service herald a new era for the 140-year-old organisation.

Growing up in Melbourne with nine siblings, Brett Dale always wanted to be a medical doctor.

“We didn’t have the money to put aside for an education so, I finished school and joined the Australian Army Medical Corps, where I trained as an Army medic. During my time in defence, I worked in all levels of health care - emergency, primary care and tertiary level health facilities. It was a really good chance to get a whole health ecosystem understanding.”

Eighteen years later, Dr Dale’s postings had included the Army School of Health in Portsea, Victoria and two deployments overseas.

“I did six months in Bougainville and almost a year in Iraq during the war.

I was in Bougainville in a clinical role. We were part of a combined multinational health element trying to support health services across Bougainville after the crisis in the 90s.

“It gave me an appreciation for putting in place sustainable education and training programs. We tried to create organic programs that were supportive for Bougainville people.

Some of the hospitals were filled with nothing but rusted old beds and to see them with a workforce of skilled nurses and medics was exceptionally rewarding.”

In Iraq, Dr Dale was part of the mission to rebuild local defence capacity by setting up the Iraqi Support Service Institute.

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“In six months, we set up training for about 11 industries from mechanics to medics, then mentored chosen leaders. It was an amazing experience, one of the biggest challenges I’ve ever had.

“If I ever had an appreciation for resilience, it would be in Iraq. By the end of my deployment, I didn’t want to go home. It was just an amazing transformation and one that I didn’t want to see undone.”

Dr Dale likens the defence family with the health fraternity.

“Defence is really amazing at team building; it has great capability of having a strategic, collective focus that sets out to achieve one goal and it can be done better than most corporate organisations simply because their purpose is greater and their product is people,” he said.

“Every time I talk about going back to health, it has so much to do with purpose. There’s no greater purpose than changing health outcomes for Australians.”

CIVILIAN LIFE There has been much public debate about the support provided to defence personnel as they transition to civilian life, and the role of healthcare professionals in that process, but Dr Dale says he always felt well prepared to make the change.

“I stepped into the general manager role at Queensland’s Motor Trades Association, which became a managing director role after two years,” he said. “There I established one of the largest education and training institutes in Queensland.”

workforce distribution of primary health care across the top end, as well as being national chair of the then 17 organisations responsible for GP training across the country.

“The way in which we deliver GP training and healthcare across the Northern Territory is foreign to the rest of Australia,” he said.

“You’d have a registrar living in a remote community that only had access to frozen foods and living in a house that was protected by barbed wire. So, we had to put in place some amazing care and support for doctors who were doing that. We provided way more than a training program.

“In my time, we quadrupled the number of doctors training in remote communities, which was an amazing result. I had an extraordinary team of medical educators who were absolutely committed to Indigenous health and we delivered a program that became one of the best in Australia.

MEMBERSHIP DRIVE Dr Dale was drawn back to Brisbane in 2016 by the opportunity to take the wheel at a membership group representing more than 15,000 businesses, employing 90,000 people.

As Group Chief Executive of Queensland’s Motor Trades Association (MTA), the peak industry body for the automotive sector, he also led the state’s largest automotive training provider, the MTA Institute of Technology.

In 2012, the health sector called Dr Dale back to his professional roots.

With such a diverse membership, Dr Dale knew communication was crucial to good representation and establishing a policy framework to support MTA advocacy.

As CEO of Northern Territory General Practice Education, he was responsible for GP training and

“Establishing a policy position that met middle ground was very tricky,” he said.

“It was key to actively engage and show that everything we needed to argue for in government policy had to demonstrate a consumer benefit.

I think that’s the same for health.”

Dr Dale’s approach to consensus building and government relations is centred around constructive relationships.

“You need an exceptionally good, trusted relationship with government and that will be my key focus – opening doors, giving confidence about our position, being a very reasonable but certainly very forceful voice that can articulate the needs of the profession,” he said.

“It would be a huge risk to ignore the expertise of doctors when considering any health policy.”

NEW IDEAS Just as he is keen to put members front and centre, Dr Dale is eager to identify opportunities to grow AMA Queensland through diversification and collaboration.

“It’s exciting times. We now have policymakers at all levels of government with a serious regard for health. When we talk about establishing new service deliverables or new conditions of service with regards to health, bringing the doctors’ view to the policy table is critical. We’ve had that during COVID-19 and it’s critical that we don’t let go of it. The time is now to shape, through AMA Queensland, the conditions in which we deliver health services as a medical profession,” he said.

Doctor Q Summer 15

Renew now

YOUR AM A QUEENSL AND MEMBERSHIP FOR 2021 We know how important it is to support your safety and security in uncertain times. Given the ongoing disruption from COVID-19, AMA Queensland has frozen its membership fees for 2021.

This year, more than 3,200 members turned to us for free, expert advice around workplace issues, pay and conditions, health and wellbeing and more.

Our work this year includes: fast tracking access to telehealth; brokering financial support for members and their practices; and securing appropriate PPE for medical professionals.

We are also ramping up the fight against role substitution in healthcare settings and the expanded scope of services for pharmacies.

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To save you time, this year we implemented member-only online platforms where you can drive the health agenda, share ideas, network with peers and access news and information wherever and whenever you want.

Renew now to continue enjoying industrial and professional support, business resources, training opportunities, savings and discounts, and a wide range of useful events and important advocacy.

WHEN IS MEMBERSHIP PAYMENT DUE AND HOW DO YOU PAY? Your renewal is due by 31 December 2020 and the payment details are on the enclosed invoice. You can pay conveniently online, via BPAY or call us on (07) 3872 2222.

Remember your membership is tax-deductible with about 40 per cent returned to you.

ANNUAL PAYERS – SWITCH TO E ASY MONTHLY PAYMENTS Simply complete and return the enclosed direct debit form. There are no additional charges for monthly payments.

HAVE YOUR DETAILS CHANGED? Have you moved or changed workplaces? Contact us via email membership@amaq.com.au or phone (07) 3872 2222.

NO INCREASE TO YOUR MEMBERSHIP FEES FOR 2021

WIN ONE OF FOUR $500 VISA PRE-PAID GIF T CARDS Renew by Friday 18 December 2020 Renew your AMA Queensland membership today to go into the draw to win one of four $500 VISA pre-paid gift vouchers.

For full prize terms and conditions visit our website at: qld.ama.com.au/2021-amaqueensland-renewals-prizes

IT’S BEEN A BIG YE AR, DON’ T LET YOUR MEMBERSHIP SLIP AWAY! These are just some of our 2020 achievements…

Worked tirelessly to campaign for the profession on sufficient personal protective equipment (PPE) provision, the importance of usual care continuing, fast track telehealth access, and economic support for practices during COVID-19.

Launched a 10-Year Framework for Primary Care Reform.

Lobbied for better consultation on implementation of the MBS changes.

Released a report card and blueprint for Private Health Insurance reform.

Conducted the yearly Resident Hospital Health Check to gauge staff sentiment and promote positive change in the hospital system.

Continued the fight against the rise of role substitution in healthcare settings.

Provided real-time updates to the Fees List in response to the MBS Review recommendations.

Made several submissions to the Aged Care Royal Commission.

Secured essential changes to the interim arrangements to ePrescribing.

Secured successful reforms to protect Medical Indemnity Insurance.

Launched a Public Hospital Report Card highlighting under-funding and declining access across the country.

Lobbied for increased funding for public hospitals to preserve the quality and quantity of health care delivered by public hospitals post COVID-19.

membership is tax-deductible

Doctor Q Summer 17

Doctors can help fulfil election promises Our ongoing pandemic forced health to the top of priorities in elections around the world and just as much in Queensland on 31 October.

A lot of promises were made in the lead up to the Queensland election and now AMA Queensland is urging the re-elected Palaszczuk Government to involve frontline clinicians in the introduction of its election health promises to ensure wellintentioned policies deliver practical improvements to patient care.

DOCTOR RECRUITMENT The State Government plans to boost recruitment of doctors and health workers and to build seven satellite hospitals across south-east Queensland to take the pressure off hospital emergency departments.

Doctors need a better understanding of the sorts of care they’ll be expected to provide at these facilities 18 Doctor Q Summer

and how the government intends to improve access and services for rural and remote Queenslanders.

PALLIATIVE CARE FUNDING The $28.5 million a year in palliative care funding promised by the Labor Government falls far short of the $277 million needed. Frontline specialists need to be integrally involved in how that funding is spent to ensure patients get the most benefit from the limited resources.

RURAL WORKFORCE AMA Queensland proposed that the government should spend $2.35m to: support doctors working in regional and rural communities with guaranteed locums;

providing extra training for rural generalists; to cover all accommodation costs for doctors in rural Hospital and Health Services; and to permit access to rural hospitals for private GPs to work as VMOs. The Palaszczuk Government will increase the number of doctors in regional, rural and remote communities as part of their commitment to increasing the number of doctors over the next four years. They have also announced a review into the key issues which need to be addressed.

JUNIOR DOCTOR WELLBEING It is vital for the re-elected State Government to invest in the expansion of a wellbeing program for all junior doctors in light of a recent report card that found half of Queensland’s trainee doctors feared they would make a clinical mistake because of fatigue from working exhaustively long hours.

The Queensland Government has committed funding to AMA Queensland’s Wellness at Work program for interns until the end of 2021, but ideally this would be rolled out to years two to five as well.

REDUCING CARBON EMISSIONS IN HOSPITAL AND HEALTH CARE SERVICES 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 that seven per cent. We put forward that the Queensland Government should: establish an Office of Sustainable Healthcare; develop an online climate change clearinghouse; and undertake a pilot program in environmental sustainability in hospitals and clinics.

The Queensland Government has already made a commitment to reduce emissions by 30 per cent by 2030 and reach zero emissions by 2050. Interestingly, Mick de Brenni MP has been appointed as Minister for Energy, Renewables and Hydrogen. They have also allocated $145 million to renewable energy

zones with ambitions to develop hydrogen hubs. ABC News reported that “there’s increasing confidence and enthusiasm around the world about the role hydrogen can play as a major carbon-neutral source of energy in transport, power generation and manufacturing.”

Premier Annastacia Palaszczuk commented: “hydrogen has the ability to be like the next LNG (Liquified Natural Gas) industry for Queensland. This is going to be about jobs, this is about a new energy resource that the whole world will be fighting over, and I want Queensland to be front and centre of that.”

“More needs to be done to ensure our public system meets the demand for care and for Queenslanders to have equal access to quality healthcare and services, regardless of where they live,” Professor Perry said.

“We look forward to working with Premier and Health Minister to ensure that limited resources are invested where they are needed most and that well-intentioned policies are transformed into improved healthcare for Queenslanders.”

AMA Queensland released an 11-point action plan to give a coal-face opinion on how healthcare could be improved.

Our $641 million strategy called for: $3m to boost primary care for opioid misuse; $26m to improve pain management services; $313m to ensure the successful roll out of e-health technologies; $7.57m to boost maternity services in rural and regional communities; $3m to reduce communitybased alcohol-related harm and violence; $4.2m to improve the health of First Nations Queenslanders with a safe and culturally safe appropriate hospital network; and $1.67m to improve doctors’ mental health and workplace wellbeing.

Doctor Q Summer 19

AM A QUEENSL AND

Resident Hospital Health Check 2020 In 2020, AMA Queensland surveyed Resident Medical Officers (Intern, Junior House Officer, Senior House Officer, Continued Residency) to evaluate the state of Junior Medical Officer employment in Queensland, and subsequently compare hospitals across Queensland.

A total of 730 junior doctors across 20 hospitals or Hospital Health Services responded to the survey, representing approximately 31 per cent of Queensland’s approximate 2,343 Resident Medical Officers (RMOs).

This was the fifth consecutive year the survey has been run, and was designed to be similar to previous surveys, so that results could be compared with those from 2019 to 2016.

PAY AND OVERTIME Among the full sample, a total of 25 per cent of respondents reported not being fully paid for claimed overtime, which was up from 20 per cent in 2019 (after having previously declined from 24 per cent 2018 and 31 per cent in 2017.

This year, we introduced questions about COVID-19 and the pandemic’s impact on RMOs’ career progression and overall wellbeing.

A further 27 per cent reported that they had been advised not to claim overtime payment by an administrative officer or SMO and 27 per cent believed doing so would lead to a negative assessment (down from 23 per cent and stable at 27 per cent respectively in 2019).

MAJOR BREAKDOWN AMONG FULL SAMPLE

WELLBEING AND WORKPL ACE CULTURE

LE AVE

Importantly, 27 per cent of respondents reported that they had felt unsafe at work (22 per cent in 2019), and 48 per cent reported that they had been concerned about making a clinical error due to fatigue related to long work hours (unchanged in 2018). Around half of respondents were satisfied with the hospital facilities (47 per cent) and the quality of the teaching and training (47 per cent) on offer (both down from 57 per cent and 51 per cent respectively in 2019).

More than 60 per cent of the total sample were satisfied that their leave preferences were taken into consideration, which is lower than previous years.

PROFESSIONAL /CAREER DE VELOPMENT Only 28 per cent had applied for professional development leave, which represents a 10 per cent reduction in trainees applying for PDL compared with 2019, with leave denied to 23 per cent of applicants. Further, 51 per cent and 33 per cent were satisfied that their clinical rotation preferences had been accommodated and with opportunities to be involved in research and auditing (in 2019, 55 per cent and 32 per cent respectively).

20 Doctor Q Summer

BULLYING, DISCRIMINATION AND HAR ASSMENT This was the first year that bullying, discrimination and sexual harassment were asked as separate questions.

Overall, 28 and 35 per cent experienced and witnessed bullying respectively,

18 per cent and 23 per cent experienced and witnessed discrimination respectively, and six per cent and 10 per cent experienced and witnessed sexual harassment respectively.

Among those reporting to have experienced or witnessed bullying, discrimination or sexual harassment, only 29 per cent reported the incident (up from 23 per cent in 2019), and only 65 per cent felt that when reported the incident was adequately dealt with (also up from 55 per cent in 2019).

COVID -19 Almost 70 per cent of respondents were satisfied with their hospitals’ communication regarding COVID-19 and 64 per cent with their departments’ updates.

More than 35 per cent said the education programs offered by their hospitals during COVID-19 were satisfactory.

More than 35 per cent of respondents reported that their career progression had been affected by COVID-19 and 47 per cent claimed their wellbeing had suffered during the pandemic.

FURTHER INFORMATION If you would like to discuss any aspect of the 2020 AMA Queensland Resident Hospital Health Check survey in greater detail, please email workplacerelations@amaq.com.au and a member of the team will get back to you.

The AMA Queensland Industrial Relations Team also provides confidential, assured advice to Doctor in Training members on employment terms and conditions, and any aspect of your employment that is causing you concern. You can contact the team on (07) 3872 2222 or email workplacerelations@amaq.com.au to discuss.

Not a member of AMA Queensland?

You can join at ama.com.au/join-ama to receive support and guidance on employment matters in addition to a range of professional development programs, services and benefits to support your journey in medicine.

TOP 6 PRIORITIES IN QUEENSLAND The following are the six highest ranked domains in order of priority from one being the highest ranked.

1. C linical rotation

2. A nnual leave

preferences

Clinical rotation preferences was rated the most important (47 per cent ranked it as most important). Overall, 51 per cent were quite or extremely satisfied with clinical rotation, which is slightly down from 55 per cent in 2019

process

51%

10%

quite or extremely satisfied

DID

G0T

GET PAID

SOME

PAID

for claimed overtime

10%

d ed ed ed sfied tisfie atisfi satisfi ite satisfi y sati tly sa rately qu emel e r t d sligh x o e m

18%

NOT

17%

not s

3. Being appropriately paid for unrostered overtime 6%

33%

30%

of the claimed overtime

4. Personal safety 27%

76%

G0T PAID

felt their safety had been compromised at work

ALL the overtime they claimed

16%

48%

extremely satisfied

6. N ot working fatigued

34%

quite satisfied

26%

5.

moderately satisfied

Residency education programs

13%

16%

slightly satisfied

8%

not at all satisfied with teaching and training opportunities

had been concerned that fatigue caused by long hours may cause clinical error

did not have adequate breaks between shifts

Find out how your hospital scored at qld.ama.com.au/advocacy/resident-hospital-health-check STATISTICAL DISCLAIMER: The AMA Queensland Resident Hospital Health Check survey was completed on a voluntary basis by Queensland doctors in training (including those at Intern, Junior House Officer, Senior House Officer, and continued Residency levels).

The purpose of this document is to evaluate the state of Junior Medical Officer employment in Queensland and subsequently compare hospitals across the state. The findings of the survey assist graduating medical students as well as current interns and residents with their decision making process when deciding on which hospitals to apply for in the upcoming intern and RMO campaigns.

This information is provided in good faith and should only be used as a guide, it is intended to be general in nature and is made available on the understanding that the AMA Queensland and the AMA Queensland Council of Doctors in Training do not make any comment or assertion that the information provided by participants is correct, or reflects the experiences of doctors who did not participate in the survey.

Before relying on the information contained in the survey results provided, users should carefully evaluate its accuracy, currency, completeness and relevance for their purposes, personal objectives and career goals, and should make their

own enquiries, including consulting with the relevant hospital and staff at the relevant hospital.

Whilst every effort has been made to ensure the accuracy of the collation of the information in this survey, AMA Queensland, its employees, agents, contractors, elected officers and the AMA Queensland Council of Doctors in Training cannot be held responsible for the information provided by participants in the survey and cannot be responsible for any loss or damage arising from any person or organisation as a result of the publication of this survey of information. AMA Queensland and the AMA Queensland Council of Doctors in Training do not take any responsibility for the outcomes published in the survey.

Grades were derived by firstly estimating the adjusted rate of the observed number of affirmative responses using a risk adjusted model for gender, training level and country of graduation (logistic regression run in the full sample), separately for each question and hospital/HHS. Adjusted rates were averaged across each domain (with rates of negative outcome subtracted from 1 so that all rates reflected positive outcomes). Grades ranged from E- to A+, and were assigned by giving the middle score (i.e., C) to average scores falling between 0.4375-0.5625, with grades increasing or decreasing with each 0.0625 increase or decrease in the score. The overall grade was the average of each domain

specific grade. Lastly, the overall raw percentage of responses for each question in 2020 were compared with the same question in 2019, with improvement, no change or worsening indicated by green, yellow and red traffic lights respectively.

Comparison of results among hospitals/HHS must be made with caution, as the survey did not involve a probabilistic sampling frame, but instead was open to the entire Queensland RMO population, achieving a response rate of 31%. Further, as RMOs were not randomly allocated to hospitals differences in attitudes and expectations of respondents cannot be adequately controlled. This introduces biases into the results which cannot be accounted for. Thus, all differences among hospital/HHS should be interpreted as specific only to the survey respondents and must not be interpreted as representative of the experiences of all junior doctors in Queensland.

Before relying on the information contained in the survey results provided, users should carefully evaluate its accuracy, currency, completeness and relevance for their purposes, personal objectives and career goals, and should make their own enquiries, including consulting with the relevant hospital and staff at the relevant hospital. All analyses and reporting of results were undertaken by an independent statistician with a background in medical research.

Doctor Q Summer 21

A S S O C I AT E PROFESSOR GEOFFREY HAWSON

AMA Queensland Retired Doctor Craft Group Representative; President, Australian Senior Active Doctors Association

Senior Doctor Craft Group As many members may know, AMA Queensland has been the only state branch to support senior doctors through representation on their state council via a Retired Doctors Craft Group.

At the AMA Queensland Council Meeting (20 August), my motion to expand this craft group to include all senior doctors was passed. Once established, senior doctors, whether retired or in part-time or full-time practice will be able to join the Senior Doctors Craft Group so that their views and concerns are better represented on Council.

In the United States, all members of the American Medical Association receive automatic membership of the Senior Physicians Section at age 65, regardless of whether they are active or retired.

Each year, a meeting geared towards issues relevant to senior doctors is held concurrently with the annual medical association meeting. AMA Queensland is considering similar opportunities and events for members.

Currently there are 150 retired doctor members of AMA Queensland who are members of the Retired Doctors Craft Group. There are 185 doctors aged over 70 years who are still practicing and for whom there has been no craft group representation. There are also doctors of varying ages considering their transition to retirement. Expansion of the Retired Doctors Craft Group to the 22 Doctor Q Summer

Senior Doctors Craft Group will enable better representation of the issues and concerns of a broader range of senior doctors. Engaging with doctors at this stage of their careers may also assist them with a smoother transition to retirement and help alleviate mental health issues that can be associated with sudden cessation of practice and loss of identity as a medical practitioner.

Along with better representation, the strategy to broaden membership of the craft group provides increased alignment with AMA Queensland’s Health Vision planning for senior doctors which includes a focus on better utilising senior doctors’ immense skills and experience and identifying more effective ways to channel their knowledge and expertise.

In preparation for this change, a new forum called the Senior Doctors Community is being launched on Queensland Doctors’ Community (https://community.amaq.com.au).

All AMA Queensland members aged 65 and over will be automatically enrolled into the group. Any members under 65 who have an interest in the issues facing senior doctors can join by contacting AMA Queensland.

At some point, all doctors become senior doctors and I encourage all AMA Queensland members to join the Senior Doctors forum.

I welcome suggestions and ideas from members as to how to make this group vital and meet our needs.

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Labor fast-tracking VAD legislation Prior to the State Election, the Labor party said that, if re-elected, Voluntary Assisted Dying (VAD) would be legalised in Queensland by February 2021. On winning the election, Premier Annastasia Palaszczuk tasked the Queensland Law Reform Commission (QLRC) with drafting the VAD legislation with guidance from key stakeholders.

VAD laws were first proposed in late 2018 when Premier Palaszczuk ordered an inquiry into end-of-life care in Queensland. In November 2018, the Legislative Assembly of Queensland established an inquiry into aged-care, end-oflife care, palliative care and VAD to be undertaken by the Health, Communities, Disability Services and Domestic and Family Violence Prevention Committee. AMA Queensland wrote a submission to this inquiry and also presented at the public hearing on 4 July 2019, standing firm on our position.

AMA Queensland’s position on VAD is that we remain opposed to voluntary assisted dying. AMA Queensland believes doctors should not be 24 Doctor Q Summer

involved in interventions that have as their primary intention the ending of a person’s life, which is the key outcome of the VAD legislation.

The proposed VAD processes are distinct from current processes where palliative care is provided to a patient where death is imminent and the intention is to relieve pain and symptoms, not hasten death (i.e. Doctrine of Double Effect).

This is protected in Queensland by the Criminal Code (Qld) section 282A which provides that a doctor, who hastens a person’s death through palliative care, is not criminally responsible for the death if the palliative care is given under certain circumstances.

On 31 March 2020, the Committee tabled Report 34: Voluntary Assisted Dying in Queensland, which recommended the Queensland Government use the draft legislation submitted to the inquiry by Professors Lindy Willmott and Ben White (QUT) as the basis of for the proposed Queensland VAD scheme.

Report 34 made a total of 21 recommendations relating to the different sections of the VAD legislation. AMA Queensland also wrote a submission in response to Report 34, again, standing by our position. AMA Queensland also called on the Queensland Government to ensure that both doctors who wish to participate in the VAD scheme as well as those who do not are given adequate protections under the legislation.

FINES FOR DISCUSSING VAD THROUGH TELEHE ALTH The Commonwealth Criminal Code Act 1995 specifically prohibits the use of all discussions, consultations and assessments with patients, family and carers regarding suicide related material, including voluntary assisted dying.

The penalty for this is 1,000 points or $220,000.

Background suggests that the Victorian and Western Australian Governments sought changes to the Commonwealth Criminal Code Act 1995, particularly WA, as they support the use of nurse practitioners in geographical locations where two doctors are not available.

The Commonwealth Attorney-General indicated there would be no change to the current law.

On 21 May 2020, Premier Palaszczuk tasked the QLRC to draft the legislation allowing VAD and to report back to the Attorney-General by 1 March 2021. However, in a surprise election announcement on 18 October 2020, Premier Palaszczuk pledged that VAD laws would be introduced in Queensland in February 2021 if re-elected.

AMA Queensland was disappointed the Premier has fast-tracked the legislation to February 2021 for three reasons; the first being the inadequate funding promised to palliative care, second, the fact that this important piece of legislation is being rushed during a global pandemic, and lastly the date set for this legislation will require stakeholders to consult members over the end-of-year, Christmas and New Year period when most members are away on leave (just like last year’s Health Legislation Amendment Bill 2019 (conversion therapy).

While AMA Queensland commends the Queensland Government for pledging $171 million over six years as an election commitment, it is simply not enough to address the inadequacy of palliative care services in Queensland. AMA Queensland called for approximately a $277 million to be invested into palliative care per annum in Queensland in the 2020 election manifesto. Secondly, there are three main implications of the Queensland Government fasttracking the proposed VAD legislation.

1. The Queensland Parliament has not been able to review the lessons learnt from the existing VAD schemes in Victoria and Western Australia.

2. The consultation time for stakeholders such as AMA Queensland members is limited.

3. The Queensland Parliament has not made a fully funded and resourced palliative care program in Queensland a priority.

On 16 October 2020, AMA Queensland received correspondence from the QLRC, calling for a submission in response to a discussion paper containing 50 questions. The questions specifically focus on the differences between the existing VAD schemes in Victoria and Western Australia and the submission to the Parliamentary Inquiry from Professors Ben White and Lindy Willmott from QUT. AMA Queensland sent a survey to all members at the start of November asking for their opinion to shape the proposed legislation. We received an overwhelming response and are in the process of collating those responses.

AMA Queensland stands firm on their original position that doctors should not be involved in patients choosing to die. Regardless of this, the legislation is going ahead and we remain involved in upholding doctors’ interests in drafting the legislation.

Doctor Q Summer 25

Navigate your future in medicine The Queensland Government’s Medical Advisory and Prevocational Accreditation Unit at Queensland Health has provided an update on the Medi-Nav website.

The Medi-Nav website was specifically designed for medical students and junior doctors to offer unique access to contemporary, Queensland-specific workforce data to support informed decisions about their future medical career. It was launched in June 2019, delivering on a key strategic priority from the Medical Practitioner Workforce Plan for Queensland – support for the next generation.

Since then, over 12,000 users have visited Medi-Nav to access statistics and information across 55 specialties and sub-specialties to: gain perspective on national and local specialist and trainee workforce demographic; view a summary of training

program information; locate accredited training sites; explore training pathway opportunities in Queensland; and hear real-life stories and advice about specialty training from Queensland clinicians.

Enhancements and new inclusions will continue to feature on the Medi-Nav website to optimise content and usability and to ensure user feedback is incorporated.

The most recent include:

UPDATED DATA The data published on the Medi-Nav website is collated from external and internal sources and has been updated to align with the most recently available data released by the Australian Government (2018).

Where there is more recent data available for certain data points, this is displayed (e.g. PGY new trainees QLD (2019))

View the latest enhancements by clicking on any specialty at: medinav.health.qld.gov.au/specialties 26 Doctor Q Summer

NEW ‘TRAINING SITES’ TAB FOR EACH SPECIALTY PAGE To improve usability, a fourth tab has been added to each specialty page to display a map of accredited training sites. This replaces the single map initially published which displayed sites for all specialties.

Additional links to regional training pathways have been included to offer access to information on training pathways and networks that incorporate regional Queensland hospitals.

NEW DATA POINT – ‘TRAINEES (2018)’ TAB In response to feedback from medical students and junior doctors, the 2020 QLD Training Program Selections (First Year) data point has been added to offer further insight into training opportunities across specialties by comparing the number of eligible applications with the number of applicants selected to commence training in Queensland.

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Doctor Q Summer 27

Improving communication

BE T WEEN HOSPITALS AND GPS Good transfer of care arrangements between hospitals and GPs improves continuity of care for patients and improve health outcomes. There is clear evidence that delayed or inaccurate communication between treating GPs/hospital doctors may negatively affect continuity of care and lead to adverse events; for instance a recent study has shown that the absence of a discharge summary was associated with a 79 per cent increase in the risk of readmission within seven days and 37 per cent increase in risk of readmission within 28 days.1 Sending a discharge summary from a hospital to a GP, a form of clinical handover, is defined in the Australian Commission on Safety and Quality in Health Care (ACSQHC) as, “The transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person or professional group.” 2

a discharge summary 4 despite 40 per cent of patients seeing their GP within four days and 75 per cent of patients seeing their GP within seven days.5 Even more concerning is the fact that up to 80 per cent of discharge summaries contain incorrect or missing information particularly regarding medication changes.

Discharge summaries can be in paper form (given to the patient) or electronic form called Electronic Discharge Summaries (EDS). EDS can be added to My Health Record (even though not everyone has a My HR) or the Viewer with reports of 58 per cent of discharge summaries being completed within 48 hours and up to 83 per cent of GPs receiving them within two weeks following discharge from hospital.3

WHAT DO GPS NEED IN A DISCHARGE SUMMARY?

AMA Queensland believes uploading the information to the Viewer and My HR should not replace point-to-point communication between clinicians.

A recent literature review of discharge summaries indicates that between 25-50 per cent of GPs don’t receive

GPs prefer quick and concise peer-to-peer summaries (95 per cent) compared to detailed summaries (five per cent) and expect any issue which impacts patient safety should be handed over immediately.

A recent survey of GPs6 indicate the following content should be included (in the following order): 1. Medication changes 2. Primary diagnosis 3. List of medications on discharge

5. Follow up instructions for GP 6. Treatment/intervention provided in hospital 7. Reason for medication changes 8. When to cease medications 9. Secondary diagnosis/problems 10. Contact details for follow-up questions 11. Radiology/pathology tests performed in hospital 12. Unreported radiology/ pathology tests

WHAT DOES AMA SAY ABOUT TRANSFER OF CARE ARRANGEMENTS BETWEEN GPS AND HOSPITALS? The AMA position statement on practice/hospital transfer of care arrangements between GP and hospitals7 indicates good transfer of care arrangements improve continuous of care for patients and improve health outcomes.

AMA Federal indicates the following information should be sent within 24 hours as the minimum standard for communication between health services and general practice; unplanned inpatients admission, discharge from an inpatient admission, after attendance at an emergency department and on patient death or other sentinel events.8

4. Reason for admission, presentation to hospital

1 Li et al (2013) Timeliness in discharge summary dissemination is associated with patients’ clinical outcomes. J. Eval. Clin. Pract.. 2013 Feb;19(1):76-9.

2 Australian Commission on Safety and Quality in Health Care (ACSQHC) 3 Queensland Health (2017) Discharge summary literature review – Clinical Excellence Division State of Queensland (Queensland Health) May 2017 4 Queensland Health (2017) Discharge summary literature review – Clinical Excellence Division State of Queensland (Queensland Health) May 2017 5 Queensland Health (2018) Queensland GPs discharge summary survey - Clinical Excellence Division State of Queensland (Queensland Health) January 2018 6 Queensland Health (2018) Queensland GPs discharge summary survey - Clinical Excellence Division State of Queensland (Queensland Health) January 2018 7 AMA (2018) Position Statement – General Practice/Hospital transfer of care arrangements between GP and hospitals Australian Medical Association, Barton Canberra 8 AMA (2017) 10 Minimum standards for communication between Health Services and General Practitioners and other treating doctors Australian Medical Association, Barton Canberra 2017

28 Doctor Q Summer

The AMA also calls for hospitals to introduce the following key performance indicators (KPIs) related to transfer of care arrangements: details of follow-up appointments; an advanced health care plan (if applicable); satisfaction with the standards of information provided in transfer of care summaries; percentage of letters to GPs after outpatient appointment within a week; percentage of patients hospital records listing the patients usual GP and GP practice; and percentage of patients where the usual GP is included in discharge planning.9 9 A MA (2018) Position Statement – General Practice/Hospital transfer of care arrangements between GP and hospitals Australian Medical Association, Barton Canberra 2018

AMA QUEENSLAND IS CALLING FOR THE FOLLOWING ACTIONS

3. All public and private hospitals should introduce KPIs related to transfer of care arrangements including:

1. All public and private hospitals to introduce as standard/policy where an electronic version of a discharge summary should be automatically sent to the GP on discharge and the same information should be added to My Health Record or the Viewer.

2. For Queensland Health and AMA Queensland to develop an agreed discharge summary template including the information included earlier in the GP survey.

percentage of electronic discharge summaries sent on the same day as the patient’s discharge; satisfaction with the standards of information provided in transfer of care summaries; percentage of letters to GPs after outpatient appointment within a week; percentage of patients hospital records listing the patients usual GP and GP practice; and percentage of patients where the usual GP is included in discharge planning.

4.

Public and private hospitals to include how they assess quality of their clinical handover documents in their audit processes.

Doctor Q Summer 29

G P F E L LO W S H I P E X A M I N AT I O N

The latest blow to junior doctors

DR MADDISON TAY LO R Chair, Council of Doctors in Training

2020 has been a year of tremendous uncertainty due to the coronavirus pandemic. There has been both positive and negative changes within our healthcare systems. However for junior doctors, the COVID-19 pandemic has meant increased hours, changed rotations to fill areas of workforce need, and changes to college training requirements.

Each college speciality has its certain set of hurdles, including pre-application barrier examinations, mandatory courses, written exams, paid applications, and clinical examinations. Throughout this year, these hurdles have been delayed, moved, cancelled, reinstated, and then cancelled again. This has all been associated with what seems to be ambiguous and delayed communication from the various colleges.

However, the changes to career progression this year come off the back of several failures of the college system over recent years. These changes have included the dramatic rise in the number of prerequisite paid courses, CV buffing, constantly changing application criteria and failed online examination delivery.

Every doctor understands being a college trainee comprises some of the most stressful years of one’s career, and to have these added challenges increasing annually is unacceptable.

It is leaving many junior doctors burnt out, anxious and reconsidering their career in medicine.

At a time when it would seem our doctors in training have already been spread thin with annual leave being cancelled due to the pandemic, the cohort of GP registrars prepared for the fellowship exam on the 9 October had the most significant exam of their lives cancelled because of technical 30 Doctor Q Summer

issues. Trainees were kicked out of the online examination midway through, which was exceedingly distressing and to compound the issue, it took several hours for the RACGP to release official communication detailing what had transpired and provide information for the trainees going forward.

Many GP registrars had been preparing for this examination for over 12 months, had taken leave in order to study, paid thousands of dollars for extra preparation courses to adjust to the online format, and had arranged their lives around this examination. There is currently no update as to when the examination will be rescheduled or indeed if it will be taking the same format.

There has been growing concern over the years about how trainees are treated during their training years.

Moreover, the response from the colleges has been subpar with only 39 per cent of trainee’s believing their college provided adequate psychological and mental health support services.1 However, it’s not just the colleges under scrutiny, many are now calling for action by the accreditation body responsible for regulating the colleges’ plans and processes. Perhaps the most concerning consequence of our flawed training system is the

mental health of our junior doctor cohort. The campaign We Are Medicine, We Are Human released by AMA Queensland’s Council of Doctors in Training highlighted many of the stressors associated with being a junior doctor in our current healthcare system. We need to ensure trainees are adequately supported, first and foremost.

As junior doctors, we will continue to advocate as effectively as we can for our colleagues and work with the colleges to ensure adequate communication and support is provided to all trainees. The key for substantiative change that will improve the lives of junior doctors will need to be a two-pronged approach, with both bottom-up and topdown advocacy. To any supervisors, directors, college members and senior clinicians reading this article, please consider the wellbeing of your trainees in this difficult climate.

Training programs are changing every year and there is tremendous uncertainty for trainees with regards to their career. Be an advocate for change, for timely communication, fair and transparent examination processes, and a reduction in the moving goal posts for junior doctors.

1 Medical Training Survey (2019) Medical Board of Australia and Ahpra, https://medicaltrainingsurvey. gov.au/Results/Reports-and-results [20/02/2020]

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Essentially connected

– ART AND MEDICINE “Art washes away from the soul the dust of everyday life.”

– Pablo Picasso It is just over a year since Doctors’ Health in Queensland presented their inaugural art show – Connectedness – Bringing Together Art and Medicine.

Of course, art and medicine have always been connected. In Ancient Greece, Apollo, the Sun God, was recognised as the God of Music, Art, Poetry and Healing. As leader of the Muses, Apollo provided inspiration for both science and the arts.

Einstein noted that: “The greatest scientists are artists as well”. Medical science has benefited greatly from its creative thinkers. As individual physicians, we are at our best when we practice medicine as an art; exploring the complexity of medicine and daring to think laterally. Algorithms fail to capture the complexity of our patient’s presentations as we consider the intersect between the biological, psychological and social aspects of the presentation.

Understanding and practising art, in its many forms, helps us to ‘see’ differently. Being capable of spotting subtle difference is key in diagnosis and management. Being ready to 32 Doctor Q Summer

respond to the unexpected is essential in surgical and medical practice and simply every moment of emergency care. Being flexible in our thinking helps us avoid cognitive bias and enables us to engage with diversity.

Art encourages us to explore our personal understandings of humanity.

This enables us to respond more confidently to our patients when they are confronting the many milestone moments of life and death.

Recognising the practice of medicine as an art helps to maintain compassion within each clinical encounter. The vital aspect of connectedness between patient and physician is key in the healing relationship. It benefits both patient and physician.

Many doctors engage with their artistic endeavours to proactively maintain their wellness. It is therefore of interest that in Greek mythology, Chiron, the centaur, was chosen by Apollo to educate his son, Asklepius, who later became the God of Medicine.

Chiron provided education in art and medicine. Chiron epitomises

the image of the wounded healer.

While we may remember the Jungian perspectives of the wounded healer, with Jung’s emphasis on psychological health, Chiron’s wound was a physical wound. Doctors’ health requires an understanding of physical and mental health issues. There is still value in embedding narratives of the wounded healer within our medical education.

Art and medicine remain essentially connected. Art can facilitate our connectedness with our colleagues and with our patients. Visualising medicine as an interweaving of both art and science, each intricately linked to healing, is empowering. It enables our creativity and helps to heal as it washes the dust from our souls.

QDHP

Queensland Doctors’ Health Programme

Queensland Doctors’ Health Programme is the service arm of Doctors’ Health in Queensland. QDHP is an independent service supported through funding from the Medical Board of Australia.

Dr Gert Tollesson

FRACS

ADULT AND PAEDIATRIC BRAIN AND SPINAL NEUROSURGEON

re to “Offering excellent patient ca stralia” adults and children across Au BRAIN AND SPINE SURGERY QUEENSLAND (BSSQ) Watkins Medical Centre Level 10, 225 Wickham Terrace, Spring Hill QLD 4001 P: (07) 3870 3708

W: www.bssq.com.au

F: (07) 3236 9555

E: admin@bssq.com.au

Office hours 8.30am to 4.30pm After hours acute referrals please phone 0417 791 407 Consulting at Spring Hill, Brisbane and Rockhampton

Doctor Q Summer 33

Clinician engagement vital to response Twenty-twenty has been a year like no other. As we continue to dig deep to prepare and respond to the challenges of COVID-19, our previous business as usual seems like a world away for most of us.

Importantly, we regularly shared information about clinician wellbeing during COVID-19. Such huge change brought about from a situation that has no obvious end and that puts our personal health (and that of our families) at risk, is anxiety-provoking and we must look after ourselves and look out for our colleagues.

This is certainly the case as an emergency physician. Clinical shifts are split between the ‘Respiratory ED’ donned in personal protective equipment (PPE) seeing patients with COVID-19 symptoms, and the ‘normal’ ED, seeing acute non-COVID-19 patients. Until we have an effective COVID-19 prevention (e.g. vaccination) and/or treatment strategy, this will be our new business as usual.

In addition, the Senate has worked closely with key clinical groups and consumers to produce important guidelines and principle documents.

These include:

My work as Senate Chair is significantly different this year to that pre-COVID. Early in the pandemic, we recognised the importance of clinician engagement and pivoted to focus solely on COVID-19 and Queensland’s response.

As Senate Chair, I represent clinicians on numerous key pandemic planning and response groups such as the COVID System Leadership Forum and the COVID-19 Health System Response Working Group, among many others.

In March we introduced a COVID-19 communication for frontline clinicians, making sure our colleagues on the frontline have access to the most relevant information about Queensland Health’s response, access to the latest research about the virus – the symptoms and treatments – PPE guidelines and other restriction changes.

34 Doctor Q Summer

Principles of ethical prescribing for self and others in the COVID-19 pandemic1.

Guideline for ethical prescribing for self and others in the COVID-19 pandemic2.

We also worked with Queensland Health’s Care at the End of Life team and Health Consumers Queensland to produce resources that support clinicians to have difficult conversations virtually, instead of face-to-face. You can access these resources here3.

DR ALEX MARKWELL

Queensland Clinical Senate Chair and Emergency Physician

For now, the Senate will balance contributing to Queensland’s response to COVID-19 and the system reform work that is flowing out of the response. Exploring opportunities to continue initiatives that have enabled us to deliver more streamlined and efficient care closer to home for Queenslanders is a vital piece of work. We are also looking forward to our last meeting of the year, ‘Adolescent to young adult care’ where we will explore barriers, challenges and solutions to providing effective care for this vulnerable cohort of our population.

Clinicians have shown incredible commitment and engagement throughout this pandemic.

This response has seen everyone at every level play a role. It has been a privilege to work alongside each and every one of you. Stay safe.

The level of clinician interest and engagement in the frontline emails, the development of guidelines and resources was beyond my expectations. Clinicians wanted and needed to be involved.

A pandemic response can only work well with an informed and engaged frontline workforce and we have seen this in Queensland at a local, regional and state level. The desire to work together, across professions, specialities, services, has been incredibly encouraging.

1 w ww.health.qld.gov.au/__data/assets/pdf_ file/0033/953736/ethical-prescribing-princples.pdf 2 w ww.health.qld.gov.au/__data/assets/pdf_ file/0032/953735/ethical-prescribing-guideline.pdf 3 https://clinicalexcellence.qld.gov.au/priority-areas/ service-improvement/improving-care-end-lifequeensland/resources/compassionate

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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 10 research papers from global journals with their commentary on the impact to everyday practice.

LONG-TERM VITAMIN D SUPPLEMENTATION AND DEPRESSION Psychiatry Research Review Issue 56 Reviewer: Professor Nicholas Keks Depression is a leading cause of suffering, disability and reduced life expectancy, particularly in the elderly where it is often poorly treated. It would be enormously beneficial if late-life depression could be prevented. Studies have identified that patients with low

COVID-19 AND THE MANDATE TO REDEFINE PREVENTIVE CARE General Practice Research Review Issue 91 Reviewer: Professor Gerard Gill The US health care system should embrace the current COVID-19 era as an opportunity to develop a new approach to providing routine preventive care for adults i.e. a shift from face-to-face annual exams to a strategy that focuses on population health.

levels of 25-hydroxyvitamin D are at higher risk of late-life depression. To date, most studies investigating any benefit of treatment with vitamin D3 for the prevention of depression have yielded negative findings, but have suffered from major methodological drawbacks such as inadequate sample size, short duration of treatment, low dose, and selection of inappropriate patients such as those with subthreshold symptomatology. The study by Okereke et al. addressed the methodological shortcomings, looking at the effects of high dose vitamin

D3 in thousands of patients without baseline depression over a fiveyear follow-up period. The negative findings here appear fairly definitive; vitamin D3 supplements do not appear to prevent depressive illness in adults. The recent observation that COVID-19 infections are linked to low vitamin D levels suggests that vitamin D may be an epiphenomenal risk factor which identifies a group vulnerable to multiple, not necessarily related illnesses.

The first step in this strategy is developing a robust, real-time clinical preventive care registry that allows tracking of care needs asynchronously from visits. These registries could become shared, interactive tools for use by both clinicians and patients to facilitate preventive care. The second step is to build the infrastructure for an annual ‘prevention kit’ for every patient, that addresses all preventive services indicated by the clinical prevention registry. After receiving the prevention kit, patients could be invited to schedule a virtual encounter with

their primary care provider to review recommendations. The third step is to create specific programmes to address the known disparities in preventive care within a given population. The primary hurdles for implementation of the plan are payment reform and provider and patient acceptance.

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

36 Doctor Q Summer

Reference: JAMA. 2020;324(5):471-480.

“Moving prevention into a telehealth environment has the potential to be the biggest game changer in GP care in Australia.”

Reference: N Engl J Med 2020; published online Aug 12

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Risky business

– H OW SA FE IS YOUR INHERITANCE? An article recently published in the Medical Journal of Australia highlighted some of the risks medical professionals may face as we see an increase in litigation against medical professionals associated with providing end-of-life care.1 This can include issues in relation to over-prescription of opioids, leaving the door open for allegations of causing death to be premature or hastened.

Similarly, Ian Frecklington QC outlined a number of COVID-19 risks that health care workers and medical professionals may find themselves being personally exposed to.2 For example, duties under the relevant workplace laws do create legal obligations not to cause harm or injury to other employees or patients.3 This is particularly relevant in the COVID-19 environment. We saw a doctor in Victoria receive significant adverse media attention for treating patients while sick. There are plaintiff law firms who are willing to act for patients on no win, no fee arrangements, in bringing claims against doctors in those types of scenarios.

and forfeited. Similarly, if you happen to be going through Family Court proceedings at the time, that inheritance may form part of the matrimonial pool and be divisible between you and your soon-to-be former spouse.

Whilst most medical professionals will have significant amounts of indemnity insurance, it is never advisable to rely on this as a sole asset-protection mechanism. Unfortunately, the profession is one of high risk, and it is not uncommon for medical professionals to find themselves listed as a defendant on proceedings of some nature, at least at some point in their career.

This can be circumvented, but it requires what can sometimes be a difficult conversation with parents who may be intending to leave their children an inheritance. The last thing most people want is to somehow appear to their parents as seeming ‘entitled’. People also often get nervous when talking about death with their parents as they do not want to cause them distress.

But this is something many professionals are aware of, and most have structures in place to address these points of exposure.

However, if the conversation is conducted in a tasteful and informative way, and particularly if done involving the whole family, effective structures can be put in place to protect the wealth that parents always intended to transition to their children. What often transpires from these discussions is that the parents were simply not aware of the potentials risks, and usually end up relieved that someone has brought them to their attention.

But have you considered what might happen to any inheritance you are set to receive?

If you are the beneficiary named in a will and you happen to be pursued by creditors at the time, any inheritance you receive could fall into the hands of those creditors

NICOLE TREACEY Special Counsel

P: (07) 3135 0500 E: nicole.treacey@ holdingredlich.com

Elderly parents often make a ‘basic’ will, gifting their assets directly to their children. At the time, and based on the advice available to them, this may seem appropriate.

Unfortunately though, what is being seen is a lot of these basic arrangements are not providing the asset protection required in order to ensure that the inheritance they wish to leave to their children is protected.

1 M itchell, Geoffrey K et al, MJA (210 (10) 3 June 2019 p 441 2 ( 2020) 27 Journal of Law and Medicine 590 3 W orkplace Health and Safety Act 2011 (NSW) s 28 Disclaimer The information in this publication is of a general nature and is not intended to address the circumstances of any particular individual or entity. Although we endeavour to provide accurate and timely information, we do not guarantee that the information in this newsletter is accurate at the date it is received or that it will continue to be accurate in the future.

Doctor Q Summer 39

Budget insights for health The 2020 Federal Budget contained no real surprises, however, there were some items of interest for medical practices and practitioners. These are outlined below.

COVID-19 TELEHEALTH As previously announced, the temporary MBS telehealth codes continue through to March 2021, as will other measures introduced to assist with treating COVID-19 such as GP respiratory clinics. There is still no long-term plan for Medicare telehealth beyond the pandemic and a lot of previously announced initiatives seem to be on hold.

40 Doctor Q Summer

MENTAL HEALTH There will be an increase in the Medicare subsidised psychological therapy sessions from 10 to 20, subject to some restrictions. It was noted in the budget that this was particularly relevant to Victoria given the second outbreak of COVID-19 and the effect of the subsequent lockdown on mental health, although it appears from ensuing announcements by the Health Minister Greg Hunt, the increase in sessions is not limited to only Victorian patients.

STRONGER RURAL HEALTH STRATEGY The Stronger Rural Health Strategy will allocate $550 million to providing opportunities for doctors to train and practice in rural and remote Australia. We await further details on what this will mean for practices in rural and remote areas, however, it seems a positive move for areas that have severe shortages.

ANGELA JEFFREY

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

PERSONAL TAX RATES The fast tracking of personal income tax cuts will see a handy tax saving for higher income earners in the 2020 year and further changes for subsequent years. From 1 July 2020, the top threshold of the 19 per cent personal income tax bracket will increase from $37,000 to $45,000.

The top threshold of the 32.5 per cent personal income tax bracket will increase from $90,000 to $120,000.

There was no change to the Division 293 threshold, so this remains at $250,000.

EXTENSION OF THE INSTANT ASSET WRITE OFF

Outlined below is the estimated tax saving for an individual Australian Resident between $40,000 – $120,000 of taxable income because of the proposed changes to income tax rates, LMITO and LITO:

The instant asset write-off has been around for some time now and has now been extended. Businesses will get a full tax deduction for the cost of any new asset they acquire from now through until 30 June 2022 (or to 30 June 2021 for second-hand assets).

Taxable income

Total tax saving compared to financial year 2020

40,000

580

60,000

1,080

80,000

1,080

100,000

1,530

120,000

2,430

Currently, small businesses can claim the entire balance of their small business pool, if the balance of the pool is less than $150,000 (for the 2020 year). Under the proposed measures, this threshold will no longer apply, so the entire balance of the small business pool can be claimed. You may consider the use of asset financing to take advantage of this write-off, depending on the type of asset finance will determine deductibility, so please check before deciding.

*Includes basic tax scales, low income tax offset, low and middle income tax offset, Medicare Levy The highest tax bracket remains at $180,000 until the Stage 3 changes which will not occur until 1 July 2024.

While you do not get the write-off until you lodge your tax return, you do have the ability to vary PAYG instalments based on estimates of income so you can pre-empt the write-off.

LOSS CARRY-BACK RULES The new loss carry-back rules allow companies to utilise losses in FY20, FY21 and FY22 to offset profits made in FY19. This will only apply to those practices that operate via a company, or utilise a company within their group structure, so will have limited impact for those that utilise trusts.

The loss carry-back changes will have an impact on franking accounts and dividend payments and so will need to be looked at in detail.

JOBKEEPER AND JOBMAKER The budget implies that JobKeeper arrangements will cease on 28 March 2021, and the new job support payments for businesses are much less financially generous. Under the new JobMaker system there is now a subsidy for hiring new employees aged 16 – 35 who have previously been on JobSeeker or similar benefits.

We recommend that you: review your JobKeeper eligibility for the December 2020 quarter and the March 2021 quarter; assess the impact that the cessation of JobKeeper will have on the profitability and cashflow of your business; and assess your eligibility for the new JobMaker subsidies.

Doctor Q Summer 41

Mandatory reporting – WH AT’S NEW?

DR SARA BIRD

Under the National Law, health practitioners and employers must make a mandatory notification to the Australian Health Practitioner Regulation Agency (Ahpra) about the conduct of a health practitioner in circumstances where there is ‘notifiable conduct’.

WHAT TYPES OF CONDUCT MUST BE REPORTED TO AHPRA? There are four concerns that constitute ‘notifiable conduct’ and trigger a mandatory notification: intoxication while practising sexual misconduct impairment a significant departure from accepted professional standards.

The National Law defines an impairment as ‘a physical or mental impairment, disability, condition or disorder (including substance abuse or dependence) that detrimentally affects or is likely to detrimentally affect the person’s capacity to practise the profession’.

WHAT’S NEW? On 1 March 2020, the requirement for a treating practitioner to make a mandatory notification to Ahpra about a colleague changed. These changes provide different thresholds for the reporting of ‘notifiable conduct’ for treating health practitioners and non-treating practitioners.

The aim of these changes is to support health practitioners in seeking help about their health by limiting the circumstances that would trigger treating health practitioners to make a mandatory notification, compared to non-treating practitioners.

42 Doctor Q Summer

A mandatory notification by a treating practitioner in relation to impairment, intoxication or practice that significantly departs from accepted professional standards is required only when there is a substantial risk of harm to the public.

When considering whether a mandatory notification is required, a treating practitioner can take into account strategies put in place by the practitioner-patient and/or their employer that reduce the risk of harm to the public. While a practitionerpatient may have an impairment that causes a minor detrimental impact on their capacity to practise, it does not trigger a mandatory notification unless it poses a substantial risk of harm to patients.

KEY MESSAGES Illness ≠ impairment

A health condition is not the same as an impairment.

An illness or condition that does not, or is not likely to, have a detrimental impact on a practitioner’s capacity to practise is not an impairment.

A notification to Ahpra does not need to be made if there are effective controls to manage the impairment and to reduce the risk and severity of harm to the public. This includes the provision of treatment, modified scope of practice or ceasing work.

Executive Manager, Professional Services

In WA, treating health practitioners providing a health service to a practitioner-patient are exempt from the requirement to make a mandatory notification.

Seek advice and support from our Medico-legal Advisory team if you receive a notification from Ahpra.

If you believe you should make a mandatory notification about another health practitioner, please feel free to contact us to discuss the situation.

MORE INFORMATION Ahpra and National Boards Guidelines: Mandatory notifications about registered health practitioners.

March 2020 https://www.ahpra.gov.au/ Notifications/mandatorynotifications/ Mandatory-notifications.aspx Mandatory notifications – a video for treating health practitioners https://www.ahpra.gov.au/ notifications/mandatorynotifications/ resources-to-help-you/watch-ourvideos.aspx Resources – helping you understand mandatory notifications https://www.ahpra.gov.au/ notifications/mandatorynotifications/ resources-to-help-you/resources.aspx

CHRIS MARIANI Director

P: 0419 017 011 E: chris@mgrs.com.au Authorised representative No. 434578

Medical practice website compliance Recently, a new client engaged me to review the practice website they were developing for their new medical practice. They had engaged a professional website developer and sent a draft format and key headings before the build commenced.

Amongst other issues, one of the obvious compliance issues was their intent to have a patient testimonial section. Advertising a testimonial on a platform controlled by the practice would be a breach of the National Law as clearly detailed in the Ahpra Guidelines for advertising regulated health services which can be downloaded from the website.1

44 Doctor Q Summer

THE GUIDELINES Section 133 of the National Law regulates advertising of regulated health services.

It states: A person must not advertise a regulated health service, or a business that provides a regulated health service, in a way that – a) is false, misleading or deceptive or is likely to be misleading or deceptive; or b) offers a gift, discount or other inducement to attract a person to use the service or the business, unless the advertisement also states the terms and conditions of the offer; or c) uses testimonials or purported testimonials about the service or business; or d) creates an unreasonable expectation of beneficial treatment; or e) directly or indirectly encourages the indiscriminate or unnecessary use of regulated health services.

Disclaimer: Medical and General Risk Solutions is a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, Australian Financial Services Licence No 240549, ABN 15 003 886 687. Authorised Representative No 436893. Chris Mariani, Authorised Representative No 434578 The information provided in this article is of a general nature and does not take into account your objectives, financial situation or need. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.

The guidelines are currently under review, so please ensure you check the Ahpra website for any updates to guidelines. Note that breaches of the guidelines can result in significant fines and disciplinary action. A good case to read is below.

04 Oct 2017 In an Australian-first, Wellness Enterprises Pty Limited, which traded as Australian Male Hormone Clinic, has been fined $127,500 plus costs after being found guilty and convicted of 17 charges related to unlawful advertising of regulated health services.2 What continues to surprise me is the number of website developers who claim to be experts in medical websites, yet seem to have no understanding, or even awareness of the basic rules that apply. The following table lists the compliance and risk issues we frequently see.

RISK/COMPLIANCE ISSUE

SOLUTION

1

Breaching advertising legislation under the National Law

Read the Ahpra Advertising Guidelines3. Carefully review your website to ensure compliance.

2

Privacy policy

You should include your ‘APP Privacy Policy’ in the footer of your website, particularly where you collect or engage with patients online (e.g. telehealth)4

3

Collecting health information online

If you intend to collect patient health information online, include a “consent to collect health information” process which includes making your Privacy Policy accessible on the website. You should include your ‘New Patient Registration Form’ next to your Privacy Policy in the footer and ensure it has the relevant consent and where to access the full Privacy Policy.

4

Overpromising, especially clinical outcomes

Be wary of marketing words used such as “we provide the best possible healthcare”. A safer approach may be to state “we aim to deliver the best possible healthcare”. In a civil claim, do you want to be held to account to the highest standard, or to the standard or a reasonable practitioner?

5

Using titles, ‘specialist’, ‘specialises in’, ‘specialty’, ‘specialised’

Be wary how you promote practitioners’ skills and qualifications.

Claiming to have a “sub-speciality” when there is no formal qualification, is better described as “an interest in”, or “experienced in”. Read www. ahpra.gov.au/Publications/Advertising-resources/Check-and-correct/ Titles.aspx

6

Website terms and conditions

Include suitable website terms and conditions drafted by your lawyers based on the content and what your website does. E.g. use of cookies, any healthcare information is of a general nature and not medical advice, etc.

7

General law and legal obligations

In addition to the Ahpra advertising guidelines, there are other laws that apply to all businesses such as the Competition and Consumer Act – which also deals with misleading and deceptive advertising.

8

‘Associate’ or room rental practitioners

They are running their own ‘medical services business’ and engage the practice to provide rooms and admin support. Be careful how you promote these practitioners - especially avoid giving the impression of employment. Ensure any advertising is consistent with their service agreement and your lawyers have reviewed the website content.

9

Website security

Ensure you have strong passwords and enable multi-factor authentication.

Speak to your web developer and IT consultants on securing the website, your domain registration, access to appropriate personnel.

The above list is not exhaustive and is a summary of the common issues I have witnessed. You should ensure you seek appropriate advice from relevant experts such as website developers, cyber security experts, lawyers, practice management consultants and your medical defence insurer.

1 2 3 4 5

www.ahpra.gov.au/Publications/Advertising-resources/Legislation-guidelines/Advertising-guidelines.aspx www.ahpra.gov.au/news/2017-10-04-media-release-advertising.aspx www.ahpra.gov.au/Publications/Advertising-resources/Legislation-guidelines/Advertising-guidelines.aspx www.oaic.gov.au/privacy/guidance-and-advice/guide-to-developing-an-app-privacy-policy/ www.ahpra.gov.au/Publications/Advertising-resources/Check-and-correct/Titles.aspx

Doctor Q Summer 45

The big internship – SURVIVAL TIPS

This time of year is an exciting one for graduating medical students – by now, most will know where they are heading for their intern year and are getting ready to transition from full-time student to full-time doctor and student (seems it never stops!).

Dr Naga Annapureddy took time out to join Credabl’s Simon Moore to chat through her internship year at Prince Charles Hospital, sharing some tips to help prepare new interns.

T I P #1

RELAX! DON’T WORRY SO MUCH A common theme at the moment is mental health and wellbeing, but many young doctors forget just how important it is to look after yourself mentally and physically.

Anxiety is a common feeling when going through change – and while some deal with it well, others take time and can struggle with it. Naga pointed out that one of the challenges of going through both her first intern year and the COVID-19 pandemic was absolutely the limitation of interacting with other young doctors, peers and mentors at a social level. While this may also be a challenge for the graduating classes of 2020 – the ability to connect in many ways previously not fully utilised is in abundance now! Facebook groups, other social media platforms such as LinkedIn and Instagram, and bodies such as AMA Queensland are important ways to both interact with others and access valuable content both professionally and personally for development and support.

T I P #2

TAKE EVERYTHING AS A LEARNING OPPORTUNITY The role of an intern is still one of learning – and although you know more than you realise, part of learning is being supported and reaching out 46 Doctor Q Summer

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

for help when you need it. This is particularly important for the aspects of being a doctor that you simply can’t prepare yourself for, like the reality of communicating the passing of someone to a family.

An important reminder from Naga is that nurses are your best friend to both support you but also to learn from!

T I P #3

SNACK AND READ! Snacks will get you through long shifts. And coffee too. And although it’s hard to comprehend the concept of free time, turning your mind to some excellent books provides a great way to switch off and learn at the same time. For those interested in a medical read, Naga recommends Adam Kaye’s This is going to hurt which is about junior doctors in the UK’s National Health Service.

If you’re looking for a nice change from everything medical, then The Night Circus by Erin Morgenstern is worthwhile, even if it takes you all year to read!

As the ancient philosopher Lao Tzu said: A journey of a thousand miles begins with a single step. While you may feel like you have already covered that distance, and some, the journey is just beginning for young doctors embarking on their internship year.

Credabl is a long term supporter of junior doctors and at any stage of your career can help with what

DR NAGA ANNAPUREDDY Intern, Prince Charles Hospital and AMA Queensland Council of Doctors in Training, Communications Portfolio

we specialise in – finance options.

However, we take our ‘partner’ tag with the industry very seriously and always have on offer relevant content, events (COVID-19 pending), blogs and webinars that focus not just on your financial wellbeing, but also your personal wellbeing.

To hear the rest of Naga’s tips, listen to her conversation with Simon available at www.credabl.com.au/blog

Give your medical practice a helping hand with Credabl.

Would a $10,000 support package improve the financial health of your practice? It’s been a challenging time for many businesses and that’s why we’re excited to announce the Credabl Helping Hand Grants.

A Helping Hand Grant could provide your medical practice with a support package designed to nurture and grow your business. Grants are valued at up to $10,000 and will be awarded to up to five medical practices around Australia – including dentists, doctors and vets.

If you own, manage or work for a medical practice you can nominate your practice today.

Find out more and tell us how this grant would support your business at credabl.com.au/helping-hand

*T&Cs Apply

e l f f a R n o Foundati

P L AY FOR P U R P O S E

2021 Foundation Raffle Medical Student SCHOL ARSHIPS In 2021, our scholarship program is again open to all medical students attending Queensland universities, who are experiencing financial hardship. Up to two scholarships of $5,000 each (paid in two equal instalments) will be awarded. The Foundation is able to assist students who do not have the financial means to continue pursuing their studies. Applications open 1 November 2020 and close 31 January 2021. Applications received after 5pm on 31 January 2021 cannot be considered.

For further information on the eligibility and conditions of the scholarship please phone (07) 3872 2222, email amaqfoundation@amaq.com.au or visit www.amaqfoundation.com.au to download an application form.

48 Doctor Q Summer

There’s a NEW way you can support the AMA Queensland Foundation AND have the chance to WIN. Introducing… the Play For Purpose Raffle. Each Play For Purpose raffle ticket is just $10.

When you buy your ticket in support of the AMA Queensland Foundation, you’re funding a range of causes to help Queenslanders in need including vital medical equipment for patients suffering from motor neurone

disease, bursaries for disadvantaged medical students, and life-changing research programs. You could also win a $250,000 first prize pack and hundreds of other fantastic prizes!

Get your tickets today via the AMA Queensland Foundation website www.amaqfoundation.com.au.

This raffle closes on 17 December 2020.

THERE’S HUNDREDS OF FANTASTIC PRIZES TO BE WON! Prize Number

Prize Type

Value

Qty

Total Value

1

$250,000 1st Prize Package including a Range Rover Evoque, $125,000 in Cashable Gold Bullion and $25,000 worth of vouchers from leading Australian retailers.

$250,000

1

$250,000

2

Freedom Furniture voucher

$15,000

1

$15,000

3

Myer voucher

$7,500

1

$7,500

4

JB HI-Fl voucher

$5,000

1

$5,000

5

Travel Club voucher

$2,500

1

$2,500

6 to 25

1 of 20 $500 JB HI-Fl vouchers

$500

20

$10,000

26 to 45

1 of 20 $150 Amazon vouchers

$150

20

$3,000

46 to 395

1 of 350 $20 Wish vouchers

$20

350

$7,000

Total

395

$300,000

AMA QUEENSL AND FOUNDATION 20-YEAR ANNIVERSARY: HELPING TO CREATE A HEALTHIER QUEENSL AND FOR THE PAST 20 YEARS.

A Fundus camera used by Dr Bill Glasson and others to conduct eye and diabetes screen clinics in West Queensland – 2003, 2004, 2005 and 2006.

Purchased special equipment and a mini bus for Red Hill Special School.

The 2014 tax appeal raised funds to purchase a brand new, speciallyfitted out street van for Rosies’ Cairns branch outreach program.

Funding ear, nose and throat surgical procedures for 36 remotely-based Queensland children.

Funding specialised tele-practice programs through Hear and Say for children living remotely requiring intensive speech therapy support.

In late 2018, the AMA Queensland Foundation approached the Queensland Government to secure funding for the Hep C Kombi Clinic for three years. Queensland Health supported this application and committed $231,000 in funding.

With the help of AMA Queensland members, the Foundation has contributed over $1.7 million to improve the health and wellbeing of many Queenslanders facing sickness, disability or financial hardship. Read about our achievements at www.amaqfoundation.com.au.

To help us continue our life-changing work across the next 20 years, please consider making a tax-deductible donation to the AMA Queensland Foundation during this Christmas Appeal.

Also, please consider leaving a bequest to the AMA Queensland Foundation in your will to create a legacy of a healthier future for generations to come. There is more information on our website.

Thank you for giving generously.

DONATE ONLINE AT www.amaqfoundation.com.au

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The AMA Queensland Foundation celebrates its 20-year anniversary in 2020.

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Thank you for your support!

Doctor Q Summer 49

RESTAURANT REVIEW

With its hidden laneway entrance, warm rustic décor and delicately fairy-light lit courtyard, you’d be forgiven for thinking you had wandered off the streets of Brisbane straight into a back street of Rome when you arrive at Fortitude Valley’s newest Italian eatery Eterna.

Showcasing customary Roman cuisine, balancing simplicity of cooking technique with complexity of flavour, this inviting and charming venue is sure to be a new favourite to add to your dining repertoire.

Open until after midnight, Eterna is just as suitable for a romantic date night as it is for a cosy supper with cherished friends or a delightful dinner alone. Where other venues strive to be bigger and bolder, Eterna shows strength in restraint, honouring the classically intimate Italian dining experience by serving beautiful traditional food done extraordinarily well.

Browse their extensive wine menu to first awaken the palate, from their selection of crisp, tropical, aromatic or buttery whites to soft, structured or full bodied reds, rose, sparkling or a bottle from their elegant range imported from Piedmont and Tuscany.

50 Doctor Q Summer

If spirits are more your style, they also serve a diverse range of gin, whisky, rum, bourbon, grappa and tequila.

The cocktail menu may also take your fancy with its delectable flavour pairings of watermelon and rose, whisky and truffle honey, or rinomato aperitif with moscato served as a spritz.

For starters, it would be remiss of you to not try the Suppli Al Telefono.

The self-proclaimed king of Italian street food, these oblong croquettes not dissimilar to arancini feature a decadent and generous heart of stringy mozzarella cheese encased in a wonderfully tangy tomato rice mixture.

For antipasti, the wagyu carpaccio is a must. Wafer thin slices of wagyu are balanced beautifully with a combination of crisp fresh rocket salad, a sharp parmigiana reggiono, and a delicately tart lemon-truffle oil with the added crunch of pine-nuts. The octopus ‘polpo alla griglia’ is served grilled and still slightly chewy, with a smooth chickpea puree with the added spicy aftertaste of salsa verde. The insalata di panzanella also comes highly recommended. With its crunchy garlic croutons, seasonal heirloom tomatoes, creamy bocconcini, salty anchovies and a sweet and sour sherry vinegar, this salad has far more complexity on the palate than your usual garden greens.

However, if share-plates are more your style, the charcuterie selection with marinated vegetables and the cheese platter with truffle honey and crackers make for the perfect ‘sip and snack’ accompaniment for after-work cocktails with colleagues.

The quintessential pasta dishes of Rome have their own section of the menu, with a carbonara rigatoni, a spicy tomato-based bucatini and a pepper and percorino tonarello on display. There’s also an enticing Moreton Bay bug and clam pacchero in chilli seafood bisque, rosemary marinated chargrilled lamb chops, Italian style slow-roasted pork belly, grilled red snapper with sautéed clams and Tasmanian mussels in a garlic white wine sauce.

The real stand-out of the mains and pasta menu however is the gnocchi alla vaccinara – a red-wine laden ox-tail ragu tender enough to eat with a spoon, swirled amongst exceptionally light pillows of pasta.

It’s the kind of wonderfully moreish late night fare that you could enjoy just as well with your date under the warm glow of the fairy lights, as you could by yourself in a quiet corner of the bar with a good book and a glass of vino.

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

The dessert menu is short and sweet with classics like tiramisu and semifreddo. However, to conclude a traditional Roman feast you should really partake in the ‘crostate di ricotta e vissciole’. This sweet and tart ricotta cherry cheesecake has a more crumbly texture than your usual creamy New York style, and with a firm pastry base rather than biscuit, it is an enjoyable if not entirely different dessert to what you would normally find on local menu.

For a true taste of Italy without roving far from home, make your next dining experience one to remember at Eterna.

Located at 610 Ann St Fortitude Valley, open from 5pm to midnight Tuesday to Thursday and 5pm to 1am Friday to Saturday.

Doctor Q Summer 51

All about you...

BOOK: BLUEBIRD – MALCOLM KNOX

C H A R I T Y: FOODBANK

A stunning new novel about longing, regret, redemption and the terrible legacy of decades of secrets buried in an Australian beachside suburb.

Demand for food relief is higher than ever recorded, with three in 10 Queenslanders who had not gone hungry before COVID-19 now experiencing food insecurity.

People aged between 18-25 are the hardest hit. Each month, Foodbank Queensland sources and supplies 1,000,000kgs of food to front-line charities – enough to support 200,000 Queenslanders in crisis. Organise a food drive at your workplace or donate directly at www.hungerdrive.org.au.

A house perched impossibly on a cliff overlooking the stunning, iconic Bluebird Beach. Prime real estate, yet somehow not real estate at all, The Lodge is, like those who live in it, falling apart.

Gordon Grimes has become the accidental keeper of this last relic of an endangered world. He lives in The Lodge with his wife Kelly who is trying to leave him, their son Ben who will do anything to save him, his goddaughter Lou who is hiding from her own troubles, and Leonie, the family matriarch who has trapped them here for their own good.

Savage, funny, revelatory and brilliant, Bluebird exposes the hollowness of the stories told to glorify a dying culture and shows how those who seek to preserve these myths end up being crushed by them.

P O D C A S T: GURU At its best, the self-help industry provides us with the chance to have a constructive look at ourselves and our goals, but at its worst, unscrupulous operators can prey on vulnerable people at a vulnerable time in their lives. It certainly wouldn’t be unexpected for a self-help guru to turn into a cult leader…

BLUEBIRD

WIN this book!

James Arthur Ray was an Oprah-endorsed self-help teacher who achieved fame, fortune, and influence. Friends and family members of his followers questioned his unorthodox methods, and tried to stop him. Guru is a story about the dark side of enlightenment. Hosted by journalist Matt Stroud.

52 Doctor Q Summer

Name:

Member no:

Telephone:

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

Entries close 30 December 2020 Doctor Q Summer 52

Reef, rainforest, outback and more Now is the perfect opportunity to plan a Northern Queensland escape. When most of us think of this area, we imagine palm fringed beaches, islands and the reef but Northern Queensland is much more. True, there are some amazing islands to experience, but it is worth considering combining this experience with the Daintree and/or Queensland Outback.

As AMA Queensland’s official travel partner, Orbit World Travel have collated a selection of escapes that covers all these experiences and more.

The first is an authentic experience of lasting memories, combining the under-stated and secluded elegance of Orpheus Island Lodge, a soul-enriching rainforest retreat at the Daintree Ecolodge, and lastly invoking your spirit of adventure at Mt Mulligan Lodge.

Orpheus Island Lodge is a rare island hideaway accommodating just 28 indulged guests and showcases a plethora of once-in-a-lifetime experiences. Its local dive and snorkel sites boast an abundance of fish and corals, including some of the region’s largest collections of soft corals. The turquoise local waters are a fisherman’s playground and home to the most sought-after reef species in the world.

Set in the heart of the World Heritage-listed Daintree Rainforest, the Daintree Ecolodge combines nature, nurture and culture in a pure rainforest environment. Nestled amongst the foliage, the Daintree Ecolodge showcases 15 eco-friendly bayans (treehouses) immersed in the

breathtaking rainforest canopy and provides the perfect base to explore the treasures of the Daintree region; the only place in the world where two UNESCO World Heritage-listed sites meet - the Daintree Rainforest and Great Barrier Reef.

With the backdrop of its majestic 18-kilometre long sandstone namesake, Mt Mulligan Lodge offers laid-back luxury in the rugged outback environment of Queensland.

Located on a 28,000-hectare working cattle station, Mt Mulligan Lodge invites just 16 guests to experience the spirit of the outback through a captivating landscape that’s steeped in Indigenous significance dating back 37,000 years.

A range of experiences have been designed to make the surrounding landscape and its fascinating history.

These include guided tours of the goldfields, including a demonstration of Australia’s oldest operating gold crusher, exploration of the historic Mount Mulligan coal mine and abandoned township, all-terrain vehicle (ATV) adventures, chefprepared picnic hampers, barramundi fishing, scenic helicopter flights,

guided nature walks and the chance to experience the operations of a working cattle station.

If you are not one for multiple stays and moving about, another great way to explore Northern Queensland is with Coral Expeditions, an Australian pioneering expedition cruise company.

They operate a fleet of small expedition ships, accommodating 42 to 120 guests to some of the most beautiful, yet undiscovered areas of Australia.

Onboard their Great Barrier Reef voyages, you will explore rainforest shores, uninhabited sand cays, remote islands and pristine reef systems.

Expert guides will share their knowledge with you above and below the water, bringing you close to the natural wonders and wildlife, and giving you a deep understanding of this precious destination.

Coral Expeditions pioneered extended expedition cruises on the outer reaches of the Great Barrier Reef 35 years ago and have forged a reputation for excellence in that time as a member of Ecotourism Australia and an accredited and award-winning ecotourism operator. Their purposedesigned small ships are built for expedition cruising, with refined steering capabilities, shallow draught and nimble Xplorer tenders. Onboard, enjoy fresh seasonal cuisine and boutique Australian wines and brews.

With an intimate atmosphere and our renowned warm Australian hospitality, you will quickly feel at home.

These are just a few options of what is available in this unique part of Australia.

Orbit World Travel would love to help you plan your next holiday – whether that’s a weekend away, a short escape or full holiday experience and have many exclusive and value-added inclusions for AMA Queensland members.

Orbit World Travel AMA Queensland preferred travel provider: P: 1300 262 885 | E: travel@amaq.com.au holidays.orbitworldtravel.com.au Doctor Q Summer 53

Greenock Creek WHERE BIG IS BEAUTIFUL

In what can only be described as a coup, Wine Direct now range the iconic Barossa winery Greenock Creek.

Early in my career, I used to share a red or two with my father, who ran a successful accounting practice in Adelaide. On one occasion in the late 80s, he brought home a mad looking Barossa chardonnay full of body and funky leesy flavour and a shiraz of uncommon oomph… I say uncommon because it packed a whopping 16 per cent in alcohol which in the late 80s was almost unheard of. This was a new client of his that as Dad put it “shows great potential” - history shows the old bloke had a good eye!

Greenock Creek was established by Michael and Annabel Waugh in 1984.

Michael spent 10 years working with Robert O’Callaghan (Rockford) and Chris Ringland before buying a rundown house with a couple of acres of old shiraz vines included. This first release, the 1986 Creek Block Shiraz was made in a couple of open fermenters in what is now their garage. Michael decided early to focus on terroir, there being so

54 Doctor Q Summer

many varied soil types and geologies within proximity of his home base. At the time the concept of terroir was widely laughed at in Australia, but it was a decision that paid off; Michael was soon fashioning and being lauded for a number of distinctly different and interesting Barossa shiraz.

The Creek Block is planted on alluvial clays; Alice’s vineyard is on Yudmanatana siltstone; Apricot Block – ferruginous loam; Seven Acre – schist siltstone; and Roenfeldt – ancient rubble and quartzite. As a result, he is somewhat of a godfather of terroir in the Barossa and has been much emulated. By 1994, the Waughs had purchased their Roenfeldt Road vineyard and worked hard to improve trellising, soil, and vine health. The first release 1995 vintage Roenfeldt Rd Shiraz went on to pick up 100 points from Robert Parker and truly launched Greenock Creek wines as one of the great wineries of the world.

PHIL MANSER

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

The Roenfeldt Rd Shiraz is a beast, an exceptionally powerful, rich and ripe shiraz which tips the scales at a remarkable 17 per cent alcohol. This is instantly mouth-watering, first when you whack your nose in the glass and then again when you taste it. There is a rich perfume of Kirsch drifting into a compote of blue and black berries.

On the tongue baked plums, coconut, cedar and a truckload of acid bring it back toward balance. Tannins are relatively soft. It’s definitely not for the fainthearted.

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Perhaps is the answer Workplace relations are vital. There are committees, conferences and cults dedicated to its agenda. I have never studied the concept but learnt all I know about running a practice and keeping team spirit buoyant from captaining cricket teams. After all, cricket is life’s ultimate metaphor.

In my general practice, we love having social events, regularly. Off field events are just as vital as on field events.

Families join us and we see each other as unique people, not just work mates.

Over dinner and drinks or a concert, play or footy game, we laugh, yarn, drink and bond. This overflows to the Monday to Friday grind and ensures a healthy balance in the workplace relationships account, just in case there are a few withdrawals when people get snaky with each other. In my experience, it is really hard to abuse someone that you know well and respect as a human being. Having some familiarity with a colleague is surely protective against poor treatment in the shared workplace.

In hospital settings, things might be different. The staff numbers are bigger and wards often have an itinerant population as people do their various terms and leave. I appreciate we are all different and that perhaps there are work mates that you will never be best mates with, but I am sure if we all looked hard, we’d find some common ground. Afterall, we are all Australians and the thing that unites us all beneath our Southern Cross, is of course sport.

I spent seven years in the hospital system and all of my best memories of that working chapter involved playing sport with my work mates.

The best year I ever had was at Prince Charles Hospital. Dr John McCarthy was my boss and we shared a passion 56 Doctor Q Summer

for cricket. John skippered the mighty Prince Charles XI against all comers that year and the only loss we suffered was against the Royal Brisbane Hospital (RBH). We were crucified by the rain and had much the worse of the batting conditions, before ultimately losing a very tight match. It is still my most devastating sporting loss.

We played rugby league as far north as Nambour. That was a cracking day out.

We lined up a team bus to make the trip and it seemed half the hospital tagged along to cheer us on. Our starting XIII was made up of a great cross-section of jobs but we all shared one huge fear and that was Dr Bill Campbell. He was the legendary Wallabies second rower and he was apparently working at Nambour General. We were scared.

We were united in our fear. It was bonding. As much as we bonded over this terror, we bonded even more when we rocked up at the Nambour Show Grounds to find that Dr Campbell was on call and wasn’t playing.

We also had a hospital mixed indoor netball team. It was a treat to knock around with so many terrific people in a completely different context. Senior medical people had to accept that some of the other ranks might have seniority on the sporting field and while the consultant called the shots at work, it would invariably be a junior nurse calling the shots on the netball court.

D R M AT T Y O U N G General Practitioner, Inala Medical Centre

It was pretty hard to shaft a person on Monday morning after you’d spent 80 minutes being belted together on the footy field or you’d celebrated hard together after an epic win on the cricket field. The whole staff morale was vibrant and we owed it all to sport.

A couple of years at QEII ensued and we had a Friday afternoon touch footy game that was essentially compulsory for anyone under 40 in the hospital.

Nurses, physios, occupational therapists, doctors of all ages and ranks and reception staff. Everyone was invited and everyone was stoked to play.

It broke down barriers and built bridges.

Of course, it is not always rosy.

Hospital sport can cause some friction.

I remember being run out through no fault of my own in that game against RBH. My batting partner completely crucified me. He called “yes” then sent me back and I was left stranded.

Even though he was an excellent specialist, I never did send him any referrals once I was a GP.

GREATER SPRINGFIELD MEDICAL & OFFICE SUITES I often meet with medical professionals who are wondering where they will establish themselves. I can’t think of a better opportunity than here in Greater Springfield. The future is here; the future is now.

Dr Robert Stable AM Emeritus Professor Bond University MBBS, DUniv (QUT), MHP, FRACGP. FAICD, FCHSM (Hon) Executive Chairman - Health City Springfield Central

Sale I Lease I Invest

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.

This brand new facility is directly adjacent to the Mater Private Hospital Springfield, AVEO Springfield, Quest Apartments, childcare, and the newly opened Springfield Central Sporting Complex, making the Greater Springfield Specialist Suites the ideal solution for your medical business or specialist office.

With areas from 40m2 to whole floors of 450m2 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 Praveen Mallesh 0412 470 882 0434 285 521 u.ranchigoda@springfieldcity.com p.mallesh@springfieldcity.com

www.gssuites.com.au

INPRINT

Dermatologic Surgery and Cosmetic Procedures in Primary Care Practice Jonathan Kantor The complete guide to skin surgery and cosmetic procedures, from surgery fundamentals to surgical and cosmetic procedures.

An invaluable new guide for family medicine and emergency physicians, Dermatologic Surgery and Cosmetic Procedures in Primary Care Practice provides state-of-the-art dermatologic procedures used in virtually every clinical practice. With practical tips and tricks used by dermatologic

surgeons, it covers excisional surgery, neurotoxin injections, surgical instrument selection, wound dressing, local anesthesia, incision and drainage, nail surgery, and more.

Thanks to our friends at McGrawHill Education, we have a copy of Dermatologic Surgery and Cosmetic Procedures in Primary Care Practice to give away.

Entries close 30 December 2020.

WIN this book

Telephone:

Name:

Member no:

Fill out this form and fax to (07) 3856 4727 or email to competitions@amaq.com.au

Entries close 30 December 2020

NOVEL WINNER Dr John Hill won a copy of The Cut by Dr Marcus Kennedy.

Our friends at Dendy Cinemas are only open on a limited basis due to COVID-19. Check out some of the classics on show for the time being.

58 Doctor Q Summer

INPRINT BOOK WINNER Dr Ivan Rapchuk won a copy of The Good Doctor: what it means, how to become one, and how to remain one, thanks to McGraw-Hill Education.

VMO ANAESTHETIST REQUIRED Hillcrest Rockhampton Private Hospital, QLD

• Opportunity to establish an independent private practice to provide anaesthesia services to private inpatients of Hillcrest Rockhampton Private Hospital. • Must have FANZCA, specialist registration with AHPRA & eligible for unrestricted provider number.

For further information visit ramsaydocs.com.au or phone Fiona Hebbard, CEO on (07) 4932 1121 or email hebbardf@ramsayhealth.com.au

Doctor Q Summer 59

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