Doctor Q July 2014

JULY 2014 . VOL 90

AMA Queensland Membership Magazine

BUDGET LOWDOWN: AUSTERE BUDGET MAY CAUSE PATIENT PAIN

THE NEW PRESIDENT OF AMA QUEENSLAND

DR SHAUN RUDD FREE TO AMA QUEENSLAND MEMBERS

RURAL AND REMOTE MENTAL HEALTH ON THE TABLE DoctorQ JULY PITT 2014 WOMEN IN MEDICINE WITH TURIA

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CONTENTS

THIS ISSUE NEW AMA QUEENSLAND PRESIDENT HERVEY BAY GP DR SHAUN RUDD WILL USE HIS AMA QUEENSLAND PRESIDENCY TO FOCUS ON PROMOTING LIFELONG EXERCISE AND IMPROVING END OF LIFE CARE.

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REGULARS

features

22 MEET AMA QUEENSLAND’S NEW BOARD AND COUNCIL 30 AUSTERE BUDGET MAY CAUSE PATIENT PAIN

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FROM THE EDITOR’S DESK

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PRESIDENT’S REPORT

10 CEO’S REPORT 12 AMA QUEENSLAND NEWS

44 A DAY IN THE LIFE OF RURAL GP: DR MANUKHARAN NITHIANANTHA

28 FOUNDATION NEWS

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46 AMA QUEENSLAND HEALTH VISION: UNIFIED HEALTH CARE

34 LMA ROUND UP 40 MEMBER NEWS

people & events 14 PRESIDENTIAL INAUGURATION

16 MEMBER VISIT TO FAR NORTH QUEENSLAND

Current issues

20 PSYCHOLOGICAL INJURY

32 WOMEN IN MEDICINE: TURIA PITT

26 ETHICAL AGONY AUNT: HOSPITAL ROMANCE

36 CALENDAR

35 RURAL AND REMOTE MENTAL HEALTH ON THE TABLE

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38 ANNUAL CONFERENCE: CAPE TOWN

business tools 48 GET THE MOST FROM YOUR INSURANCE

49 WILL MONETARY POLICY COME TO THE RESCUE? 50 SALARY PACKAGING MYTHS

I’m passionate about advocating on behalf of both patients and doctors...

52 INSURANCE ISSUES WHEN RENTING ROOMS 54 LEASING TIPS AND TRAPS

Life

56 TRAVEL

Dr Thomas Campbell

57 WINE 58 ALL ABOUT YOU 59 OCKER DOCTOR

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60 MOVIES 61 ON STAGE 62 IN PRINT

DoctorQ JULY 2014

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editor’s desk

FROM THE EDITOR’S DESK MICHELLE FORD RUSS Doctor Q Editor July is always an exciting time at the AMA Queensland office, with a new President, Board and Council to meet and work with. Dr Shaun Rudd has taken over the robes, with Dr Chris Zappala in the ready as President-Elect. Find out a bit more about Dr Rudd and what he’s all about on p18.

We’ve listed the new Council on p22 so that you can see who is here to represent you. Our Council is here to put member concerns forward and be proactive in improving working life for Queensland’s doctors.

Our Policy Officer Leif Bremermann has had a look over the State and Federal budgets and highlighted the changes that will have an impact on you on p30.

I know that talk of co-payments has already created some patient confusion and cancelled appointments for many of our GPs. Our ever-popular Women in Medicine Breakfast is coming up on 6 August, where we’ll hear from a woman who epitomises resilience, Turia Pitt. Turia suffered burns on 65 per cent of her body in a grass fire while competing in a marathon in 2011 and will discuss how with a fighting will and a strong support network, we can thrive in adverse times. Q

CONGRATULATIONS

BOARD OF DIRECTORS Dr Shaun Rudd President

Dr Kirsten Price Honorary Secretary

Dr Chris Zappala President-Elect

Dr Brad Horsburgh Elected Member

Dr Bill Boyd Chair of Council

Dr Josie Sundin Elected Member

Dr Bav Manoharan Treasurer

COUNCIL Dr Tom Arthur Greater Brisbane Area

Dr Sharon Kelly Specialist Craft Group

Dr Sharmila Biswas Far North Area

Dr Richard Kidd General Practitioner Craft Group

Dr Kimberley Bondeson Greater Brisbane Area Dr Bill Boyd Capricorn Area Dr Thomas Campbell Greater Brisbane Area

Congratulations to the following members who were recognised for their services on the Queen’s Birthday.

Dr Dilip Dhupelia Part Time Medical Practitioner Craft Group

Professor Ian WRONSKI AO, Townsville Member: 15 years

Dr Vanessa Grayson Residents and Registrars Craft Group

Professor Wronski was appointed an Officer in the General Division for distinguished service to tertiary education, particularly through leadership and research roles in Indigenous, rural and remote health, and to medicine in the field of tropical health.

Congratulations also to Colleen Sullivan, who received a Medal of the Order of Australia for her work in medical administration.

Professor Caroline DE COSTA AM, Cairns Member: 10 years Professor de Costa was appointed a Member in the General Division for significant service to medicine, particularly to Indigenous and migrant women’s reproductive health.

Dr Zelle HODGE AM, Brisbane Member: 39 years AMA Queensland Past President Dr Hodge was appointed a Member in the General Division for significant service to medicine, particularly through a range of roles in professional organisations, and to women.

IT’S A GIRL! Congratulations to Dr Alex Markwell and husband Anthony, who welcomed daughter Bronte on 17 June, just a few days after the Inauguration.

Dr John Hall Downs and West Area Dr Noel Hayman Greater Brisbane Area Dr Wayne Herdy North Coast Area

Dr Luke Lawton North Area Dr Kelly MacGroarty Specialist Craft Group Dr Bav Manoharan Gold Coast Area Dr John Murray Full Time Salaried Medical Practitioner Craft Group Dr Paul Neeskens General Practitioner Craft Group Dr Kirsten Price General Practitioner Craft Group Dr Josie Sundin Greater Brisbane Area

Dr Brad Horsburgh Greater Brisbane Area

AMA QUEENSLAND SECRETARIAT Jane Schmitt Chief Executive Officer Filomena Ferlan General Manager Corporate Services Colleen Harper Manager - AMA Queensland Foundation

Holly Bretherton General Manager Member Relations and Communications Andrew Turner Manager - Member Services

Editor: Michelle Ford Russ Graphic Designer: Erin Sticklen Journalist: Rachael Finley

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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Advertising: Louise Glynn Doctor Q is published by AMA Queensland Contact Phone: (07) 3872 2222 Postal Address: PO Box 123, Red Hill QLD 4059 Print Post Approved PP100007532 Email: amaq@amaq.com.au

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DoctorQ JULY 2014

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PRESIDENT’S REPORT

PRIORITIES FOR THE FUTURE WITH A NEW COUNCIL AND BOARD, WE SET OUT ON A NEW YEAR READY TO SUPPORT MEMBERS, ADVOCATE ON BEHALF OF THE PROFESSION AND WORK TOWARDS BETTER HEALTH OUTCOMES FOR QUEENSLANDERS.

DR SHUAN RUDD President, AMA Queensland One of the benefits of the AMA Queensland presidency is that it will allow me to focus on key issues and priorities that will benefit Queensland. Over the past year, Dr Rowan has been able to use his presidential term to raise awareness about alcohol and substance abuse while contributing to legislation that seeks to reduce alcoholfuelled violence.

Over the next year, I look forward to working with government, members and the public to build a healthier Queensland with a focus on lifelong exercise and end-of-life care.

In my presidential term, I too will focus on several health issues I am passionate about. Over the next year, I look forward to working with government, members and the public to build a healthier Queensland with a focus on lifelong exercise, end-oflife care, and opportunities for medical students.

health suffers due to lifestyle choices. The comprehensive health benefits, numerous options, and ease of access associated with exercise make it not only an effective health priority, but a cost-efficient one.

IMPROVING END-OF-LIFE CARE

As a general practitioner, I see patients with a variety of health concerns. In particular, I have seen the impact sedentary lifestyles have had on the weight and general health of my patients. It is with this in mind that I have selected lifelong exercise as a public health platform for my presidency.

Too many resources are spent on futile end-of-life care. As medical practitioners, we need to make sure we are providing patients with tailored care leading up to their death. We need to change the attitude that ceasing medical treatment is a failure; rather, it is sometimes the best option to allow patients to have the most comfortable and dignified death.

Specialists and general practitioners both see too many cases where a patient’s

For many patients, spending their last few days in a hospital is an unpleasant

PROMOTING LIFELONG EXERCISE

experience for their loved ones and them.

We have a responsibility to ensure our patients are taken care of in their lives but also during their deaths. This means, where appropriate, providing support that enables patients to spend their last days where they wish with those they love.

MEDICAL STUDENTS AND DOCTORS IN TRAINING Junior doctors and medical students are a vital membership group as they are ultimately the future of the medical profession. AMA Queensland will continue to ensure our young members are provided with the training resources and opportunities they need. In coordination with our Council of Doctors in Training, we will work to continue providing junior doctors and medical students with quality events such as the Junior Doctor Conference and professional development opportunities.

REGIONAL VISITS I look forward to meeting members from around the state. As a regional practitioner, I understand the unique concerns of these areas, particularly in recruitment. Over the next year, we will be embarking on a number of regional trips and will continue to advocate for measures that will boost rural health and provide better support to those practising in these areas.

Dr Rudd practices what he preaches too: a fervent Aussie Rules player with the Hervey Bay Fruit Bats and a Queensland representative in the Queensland Masters League.

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The year ahead is an exciting one and with the support of a committed council, I am confident in what we will be able to achieve for the profession and the patients it serves. Q

ceo’S REPORT

CHANGING TIMES FROM ADVOCACY TO MEMBER EVENTS, AMA QUEENSLAND CONTINUES TO WORK IN THE BEST INTEREST OF MEMBERS.

JANE SCHMITT Chief Executive Officer, AMA Queensland NEW PATIENT CO-PAYMENT There is significant confusion surrounding the $7 co-payment on GP, radiology and pathology visits announced in the Federal Budget. A number of questions remain about how the co-payment will be implemented, though it will not take effect until 1 July 2015. Some members have already reported a reduction in patient visits, while others have expressed concern about a general lack of understanding of the proposed scheme.

At the time of writing this column, the new co-payment scheme has not yet been brought to the Senate. Until then, it is unclear if the co-payment will be approved by the Senate and if any modifications will be made to make the scheme more viable.

In its current form, AMA and AMA Queensland oppose the co-payment scheme. Federally, AMA President, A/ Prof Brian Owler, has spoken about AMA’s opposition to the co-payment, including in a recent editorial where he noted the flaws in the proposed scheme.

We echo these sentiments and have been gathering feedback from members that will guide our advocacy work. We issued a survey to GPs, radiologists, and pathologists to find out how they would be affected by the co-payment scheme. We will bring these responses to government and continue to advocate for a more effective system.

We have also added a designated copayment section to our website which we will continue to update with articles, new developments and other relevant information.

WOMEN IN MEDICINE On 6 August, we will be hosting our annual Women in Medicine breakfast. This event recognises the achievements of women in the medical field and this year we are honoured to have Turia Pitt as our special guest speaker.

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Turia exemplifies the strength of the human spirit. Three years ago, while running in a WA ultramarathon, she suffered full thickness burns to over 65 per cent of her body. Though her injuries were devastating, Turia refused to let them define her.

She is a fitting speaker for this year’s event which will focus on resilience and perseverance. We recently interviewed Turia to chat about her life and recovery, which can be found on page 32.

WELCOME TO THE NEW BOARD AND COUNCIL Our Board and Council commenced in June with Dr Bill Boyd serving as the Chair of both. Our Board meets seven times per year and is responsible for governance oversight including financial overview of the Association.

Our Council meets four times per year and provides crucial advice for the development and implementation of AMA Queensland

policy, taking into account issues raised by members and the changing health environment.

To find out more about the representative in your area or your craft group, we encourage you to visit amaq.com.au. Any information or issues you provide to your craft group representative, geographical representative, or AMA Queensland directly can then be raised at Council meetings with feedback provided to you.

Over the next few months our Council will be approving the final Health Vision goals for the Association. These will complement the Association’s values of compassion, trust and knowledge and will deal with areas like end-of-life care and workforce capacity.

I would like to extend a sincere welcome to the new Board and Council. I look forward to the next year and what we will be able to accomplish. Q

Federally, AMA President, A/Prof Brian Owler, has spoken about AMA’s opposition to the co-payment...

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AMA Queensland NEWSnews national conference

NEW AMA PRESIDENT Sydney neurosurgeon, Associate Professor Brian Owler has now taken over from Dr Steve Hambleton as Federal President of the AMA.

Who has inspired you as a doctor? Tell us about them in our Unsung Heroes segment at editor@ amaq.com.au.

A/Prof Owler is a driving force behind a successful anti-speeding campaign and is a prominent campaigner for stronger laws to minimise alcohol-related violence, and greater community education about the health harms caused by alcohol abuse.

He also actively promotes the benefits of vaccination. Q

DR QUIN HONOURED

WEBSITE WINNERS

In the March edition of Doctor Q, we featured an Unsung Heroes story on Dr Bernard Quin, a GP who was killed in WWII while caring for the people of Nauru.

AMA Queensland’s redeveloped website and Health Vision blog won the most Innovative Use of Website or New Media award at AMA’s National Conference in May.

Local GP Dr Angie Ryan has worked tirelessly with Dr Quin’s family to have his sacrifice acknowledged, particularly as the Australian War Memorial could not formally recognise Dr Quin’s efforts as he was not a serving member of the Australian Armed Forces at the time of his death.

Dr Hambleton presented the President’s Medal to Dr Quin’s son Peter, on his family’s behalf, while Dr Quin’s children, grandchildren and great-grandchildren were in attendance (pictured above).

“It is fitting for the AMA to offer him proper recognition and to uphold Dr Quin as an exemplar of the provisions of the Declaration of Geneva, by which a doctor pledges to consecrate his or her life to the service of humanity,” said Dr Hambleton.

“We are proud and honoured to recognise his exceptional service as a medical practitioner – his selfless commitment and devotion to the people of Nauru embodies what it truly means to be a doctor.”

Dr Hambleton said that, in honouring Dr Quin, the AMA also paid tribute to “those members of our profession who have put their patients’ needs above their own in order to provide ongoing care for others, and who have never been formally acknowledged”. Q

We have had great feedback on the improved site, which Dr Hambleton said was “fresh, vibrant, and easy to navigate”.

Blog contributors have written about endof-life care, workforce and training, public and preventive health, creating a unified health system, and reprioritising care in response to changing demands.

Dr Hambleton commented: “The new Health Vision Blog site developed by AMA Queensland has made a space for the medical community to converse and share views on important health care challenges.

“The space provided for feedback and discussion is highly valued by users, and is a source of great insight for AMA Queensland in helping it to keep up with issues of importance to the medical profession,” he said. Q

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DoctorQ JULY 2014

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People & EVENTS

For a complete overview of the new AMA Queensland Councillors turn to page 22

PRESIDENTIAL INAUGURATION The AMA Queensland Council and guests turned out to see Dr Shaun Rudd installed as 2014 - 2015 President at the Royal on the Park Hotel. Q

AWARDS AMA Memorial Prize Dr Nicholas Gattas William Nathaniel Robertson Prize Dr Lisa Major Harold Plant Memorial Prize Dr Matthew Cheng John Bostock Prize in Psychiatry Dr Rachele Quested

ABOVE: Dr Larry Gahan provided a moving tribute to Dr Humphry Cramond MBE OAM

Lilian Cooper Prize Dr Nicholas Gattas AMA Medal of Achievement – James Cook University Noah Freelander

AMA Queensland Children’s Health Prize – Griffith University Gemma O’Leary AMA Award of Distinction Ms Maree Campbell AMA Award of Distinction Mrs Maureen Curran Citation of the Branch Dr Frank New Citation of the Branch Dr Philip Allen President’s Award Dr Ross Cartmill

AMA Queensland Child Health Prize – Bond University Ali Eqbal

ABOVE: Health Minister Lawrence Springborg with newly installed President Dr Shaun Rudd

AMA Queensland Vice Presidents Dr John Lee, Professor Tess Cramond AO OBE OStJ, Professor Joan Lawrence AM and Dr Charles Roe AM.

ABOVE: Dr Lisa Major, Rhys Thomas, Mikaela Seymour, Dr Campbell Schmidt and Dr Lisa Byrom

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BELOW: Attending members of the 2013-2014 Council

DoctorQ JULY 2014

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People & EVENTS

ABOVE: The AMA Queensland team (including Dr Sharmila Biswas) meet with representatives of the Gurriny Yealamucka Health Service in Yarrabah.

MEMBER VISIT TO THE FAR NORTH President Dr Shaun Rudd, AMA Queensland Councillor Dr Dilip Dhupelia and CEO Jane Schmitt flew north to visit members in Cairns and Cooktown. More than 40 members attended cocktails at the Cairns Holiday Inn to discuss issues facing the medical profession, specifically in Far North Queensland.

This eye-opening trip enabled the trio to visit Indigenous communities such as Hope Vale and Yarrabah and get a better understanding of health care in regional and rural Queensland. Dr Rudd is looking forward to undertaking many more regional visits over the coming year. Q

ABOVE: Dr Shaun Rudd and Workplace Relations Manager Andrew Turner meet with Dr Tash Coventry and Leslie Jacobus at the Hope Vale Clinic.

ABOVE: Dr Rudd meets with media in Cairns.

LEFT: Dr Dilip Dhupelia (far left) and Dr Shaun Rudd (far right) with Dr Des Hill, Dr Alistair Frame and Dr Tash Coventry in Cooktown.

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DoctorQ JULY 2014

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Feature story

NEW PRESIDENT:

DR SHAUN RUDD DR SHAUN RUDD WAS SWORN IN AS PRESIDENT AT THE RECENT PRESIDENTIAL INAUGURATION, TAKING OVER FROM DR CHRISTIAN ROWAN. WE SPOKE TO DR RUDD ABOUT HIS PLANS WHILE IN OFFICE.

Dr Shaun Rudd on his presidency in one word: collegiality. (The relationship between colleagues explicitly united in a common purpose and respecting each other’s abilities to work toward that purpose.)

“We need stronger ties to each other where we look after each other, become more aware of what each other does and appreciate that we are all part of the same profession,” said Dr Rudd.

“Clearly one of the best ways of doing this is to belong to a common group.

The AMA is the association that gets us all together to work towards common goals.”

Growing up and training in Belfast, Northern Ireland, and emigrating to Australia in 1987, Dr Rudd said one point of difference in the United Kingdom was particularly strong collegiality.

“It’s much more difficult here, with large distances involved, doctors trained all over the world and a lack of opportunity to get together , but that just makes it all the more important.

“My plan is to encourage greater collegiality within our membership, particularly fostering that culture within our Doctors in Training. I hope to build membership and strengthen the association further.”

Dr Rudd is passionate about a unified health care system, a Health Vision topic raised by our members and explored on page 46.

He believes GPs and community care could play a greater role in patient care, leaving hospital care more suited to the very sick and injured.

T

PRESIDEN

2014-15

“Many of our patients don’t like being away from their families and in hospital and would be far more comfortable receiving care at home if it’s possible. Many patients could be discharged from hospitals earlier and put back into the care of their GP,” he said.

Discussion on unified health care brings us to our next pressing topic: end of life care. Dr Rudd is encouraged by recent conversations on end-of-life care, both from patients and clinicians.

“We need more doctors who are able to make the strong clinical decisions and talking to patients about care in their final months.

“We often practice defensive medicine and patients expect that we can fix everything. Patients are often subjected to endless testing and futile treatments instead of making their final wishes heard,” he said.

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Feature story

“The good news is, many groups seem to be working towards standardised advanced care directives, so I’m looking forward to working on that during my term.”

As far as public health campaigns go, Dr Rudd said the most obvious concern for all doctors is the obesity epidemic.

“Nobody knows how to fix it. Prevention is better than cure, because it is just so hard once patients are already overweight,” he said.

“From the cradle to the grave, I believe exercise is a great solution to people’s mental health and wellbeing concerns.

Dr Rudd practices what he preaches too: a fervent Aussie Rules player with the Hervey Bay Fruit Bats and a Queensland representative in the Queensland Masters League.

“Team sports can offer so much. It gives people a sense of belonging, mateship, belonging to a tribe and being part of a community. There is something to be gained from being a part of something bigger than yourself.

Declaration of Geneva The Declaration of Geneva was adopted by the General Assembly of the World Medical Association at Geneva in 1948 and amended in 1968, 1984, 1994, 2005 and 2006. It is a declaration of medical practitioners’ dedication to the humanitarian goals of medicine, a declaration that was especially important in view of the medical crimes which had just been committed in Nazi Germany.

“I solemnly pledge to consecrate my life to the service of humanity; I will give to my teachers the respect and gratitude that is their due; I will practise my profession with conscience and dignity;

“The fact it reduces the risk of developing chronic diseases, improves mood, boosts energy levels, encourages better sleep and keeps weight off helps too!”

The health of my patient will be my first consideration;

DR SHAUN RUDD BIO

I will maintain by all the means in my power, the honour and the noble traditions of the medical profession;

Dr Shaun Rudd graduated from Queens University Belfast in 1978. Following a number of years working in the public hospital system in Northern Ireland, he completed General Practice Vocational Training. The training included a year of General Practice in the small township of Bramhall Lane just outside Manchester, England.

In 1987, Dr Rudd immigrated to Australia where he worked for the first 11 years as a GP in Casterton, a small country town in the western districts of Victoria. Almost 15 years ago, he moved to Hervey Bay in sunny Queensland where he does three clinical days a week and works as a General Practice Liaison Officer, liaising between the Primary Care and Hospital Care Sector, the other two days.

Dr Rudd has served on the AMA Queensland Council for eight years and has served on numerous committees for International Medical Graduates, general practice and public health. He has also chaired a Public Hospital Board and been a member of a Private Hospital Board.

Outside medicine, his main interest is playing and watching team sports with a little bit of fishing thrown in. He is a passionate, proud, paid up member of the Hawthorn Football Club and still plays Masters Football in the Queensland Masters League, representing Queensland in the Veterans Team (over 55s) in interstate football. Q

I will respect the secrets that are confided in me, even after the patient has died;

My colleagues will be my sisters and brothers; I will not permit considerations of age, disease or disability, creed, ethnic origin, gender, nationality, political affiliation, race, sexual orientation, social standing or any other factor to intervene between my duty and my patient; I will maintain the utmost respect for human life; I will not use my medical knowledge to violate human rights and civil liberties, even under threat; I make these promises solemnly, freely and upon my honour.”

DR CHRIS ZAPPALA PRESIDENT-ELECT

Dr Zappala has been installed as PresidentElect for 2014 - 2015. He is a Thoracic and Sleep Physician and has served on AMA Queensland Council since 2007. Dr Zappala consults at the Royal Brisbane and Women’s Hospital, St Andrew’s Brisbane, St Andrew’s Toowoomba and The Wesley Hospital.

DoctorQ JULY 2014

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CURRENT ISSUES

PSYCHOLOGICAL INJURY: AN ORGANISATIONAL PSYCHOLOGY PERSPECTIVE RECENT RESEARCH HAS INDICATED THAT ONE IN FIVE PEOPLE ARE LIKELY TO BE AFFECTED BY MENTAL ILLNESS AT SOME POINT IN THEIR WORKING CAREER. THIS RESULTS IN APPROXIMATELY SIX MILLION WORKING DAYS LOST BY AUSTRALIAN WORKPLACES EACH YEAR DUE TO MENTAL ILLNESS. WORKPLACE RELATIONS ADVISOR LUKE DONALDSON EXPLAINS MORE ABOUT PSYCHOLOGICAL INJURY AND YOUR ROLE AS AN EMPLOYER.

LUKE DONALDSON

Workplace Relations Advisor AMA Queensland

With staggering figures such as these, it is important to understand that principals and managers have an essential role in identifying, managing and facilitating psychological stressors within the workplace.

As a minimum, employers are to have policies in place that support the mental health of their employees.

For instance, WorkSafe Australia has identified common causes of work related psychological injury attributing to: Communication difficulties between workers and managers; Bullying, harassment or intimidation; Fatigue (as a result of job demands or work schedules); Work overload and underload; Too much change; Insufficient training; No opportunity to utilise personal talents or abilities effectively; and, Lack of control over how work is done.

The majority of work-related stressors leading to psychological injury claims are not the result of a major traumatic event or critical incident. Most claims develop over long periods, often in response to the interaction of a number of work related and personal factors. Here, the effect of unmanaged workplace stressors on your practice may show up as high staff turnover, an increase in unplanned absence, workplace conflict, reduced work performance, patient complaints, staff replacement costs, and workers’ compensation claims.

You may ask, how you can manage psychological injuries in the workplace.

Psychological injuries are intangible, but only become tangible through absenteeism, de-motivation and performance and attitudinal based issues.

Most of the ‘things to do’ in managing psychological injury come down to effective management practices: 20

JULY 2014 DoctorQ

Show that you take your staff seriously when people admit to being under too much pressure; Ensure your staff have the skills, training and resources they need, so that they know what to do, are confident that they can do it and receive credit for doing it well; If possible, provide some scope for varying working conditions and for people to influence the way their jobs are done. This will increase their interest in, and sense of ownership of, their work; Ensure that people are treated fairly and consistently in line with the policies and practices in your practice and that bullying and harassment are not tolerated at work; and, Ensure good two-way communication, especially at times of change. Q

PSYCHOLOGICAL HEALTH Workers’ psychological and physical health can be adversely affected by exposure to a poorly designed or managed work environment, a traumatic event, workplace violence, fatigue, bullying or harassment and excessive or prolonged work pressures. Any of these factors can increase the likelihood of workers experiencing a stress response.

CRISIS CONTACTS Lifeline - 13 11 14 (24hr crisis hotline) www.lifeline.org.au Beyondblue - 1300 224 636 www.beyondblue.org.au

Dr Francis Tomlinson NeurosurgeoN & spiNal surgeoN

Dr Terry Coyne

NeurosurgeoN & spiNal surgeoN

Dr Geoff Askin

paediatric & adult spiNal surgeoN

Dr Richard Kahler NeurosurgeoN & spiNal surgeoN

Dr David Walker

NeurosurgeoN & spiNal surgeoN

Dr Michael Bryant NeurosurgeoN & spiNal surgeoN

Dr Steven Yang

HaNd & spiNe surgeoN

Operating Hospitals The wesley Hospital Auchenflower Holy Spirit Northside Chermside St Andrew’s Hospital Spring Hill Mater Private Hospital South Brisbane Mater Private Children’s Hospital South Brisbane Mater Children’s Hospital South Brisbane

Clinic Locations Auchenflower Spring Hill Chermside North Lakes South Brisbane

Rockhampton Ipswich Toowoomba Lismore Mackay

07 3833 2500 FAX

07 3833 2511 brizbrain.com.au

PRoud SuPPoRTeR of

Newro FOUNDATION New Ideas New Research New Hope

IN PARTNeRSHIP wITH

Queensland’s first combined neurosurgery, spinal surgery and orthopaedic practice

How the MBAQ can help you The Association provides financial assistance to help medical practitioners through crises. If you find yourself in a financial crisis, then make contact with the MBAQ to receive the application forms for assistance.

How you can help the MBAQ You may contribute to the Medical Benevolent Association of Queensland in several ways: • By becoming a member of the Association: Subscriptions - Ordinary Annual membership $30 p/a

- Life membership $50 one sum • By making a tax-deductible donation to the Association.

• By making a bequest in your Will.

• By naming the Association as the beneficiary where there is a surplus following functions such as Year Reunions or LMA Dinners.

Tragedy is unpredictable and may strike at any age in the life of a medical practitioner...

More Information Further information can be found on the MBAQ website at www.MBAQ.org.au. All donations are tax deductible.

Donate or subscribe today!

Medical Benevolent Association

of Queensland DoctorQ JULY 2014

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AMA QUEENSLAND 2014- 2015

COUNCILLORS

RESPONSIBLE FOR DETERMINING QUESTIONS AND MATTERS OF POLICY FOR THE ASSOCIATION, MAKING BY-LAWS ABOUT ETHICAL CONSIDERATIONS (INCLUDING HANDLING COMPLAINTS RELATED TO THE PROFESSION), AND MAKING RECOMMENDATIONS TO THE BOARD OF DIRECTORS ABOUT REPRESENTING THE ASSOCIATION ON ALL MATTER OF POLICY WITH GOVERNMENT OR OTHER STAKEHOLDERS, THE AMA QUEENSLAND COUNCILLORS FOR 2014 - 2015 ARE:

BOARD MEMBER

BOARD MEMBER

COUNCILLOR

COUNCILLOR

DR SHAUN RUDD

DR CHRISTOPHER ZAPPALA

DR CHRISTIAN ROWAN

MBBCH BAO (Belfast) President

MD MHM MBBS MD (Melb)(Hons) AMusA GCAE FRACP

MBBS FRACGP FARGP FACRRM FRACMA FAChAM (RACP)

Specialty: General Practice

President-Elect

Immediate Past President

Specialty: Thoracic and Sleep Physician

Specialty: Addiction Medicine

Dr Chris Zappala achieved his MBBS at the University of Queensland and underwent his advanced training at the Royal Brisbane.

Dr Zappala worked for two years in London at the Royal Brompton Hospital where he began his interest and research in interstitial lung disease and secondary pulmonary hypertension. His research interests include examining how change in serial pulmonary function and chest imaging describe disease behaviour and predict survival in interstitial lung disease. Dr Zappala is a Physician Partner at Genesis SleepCare and consults at the Royal Brisbane and Women’s Hospital, St Andrew’s Brisbane, St Andrew’s Toowoomba and The Wesley Hospital.

Dr Rowan is a graduate of the University of Queensland. He has completed Fellowships with the Royal Australasian College of Physicians’ Chapter of Addiction Medicine, the Royal Australian College of General Practitioners, the Australian College of Rural and Remote Medicine and the Royal Australian College of Medical Administrators.

He is employed in both public and private practice, has an appointment with Griffith University and is the Executive Director of Medical Services at St Andrew’s War Memorial Hospital in Brisbane.

Dr Rudd has been practising as a GP for 27 years and is currently based in Hervey Bay. He enjoys all areas of General Practice and has been a representative on AMA Queensland Branch Council for the past eight years. He has also served as the AMA Queensland Honorary Secretary from 2007-2008; Chair of the AMA Queensland International Medical Graduates Committee and Chair of the General Practice Liaison Officer State Committee.

“To represent and serve the members of our Association, to continue to build a strong membership and financial base that provides us with a powerful lobbying platform.”

Additionally councillors have an internal role to assist the Member Relations Department, along with other Departments within the Secretariat, including welcoming new AMA Queensland members 22

COUNCILLOR

JULY 2014 DoctorQ DoctorQ

“I’m interested in re-establishing the central importance of the member focus of our organisation and I want AMA Queensland to be a pro-active and positive participant in health reform.”

“My intention is to ensure the independence and integrity of the medical profession. I believe in representing the interests of all patients both urban and rural and the medical staff who care for them.”

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COUNCILLOR

COUNCILLOR

DR TOM ARTHUR

DR SHARMILA BISWAS

BSc MBBS GradDipAppAnat

MBChB DCH

Greater Brisbane Area Representative

Far North Area Representative

Specialty: Surgery

Specialty: General Practice

“I have a strong interest in the adequate training and ongoing education of doctors, with a focus on pre-vocational education and technical skills. I’m a firm believer in the importance of AMA to the medical profession, and see my role as councillor to encourage greater interaction and engagement from the medical practitioners in my region.”

“My intention as a Branch Councillor is to support and maintain the integrity of the profession, maintain standards and advocate for the delivery of services to patients using best practice in all areas. My primary interest is to raise the profile of the regions.”

COUNCILLOR

DR KIMBERLEY BONDESON BSc (Hons) MBBS FRACGP DAME Greater Brisbane Area Representative Specialty: General Practice, Aviation Medicine “To represent the views and voices of the doctors in the Greater Brisbane Area. This includes both public and private doctors, specialist and general practitioners, and doctors in training. To ensure that concerns of our patients and the public are listened carefully to, and to advocate for those who do not have a voice.”

BOARD MEMBER

BOARD MEMBER

COUNCILLOR

COUNCILLOR

COUNCILLOR

DR BILL BOYD

DR THOMAS CAMPBELL

DR DILIP DHUPELIA

MBChB (Dundee) FRACOG FRANZCOG

MBBS DPhil

Capricorn Area Representative

Greater Brisbane Area Representative

LRCPS (Ire) Dip Obst ACOG FRACGP FARGP FAICDA FRACMA

Specialty: Obstetrics and Gynaecology

Specialty: Opthalmology

Part Time Medical Practitioner Craft Group

Dr Boyd will return to Chair of AMA Queensland Council.

“I’m passionate about advocating on behalf of both patients and doctors, and because I value the AMA Queensland’s tireless efforts to ensure that we all benefit from an excellent health care system.”

“I am delighted to have the opportunity to take part in the many and varied activities of AMA Queensland on behalf of our members.”

I look forward to working within a wide ranging team and hopefully add value to the fine work already being performed in representation, leadership and advocacy.

Specialty: General Practice “Having had extensive medical experience in both the public and private sectors, as well as within the Federal and State Government sectors, I have a good grasp of health improvement strategies within the national health reform environment in areas such as integration of primary and secondary services and ensuring holistic care within a seamless patient journey. I look forward to working within a wide ranging team and hopefully add value to the fine work already being performed in representation, leadership and advocacy.”

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Feature story

COUNCILLOR

COUNCILLOR

COUNCILLOR

COUNCILLOR

DR VANESSA GRAYSON

DR JOHN HALL

DR NOEL HAYMAN

DR WAYNE HERDY

BSc MBBS

MBBS BSc (Hons) FRACGP FACRRM DRANZCOG (Adv) GradDipRural Dip ACSCM

BSc App MBBS MPHFAFPHM (RACP) FRACGP

MBBS BA (Hons) LlB LlM FACLM

Greater Brisbane Area Representative

North Coast Area Representative

Residents and Registrars Craft Group Specialty: Emergency Medicine “I hope to improve the understanding of our members on the issues that are impacting on their working conditions and future training opportunities. I look forward to ensuring that the Queensland DiTs are well represented within AMA Queensland.”

Downs and West Area Representative Specialty: Rural Procedural Medicine and General Practice “I will help advise Council on issues affecting rural Queenslander’s health and their healthcare teams.

I will highlight important issues including the strengthening of the rural healthcare workforce, access to essential healthcare for rural Queenslanders, including quality primary care, emergency services, inpatient care and maternity services, and strengthening access to specialty services.”

Specialty: General Practice

Specialty: Public Health and General Practice “Indigenous health: I believe we can do so much better in this area if we all work together. I would love to see more Indigenous students studying medicine – if I can do it, anyone can.”

“I aim to represent the views of my constituents to Council; to promote patient safety especially by diminishing role substitution and developing task delegation; and to assure the future of young graduates by promoting best education and best career prospects.”

I hope to be an active voice for all our colleagues, and encourage our members to contact me at any time.

BOARD MEMBER

COUNCILLOR

COUNCILLOR

COUNCILLOR

DR BRAD HORSBURGH

DR SHARON KELLY

DR RICHARD KIDD

DR LUKE LAWTON

MBBS FRANZCO FRACS

MBBS (Hons), FRACS

BHB MBChB Dip Obs FAMA

Specialist Craft Group

General Practitioner Craft Group

BAppSc MBBS (Hons) MPH FACEM

Specialty: ENT Surgery

Specialty: General Practice

North Area Representative

“As a specialist practicing in both public and private sectors I am well placed to advocate for a wide variety of specialists and particularly, for visiting medical officers, without whom public hospitals could not run. The doctors in these hospitals have recently experienced unprecedented changes in funding and administration. On behalf of AMA Queensland I will continue to advocate for these doctors and the vital services they provide for patients.”

“I intend to work for doctors to be free and safe to practise and teach medicine to the highest standards and thereby promote patient and community good health.”

Greater Brisbane Area Representative Specialty: Ophthalmology “As a VMO ophthalmologist, I have experienced firsthand, the fact that there has been no material increase in public ophthalmology services at the Royal Brisbane in 25 years. There are no public ophthalmology services between Townsville and Nambour.

I want to see our Association encourage the Health and Hospital Services throughout the state to assist and support enthusiastic young consultants who wish to work in the public hospital system.”

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COUNCILLOR

JULY 2014 DoctorQ DoctorQ

Specialty: Emergency Medicine “With current external pressures on medical practice I believe it is more important than ever to engage our profession in the formulation of healthcare policy, particularly for regional areas. I hope to be an active voice for all our colleagues in North Queensland, and encourage our members to contact me at any time with their concerns.”

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BOARD MEMBER

COUNCILLOR

COUNCILLOR

COUNCILLOR

COUNCILLOR

DR KELLY MACGROARTY

DR BAV MANOHARAN

DR JOHN MURRAY

DR PAUL NEESKENS

MBBS BSc

MBBS FFARACS

MBBS MClinEpi GAICD

MBBS FRACS FAOA

Gold Coast Area Representative Specialty: Surgery

Full Time Salaried Medical Practitioner Craft Group

General Practitioner Craft Group

Specialist Craft Group Specialty: Orthopaedic Surgery “As an AMA Queensland Council member, I will focus on assisting the President to improve relationships between general practice and the surgical disciplines. I would like to help improve access to hospital services for all patients, in particular, prompt specialist review and treatment. I will also endeavour to strengthen our commitment for training opportunities in the surgical specialities for the next generation of doctors.”

“We need to work to improve the quality of and fair access to training and education in both the prevocational and vocational arenas, including, ensuring training is affordable to trainee doctors, and that working conditions and awards are protected and enforced. We need to ensure fair and transparent processes for allocation of both prevocational and vocational positions.”

BOARD MEMBER

“To see that the issues impacting on full time salaried staff in Queensland hospitals continue to receive the same prominence in AMA Queensland deliberations as those matters impacting on GPs and VMOs.”

COUNCILLOR

DR KIRSTEN PRICE

DR JOSIE SUNDIN

MBBS MBA FRACGP GAICD

MBBS FRANZCP FFFP Fellow Faculty of Forensic Psychiatrists

Specialty: General Practice

Greater Brisbane Area Representative

“The AMA has a powerful voice, and we must ensure that we work constructively toward outcomes are real and useful. I am pleased to do my part to achieve the best possible healthcare for Queenslanders, including assuring sustainable high quality training for our junior colleagues.”

Specialty: Psychiatry “I have a long standing interest in medical ethics and the interface between medicine and the law. I have a keen interest in fostering good relationships and mutual knowledge between these two professions. I hope to help in the areas of natural justice, advocacy and education.”

Specialty: General Practice “As a family GP with an interest in epidemiology, I hope to bring to Council insights from 27 years of General Practice in a regional community, insights from my recently completed study of Epidemiology and insights from 18 years of involvement with Divisions of GP. I feel it is critical for the AMA to bring together the wide array of medical practitioners -public, private, generalist, specialist, students, doctors in training, academics, full time, part time and retired. I feel it is important for all practitioners to work together in the pursuit of good outcomes for the profession, for the community and our patients. ”

COUNCILLORS

BOARD MEMBER

COUNCILLOR

General Practitioner Craft Group

Specialty: Anaesthesia

For a complete overview of each Council member, please see the AMA Queensland website (www.amaq.com.au), under the About Us section.

The AMA Queensland Council are here to serve and represent you, our members. If you wish to contact any of our Council members, please contact them through our Personal Assistant to President and CEO Erica Judd on (07) 3872 2222 or email e.judd@amaq.com.au.

MANY THANKS AMA Queensland would like to thank the following members who have stepped down from Council this year: Drs Mason Stevenson,

David Alcorn

Carl O’Kane

Alex Markwell

Jonathon Shirley

Ben Duke

Larry Gahan Their time and service on the 2013 - 2014 Council and to the Association was greatly appreciated.

DoctorQ JULY 2014

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CURRENT ISSUES

NO SECRETS IN A COUNTRY HOSPITAL

WHAT HAPPENS WHEN LOVE STRIKES OVER SCRUBS AND SCALPELS? YOU CAN COUNT ON ONE THING, AND THAT IS YOUR COWORKERS FINDING OUT. OUR ETHICS AND MEDICO-LEGAL COMMITTEE HELP OUT A LOVESICK SUPERVISING CONSULTANT. Dear Amorous, Dear Ethical Agony Aunt, I am a recently qualified consultant working in a regional hospital.

I’m supervising a very talented registrar who has just started a year-long rotation at the hospital.

Understandably, we work very long hours together and in a short space of time we developed a really strong rapport. We work well together but we also make each other laugh. A few days ago we found ourselves alone at the end of a long shift, we went out for a drink and ... one thing led to another.

I haven’t met someone who I like so much in a very long time, and I’d like to turn this into a real relationship, but I’m unsure about how it will impact on my professional conduct and how I might handle any conflicts that arise.

What do you think – can I take it to a second date?

Amorous

DO YOU HAVE AN ETHICAL ISSUE? The experts from our Ethics and Medico-Legal Committee answer your ethical dilemmas. Send your ethical dilemma to policy@amaq.com.au.

It’s something of a tradition that people fall in love in the workplace; especially in medicine. Think of all those famous or perhaps more accurately infamous hospital romance books that clog up second-hand book-store shelves.

Such romances are more likely to happen when you are working long hours or are at a distance from your usual circle of friends and family.

No one is opposed to you falling in love, but a real relationship is based on foundations of respect and equity.

Trying to supervise someone you are involved with, simply doesn’t work. Being a boss or a supervisor requires you to teach, to guide, to form judgements and if necessary provide negative feedback to your registrar.

It is by definition an unbalanced relationship; a relationship where the supervisor has more power. Your love interest is unlikely to appreciate or benefit from this experience if the supervisor is his partner.

In addition, imagine the reactions of his peers or yours should the relationship come to light. As we know, hospitals are gossipy places. I doubt your relationship would remain secret for long. Your partner and you would be vulnerable to accusations of favouritism and bias.

I suggest that you explain all of this to your registrar and arrange an alternative supervisor as soon as possible.

If there is no suitable colleague on the grounds, I suggest you contact a city

based colleague and ask them to provide supervision via video, telephone and if possible through intermittent onsite visits with your registrar.

If this does, in the future, develop into a relationship, you will also need to disclose this to colleagues to ensure transparency and open communication in the workplace.

You should also turn your mind to potential outcomes if the relationship does not work out – how will you both continue in an amicable working partnership?

So no second date until you have made appropriate arrangements. Remember, a pleasure delayed can be a pleasure enhanced.

Best wishes, Your Agony Aunt Q

No one is opposed to you falling in love, but a real relationship is based on foundations of respect and equity.

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FOUNDATION

On any given night in Australia, 1 in 200 people are homeless?

In Queensland alone, it’s estimated that nearly 20,000 people are homeless?

40% of them are between 12-34 years old, and more than 17% are children under 12 years old?

Contrary to popular perception, only 3% of them are homeless because of mental health and substance abuse issues?1 The two biggest causes of homelessness in Queensland are financial difficulties and domestic violence and relationship issues.1 The rate of homelessness in Cairns is the highest proportion of Australia’s 18 major cities, with an estimated 2,300 people without a home2.

DONATE ONLINE TODAY AT www.amaqfoundation.org.au

1 Homelessness Australia (http://www.homelessnessaustralia. org.au/index.php/about-homelessness/homeless-statistics) 2 Australian Government ‘State of Australian Cities 2013’ report

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CAIRNS HOMELESS STILL NEED YOUR HELP Thank you to everyone who has donated to the Foundation’s end of financial year Tax Appeal—we’re delighted to announce that more than 80 members have donated money towards a new street van for Rosies’ Cairns outreach program. We are now more than half way, so don’t miss your chance to help provide critical support to those most vulnerable in our community.

children would have no food, youth unable to connect with their families would have no-one to talk to, and women who are victims of alcohol and domestic violence would have nowhere to go. Socially isolated men both young and old, the Indigenous peoples far from their homelands, and anyone in need of medical attention exacerbated by hunger would continue to suffer,” she said.

Local GP and AMA Queensland Far North Area Representative, Dr Sharmila Biswas, is familiar with the homelessness epidemic reportedly taking over in the city she has called home for 20 years. “It’s a very, very complex social challenge”, says Dr Biswas.

“Homelessness is not just about being without a secure house or shelter, it’s an extreme form of social disadvantage and moreover, social exclusion. The impact is not only felt by the individual, but the community as a whole”.

Dr Biswas has witnessed first-hand the increasing numbers of those who rely on the van, not only for basic needs such as food, drink, emergency clothing, and blankets, but also to feel some connection with the community around them. “For a short time they feel welcomed rather than shunned, and are treated with dignity and respect.

The street outreach van is quite literally a life saver for these people.”

For those forced to sleep on the city’s streets, survival is knowing where to get a feed or a hot drink, a blanket or a bed, or the savvy to avoid the dangers that surround them out in the open with no shelter or protection.

Dr Biswas firmly believes that without the presence of Rosies’ street outreach van in Cairns, many of the homeless wouldn’t survive. “Neglected and disadvantaged

The outreach program has been operating in Cairns since 1990, leading teams of volunteers onto the streets to provide vital services, and most importantly a listening ear to those who society excludes. At all times the aim is to encourage self-care and self-determination in all patrons. A new, larger and fully fitted out van will allow the program to continue and grow, enabling them to better support those who need help most. Q

FOUNDATION

MDA NATIONAL SUPPORTS THANK YOU DOCTOR CAMPAIGN Nearly every doctor will at some stage receive a gift from a thankful patient, which can raise ethical and medico-legal issues.

This is why MDA National is supporting the AMA Queensland Foundation’s Thank You Doctor campaign which offers doctors the opportunity to receive gifts from patients without transgressing ethical and professional boundaries, while supporting a worthwhile cause.

CONSIDER THIS SCENARIO An elderly palliative care patient hands you an envelope containing $1,000 in cash. You refuse to accept the gift and she gets very upset. She tells you she wants you to have it because she’s so grateful for the exceptional care you provided to her over the years.

What should you do?

The patient clearly respects and admires you, and feels the best way she can show her appreciation is by a gift of money. However, a cash gift of this size cannot be considered a token gift. If someone in the patient’s family raises a concern about the gift, or reports the matter to AHPRA, you could be accused of breaching the Medical Board of Australia’s

Good Medical Practice: A Code of Conduct for Doctors in Australia which states: Good medical practice involves… 8.12.2 Not encouraging patients to give, lend or bequeath money or gifts that will benefit you directly or indirectly.

SO HOW CAN YOU DECLINE A GIFT WITHOUT OFFENDING YOUR PATIENT? Explain that although the thought is kindly appreciated, you are unable to accept the gift for reasons of ethical and professional conduct. As a constructive alternative, you may also suggest the patient donate the money to a worthy charity you both support.

CONTRIBUTING TO THE THANK YOU DOCTOR CAMPAIGN Patients can choose to make a donation to the Thank You Doctor campaign and request an appreciation letter to be sent to their doctor regarding the donation made to thank them. The Foundation has achieved many successes in supporting doctors’ health and wellbeing as well as relieving sickness, suffering and disability among patients. Q

RED HILL SS ENJOYING THEIR HOT WHEELS It is now just over a year since Red Hill Special Needs School received their new bus, thanks to the generosity of Sullivan Nicolaides Pathology and the AMA Queensland Foundation.

Principal Pamela Stack said access to the mini bus through Sullivan Nicolaides Pathology has enabled individual classes to engage in regular programs which support and enhance curriculum, such as visiting the library or the gym, or going to a school camp. Q ABOVE: Weekly horse-riding lessons at the McIntyre Centre which strengthens the students’ core muscles, improving their posture and coordination and increasing their joint mobility.

DOCTORS DOING GOOD

Do you have a project which needs financial assistance?

Contact Colleen Harper, Foundation Manager: Phone: (07) 3872 2204 Email: c.harper@amaq.com.au Website: www.amaqfoundation.com.au

This article is provided by MDA National. They recommend that you contact your indemnity provider if you have specific questions about your indemnity cover.

DoctorQ JULY 2014

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Feature story

AU$TERE BUDGET MAY CAUSE PATIENT PAIN ON MAY 13, 2014, FEDERAL TREASURER JOE HOCKEY PRESENTED HIS BUDGET TO THE AUSTRALIAN PARLIAMENT. AS EXPECTED, IT WAS A TOUGH BUDGET THAT CONTAINED A NUMBER OF MEASURES WHICH WILL HAVE A SIGNIFICANT IMPACT ON THE FUTURE OF HEALTH SERVICE DELIVERY IN AUSTRALIA. POLICY OFFICER LEIF BREMERMANN TAKES US THROUGH THE POTENTIAL CHANGES. Perhaps the most controversial decision was the proposed introduction of co-payments on GP visits. This was no surprise given that the National Commission of Audit report, delivered almost two weeks earlier, had called for the introduction of a GP co-payment.

Whereas the Commission’s report had called for a $15 co-payment ($5 for concession card holders) up until the safety net threshold was reached and a $7.50 co-payment thereafter ($2.50 for concession card holders), the Budget opted to set the co-payment at $7. A new Low Gap Incentive of $6.20 will replace bulk billing

incentives for providers of these services. The Low Gap Incentive will be paid to providers where they provide services to patients with concession cards or children under 16 years of age and only charge the $7 patient contribution - for the first 10 services in a year, or where they charge no patient contribution for additional services in that year.

Although the Audit Commission recommended a co-payment be used to make Medicare more sustainable, the Government decided to use $5 from the copayment to establish a $20 billion Medical Research Future Fund; the remaining $2 goes directly to GPs. Health Minister Peter Dutton explained Government modeling showed the measure would slightly reduce the growth in GP visits and that the $2 doctors will receive would deliver them $468m over the next four years. However the co-payment ignores the fact that many patients are already paying substantial co-payments for other services.

Many visits combine these services, so the co-payment may actually be $14 or $211.

efficiency, arguing that since the Federal Government does not run hospitals, it is not best placed to drive efficiency improvements within them. By “reshaping” the National Health Partnerships Agreements (NPAs) signed between the Federal Government and the States under the previous Labor Government, the Commonwealth expects to save at least $1.8 billion over four years.

Another $1.3 billion over four years will be clawed back as the government stops compensating states for services used by Commonwealth-provided concession cards.

An additional $390 million will be pulled from dental funding arrangements with the states. Billions of dollars in funding tied to expiring NPAs is also being wiped from state budgets, although some states had expected this to occur.

State Governments of all political stripes are concerned. Queensland Treasurer Tim Nicholls, speaking before he handed down his State Budget on 3 June, said “We’ll obviously have to adapt… and make changes

The AMA recognises the Government’s priority is to achieve a budget surplus, but it should not be achieved by costing health services out of the reach of ordinary Australians.

Co-payment supporters argue unless the growth in spending on doctor visits is curtailed, savings will have to be found in other areas of the health system including public hospitals2. Yet despite the co-payment’s inclusion in the Budget, the Commonwealth will also remove billions of dollars of funding for public hospitals around Australia. The budget papers explain this measure as a drive for 30

JULY 2014 DoctorQ

to some aspects of [Queensland’s budget].

It’s made the job a bit tougher.” However, the Federal Budget appears to have had little impact on the 2014-15 Queensland Budget, at least insofar as spending on health is concerned. Although it reflected cuts to health concession schemes, such as in oral health, overall spending in the health portfolio increased to $13.6 billion3, up from $12.3 billion the previous year. It is important

Feature story

to note, however, that the biggest Federal cuts to State health budgets are expected to occur from 2017 onwards, at which time the Federal Government will index public hospital funding by a combination of growth in the Consumer Price Index and population.

At time of writing, it is unclear precisely how this will proceed.

The Budget also ended funding for the Prevocational General Practice Placements Program, which aims to attract doctors to rural general practice. Funding for this program will end in December 2014.

There is some good news, however. The Federal Budget doubled the Practice Incentives Program teaching payment for doctors and practices providing training to medical students and young doctors - a cost of $238.4 million. It also committed $52.5 million to infrastructure funding for rural and remote practices, and will make another 300 GP training places available.

The AMA expressed disappointment with the Budget. In regards to co-payments, outgoing AMA Vice President Geoffrey Dobb explained some of these concerns, saying “There is a place for co-payments for patients with the right model – but this is not the right model. There will also be a greater red tape burden on general practice without adequate compensation.”

On the changes to the National Health Reform Funding Agreement, Professor Dobb was concerned that it will create uncertainty in the states and territories about public hospital funding. “State budgets will be in danger of being overrun by public hospital cuts. Patient will have longer waits for public hospital services. Put together, the cuts and co-payments threaten fairness and equity in the health system. The AMA recognises the government’s priority is to achieve a budget surplus, but it should not be achieved by costing health services out of the reach of ordinary Australians.”

AMA Queensland Immediate Past President Dr Christian Rowan echoed Professor Dobb’s statement that the immediate impact of the budget will be hardest felt by the most vulnerable populations. “Vulnerable populations who are most reliant on the health care system, such as low income families and patients with chronic illnesses, will be the most affected by the changes to the budget,” Dr Rowan said. “The last thing we want is for patients to forgo medical treatment because of a financial barrier.

We are afraid that the current budget will shift the cost to the patient and limit the accessibility of our health care system. Some of the initiatives announced last night will have long term benefits such as reforms to Medicare Locals and increased investment in medical research. While we welcome these investments, we need to also focus on the immediate impact for patients.”

Although there were some welcome changes for health in the Budget, it is clear that the

overall reaction to the Federal Budget has certainly been poor, with reliable opinion polls like Newspoll showing a sharp drop in support for the Abbott Government4. The Government also faces a tough battle getting many of their budget measures through the Senate; for example, Labor, the Greens and the Palmer United Party have all expressed their intent to block the introduction of co-payments. So it is highly likely the Government will need to make significant concessions on many of its Budget initiatives before they become reality.

If the Government is able to introduce measures like the co-payment into the Australian health system, it will be a watershed moment in Australian history.

Your AMA will continue to actively take the views of doctors to Government so that all Australians can access health care when they need it. Q

1 Medical Journal of Australia 200 (10), 2 June 2014, p.566 2 http://www.theaustralian.com.au/national-affairs/budget-2014/gps-told-use-windfall-to-help-needy/story-fnmbxudx-1226919494529# 3 This includes the budget for the Queensland Ambulance Service (QAS), which became part of Queensland Health in October 2013. If the QAS component is removed, total health spending has increased to $13.1 billion.

4 http://www.theaustralian.com.au/national-affairs/tony-abbott-pinned-down-by-budget-newspoll/story-fn59niix-1226940801911# DoctorQ JULY 2014

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Feature story

A WOMAN WITH EVERYTHING TO LIVE FOR

AHEAD OF THE WOMEN IN MEDICINE BREAKFAST, GUEST SPEAKER TURIA PITT RECENTLY TOOK THE TIME TO CHAT WITH AMA QUEENSLAND ABOUT HER BOOK, HER RECOVERY AND THE IMPORTANCE OF ENJOYING LIFE.

Q Reading your book, it struck me how quickly your life changed.

It did and it’s crazy to think that the fire was really only a couple seconds of my life and yet it had such a profound impact – it turned my life upside down.

Q But it sounds like you have had a great support team behind you.

I’m so lucky. I have the best support network ever- not only my partner Michael and my mum, but the town of Ulladulla where I grew up. Even the local teams like physios and therapists, they all go above and beyond. It’s a good feeling to have the whole community behind you.

Q One of the most striking things is how positive you’ve been. How do you handle the more challenging days?

I don’t try to cheer myself up. I just think I’m having a bad day, and that’s actually okay. It’s not realistic for us to feel okay all the time. I’m sure you have bad days, my mum has bad days, Michael has bad days.

Tomorrow will be better.

Q In the past few years, you’ve also gotten involved with Interplast, what motivated you to do that?

I’ve always been involved in charities but I found out about Interplast through my plastic surgeon – my burns surgeon – because he volunteers for them annually. I’m actually their official ambassador now.

Q You mention in your book that you don’t think you would have survived if the fire had occurred in a less developed nation.

There is no way I would have survived.

I wouldn’t have had any medical treatment. These guys don’t get treated, so a relatively small burn contracts and it is quite horrific – I would have died and that’s pretty sobering.

I went to Laos [with Interplast] and the doctors and nurses work so hard. They work up to 20 hours a day in the worst conditions. I know we all like to have a go at politicians, but I had the best medical treatment money can buy – all due to the doctors in Australia and our government.

Q How do you think you’ve changed since the fire?

INTERPLAST Interplast is an organisation that provides free reconstructive surgery to adults and children in developing nations. If you’re interested in volunteering with Interplast, visit interplast.org.au for more information.

I probably didn’t enjoy life as much as I do now. That sounds weird, but I didn’t take the time to stop and smell the roses. I was always go go go. I’ve learned to relax now – I stressed a lot before.

Q Your story has impacted a lot of people.

Have you been surprised with the reaction you’ve received?

I don’t really think about it, I’m just getting on with it as I’ve always done. But if my story helps people in their life, that’s really great and special and I’m very thankful for that. Q

Q How have your experiences prepared you for your work with Interplast?

I suppose comparing previous fundraising efforts to my efforts now, it’s really hard to raise money when you haven’t had that personal experience. Now after what I’ve been through and my personal connection to Interplast, it’s made it so much easier and I’ve been able to make such a difference.

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JULY 2014 DoctorQ

Everything to Live For Turia’s inspirational story can be found in her book Everything to Live For which retails for $35 at all good book stores.

WEDNESDAY 6 AUGUST, 7AM

MODA PORTSIDE, 39 HERCULES ST, HAMILTON

Many are familiar with Turia Pitt’s story of recovery and persistence. The former mining engineer and model was participating in an ultra-marathon in WA when she and five other runners were caught in a rapid grassfire.

Suffering burns to over 65 per cent of her body, Turia’s long recovery has included over a dozen surgeries and countless hours of rehabilitation.

Though the injuries sustained were devastating, Turia’s story is one of hope. She demonstrates how much can we can overcome with a fighting will, a positive attitude and a strong support network.

Turia serves as an ambassador for Interplast, an organisation that provides free reconstructive surgery to those in developing nations.

She was also recently named the NSW Premier’s Woman of the Year and was a 2014 finalist for Young Australian of the Year.

FRE BOO E K

Rece ive of Tu a FREE co py Every ria’s bo ok, thing t on ar o Live For r i val RRP

Turia is currently training for three upcoming events: the 20km Lake Argyle Swim, the Variety Cycle from Sydney to Uluru and a section of the Great Wall of China – all to raise money for Interplast.

Every woman, whether in her personal or professional life, is bound to face times of change and challenge. Thriving during these challenging times is only possible with resilience, perseverance and determination. We’re honoured to have Turia Pitt as our special guest presenter for the annual AMA Queensland Women in Medicine Breakfast, and look forward to hearing her discuss:  Her own experiences of recovery and perseverance after sustaining devastating injuries in a 2011 grassfire  Coping with all aspects of change and approaching it with positivity  The importance of hope and determination in the face of adversity

$35.00

TICKET PRICE: $70 AMA Queensland member (Includes staff in a member practice) $80 Non-member $65 Medical students and DiTs (AMA Queensland members only) $650 Member table of 10 (inc. GST) $750 Non member table of 10 (inc. GST)

CONTACT: For further details phone (07) 3872 2222 or to register email registrations@amaq.com.au

DoctorQ JULY 2014

33

AROUND THE REGIONS

LOCAL MEDICAL ASSOCIATION ROUND UP

JOIN YOUR LMA

STAY CONNECTED WITH COLLEAGUES AND UP TO DATE WITH THE LATEST HEALTH NEWS AND ISSUES AFFECTING YOUR LOCAL AREA. DON’T STAND ON THE SIDELINES —JOIN YOUR LOCAL MEDICAL ASSOCIATION TODAY AND MAKE A DIFFERENCE.

SUNSHINE COAST

CENTRAL QUEENSLAND

REDCLIFFE & DISTRICT

Monthly dinner meetings are generally held on the fourth Thursday of each month.

For information on meeting dates and membership contact Central Queensland LMA Secretariat Dr Harley Wilson.

Next meeting: 30 July and 26 August

Convenor: Jo Bourke

Phone: 0419 277 611

Convenor: Margaret MacPherson

Phone: (07) 5479 3979

Email: harleywilson00@gmail.com

Phone: (07) 3121 4043

Venue: Maroochydore Surf Club

Venue: Golden Ox Restaurant, Redcliffe Time: 7pm for 7.30pm

Fax: (07) 5479 3995 Email: jobo@squirrel.com.au For further information or to join visit www.sclma.com.au

BUNDABERG For information on meeting dates and how to join, contact Bundaberg LMA President, Dr Daud Yunus.

CAIRNS

Phone: (07) 4152 2888

For information on meeting dates and membership contact Cairns LMA President Dr Sharmila Biswas.

Fax: (07) 4153 3245

Phone: (07) 4036 4333

TOWNSVILLE For information on meeting dates and membership contact Townsville LMA President Dr Carl O’Kane.

Phone: (07) 4433 1111

Email: daud.yunus@gmail.com

TOOWOOMBA & DARLING DOWNS For further information, go to www.tddlma. org.au or email info@tddlma.org.au Membership to the Toowoomba and Darling Downs LMA is just $70. To join, download an application form at www.tddlma.org. au/membership.html

BRISBANE NORTHSIDE Meetings are generally held on the second Tuesday of alternate months.

Convenor: Dr Graham McNally Phone: (07) 3265 3111 For further information or to join, visit www. northsidelocalmedical.wordpress.com

GOLD COAST Monthly meetings are generally held on the third Thursday of each month. For information on meeting dates go to www. gcma.org.au or email info@gcma.org.au A membership form can be downloaded from our site.

Phone: 0419 780 505 Fax: (07) 5575 7551 Email: info@gcma.org.au

CAN’T FIND YOUR LOCAL AREA?

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JULY 2014 DoctorQ

If your Local Medical Association does not appear above or your details are incorrect, please email amaq@amaq.com.au with corrections, contact details, how to join, web address, dates for upcoming meetings and who to contact for further information.

AROUND THE REGIONS

RURAL AND REMOTE MENTAL HEALTH ON THE TABLE AMA QUEENSLAND WAS INVITED TO ATTEND A MINISTERIAL ROUNDTABLE IN CHARLEVEILLE TO DISCUSS THE DEVASTATING IMPACT OF THE PROTRACTED DROUGHT ON RURAL QUEENSLAND, WITH PARTICULAR FOCUS ON MENTAL HEALTH. DR JOHN HALL ATTENDED ON BEHALF OF AMA QUEENSLAND AND THE RURAL DOCTORS ASSOCIATION OF QUEENSLAND.

DR JOHN HALL

Downs and West Area Representative

This was an interesting collaboration of state and federal MPs, mayors, Medicare Locals, professional associations, rural lobby groups, mental health workers and Queensland Health. We heard some poignant accounts of grazier’s personal and financial struggles with the drought, including how the current drought has knock-on effects to both the farming and business communities.

Interestingly we heard how the current drought dates back to 2002. There has been some relief but it has come in the form of devastating floods which have been destructive and damaging in other ways.

There has been an ongoing lack of the regular and seasonal precipitation required for reliable farming conditions. Past droughts and cumulative natural disasters are resulting in significant stress and mental health related issues. This has led to concern over the increased risk of suicide, given that we know the rates are already increased in rural communities.

Significant barriers to providing an adequate response to this crisis were identified: fragmentation of services; lack of local champions and community engagement; inadequate provision of financial planning counsellors, and inadequate access to local mental health services and GPs. There is no clear delineation of responsibility for the delivery of mental health services.

The Queensland public health system is geared towards delivering acute and subacute services.

We put forward the importance of early intervention and prevention strategies such as health promotion designed to increase awareness and resilience while reducing stigma. The group endorsed these suggested solutions and strategies.

I outlined the key role of the rural GP in the coordination and provision of frontline mental health and hospital services often in the absence of locally available psychology and psychiatry services. The group acknowledged that a rural GP is often the only practitioner that members of a struggling family will trust and voluntarily seek help from.

It was noted that rural doctors are well placed to continue in that role and should be supported by increased collaboration with other mental health services.

Continued work on the existing rural medical and health workforce crisis was supported, understanding that rural GPs have strong long-term relationships within

The group acknowledged that a rural GP is often the only practitioner that members of a struggling family will trust and voluntarily seek help from.

the community and deliver a broad range of generalist services.

The state-wide rural and remote clinical network (SRRCN) has been tasked with the administrative carriage of this work in collaboration with the Queensland Mental Health Commission (QMHC). Specifically they are to develop a Rural and Remote Service Intervention and Prevention Plan outlining an overarching framework which can be made specific by local coordinators and through local networks. They will also finalise an issues paper that informs a collective and on-going response to rural and remote mental health and wellbeing.

Other important tasks were delegated to the rural Hospital and Health Services including: Service mapping of local mental health and other drought-related services (such as financial counselling) in each community; and Considering the nature, format and implementation of ‘local champions’ in each community, who would help to identify and engage at risk members of the community Queensland Health is also developing an online portal which will include links to maps of available services and existing mental health resources. They will also target community education and de-mystifying mental health, outlining the early warning signs and encouraging people to seek appropriate help. A significant investment in health promotion and marketing has been approved for distribution via a number of popular rural media outlets. Q DoctorQ JULY 2014

35

events calendar People & EVENTS

COMING

UP

18 - 19 JULY

WHAT’S ON

JUNE - JULY

6 AUGUST

PRIVATE PRACTICE SERIES

Learn how to navigate the new employment landscape with topics such as how to manage underperformance or chronic absenteeism, and how to ensure terminations, workplace bullying, and harrassment complaints are compliant with the Fair Work Act.

Moda Portside

We’re honoured to have Turia Pitt as our special guest presenter for the annual AMA Queensland Women in Medicine Breakfast, and look forward to hearing her discuss thriving during challenging times with resilience, perseverance and determination.

21 - 27 SEPTEMBER

TO VIEW THE FULL EVENTS CALENDAR

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JULY 2014 DoctorQ

Victoria Park Golf Complex Suitable for those considering their options in private practice and those already in private practice who are looking to improve their current practice.

Open to members and non-members.

25 OCTOBER

PRIVATE PRACTICE CONFERENCE Townsville

Join legal, accounting and financial experts specialising in the medical profession at this one-stop-shop event for doctors, practice staff and consultants already working in or wanting to start out in private practice. The conference also includes the Sandford Jackson Oration.

Or to register for an event, visit amaq.com.au or contact the AMA Queensland Membership team on (07) 3872 2222 or email registrations@amaq.com.au

ANNUAL CONFERENCE Cape Town, South Africa As a conference delegate you will learn from world renowned Australian and International speakers and develop a better understanding of the medical issues that will affect you and your patients.

Conference Theme - Health has a Postcode (Social Determinants of Health).

1 NOVEMBER

Statewide

WOMEN IN MEDICINE BREAKFAST

FRESH THINKING -

PRIVATE PRACTICE CONFERENCE

MEDICOLEGAL CONFERENCE Law Society House, Brisbane Featuring incoming Health Ombudsman Leon AtkinsonMcEwan, this conference will explore consent and capacity, the recent privacy legislation changes and essential risk management strategies.

18 - 19 JULY | VICTORIA PARK GOLF COMPLEX, BRISBANE

FRESH THINKING STARTING & WORKING IN PRIVATE PRACTICE CONFERENCE 2014

22

CONTINUING PROFESSIONAL DEVELOPMENT POINTS

*Approved

With unprecedented employment changes to conditions in the Queensland public sector, you may be considering transitioning to private practice.

The Fresh Thinking program has been designed to provide information you require in establishing a private medical practice (fundamentals stream); or if you are working in an already established medical practice, to enhance and refine your skills and knowledge (advanced stream).

This conference will equip doctors, practice staff and consultants with access to experts in the area, and is open to both members and non-members as a part of AMA Queensland’s Workplace Relations service. Once registered, delegates may attend any session of their choosing to best meet their specific requirements.

Register now for an education-packed conference that will give you the crucial information required for starting and/or working in private practice.

To view the full program and brochure go to www.amaq.com.au

DAY 1

DAY 2

Effective patient engagement in the 21st century Associate Professor Michael Greco, Patient Opinion Australia

Everyone’s watching: The impact of social media on your practice Allyson Alker, MDA National

Exceeding patient expectations Colleen Sullivan, FAAPM Life Member

PCEHR, eHealth and new technology Andrew Turner, AMA Queensland

Financial foundations - Getting it right from the start Julie Smith, William Buck (Qld)

Financial healthcheck for your practice Paul Copeland, William Buck (Qld)

New privacy reform and medicine Andrew Turner, AMA Queensland

Reasonable management action: WorkCover and your staff Kate Macartney, WorkCover Queensland

Quality assurance through accreditation AGPAL

Embracing new technology in your practice Deana Scott, Virtual Medical Office

Expanding your practice – Balancing people, profits and the environment Stacy Kambouris, HMED Consult, Health and Medical Consulting

Healthy financial strategies for private practice Simon Moore, Investec Specialist Bank

Emerging employment issues in 2015 Rachel Drew, TressCox Lawyers and Andrew Turner, AMA Queensland Setting up your business structure Lynette Reynolds, TressCox Lawyers Afternoon tea and networking

Healthcare marketing: Why it matters and how you can make it work for you Damien Edmonds, Edmonds Marketing Engaging support staff George Sotiris, AMA Queensland Having difficult conversations with problem patients Luke Donaldson, AMA Queensland Afternoon tea and networking

Conference

CAPE TOWN SIGHTSEEING

THERE’S PLENTY OF CHANCES TO TAKE A BREAK ON THE ANNUAL CONFERENCE THIS YEAR IN CAPE TOWN, SOUTH AFRICA. CONFERENCE COORDINATOR NEIL MACKINTOSH SHOWS US SOME OF THE HIGHLIGHTS TO TAKE IN DURING THE DOWN TIME.

TABLE MOUNTAIN

ADDERLEY STREET FLOWER SELLERS

Table Mountain provides Cape Town with a uniquely beautiful setting. Visible at times from 200 kilometres out at sea, the mountain made the anchorage of Table Bay easy to find and attracted early seafarers to the “Tavern of the Seas” for shelter, drinking water and fresh produce. The level but rocky summit provides breathtaking views - the City and Table Bay are spread out below.

The flower sellers that occupy the arcade off Adderley Street in the CBD have been there for more than 100 years and always deliver a range of freshly cut flowers at reasonable prices.

ST GEORGE’S CATHEDRAL

Known as ‘the people’s Cathedral’ for its role in the resistance against apartheid, St. George’s Cathedral is the oldest cathedral in Southern Africa and the mother church of the Anglican Diocese of Cape Town.

KIRSTENBOSCH BOTANICAL GARDEN

Nestled on the eastern slopes of Table Mountain, Kirstenbosch Botanical Garden boasts over 22,000 indigenous plant species, and was the first botanical garden to be declared a UNESCO World Heritage Site.

Credit:

Guests will be taken along Dorp Street, the oldest street in the Bo-Kaap in the Malay Quarter. Bo-Kaap is a visual masterpiece with cobblestoned streets.

Our city tour will take us past the statues of Jan van Riebeeck, a Dutch colonial administrator and founder of Cape Town.

My De

ountain

stinatio

n Cape

Town

From human wrongs to human rights, exhibitions on the lower level of this museum explore the long history of slavery in South Africa. They also often feature exhibitions on more current human rights issues.

BOULDERS BEACH

Boulders Beach is home to more than 3,000 African penguins. Check out the cuties pictures above and more. l St George’s Cathedra ues Blog

Credit: Greg Lumley, SA

Ven

ROBBEN ISLAND

A tiny eight by seven feet, Mandela’s cell on Robben Island is a stark reminder of the adversity that once plagued South Africa. Q

Credit: Greg Lumley, SA Venues Blog

12 Apo

stles

JULY 2014 DoctorQ

Table M

IZIKO SLAVE LODGE MUSEUM

BO-KAAP

JAN VAN RIEBEECK STATUE

38

rden

tional Botanical Ga

Kirstenbosch Na

Bo-kaap

a Arya

Credit: Ram

To find out more about this conference, download a brochure or to register please visit the events page at www.amaq.com.au

CONFERENCE THEME:

Health has a Postcode Social Determinants of Health

AMA Queensland Annual Conference

SPONSORS

21-27 SEPTEMBER 2014

MEMBER NEWS

CONGRATULATIONS to the following doctors who are now elected members of AMA Queensland.

APRIL 2014

MAY 2014

DOCTORS IN TRAINING

DOCTORS IN TRAINING

Dr Beini Chen Dr Felicity O’Malley Dr Kaitlyn Mullane Dr Nicholas Lintell Dr Susanna Rossotti Dr Aarti Malhotra Dr Sabin Smith Dr Gulchekhra Sidari Dr Anson Chan Dr Catherine Barnett Dr Liam Flynn Dr Sachin Khullar Dr Anna-Marie LochWilkinson Dr Carmel Newitt Dr Deborah Maher Dr Gary Chang Dr Laura Condon Dr Paul Gales Dr Petrina Duncan

Dr Baillie Ferris Dr Cariad Wratten Dr Deborah Khoo Dr Emily Walpole Dr Vivian Kwok Dr Dominic Eu

GENERAL PRACTITIONERS Dr Behzad Rafiee Dr Kishan Sharma Dr Sean Pham Dr John Endacott Dr Laurence McEntee Dr Mark Paine

PART-TIME PRACTITIONERS Dr Alok Jhamb Dr Anthony Ringuet Dr Philip Robinson Dr Simon Broadley Dr Stephen Bruce Dr Miriam Susnja Dr Monique Dade Dr Neisha D’Silva Dr Tisha Searles Dr Chik Tan Dr Graeme MacDonald Dr Petra Millar Dr Robyn Brady Dr Antonio Tsahtsarlis Dr Sheri Newman

GENERAL PRACTITIONERS Dr Irshad Rasheed Dr Karen Love Dr Kaylene Girgenti Dr Prasanna Pathmaperuma

PART-TIME PRACTITIONERS Dr Shamile Hussain Dr Simone Ramsay Dr Lalith Jesuthasan Dr Rachael Gray Dr Helen Weston

SALARIED PRACTITIONERS Dr Alistair Frame Dr Kah Chan Dr Marc Blackstone Dr Samuel Jones Dr Vikram Goel Dr Hoe Lo Dr Bach Truong Dr Ranjeev Pulle

MAKING THE MOST OF YOUR MEMBERSHIP At AMA Queensland, we want to hear from you. We invite members to get involved, as with your direct input and participation, we can shape a valuable, innovative member service offering that engages, inspires and supports members.

Here are a few ways to get involved...

Do you have a burning issue in your local HHS or community that you would like to take forward? Contact the policy team to help you get traction on the issue with the support and advice you need.

Want to join a Committee to have a hands-on role shaping our approach to member advocacy? We have a number of Committees including the Council of Doctors in Training, Council of General Practice, Ethics and Medico-Legal Committee, and Salaried Medical Officers Committee, who undertake crucial representation on behalf of members lobbying government and key stakeholders Are you a budding writer? You can write an article for our Health Vision blog or

our magazine, Doctor Q, like member and regular columnist Dr Matt Young does Got a great event idea? Let us know.

Members of our Council of Doctors in Training recently proposed the idea for the inaugural Junior Doctor Conference, which has now sold out and will be an annual, low-cost professional development fixture. Members have also directly developed the content for our second Annual Medico-Legal Conference Would you like to start a special interest group for interested member colleagues?

We can provide the facilities, catering and support on site here at AMA Queensland, and we will also consider requests for support of regional member networking activities.

To have a chat about how you can get involved, contact Holly Bretherton, Member Relations and Communications General Manager on (07) 3872 2248, or for policy and advocacy related issues, contact Senior Policy Officer Emily Cotterill on (07) 3872 2258. Q

SALARIED PRACTITIONERS Dr Mark Downing Dr Christopher Gillespie Dr Daniel Bitmead Dr Fraser Taylor Dr Geoffrey Rofe Dr Helen Healy Dr Ian Scott Dr Kiran Shekar Dr Lokugam Seneviratna Dr Monika Ruhnke Dr Richard Skoien Dr Sibi Kurian Dr Stefan Blum Dr Thomas Ulahannan Dr Heinrich Cornelissen

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JULY 2014 DoctorQ

Council of Doctors in Training members Doctors Bav Manoharan, Lisa Byrom and Tom Arthur, are part of the team who put forward the inaugural Junior Doctor Conference.

BE R

REFER A MEMBER AND RECEIVE A DISCOUNTED 2015 MEMBERSHIP

EWA

RDE

Refer 1 member

Refer 2 members

Refer 3 members

Refer 4 members

25% discount on your2015 membership

50% discount on your 2015 membership

75% discount on your 2015 membership

No membership fee for 2015

D

Building the future of our profession... together.

As an active member, you know first-hand the value your membership provides in helping achieve career success and strengthening the medical profession.

The AMA Queensland Member-Get-A-Member Campaign provides the ideal opportunity to share this success by encouraging your non member colleagues to join. A vital and growing AMA Queensland means greater recognition for the medical profession, more resources and support for members, and a louder voice in Queensland.

With your help: AMA Queensland benefits by representing another doctor The new member you recruit benefits by taking advantage of all membership has to offer You benefit by strengthening AMA Queensland and sharing the value of membership with another colleague – plus there are incentives for recruiters.

To take advantage of this offer, ensure the member you refer puts your full name in the comment section of the membership application.

AMA Queensland Business Support Services

Saving you valuable time Our professional team can help you with:Â Bookkeeping

Marketing and communications

Meetings and events

Customised services

Membership needs Who do we help?

Private practices, committees, associations, societies and colleges.

Find out today how AMA Business Support Services can save you valuable time!

P: (07) 3872 2222 W: www.amaq.com.au E: bss@amaq.com.au

As a new client you will receive a free award subscription update!

SPECIAL OFFER!

DoctorQ JULY 2014

41

AMA Queensland Membership application form HOW TO APPLY:

3. EMPLOYMENT TYPE/STATUS

• o nline at www.amaq.com.au • or by using this application form.

Salaried

I hereby apply to be elected a member of the Australian Medical Association and the Queensland Branch of the Australian Medical Association, and agree if elected, to observe the principles stated in the Declaration of Geneva.

1. APPLICATION FOR ADMISSION AS: (please tick) Resident & Registrar

Intern

Principal house officer

Junior house officer

Registrar specialty:

Employer?

Employee?

Employer:

Discipline: Right of private practice:

Yes

No

Private hospital VMO:

Yes

No

Public hospital VMO:

Yes

No

International Medical Graduate:

Yes

No

A registered Medical Practitioner am desirous of being and hereby apply to be elected a Member of the Australian Medical Association and the Queensland Branch of the Australian Medical Association, AND I AGREE if elected to observe the principles stated in the Declaration of Geneva.

Are you currently registered with the Medical Board of Australia?

Yes

Position:

Are you:

I, (insert name)

Academic Specialty (please specify):

Specialist

Full-time

4. DECLARATION

Senior house officer General practitioner

Private

No

If applicable, under which specialty/specialties are you registered with the

Do you have or have you ever had a suspension, condition/s or other restriction/s placed on your registration or been subject to criminal proceedings?

Yes No

2. CONTACT DETAILS: (Please print BLOCK LETTERS in blue/black ink)

If Yes, please forward an extract of the orders made and any convictions recorded to the General Manager of Membership, Holly Bretherton h.bretherton@amaq.com.au for further review with your application for membership, or call Holly to discuss on (07) 3872 2248.

Full name:

Signature:

Medical Board of Australia?

Gender:

Male

Female

Date of birth:

/

/

Date:

Your membership with AMA Queensland also includes membership with the Australian Salaried Medical Officers Federation Queensland (ASMOFQ) and additionally it’s Federal counterpart the Queensland Branch of the Australian Salaried Medical Officers Federation for no extra fee.

Postal/home address:

As a salaried doctor, I do not wish to be an ASMOFQ member.

Principal practice name:

5. REGISTER TO VOTE Register your vote. Members have the opportunity to vote for craft group and area representatives in the annual Branch, and Federal Council elections of AMA. To register for vote please complete the Craft Group section below.

Principal practice address:

Suburb:

State:

Preferred Mailing/Geographic Area: (Please tick)

Postcode:

Greater Brisbane 4000-4199, 4300-4349, 4500-4549 Capricorn Coast 4676-4798 Gold Coast Area 4200-4299 North Coast Area 4550-4601, 4619-4675 North Area 4799-4850 Far North Area 4851-4899 Downs and West Area 4350-4499, 4602-4618

Practice phone: Mobile:

After hours phone:

Practice fax:

Pager number:

Email: Graduation year:

AMA Queensland Craft Group: (Please tick) General Practitioner Specialist Full-time Salaried Medical Officer

Institution:

Qualification/s: (including College fellowships) Please indicate if your spouse is a medical practitioner:

Yes

No

If yes, please name: Please indicate if you are proficient in a language/s other than English:

How do you wish to receive Doctor Q magazine?:

Online

Post

How do you wish to receive the Annual Report?:

Online

Post

Federal AMA Craft Group: (Please tick) General Practitioner Salaried Doctor Paediatrician Psychiatrist Opthalmologist Surgeon Physician

Part-time Medical Practitoner Doctor in Training Medical Student Doctors-in-training Obstetrician Gynaecologist Pathologist Dermatologist Radiologist Emergency Physician Anaesthetist Orthopaedic Surgeon

8. PAYMENT DETAILS: (Payment is accepted by cheque, credit card or direct debit)

JULY 2014 MEMBERSHIP RATES Membership category

Single

Joint*

Promotional Code (if applicable):

Full Time Practitioner Part Time working 0-10 Hrs P/Week

$693.00

$577.50

Membership category: (refer to table on the left)

$172.00

$136.00

Part Time working 11-20 Hrs P/Week

$374.50

$297.00

Subscription amount $

Part Time working 21-30 Hrs P/Week

$498.50

$406.00

Intern

$219.00

$164.50

Junior House Officer

$256.50

$192.00

Senior House Officer

$295.00

$226.00

Principle House Officer

$357.50

$268.00

Registrar

$426.00

$319.50

Full Time Academic

$406.50

$324.00

Overseas

$362.50

$298.50

Parental Leave

$163.50

$105.00

Retired

$127.00

$270.00

Expiry date:

Over Seventy Practicing

$330.50

$130.50

I authorise and request AMA Queensland to debit the above nominated credit card upon receipt of this authorisation and thereafter as nominated above (monthly, quarterly or annually). I acknowledge this is a perpetual authorisation and will remain in force until cancelled in writing. In the event that my application for membership is not approved AMA Queensland will refund any subscription amount paid.

*Joint rates apply to members with a spouse/partner who is also an AMA Member.

CONCESSIONS AVAILABLE (CONDITIONS APPLY) International Medical Graduate 1st year practising in Australia

20% discount off the above fees

International Medical Graduate 2nd year practising in Australia

10% discount off the above fees

A one-off 50% exam concession is available for Junior doctors that sit an exam

Please discuss with AMA Queensland staff to access this reduction

Select ONE payment method from below: 8a. PAYMENT BY CREDIT CARD: Please charge my credit card:

Visa

Payment :

MasterCard

In full

Quarterly

Amex Monthly

Card number:

/

Amount $

Cardholder’s name: Signature:

6. DIRECTORY OF MEMBERS (GP’s and Specialists only) The AMA Queensland Directory of Members (DOM) is the ‘Who’s Who of Queensland medicine’ and is a comprehensive and convenient reference resource for anyone involved in Queensland’s health industry, with more than 4,000 copies distributed each year. The Directory lists General Practitioner and Specialist members of AMA Queensland as well as public hospitals, private hospitals, an overview of the medico-legal guidelines and doctors willing to involve themselves in such work. The Directory is also available to AMA Queensland members via the ‘members only’ area online in a fully searchable format.

Please note: In order to appear in the specialist section of the Directory of Members, members must be registered in their chosen specialty/specialities with the Medical Board of Australia (Ph: 1300 419 495).

8b. PAYMENT BY DIRECT DEBIT: T o download a direct debit form go to www.amaq.com.au/directdebit or contact the membership department on 07 3872 2222 or membership@amaq.com.au.

8c. PAYMENT CHEQUE/MONEY ORDER: I have enclosed a cheque/money order payable to AMA Queensland

9. WHAT WOULD YOU LIKE FROM YOUR MEMBERSHIP: Why are you joining AMA Queensland: (Please tick) Belonging to the peak medical professional body Lobbying health policy areas Professional resources and training Workplace and industrial relations support and advice

I wish to OPT IN to the Directory of Members

10. WHAT HAPPENS NEXT Privacy: AMA Queensland values your privacy. For a full privacy disclosure statement please refer to http://www.amaq.com.au/privacy

7. MEMBER GET A MEMBER PROGRAM

REDUCTION

AMA Queensland’s Member Get a Member Program offers an outstanding financial incentive for existing members to introduce new doctors to join AMA Queensland. Receive a 25% discount on next year’s membership for each new member you introduce.

Have you been referred by a member or would you like to refer a colleague?

Let us know who so we can apply the discount!

Name of member who referred you: Name of colleague you are referring:

Upon receipt of your application, your payment will be processed. Payment of the subscription amount is accepted subject to approval of your application for membership by the Board of AMA Queensland. If your membership application is approved by the board, you will then be notified by letter. Upon Board approval, you are entitled to member services and benefits. You will then receive a membership pack including a membership card and certificate. Any application not approved by the board will be notified in due course and any subscription paid will be refunded to you.

NB: For new members who wish to access the AMA Volkswagen offer for the purchase of a new vehicle, please note you must have at least three months membership before you can access the advertised discounts.

Return complete form to: Membership Department, AMA Queensland, Reply Paid 123 Red Hill (Postage is free by marking Reply Paid on any plain envelope) or fax all pages to (07) 3856 4727 or APPLY ONLINE at www.amaq.com.au/membership

MEMBER NEWS BLACKWATER, QUEENSLAND Blackwater is west of Rockhampton in the Capricorn region and is known as the coal capital of Queensland. The coal is transported directly from coalmines south of town to Gladstone by train. The name ‘Blackwater’ is not a reference to the effects of mining operations, but comes from the discolouration of local waterholes caused by tea trees.

A DAY IN THE LIFE OF A

RURAL GP

WITH A POPULATION OF 5,100, BLACKWATER HAD ITS SETBACKS. THE AIRPORT RECENTLY SHUT DOWN, COUNCIL IS NOW BASED 74KM AWAY AND ITS CERTAINLY IN NEED OF SOME ATTENTION AND INVESTMENT. SO IT WAS A PRETTY BIG DEAL WHEN DR MANUKHARAN (MANU) NITHIANANTHA BUILT A SEVEN FIGURE, STATE OF THE ART MEDICAL PRACTICE WHICH, THROUGH TELEHEALTH AND MULTI-DISCLIPLINED DOCTORS, BRINGS THE PEOPLE OF BLACKWATER AND SURROUNDING TOWNS THE BEST MEDICAL CARE. WE ASKED DR MANU ABOUT HIS DAILY LIFE AS A RURAL GP.

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4.30am

Briefly calm myself by thinking of all the things I am grateful for that I have. It helps take my mind away from fear and of course, regret. Praying is also a form of relaxation.

6am - 8am

Minesite visit where I perform injury and health reviews, policy reviews, mine medicals and also visit injured employees.

We offer a 24 hour on call cover to around eight mines.

8am - 12noon

Consultations and Telehealth - part of building a state of the art facility for this town, I incorporate dedicated and regular weekly telehealth clinics with over 10 different specialists from varying specialties including Paediatrics, Orthopaedics, Psychiatry, Urology, Dermatology, Gastroenterology etc. We are also setup to transmit live images of magnified skin, scans and results during the consult.

MEMBER NEWS

12noon - 4pm

How do you balance work/family commitments?

I used to do this very badly. I spent six years working >85 hours per week and noted myself getting exhausted and deprived of emotions. The only thing that kept me going was the immense satisfaction of my work and the variety of presentations. Since then I have actually resigned from Queensland Health this year and developed my community health centre into a multi-faceted health service and was able to take weekends off to recharge and spend with family and hobbies (being the boss has its advantages). I also take the odd weekday off (money is not everything you know).

4pm - 5pm

What food keeps you going through the day?

I have found that discipline in diet is critical when you have virtually no time to spare. My Fitbit tells me that just on an average work day (starting early and without exercise), I burn >3,000 calories per day. So a high protein cereal breakfast with a shake is sufficient and quick for a hearty breakfast and then a precooked lunch (cooked the night before) is needed for a recharge. I love cooking dinner as it actually relaxes me.

Mole scanning and skin procedures I am passionate about skin. I have trained as a surgical registrar in plastic surgery and have accredited us in mole scanning and complex skin cancer excisions. We also perform minimally invasive cosmetic skin procedures.

Ultrasound This is my main passion outside consulting. I have been a medical sonographer for six years and have done hundreds upon hundreds of scans. I scan for Obstetrics, lumps and bumps, musculoskeletal, emergencies, abdominal and of course, Ultrasound-GuidedProcedures.

3pm - 6pm

Teaching and community events A vital part of our existence in the rural sector is to encourage, promote and nurture more permanent rural practitioners. We need to show young medical students that rural medicine is not just about locum work. It is very generous in the pleasures of being a permanent rural practitioner, being part of and a respectable member in the community and developing relationships with people’s lives.

6pm - Bed

Study and paperwork - a compulsory part of a constantly training doctor and a business owner) Trauma and emergencies - part of being 24/7 on call for a rural hospital and a 24 hour mining industry) Cooking and cats - another passion and necessity, as the cats are my companions when I am away from my wife.

How do you stay organised?

Phone apps with reminders, email reminders and a very good set of staff who remind me.

I have set times in the week for paperwork alone otherwise it never gets done. I have to schedule study-time for the same reason. But the social calendar is not as well organised.

I am improving on this.

What do you do in your down time?

Read about general knowledge, watch cartoons (yes, that’s right) and sometimes race cars on a track.

What were your challenges during the day? What were your triumphs? Why was a particular event significant?

The challenges always revolve around getting everything done in a time-efficient manner but also providing quality care at the same time. One lesson I have learnt over the years is that people remember quality, not quantity (even if it may not seem so at the time). People talk about doctors all the time to each other. How do you want to be remembered? The triumphs are in achieving that. But sometimes, you help one person in a very great way.

That is not only a singular triumph or significant event. That is something you remember for the rest of your life. It makes you look at the man in the mirror and be proud.

What were you trying to get done that day? Did you get to it?

Generally speaking I finish >90 per cent of the tasks of the day. Some things that I can’t, I finish early the next morning. But of course, at times, we can’t get things done. C’est la vie.

How was the balance of your day? Did you get chance to exercise, spend time with friends or family?

The balance is set in my week rather than my day. I am happy with that. I work hard during my work days, exercise late night and spend my time with friends and family on weekends or weekdays I take off. So far it works as the time away from work is always increasing as the business grows. My eventual plan is to have a self-managed business and practice medicine for purely the enjoyment of it. Q

DoctorQ JULY 2014

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CURRENT health vision ISSUES

AMA QUEENSLAND’S HEALTH VISION

UNIFIED HEALTH CARE GENERAL PRACTICE – THE LYNCHPIN OF A UNITED HEALTH SYSTEM ELEANOR CHEW, THE QUEENSLAND CHAIR OF THE RACGP EXPLAINS THE CONCEPT OF THE “MEDICAL HOME” WHICH, ALTHOUGH NOT AMA QUEENSLAND POLICY, MAKES FOR THOUGHT PROVOKING READING AS WE TACKLE THE CONCEPT OF HOW TO BETTER UNITE THE HEALTH SYSTEM AND MAKE IT MORE EFFICIENT. The Australian healthcare system is complex and multifaceted. Involving multiple healthcare providers and systems at the primary, secondary and tertiary levels, each offers a varying degree of responsibility for patient care.

It is evident that our current system lends itself to episodic and fragmented care. Health care provided in isolation or silos ultimately impacts the quality of healthcare delivered, compromising patient care and safety.

‘increasing scope of practice’, there has been a slow erosion of this vital role that general practice plays. This can only lead to fragmentation of care to the detriment of our patients. The uprise of collaborative care arrangements is certainly supported by the RACGP, as is the development and uptake of interoperable eHealth initiatives, provided the general practitioner remains central to the coordination of care and patient information.

The health system maze is difficult enough to navigate for those of us who know how. What of our poor patients?

In particular spare a thought for those with complex and chronic conditions that take them across the whole spectrum of healthcare services delivered by multiple healthcare providers. The provision of ongoing and multidisciplinary care presents a significant challenge to the current health system that has evolved to focus predominantly on episodic and acute care.

The RACGP advocates for every Australian to have a “medical home” that provides coordinated, continuing, comprehensive primary healthcare through a therapeutic relationship with a personal GP in a healthcare setting that facilitates partnerships between individual patients, their healthcare professionals and, when appropriate, the patient’s family.

General practice is, and always has been, the lynchpin in the Australian health system. Due to workforce initiatives promoting ‘task substitution’ and

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The medical home puts the patient at the centre of coordinated, integrated and whole-person care delivery, and is driven by improved health outcomes, reduced hospital admissions and lower healthcare costs. Evidence supports identifiable and measurable benefits of a medical home including:

Think for a moment of a patient you know with complex and chronic conditions? How many different hospitals and specialists do they see?

Their life is a mish mash of scheduling appointments, car park fees, a book of scripts and phone calls, faxes and paperwork and waiting rooms. How can we serve this patient better?

RACGP Chair Dr Eleanor Chew and Rohan Mead, Group Managing Director of Australian Unity Limited, Director of the Australian Centre for Health Research and Chair of the Business Council of Australia’s Healthy Australia task force throw some concepts on the table to help us work towards more unified health care.

improved continuity of patient care improved quality and cost effectiveness of care for patients with a chronic disease achieved through reduced avoidable hospital presentations, admissions, and length of hospital stay reduced disparities in access to quality care among traditionally difficult to reach groups improved overall population health lower overall healthcare spending.

So how can general practice be supported and rewarded to maintain its central role in a united health system? The RACGP advocates for appropriately funded voluntary enrolment of patients with a general practice. This would allow for the provision of patient-centred, continuing and coordinated care over an extended period of time. A move to such a system would assist with disease prevention and health promotion, while improving healthcare efficiency and reducing overall healthcare costs.

Synonymous with comprehensive, integrated, quality care and access, general practice in Australia encapsulates the very definition of the medical home. The RACGP’s 2013-14 pre-budget submission outlined a number of recommendations to initiate the introduction of the medical home model in Australia. Q

CURRENT health vision ISSUES

A FUNDAMENTAL RETHINK ROHAN MEAD, GROUP MANAGING DIRECTOR OF AUSTRALIAN UNITY LIMITED, DIRECTOR OF THE AUSTRALIAN CENTRE FOR HEALTH RESEARCH AND CHAIR OF THE BUSINESS COUNCIL OF AUSTRALIA’S HEALTHY AUSTRALIA TASK FORCE ARGUES THAT A ‘FUNDAMENTAL RETHINK’ IS REQUIRED TO SHED THE AUSTRALIAN HEALTH CARE SYSTEM OF THE BAGGAGE OF ITS PAST.

Q: What is the path to a better, safer and more economically sustainable healthcare system?

providers and clinicians together, to seek a new path.

In asking this, I reminded the conference of the telling observation from Inga Clendinnen in her moving book Tiger’s Eye, as she was being treated for major liver disease.

“I soon learned in hospital that it is the vertical people who have all the power.’’

Can we really dispute conclusion? I argue not.

Clendinnen’s

Should we care? I argue, vehemently, yes.

A: Improving access to health information for clinicians and other healthcare providers.

Engaging and empowering citizens and patients is the key to better national health outcomes and improved value in the healthcare system. Not only would this involve a recalibration of the way clinicians deliver care, but also the level of responsibility individuals take for managing their own health.

In my speech to the Australian Medical Association’s national conference, I highlighted the urgent need for the nation’s healthcare system to shed the ballast of its 200-year old health system, one based on acute and episodic treatment where producer interests all too often trump patient interests. I asked us, healthcare

Readers don’t need to be told the statistics on longevity and chronic disease. Suffice to say we are dealing with a changed landscape in the health system from two or three decades ago, let alone 20. And we have been far from nimble.

Meanwhile, health costs continue to rise at unsustainable levels both in absolute

A: Putting the patient at its centre.

Q: And what is a key to driving that quality and safety?

terms and as a proportion of state and federal budgets. Recent Deloitte research commissioned by the Business Council of Australia is evidence of that.

My view is that a fundamental rethink is required. A healthcare sector re-oriented around the patient will, with increased transparency, reduce waste and direct limited resources to where they have most value. This is the path to a better, safer and more economically sustainable system.

Part of the transparency dilemma is the difficulty in obtaining and collating information about patients that can be used to chart their, and others, optimum future healthcare.

We must be prepared to actively find out if patients got better, not just that they were treated. We must measure their health at regular intervals post-treatment.

We must not be afraid to use this information.

We must not be afraid to measure the cost of adverse events as part of the costs of measuring the health system.

In other words, we must clear away the rusted-on impediments to creating and sustaining the fundamental information bases that will open this sector to continuous improvement.

There are undeniable logistical issues with the government’s electronic health records.

But it shouldn’t divert us from the broader goal of improving information systems in the health sector.

We must, as one, be prepared to probe the system for pattern failures, appropriateness of treatment, and outcomes assessments.

We must ask, and answer, the scary questions. Only then will we find ourselves on the path of better, safer and more economically sustainable healthcare. Q

GET INVOLVED Visit amaqhealthvision.com Send us an email at healthvision@ amaq.com.au Follow us on facebook and twitter at amaqueensland using the hashtag #amaqhealthvision Come to one of our events Call us on (07) 3872 2222 DoctorQ JULY JULY2014 2014 DoctorQ

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GET THE MOST FROM YOUR INSURANCE CRAIG WRIGHT FROM EXPERIEN INSURANCE SERVICES GIVES US THE TOP FIVE TIPS FOR GETTING THE MOST OUT OF YOUR INSURANCE.

ONE: Don’t get caught by the fine print Understanding the fine print of insurance policies can be complex. Advisers are educated in looking at the fine print, know what details are included or excluded within a given policy and spend considerable time studying product disclosure statements.

This allows them to confidently recommend you the most appropriate cover options available.

TWO: Get tax deductions on premiums Did you know that income protection insurance premiums are fully tax deductible for individuals? There are also tax advantages available for life and TPD insurance policies.

An adviser will assist you in achieving the most effective tax savings.

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THREE: Don’t rely on default cover insurance from your super Insurance cover offered through super funds are often set at a ‘default’ level with all members in mind, so does not take your personal circumstances and profession into consideration. That’s why you should always assess whether the level of cover is enough to support all your financial commitments.

FOUR: Buying direct may cost you more Getting your insurance over the counter or direct can appear to be a quicker solution.

However, you may not be aware of all the product details, know what’s best for your needs/circumstances or have missed a fundamental inclusion/exclusion of the policy. Direct life insurance may be very restrictive and more expensive than products tailored to your unique needs.

FIVE: Review regularly As you get older and your life changes, so do your insurance needs. It’s important to regularly assess your level of coverage and make sure it’s still adequate. Being underinsured could leave your family vulnerable should anything happen to you.

If you’re getting married, divorced, starting a practice or increasing your debt levels, it may be time to review your coverage levels and your beneficiaries.

Contact Craig Wright on (07) 3018 8168 or craig.wright@experien.com.au for an obligation free consultation on the best insurance coverage for your needs. Q

6/16/2014 3:43:04 PM

professional services

WILL MONETARY POLICY COME TO THE RESCUE? THE FEDERAL BUDGET HAS IRONICALLY PLACED A RENEWED FOCUS ON MONETARY POLICY. THE RESERVE BANK’S OFFICIAL CASH RATE DECISIONS WILL BE A KEY DETERMINANT OF THE PACE OF AUSTRALIAN GROWTH, BUT THE PATH OF US INTEREST RATES IS LIKELY TO BE MORE IMPORTANT IN DETERMINING THE MOMENTUM OF EQUITY MARKETS. MACQUARIE’S ROSS NOYE GIVES US AN UPDATE. Ross Noye

Monetary policy settings worldwide continue to be the focus of attention for investors, and rightly so given their importance in determining the path of economic growth and flow of funds. Monetary policy remains extremely loose globally, with the US Federal funds rate remaining at zero since December 2008 and Europe cutting rates to 0.25 per cent during November last year. Of the developed markets, only New Zealand has tightened monetary policy recently, reflecting improvements seen in that economy and increasing inflationary pressures.

In Australia, the May Federal Budget saw the introduction of a temporary two per cent levy for people earning more than $180,000, while company tax was decreased to 28.5 per cent, although the parental leave levy will apply for companies with revenue greater than $5 million.

Other measures include greater means testing, co-payments for government services, the reintroduction of fuel excise indexation and the $11.6 billion Infrastructure Growth Package.

Consumer sentiment has declined substantially based on readings taken immediately following the Budget. There were a number of measures announced, such as infrastructure spending, that are likely to increase growth directly through construction activity and, indirectly, from the productivity improvements that should come from improved infrastructure. However, this poses a policy dilemma: in the short to medium-term, growth will be curbed by the Budget but the benefits will take some time to flow through.

This largely becomes the problem of monetary policy. Prior to the budget, some improvement in economic indicators (such as housing commencements and retail sales, as well as improvements in the global landscape and a lower Australian dollar), saw market expectations of an increase in the official cash rate by year end.

Concerns that the Budget will restrict growth saw expectations of rate increases significantly pared back. The 30-day interbank futures rate shown in the chart below suggests that the official cash rate will remain unchanged over the next 12 months.

We believe the Reserve Bank may need to ease monetary policy further in order to ensure the maintenance of the growth momentum seen in the Australia economy pre-budget. Given the fall in consumer sentiment, this will be a key area of focus, as will the unemployment rate which has the capacity to further undermine confidence if it rises over the next few months. Note, however, that confidence also fell sharply following the 2013 Budget, only to rebound just as sharply over the following months. This raises the possibility that the initial negative reaction to the Budget may be replaced with a more positive view as the impact of the policy changes is better understood.

A lower official cash rate is typically positive for shares and property. Q

Macquarie Private Wealth (07) 3233 5805 0438 779 955 ross.noye@macquarie.com Ross Noye is a stockbroker and financial advisor at Macquarie who specialises in investment and retirement planning.

Confidence also fell sharply following the 2013 Budget, only to rebound just as sharply over the following months.

IMPORTANT INFORMATION: This information is provided by Macquarie Equities Limited ABN 41 002 574 923 (“MEL”), participant of Australian Securities Exchange Group, Australian financial services licence 237504, 1 Shelley St, Sydney NSW 2000. This information has been prepared by MEL and does not take into account your objectives, financial situation or needs. Before acting on this advice you should consider whether it is appropriate to your situation. Except for Macquarie Bank Limited (Australian Credit Licence 237502) ABN 46 008 583 542 (MBL), any Macquarie entity referred to on this page is not an authorised deposit-taking institution for the purposes of the Banking Act 1959 (Cth). That entity’s obligations do not represent deposits or other liabilities of MBL. MBL does not guarantee or otherwise provide assurance in respect of the obligations of that entity, unless noted otherwise.

DoctorQ JULY 2014

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professional services

SALARY PACKAGING MYTHS SALARY PACKAGING CAN BE A GREAT WAY FOR DOCTORS TO GET AHEAD FINANCIALLY, BUT MANY SIMPLY DON’T GET AROUND TO ORGANISING IT OR DON’T KNOW HOW TO PUT IT INTO ACTION TO SAVE MONEY. JULIE SMITH FROM WILLIAM BUCK DEBUNKS SOME SALARY PACKAGING MYTHS.

Julie Smith William Buck (07) 3229 5100 julie.smith@williambuckqld.com.au

Julie Smith is Tax Services Director at William Buck Chartered Accountants and Advisors.

Quite simply, salary packaging is a process where you restructure the way in which you take your salary in order to save tax. The ‘packaging’ involves paying for certain items in pre-tax dollars, with the balance of your salary paid like normal wages into your bank account (less your regular superannuation contribution and tax withheld).

Here we explain some of the common myths of salary packaging.

MYTH 1 – THERE’S NOT MUCH BENEFIT TO ME There are many benefits to having an effective salary sacrificing arrangement including reducing the tax you pay and increasing your disposable income.

DETAILS

60,000

60,000

-

(9,000)

Taxable Income

60,000

51,000

Tax Payable

12,450

9,615

Net wages paid by hospital

47,550

41,385

-

9,000

47,550

50,385

ADD: Reimbursement of amount sacrificed

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The following example outlines the tax savings and additional disposable income available to a first year intern.

SALARY PACKAGE

Less: Amount Sacrificed

DISCLAIMER: This article has been prepared by Julie Smith of William Buck. The article is intended to be general in nature and should not be relied upon by any person without seeking advice concerning their own circumstances.

Depending on your employer, there are limits to how much you may salary sacrifice. Most hospitals and not-for-profit organisations have a limit of $9,009 per annum.

NO PACKAGE

Salary

Essentially, salary packaging means that you save tax, which leaves more money in your pocket at the end of the year.

Essentially, salary packaging means that you save tax, which leaves more money in your pocket at the end of the year. This is due to paying for some items in pre-tax dollars, which reduces your taxable income. A reduced taxable income equates to less income tax and more savings!

Total

MYTH 2 – YOU CAN PACKAGE AT ANYTIME! There are certain conditions that must be met to ensure you are entering an effective salary sacrificing arrangement.

Essentially, salary packaging can only occur on salary you will earn in the future, rather than salary you have earned prior to establishing the salary packaging arrangements.

It is therefore in your interests to set it up as soon as you start working. The salary packaging year runs from 1 April through to 31 March. For established packages, it is a good idea to revisit your salary packaging arrangements each March to ensure that you are making the most of the opportunities. This is especially important as your salary increases, as your tax savings are likely to increase along with the tax level you pay.

MYTH 3 – I’M NOT SURE ABOUT FRINGE BENEFITS TAX AND DON’T WANT TO PAY ANY ADDITIONAL TAXES Fringe Benefits Tax is a specific area of tax law that is designed to tax salary packaging arrangements.

TAX SAVINGS

2,835

The good news is that in most cases, for doctors working in either Queensland Health, or the Mater Hospital system, there are exemptions to Fringe Benefits Tax that enable you to enter into a salary packaging arrangement and still access the benefits that we have discussed.

The most important thing is to get advice to make sure that the arrangement you are considering is within the provisions of the Fringe Benefits Tax exemptions. If not, the resulting tax bill will most certainly wipe out any expected tax savings.

MYTH 4 – IT DOESN’T MATTER WHAT I PACKAGE With such a wide range of benefits you can choose to package, you will need to explore what is most beneficial to you and your situation. Generally speaking, you should look to package benefits that are not tax deductible (otherwise you would claim them on your tax return).

It is very important to ensure you have effectively structured your salary packaging arrangement to suit your situation, or you may find it is not as tax effective as it first appeared. Q

We don’t have a one size fits all solution.

Our experienced advisors listen to your goals and aspirations and how they can help you achieve them.

William Buck (Qld) GPO Box 563, Brisbane QLD 4001 Telephone: +61 7 3229 5100 Facsimile: +61 7 3221 6027 williambuck.com

CHARTERED ACCOUNTANTS & ADVISORS

professional services

INSURANCE ISSUES WHEN RENTING ROOMS HOW DOES INSURANCE LIABILITY CHANGE FOR A PRACTICE THAT RENTS ROOMS OUT TO OTHER PRACTITIONERS? CHRIS MARIANI SHOWS US SOME AREAS WHERE YOU MIGHT NOT BE COVERED IN THIS PRACTICE MODEL.

Chris Mariani AMA Queensland Insurance Solutions 1300 883 059 chris.mariani@amaqis.com.au Chris Mariani is a medical indemnity specialist at AMA Queensland Insurance Solutions.

Recently, I visited an AMA Queensland member who ran a successful specialist practice. The practice operated under a trading name (let’s call it XYZ Medical) – clearly visible to patients as they walked into the practice. The specialists’ names were proudly written under XYZ Medical, along with their qualifications.

PUBLIC LIABILITY INSURANCE

As a layman walking into XYZ Medical, I would likely assume that this was the business I was seeing – and as such if something went wrong, I’d likely sue the name on the front door. However, like many practices, each specialist ran their own business with XYZ Medical simply providing the facilities and administration support. I asked the doctor to show me what insurances they had in place.

Some clients have long-term doctors in the practice and sometimes it makes sense to extend the practice’s public liability to cover the room rental doctors, rather than each doctor buying their own policy. Either way, this should be written in the contract so it is clear what is expected of each party.

Similar to many, the doctor owner of XYZ Medical had a number of gaps in his insurance program.

For example, he had wrongly assumed his personal medical indemnity policy would cover his receptionist breaching privacy of a patient of one of the room rental specialists.

So what can practices with similar structures do to ensure they have the right insurances?

GET ADVICE Speak to an insurance adviser who specialises in the medical sector. We are more than happy to review your individual situation, just give us a call to discuss.

DOES THE PRACTICE NEED ITS OWN MEDICAL INDEMNITY POLICY? Generally the ‘trigger’ for your own medical indemnity policy is ‘your treatment of your patient’.

So should your reception staff make an error on a patient of the room rental doctor (eg they filed away patient test results rather than bringing these to the doctor’s attention), you may find your own medical indemnity won’t respond. A separate policy for the practice may be required.

DISCLAIMER: AMA Queensland Insurance Solutions is a trading name of KSLR Pty Ltd, a Corporate Authorised Representative of Insurance Advisernet Australia Pty Limited, AFSL 240549.

Corporate Authorised Representative No: 366807.

The information provided in this article is of a general nature and does not take into account your objectives, financial situation or needs. Please refer to the relevant Product Disclosure Statement before purchasing any insurance product.

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You should have public liability insurance for the practice premises (eg a patient or visitor slips in the waiting room. Equally, the room rental doctor should have their own public liability for their errors (eg they leave their doctor’s bag on the ground and a patient trips over it).

THE ROOM RENTAL CONTRACT It is prudent to seek legal advice on drafting an appropriate room rental agreement. From a risk and insurance perspective, some of the items to consider: Indemnity clause – the standard legal position is on the basis of ‘you’re responsible for your mistakes and I’m responsible for mine’. If the contract changes this position, it can impact on the insurances of you and/or the room rental doctor. Speak to your lawyer about the intent of the indemnity clause and make sure you understand the impacts.

Insurance clause. Generally the room rental doctor is independent and as such is responsible for their own insurances. For example, this could include Medical Indemnity, Public Liability, Workers Compensation (where required) and insurance for any contents and equipment they own. Clearly stipulating what insurances the room rental doctor is required to hold avoids any issues with the doctor assuming they were covered under your policies. Q

He had wrongly assumed his personal medical indemnity policy would cover his receptionist breaching privacy of a patient of one of the room rental specialists

www.amaqis.com.au

Insurance renewal time getting you down?

Let’s face it insurance is boring.

But necessary.

We know doctors have a busy schedule, and while it may be easy to renew your insurance each year without proper revision, changes may have occurred for which you may not be fully covered and premiums need competitive comparison.

For peace of mind and taking the yawn out of renewal time, contact AMA Queensland Insurance Solutions.

All insurance needs covered for all members through AMA Queensland Insurance Solutions.

AMA Qu eenslan d Insuran ce Solution Your Ins s urance Speciali sts

For more information phone: 1300 883 059

professional services

LEASING TIPS AND TRAPS IF YOU ARE ENTERING INTO A LEASE FOR THE FIRST TIME, TAKING A TRANSFER OF AN EXISTING LEASE OR RENEGOTIATING WITH YOUR EXISTING LANDLORD, LYNETTE REYNOLDS FROM TRESSCOX LAWYERS LOOKS AT SOME OF THE ISSUES YOU SHOULD CONSIDER.

LEGAL CONTRACT Lynette Reynolds Partner (07) 3004 3530 Lynette_Reynolds@tresscox.com.au Lynette Reynolds is a Partner at TressCox Lawyers and advises clients in commercial property, banking and finance and purchases and sales of businesses.

A lease is a legal document and constitutes a binding contract between the parties. You should always obtain legal advice about the terms and conditions of the lease.

TERM OF LEASE Check the offered term of the lease and whether or not you are given any option rights. For example, a lease for three years with two three-year options gives you more flexibility than a fixed term lease for nine years. You should remember that you cannot end a lease simply because your business ends, you wish to relocate or some of your fellow doctors retire or move practice.

REPAIR OBLIGATIONS Most leases require the tenant to keep the leased premises in good repair. It is common for the landlord to have no obligation to keep the building in good repair. You should consider if the landlord should be required to maintain important areas such as lifts, the foyer, the roof and the structure of the building. You should also check the exclusions to your repair obligations. For example, a tenant would normally wish to exclude damage caused by fair wear and tear and damage arising from outside risks such as floods, earthquakes and storms.

Remember that you cannot end a lease simply because your business ends, you wish to relocate or some of your fellow doctors retire or move practice.

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AIR-CONDITIONING A common area of contention between a landlord and a tenant relates to air-conditioning. Is the landlord required to provide air-conditioned premises and to ensure that the air-conditioning system is available and working throughout the entire term of the lease? Often the landlord will require the tenant to enter into a service and maintenance agreement. The responsibility for capital repairs should be expressly negotiated and documented.

INSURANCE AND INDEMNITY It is common for landlords to include extensive indemnity and release obligations in lease documents. In our experience these regularly require negotiation. If you accept a contractual liability for a full indemnity, it is likely that you will not have insurance cover. This means that the medical practice may be required to make a payment or part payment from its own funds in relation to a claim. It is also common for landlords to require conditions in your insurance policies

such as ‘waiver of rights of subrogation’. These conditions can be difficult or costly to obtain.

MAKE GOOD OBLIGATIONS A significant cost for a tenant can arise under make good obligations in a lease. Most leases will provide that at the end of the lease you must remove your fitout and return the premises to their original condition (such as the base building condition). The removal of fitout, furnishings, floor coverings and the removal of cabling and light fittings can be very expensive.

CONCLUSION A lease agreement contains a number of contractual obligations which will expose a medical practice to liability, including some for significant monetary payments. As is the case with most contracts, the document is used and read mainly when there is a dispute or an unforeseen payment arises. The above points are only some of the issues to be considered when negotiating a lease. Other issues include the manner and timing of rent reviews, fit-out incentive terms, rent free periods, which outgoings are payable and rights to assign or sublet. You should always seek specific legal advice whenever renewing a lease, entering into a new lease or taking a transfer of someone else’s lease. Q

“

“ , Partner

, Partner

, Partner

, Partner

, Partner

, Partner

, Partner

• • • • • • Business structuring and contracts

•

• • • • •

lifestyle

LEND A HAND

Travelling FOR PEOPLE THAT WANT A LITTLE MORE FROM THEIR TRAVEL, TAKING ON SOME CORPORATE SOCIAL RESPONSIBILITY MIGHT BE JUST THE TICKET TO REALLY SEE A COUNTRY AND ITS CULTURE AND GET YOUR HANDS DIRTY AT THE SAME TIME. ROS BULAT FROM AMA TRAVEL GIVES US SOME TIPS ON TRAVEL THAT WILL CHANGE MORE THAN ONE LIFE.

In our ever changing world, people of all ages and interests are looking at ways that they can give back a little to those that are far less fortunate. Corporate social responsibility travelling is an ever growing style of travel that is fast becoming the new must do. You do need to be careful though.

There are organisations that take advantage of generosity. We work alongside several organisations that help our people and their donations get right to where it is needed.

KEEPING ACTIVE

THE SCHOOL LEAVER

DIVERSITY

Schoolies has become a contentious topic, in particular for South-East Queenslanders. Our children are growing up so much more aware of the world around us. Many have been travelling since they were young and have had the opportunity to see first hand how others live and how very lucky they are. As an alternative, many school leavers are opting to spend their holiday time working alongside others in non-government organisations to help make a difference. As an added bonus, it can also be a great addition to their resume.

There really is something for everyone!

Existing programs are already in place, including everything from:

THE PROFESSIONAL While getting in and helping a community might paint the picture of very basic facilities, that isn’t always the case. Don’t get me wrong, there are plenty of opportunities for this if it is what you are after but it is not always the case. Take for example the amazing work that is done by Orient Express in Myanmar. While cruising in Colonial-esque style luxury you can see and participate in the great work that their onboard doctor does in these remote communities.

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A great way to combine keeping active, immersing yourself into local communities and seeing something new is a cycling tour.

Very popular in Vietnam and Cambodia, you have the opportunity to get out of the main cities and really experience the country and its people. Perhaps you have a group of like minded friends that would like to do this together and take the opportunity to raise money along the way?

Saving endangered rainforests Educating children Bringing safe water to a community Medical assistance to remote areas Raising endangered animals to return to the wild We can work on a bespoke program to fit your needs and help you, your family and friends make a difference in people’s lives. Q

For more in AMA Tra formation call o r email R vel Quee os at nsland.

PHONE : 1800 26 2 885 FAX: (0 7) 5556 72 00 EMAIL: travel@ amaq.co m.au WEB: www.am aq.world travel.co m.au

lifestyle

JUST WHAT THE DOCTOR

IN A WORLD OF CORPORATE TAKE OVERS, FOREIGN OWNERSHIP OF ICONIC BRANDS AND VIRTUAL WINERIES IT’S NICE TO SEE A FAMILY OWNED AND OPERATED WINERY FLOURISH IN THE CHAOS. PHIL MANSER FROM WINE DIRECT INTRODUCES US TO RICHARD HAMILTON WINES. Founded in 1837, Richard Hamilton Wines remains one of Australia’s oldest Australian owned wine companies with vineyards in metro Adelaide, McLaren Vale and more recently in the

A BRIEF HISTORY

Phil Manser Wine Direct 1800 649 463 phil.manser@winedirect.com.au

Hamilton is one of the original Australian winemaking families. In 1837 Richard Hamilton founded the Hamilton Vineyards, just south of Adelaide in 1837. It was planted with stock brought by the family from South Africa, en route from England.

Ordered Coonawarra (Leconfield Wines, established in 1972). To this day many of the original vineyards planted in the 1800s and mid 1900s exist today and feed many of their estate labels. I actually live on an estate where those original vines still grow today!

Five generations later, Richard Hamilton’s great-great grandson, Dr (Mr) Richard Hamilton presides over a family company that continues to flourish in what can only be described as one of the wine industry’s most challenging eras. The key to their ongoing success is focusing their resources on what they’re really good at: making intensely flavoured, long lived classic red wines from areas well suited to their production.

From their Coonawarra winery Leconfield, the merlot and cabernet continue to win praise both here and abroad with the 2012 Merlot recently winning the trophy for Best merlot Australia/New Zealand at the Winestate Wine of The Year Awards.

The cabernet regularly scores mid

90s from Halliday and in my opinion is one of the best value and long lived cabernets you’ll get from the district.

In McLaren Vale, the story is the same.

Whether it’s their modestly priced estate shiraz from vineyards planted in 1947 or the brooding monster that is Centurion, sourced from their 1892 block, the theme is the same, intense fruit supported in the distance by high quality oak.

Powering this success is the winemaking team of Paul Gordon and Tim Bailey, both experienced hands in winemaking here and in Europe, who follow in the footsteps of some of the greats that have made wine for Hamilton, notably, Ralph Fowler and Brian Barry. Q

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all about you

BOOKLOVERS

CLUB

LOOKING FOR A NEW READ?

Put that work down for a minute and check out these great titles. Q

AUTOBIOGRAPHY

UNDER THE MICROSCOPE

A QUOTE FROM THE LATE DR MAYA ANGELOU

“Love recognises no barriers.

It jumps hurdles, leaps fences, penetrates walls to arrive at its destination full of hope.”

EARL OWEN Under the Microscope is the story of an extraordinary man, his many life-changing inventions, and his exceptional life and special friendships. Earl Owen was one of the earliest, most inventive and enterprising pioneers of microsurgery; he designed instruments and microscopes for his operations; he did the first finger replacement on a child; co-led the team that completed the first successful hand transplant; and trained the team that completed the first double-hand transplant.

JEANS FOR GENES DAY Get out your best denim and help raise money on Genes for Jeans Day on 1 August. Jeans for Genes raises money for the Children’s Medical Research Institute, a pioneer in paediatric medical research since 1958. Register your workplace now at www.jeansforgenes.org.au

THE LIGHT BETWEEN OCEANS FICTION

ML STEDMAN 1926. Tom Sherbourne is a young lighthouse keeper on a remote island off Western Australia. The only inhabitants of Janus Rock, he and his wife Isabel live a quiet life, cocooned from the rest of the world.

Then one April morning a boat washes ashore carrying a dead man and a crying infant - and the path of the couple’s lives hits an unthinkable crossroads. Only years later do they discover the devastating consequences of the decision they made that day - as the baby’s real story unfolds...

APP SNAP - Fitness Buddy Now you’ll always have a buddy to work out with in the Fitness Buddy app. Access more than 1,700 exercises or 75 work out routines, or build your own. Type in your goals, specific equipment you wish to use or body areas you want to target and the Fitness Buddy app will give you detailed instructions and animations on completing the exercise, as well as showing you the muscles that you’re working. You can also track your weight and measurements and graph how those guns are progressing. Q

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Millions of years of evolution are finally paying off for Geeko Sapiens.

ocker doctor

GO ON - MAKE AN APPOINTMENT TODAY

AFTER CELEBRATING FAMILY DOCTOR WEEK IN LATE JUNE IT’S TIME TO THINK ABOUT DOCTORS AND MORE PARTICULARLY, YOUR FAMILY DOCTOR. OUR OWN OCKER DOCTOR, DR MATT YOUNG, GIVES SOME PRETTY GOOD REASONS AS TO WHY EVERY DOCTOR SHOULD HAVE THEIR OWN FAMILY DOCTOR TOO.

DR MATT YOUNG General Practitioner

Every Australian needs a family doctor.

Everyone has heard this worn out hackneyed refrain plenty of times before, but the great tragedy for our profession seems to be that precious few of us actually heed this advice.

The obesity epidemic shattering our great nation’s heritage of tall, lean bronzed diggers and life savers is certainly not ignoring our medical profession. Anyone who has cast an eye around any medical conference will attest that it is always a grim exercise. We don’t look that fit and healthy, do we? There aren’t too many doctors that are going to be able to look their next obese, hypertensive, diabetic, snoring patient in the eye and tell them to lose some weight with any great degree of credibility.

Even when the exercise bug bites, it is often in an unhealthy way. The obsessive trait that seems so rife in medical personalities turns exercise into a hellish chore that dominates their non-medical life. Plenty of my medical mates are gym junkies and throw themselves into training with the same single minded obsessiveness that they showed during their study years. But even this I feel is counterproductive to good health. Moderation is missing and sometimes I think they are compensating for their crazy hours, poor diet and abysmal lack of attention to mental health. Their obsession even further distorts their unbalanced life and isolates them from families and friends.

Nor is our medical cohort immune from the perils of depression and mental illness.

Statistically, every second doctor you meet will end up with an episode of depression.

Our suicide rates are up there at an Olympic level. The most important of life’s jewels, friends and family, seem to get swamped by the responsibilities and time pressures of medical life. Drug and alcohol abuse run rampant and half of our profession gets divorced. Thank God we get paid well, so that we can pay the tax man, the divorce lawyers and the maintenance bills.

It seems pretty obvious to me that we all need to take stock of our own health.

Better still, enlist the help of a trained professional to help out. I reckon a pretty good starting point would be to make an appointment with some young switched on General Practitioner. (I deliberately suggest a younger one, because you really need someone who is going to outlive you and hence be sure to see you through to your own end.)

There aren’t too many doctors that are going to be able to look their next obese, hypertensive, diabetic, snoring patient in the eye and tell them to lose some weight with any great degree of credibility.

Resist the arrogant temptation to look after yourself. How many doctors check their own blood pressure and then raid the sample packs in the treatment room to grab a few boxes of their favourite antihypertensive? How big are those cheeky nips of scotch you need to relax after a day’s work? How many doctors eat their lunch on the run or eat some take away poison full of fat and carcinogens? And how many of us think running up the steps to the next cardiac arrest counts as the sort of exercise that is really going to prevent their own?

When was the last time you had your own cholesterol and glucose checked? A lot longer ago than most of your own patients, I bet. It is an eerie feeling when you start having patients who are younger than you, ending up with terminal diseases and when your own age is now a risk factor for most differential diagnoses.

So take a stand. Do something about it right now. Do some exercise, play some sport, eat better and drink less, get a hobby and spend good times with good people in good places. Dig out the phone number of that fresh faced student that you taught years ago, who ended up as a GP or of that long lost mate who has a practice up the street, and make an appointment. Be a role model for your family, friends and patients, but more importantly, do it for yourself. Remember the patient whose health is most important, is the doctor’s.

You deserve to be healthy. Q

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lifestyle

MONTY PYTHON LIVE (MOSTLY) 6 August, 7pm Monty Python reunite for the first time in three decades on stage at London’s O2 Arena to once again perform some of their greatest hits, with modern, topical, Pythonesque twists. Monty Python haven’t performed live since 1980 at the Hollywood Bowl, so when the five surviving Python members announced that the circus was set to fly again, tickets for their first show sold out in 43.5 seconds.

MET OPERA Rigoletto - 26 July 10.30am, 27 July 1pm, 31 July 10am Rising Italian conductor Michele Mariotti leads the new production premiere of Rigoletto, seen in a new staging by the Tony Award-winning director Michael Mayer in his Met debut.

Otello -16 Aug 10.30am, 17 Aug 1pm, 21 Aug 10am Verdi’s towering masterpiece, based on Shakespeare’s tragedy, makes its first Captured Live in HD appearance.

Semyon Bychkov conducts an extraordinary cast led by Johan Botha in the title role of the jealous Moor of Venice.

COMING FILMS 10 July

Dawn of the Planet of the Apes

24 July

Devils Knot Mrs Brown’s Boys ‘D Movie

31 July

Sex Tape These Final Hours Deliver us from Evil The Keeper of the Lost Causes

ORE FOR M ISIT INFO VOM.AU .C DENDY

7 August Guardians of the Galaxy 14 August The Hundred Foot Journey 21 August The Giver

HOLD YOUR FUNCTION OR BIRTHDAY PARTY AT DENDY!

We love hosting corporate film nights and group bookings at Dendy. It is a great way to thank clients or staff – or perhaps you have a favourite charity that you would like to raise some money for? We have a functions pack and cinema package to suit all requirements – plus a specially tailored functions menu. Please contact Events & Publicity Manager Jenny Sonter on jennys@ dendy.com.au for a free quote.

A SMALL FAMILY BUSINESS NATIONAL THEATRE LIVE

12 and 13 July, 1pm Moments after taking over his father-in-law’s business, Jack McCracken is approached by a private detective armed with some compromising information.

Jack’s integrity fades away as he discovers his extended family to be thieves and adulterers, looting the business from their suburban homes.

Rampant self-interest takes over and comic hysteria builds to a macabre climax.

WIN MOVIE TICKETS FOR TWO Name:

Member No:

Postal address: Portside Wharf, Remora Road, Hamilton Ph: (07) 3137 6000 www.dendy.com.au 60

JULY 2014 DoctorQ

Phone:

FAX BACK TO (07) 3856 4727 or email amaq@amaq.com.au by 31 July

CULTURE

FREE EVENT! THE SEED PROJECT 20 June - 22 August, Melbourne St Green Brisbane’s newest weekly ‘mini festival’ The Seed Project offers free live original music every Friday night from the very best local independent bands before they’ve hit the mainstream airwaves.

From funk and pop-rap, heavy metal and alt rock, to folk and hip-hop you’ll leave each Friday night as a new fan, in love with a new music genre and simply having had a great evening out.

E MOR FOR ATION RM INFO COM.AU .

C QPA 36 246 R O 1

EXPRESSIONS DANCE COMPANY THE RED SHOES

PERFECT TRIPOD AUSTRALIAN SONGS

KAWAI PIANO SERIES FOUR HANDS

18 - 26 July, Playhouse, QPAC

25 July, Concert Hall, QPAC

3 August, Concert Hall, QPAC

A woman’s obsession with dance leads to her ultimate self-destruction in this story of passion and jealousy. Inspired by Hans Christian Andersen’s legendary gothic fairytale and the 1948 Academy Award winning film, The Red Shoes is a twisted tale of delusion and reality intertwined with beauty in a stunning romantic fantasy.

Australia’s most magnificent, mellifluous harmony combo… now with 33.3 per cent more magic. Perfect Tripod’s Australian Songs is a breathtaking harmony-pop experience from four of the most gloriously warm and seasoned voices that ever entwined across this wide brown land.

Director of the Yong Siew Toh Conservatory of Music, Bernard Lanskey will perform a stunning concert of duets with his friend of many decades and colleague Stephen Emmerson. The afternoon opens with Brahms’ deeply touching homage to Robert Schumann – a neglected masterpiece written in honour of his frien and culminates in Schubert’s Fantasie.

You will long remember this extraordinary blend of spectacular dance, striking imagery, original film and live music.

SHEER POETIC BEAUTY AND GRIPPING STORYTELLING

Name:

WIN DOUBLE PASSES TO THE RED SHOES

Take the alternately rib-tickling and tearjerking giants of Melbourne’s live musical/ comedy scene, add the peerless vocal and arranging skills of one-man showbiz powerhouse Eddie Perfect, turn them loose on the Great Australian Songbook, and let those neck hairs run free.

In between, Andrew Schultz’s variations, written specifically for the duo to complement this program, will be an imposing centrepiece with its distinct sense of yearning and broad expansive gestures.

Member No:

Postal address:

Phone:

FAX BACK TO (07) 3856 4727 or email amaq@amaq.com.au by 31 July DoctorQ JULY 2014

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IN PRINT lifestyle

PSYCHODERMATOLOGY THE PSYCHOLOGICAL IMPACT OF SKIN DISORDERS

Doctor Q has a copy of Psychodermatology to give away.

Simply fill out your details in block letters on the form and fax it to (07) 3856 4727 or email amaq@amaq.com.au.

CHECK FOR YOUR NAME!

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COMPETITION WINNERS

Entries close 31 July

Psychodermatology covers all aspects of how the mind and body interact in relation to the onset and progression of various skin disorders. This book is the first text written by a multidisciplinary team of psychiatrists, psychologists, child specialists and dermatologists for all the health professionals who treat patients with skin problems. They cover a broad range of issues affecting these patients, including: stigma, coping, relationships, psychological treatments, the impact on children, comorbidities, psychoneuroimmunology, quality of life and psychological treatments.

Psychodermatology is the first multidisciplinary text to cover the bodymind interactions affecting skin disease and takes a broad-ranging approach from psychoneuroimmunology to dealing with stigma. It was written for all health professionals working with patients with skin diseases.

Edited by Carl Walker and Linda Papadopoulos, Psychodermatology is published by Cambridge University Press and retails for $96.00.

This book is available in print and as an ebook at www.ebooks.cambridge.org Q

WIN THIS BOOK! Name: Postal Address:

Telephone: Member No:

DENDY WINNERS

QPAC WINNERS

BOOK WINNER

DOUBLE PASS WINNERS

Dr Marjorie Busby and Dr Su Mien Yeoh won double passes to David Campbell and John Bucchino in concert.

Dr Maxim Wilson won a copy of Case Studies in Epilepsy: Common and Uncommon Presentations.

1. Dr Marjorie Busby 2. Dr Noel Saines 3. Dr Nigel Dore 4. Dr John Holmes 5. Dr Anthony Coorey 6. Dr Tim Briggs 7. Dr MGE O’Rourke 8. Dr Michael Toch 9. Dr James Bowman 10. Dr Joan Lawrence

CLASSIFIEDS Available Positions - General Practitioners 7Springs Medical Practice is currently seeking experienced General Practitioners for our modern, purpose built facilities. Excellent career opportunities.

7Springs Medical is a: • Mixed billing practice • Flexible and family friendly • Limited after hours (on roster with all doctors) • Teaching Practice

• Multiple experienced GP supports • Allied Health on site • Excellent facilities • Nice practice manager • Location - RA2

Phone: 07 4529 2777 Email: employment@ sevensprings.com.au 881 Ruthven Street Toowoomba Q 4350 www.sevensprings.com.au

Private Consulting Suites available for specialists in the heart of the Western Suburbs, 5km from the city Location: 185 Moggill Road, Taringa QLD 4068 Onsite administration staff available for bookings Nursing support and onsite minor operations facilities available if required.

For further information, please contact Dr Shobhan Manoharan E: smanoharan@westderm.com.au P: (07) 3871 3437

W: firstnationalcommercial.com.au

FIRST FLOOR OFFICE – P.A. CENTRAL – FOR LEASE • Attractive incentives on offer • Major carpark adjoining • Opposite Centro Buranda and the PA Hospital with direct overpass access • 125 to 200m2 available • Adjoining Southern X Radiology

• Ideal for medical suites and other related services • Disabled access and amenities

CONTACT: George Koukides: 0412 872 786

Specialised support service for Doctors, their families and medical staff Individually tailored support for doctors, medical staff and their families, from assistance dealing with the stress of short notice relocations, a hand at home, to help when a family member is unwell.

Our services include: • Support for families relocating • Supporting new doctors moving to Brisbane • Researching and sourcing local services • Nanny services for families • Respite for parents and carers • Help with household organisation and domestic chores

www.angelsinaprons.com.au | Call us on 0406 076 885 or email sharon@angelsinaprons.com.au

DoctorQ JULY 2014

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Exclusive.

Affordable.

Rules were made to be broken There is a profusion of credit cards on the market, so why does the Investec Signature card stand out in the crowd?

You earn more Qantas Points* on eligible spend – 1 point for 1 dollar, without any caps or limits – and enjoy Priority Pass access to over 600 airport lounges, complimentary travel insurance^, Visa Front Line entertainment access for hard-toget bookings and much, much more.

You’ll feel like you’re part of an exclusive club, yet it’s surprisingly affordable.

Speak to your local finance specialist on 07 3018 8100 or visit investec.com.au/card to find out more.

Specialist Banking Equipment and fit-out finance | Goodwill funding | Credit cards | Home loans | Commercial and property finance | Car finance | SMSF lending and deposits | Transactional banking and overdrafts | Savings and deposits | Foreign exchange All finance products are issued by Investec Bank (Australia) Limited ABN 55 071 292 594, AFSL 234975, Australian Credit Licence No. 234975 (Investec Bank). All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Information contained in this document is general in nature and does not take into account your personal financial or investment needs or circumstances. We reserve the right to cease offering these products at any time without notice. You should obtain independent financial, tax and legal advice, as appropriate. *Qantas Points are earned in accordance with the Investec Qantas Rewards Program Terms and Conditions available at investec.com.au/cards. You must be a member of the Qantas Frequent Flyer program in order to earn and redeem points. Qantas Points and membership are subject to the Qantas Frequent Flyer program Terms and Conditions available at qantas.com/terms. You earn 1 Qantas Point for every $1 of eligible spend in Australia and 2 Qantas Points for every $1 of eligible international spend on the Investec Signature credit card. See definition of Eligible Spend in the Investec Qantas Rewards Program Terms and Conditions, available at investec.com.au/cards. Investec recommends that you seek independent tax advice in respect of the tax consequences (including fringe benefits tax, and goods and services tax and income tax) arising from the use of this product or from participating in the Qantas Frequent Flyer program or from using any of the rewards or other available program facilities. ^Investec card Insurances are underwritten by ACE Insurance Limited (ABN 23 001 642 020, AFSL No. 239687) (ACE) and are subject to the terms, conditions and exclusions contained in the policy of insurance between Investec (ABN 55 071 292 594, AFSL & ACL No. 234975) (Investec) and ACE relating to the Investec card. It is important for you to read the Terms and Conditions available at investec.com.au/cards and consider the appropriateness of that insurance in relation to your individual requirements. When you purchase your return travel tickets on your Investec card you, your spouse and dependent children, if travelling together, will automatically have access to travel insurance for trips of up to 90 days.