vicdoc: August 2009

vicdoc

09

MAGAZINE OF THE AUSTRALIAN MEDICAL ASSOCIATION (VICTORIA) LIMITED AUGUST 2009

poSiTive AGeiNG

YoUNG DocTorS meeT heAlTh miNiSTer

AmA NATioNAl preSiDeNT Dr peSce SpeAkS

ScieNce of Sleep

FINANCE ADVISORY SERVICEExpERtS IN ADVISINg MEDICAl pROFESSIONAlS ON:

• Residentialandinvestmentpropertylending• Practiceacquisitionlending• Commerciallending• Workingcapitallending• Linesofcredit • Vehicleandequipmentlending

Financestructuringiscriticaltomaximisetaxefficiencyandguardagainstcostlyrestructures.

WhatWeoFFeR:

• SpecialisedadviceandService• ongoingSupport• NoFeeforService

ourconsultantsactasanintermediarybetweenyouandourpaneloflenderstoarrangefinance.theygiveimportantconsiderationtoensurethefacilityprovidesthefeaturesthatareappropriateforyounow,andgiveflexibilityforyouinthefuture.

tOp 3 RECOMMENDAtIONS:

1. Meetwithourfinanceconsultantstodiscusstheimportanceof appropriatestructuring2. Meetwithourfinanceconsultantstoobtainindependent objectiveadvice3. trustourfinanceconsultantstopresentcompetitivelending solutionsspecifictoyourrequirements.

CONtACt US FOR A FREE ReVIeWoFYoURSItUatIoNPriorityReviewRequestForm–Fax(03)96865288

Phone(03)[email protected]

Name

address

PaYG Selfemployed

homePurchase Refinance

other WorkingCapital

telephone

email

Bestcontacttime

.

We CAN mANAge your fiNANCesso you can spend more time doing the things you love.

fiNANCe ADViCe for HeALTH ProfessioNALs

inside

Magazine of the Australian MedicalAssociation (Victoria) Limited293 Royal ParadeParkville Victoria 3052T: 03 9280 8722F: 03 9280 8786Country Freecall 1800 810 451www.amavic.com.au

Editorial: Ben HarrisE: [email protected]

Layout: Niki Vounoridis

Advertising:T: 03 9280 8722F: 03 9280 8786E: [email protected]

Vicdoc is published by AMA Victoria Services Pty Ltd ISSN 1440-8945 ACN 004 158 614

The views expressed by individuals inthis issue do not reflect necessarily thepolicy of AMA (Victoria) Ltd.

No responsibility is accepted by AMAVictoria, the publisher or the printersfor the accuracy of information containedin the text and advertisements. Publicationof an advertisement does not implyendorsement by AMA Victoria.

AMA Victoria Board MembersDr Harry Hemley (President)Prof Robert ConyersProf Graham BurrowsDr Cathy HuttonDr John LeslieDr Roderick McRaeDr Stephen ParnisDr Zoe Wainer

AMA Victoria OfficersMs Jane StephensChief Executive Officer

Ms Michelle BourkeDirector, Marketing & Membership

Mr John FisherDirector, Corporate Services

Mr Ben HarrisDirector, Policy & Public Affairs

Mrs Judith MerrickDirector, Training & Practice Support

Mr Geoff O’KearneyDirector, Workplace & Advocacy

Mr Frank SprangerDirector, Business Development

Commission statementAMA Victoria and its related at times receive non-subscription income through commissions and other forms of income paid by service providers that provide commercial benefits to members. Through this we can provide improved services to members and keep subscriptions to a minimum.

Information published in vicdoc is copyrightto AMA Victoria. Information from thismagazine should not be reproduced withoutpermission. Contact Claire BellettE: [email protected]

Closing date for next issue:Advertising: 2 August 2009Editorial: 10 August 2009

vicdoc

NEWS AND FEATURES

5911 13 14 15 16 171819 20 232424 252628293132

From the Federal President

DiTs engage with Minister

From the GP Section

Get the most out of your staff

Life in emergency

Tobacco control award

News briefs

EBA update

Solutions for ageing

Positive ageing

Issues in aged care

Accreditation improving care

GP contract reviews

New termination laws

More doctors before PSR

Subdivisions spark debate

Peer support and DiTs

Renovations

Doctors in Training

The science and art of sleep

vicdoc AUGUST> 09 3

Madelene Fox

Policy Assistant, AM

A Victoria

Katrina CoxRecruitm

ent Manager,

mpstaff

Andrea RavasPractice Services M

anager, m

p practicesolutions

Contributors

REGULARS

467

3435

From the President

From the CEO

Advocacy

Classifieds

Events

Page 32Page 18Page 9

From the President

4 vicdoc AUGUST> 09

Leadership in health

The challenges of an ageing population are immense — so much so that governments appear unwilling to take the lead and consider

the tough choices.

As a profession, medicine can sit back and wait for someone, somewhere, to come up with the answers. If we take this path, we need to hope that the solutions work, and that those solutions come on time. If we are relying on government, then a good solution on time may be a bit much to hope for.

The alternative is that we can take the lead. The medical profession is in a unique position to see health problems from a variety of perspectives. We have doctors caring for patients in general practice, residential facilities and hospitals. There are doctors in research, doing home visits, and leading in public health. Medicine can, and should, provide leadership to the community.

Leadership requires a team approach, particularly with complex issues. So to ensure we weren’t just going for a walk, AMA Victoria’s Section of General Practice held a forum a few weeks ago examining some of the issues in ageing and aged care. We had a number of individuals participating, representing a variety of organisations.

Ageing and aged care is a microcosm of the challenges in Australia’s health system. There are the typical difficulties posed by a federal health system: cost shifting, blame shifting and hoping the other level of government blinks first. There are community- and institution- based care providers, including hospitals, residential facilities and general practice, which do not communicate well.

There is an astonishing amount of red tape, process-driven care and a myriad of government and community programs that are difficult to navigate. There are armies of well-intentioned people who still have trouble connecting services to people.

With all the talk of systems, it is important to remember that we are actually talking about people. That’s why we are here — to provide services to people.

Some of these people are vulnerable, suffer from chronic conditions, speak another language or are otherwise infirm. However, many older people are

ready, willing and eager to get involved in their own health care, and are looking for better options.

As our population ages, it means that we will have a greater number of older people to take care of. We need a vigorous debate about the important issues — where people get care, how people get care, from whom and when. These are the questions we should we be asking. We need to consider advanced care directives, improved preventative health care, better use of teams, and hundreds of other issues.

The doctors in general practice need infrastructure support to coordinate the care of frail, elderly patients – this has not been forthcoming. These services are fragmented and disjointed. Government must support general practice to coordinate the care of the frail elderly by providing proper infrastructure support to do the job.

Some ageing and aged care issues are explored in the following pages. However, it seems that for every issue discussed, two more are raised. The medical profession must take a central role in these debates. There are tough and complex issues facing the profession and the community.

When life gets hard, people look to doctors for help, advice and assistance. Similarly, when the public debate is difficult, the community will be looking to the medical profession to take a leadership role in encouraging public debate.

The final National Health and Hospitals Reform Commission and Preventative Health Taskforce reports will be publicly released in the coming months. I’m sure we will see many innovative ideas presented in these reports, but we will also encounter some challenges.

Doctors must take the lead in ensuring the Commonwealth and Victorian Governments’ ageing and aged care solutions are patient-centred, team-based and underpinned by good communication.

Dr Harry Hemley President, AMA Victoria

From the President

vicdoc

vicdoc AUGUST> 09 5

Main heading to a story can go here.Main heading also here

Colleagues,

A quick note to introduce myself and report that I am very pleased to have been elected as the new Federal President of the AMA.

I was elected on a platform of engagement: engagement with government, engagement with members, and engagement with the community.

With your support I plan to engage more closely with government on health and health reform. I want government to discuss issues with the AMA because our opinion is valued, not because we must be neutralised.

I plan to deal openly and honestly with government, highlight problems and bring solutions to the table, rather than simply highlighting our differences in the media. This requires that we have a seat at the table while policy is being developed. Only then can we ensure that our deep understanding of the needs of our patients is central to the development of health policy. I have made it clear to government that I will not tolerate vilification of the profession. There are many fundamental reasons why we must consider changes in the health system from time to time, but none justifies the easy use of the ‘greedy, self-interested doctor’ tag.

My style will be inclusive but robust. Dialogue is two-way. We will listen to government, and work with the Minister, DoHA and the Department of Human Services to deliver the best possible outcome for patients, but I expect also that Government will listen to us, and make far better use of the depth of knowledge and understanding that we bring to health policy.

We can’t afford for the health debate to be driven by ideology. Ideology is the single greatest obstacle to sound evidence-based health policy. The debate must be driven by evidence, and using evidence to provide positive outcomes is something the medical profession understands better than most.

My presidency is about engagement, but also self-analysis.

We need to look now to the future of our profession and the future of the AMA. We must have the confidence in ourselves to defend our core values, but at the same time consider the changes that we must adopt to meet the challenges of the changing health needs of our nation. In this context, I believe we should focus on promoting our own innovative ideas, rather than be seen to be reacting to an agenda driven by others. The need to consider how we can enhance the role of our nursing and allied health colleagues cannot and should not displace the doctor from the central role in our health system. The well-trained doctor is at the foundation of a quality health care team, not a discretionary add-on.

Importantly, we need to address the concerns of doctors who have remained outside the AMA family. It is more important than ever that the profession speaks in a united voice. I hope to build confidence and support for the idea that, while we represent doctors, the AMA also works towards real, long-term health benefits for all Australians. If we can grow the membership of the AMA, we can also grow its perspective and vision.

I look forward to meeting as many members as I can over the coming months and listening to your views. I’d also invite you to respond with your thoughts and concerns. I won’t be able to respond personally to you all, but I will read and consider everything that you send.

I look forward to working with you all towards a stronger AMA and a healthier Australia.

Yours sincerely,

Dr Andrew Pesce

Email, [email protected]

A message from the Federal President

From the CEO

6 vicdoc AUGUST> 09

I have been very pleased recently to have had the opportunity to travel throughout Victoria with our new President, Dr Harry Hemley, to attend

AMA Victoria’s regional and suburban subdivision meetings.

Meeting new members as well as old acquaintances is one of the pleasures of a job like mine, as each meeting allows me to get in touch with members’ views and also to gain insights into their professional lives.

Our subdivision meetings these days have a special ‘soap box’ time, in which members can vent their feelings on anything that is causing problems, hopefully with the possibility that AMA will be able to help. Of course, many of the problems are ongoing, but there are always new ones as well. And rest assured that we do take each problem seriously and do our best to help. Our policy staff, under the guidance of Ben Harris, our Director Policy and Public Affairs, take the trouble to follow up on issues and provide feedback to the members concerned. Or sometimes it is a matter of industrial or legal advice which the Workplace and Advocacy staff, under Geoff O’Kearney’s direction, can help with.

In addition, we have a very professional team of staff who work in our new businesses, and they can help with staff recruitment and all manner of business solutions in your practice. Judith Merrick is the director of the commercial areas of AMA Victoria, which include AMA Victoria Education and Training, mp practice solutions and mpstaff. Judith is very keen to hear from you if you have suggestions for training or business services which can help you in your practice.

Generally, we are able to give first line advice on business solutions at no fee, but thereafter there is a fee, which of course is offered at a lower rate to members.

Our aim is to provide quality service at a reasonable price, with members being rewarded with special membership rates. Please call Judith Merrick on (03) 9280 8761 if you want to discuss our business services. Or call Katrina Cox, Manager of mpstaff on (03) 9348 1111 or Andrea Ravas, Manager of mp practice solutions on (03) 9280 8768 for help with your practice needs. Or visit www.amavic.com.au

Why do we have businesses at all? Because we want to keep your membership subscriptions down if we can.

Which reminds me - our subdivision meetings are not sponsored, other than by the provision of our lovely Prius hybrid car from Australasian Vehicle Buying Services. All costs of catering are covered by AMA Victoria - so if you don’t turn up we have to pay for your meal anyway. Not a good use of members’ funds! Please let us know two days out if you aren’t able to attend after all, or encourage one of your colleagues to attend in your place. And we are always happy to welcome non-members to subdivision meetings, if you feel you have a potential new recruit!

We look forward to seeing you at a subdivision meeting soon.

Jane Stephens Chief Executive Officer, AMA Victoria

From the CEO

Out and about

EBA

AMA Victoria continues to work on implementation of the EBA. There are still a few areas of dispute with the government, and the government has made a couple of mistakes in implementation. We are beginning work on the 80/20 rule with individual hospitals.

TAC

There is a proposal doing the rounds that would treat TAC patients the same as public patients, rather than as private patients as is currently the case. Funding for TAC patients would be ‘rolled up’ in public hospital budgets. AMA Victoria supports the current arrangements, and is in intense discussions with various arms of government.

National registration

We have had a number of discussions about implementing national registration, and it looks like we will win some further concessions on issues such as mandatory reporting.

Parliament

AMA Victoria is supporting two pieces of legislation currently before Parliament; one to implement the Tobacco Control Strategy, and the other to allow 16 and 17 year olds to donate blood without parental consent (other existing protections would remain).

War on red tape

The Victorian Government has begun a review of taxi subsidy forms, following posts from doctors on our blog site, www.waronredtape.com.au. See the web site for further action on reducing red tape in general practice.

Influenza

H1N1 09 influenza continues to affect a large number of Victorians, including some particularly vulnerable groups and pregnant women. AMA Victoria is continuing to work towards better information for GPs and communicating public health messages to the public.

Meetings June-July

22 June VIFM - EBA discussions Kim Sykes DHS - national registration

23 June Office of Senior Victorians - ageing issues

25 June Barwon Health - underpayment of salary mediation Health sector group (pharmacy, optometry, dentistry, physiotherapy associations)

2 July

VHIA - EBA discussions

3 July TAC - doctor billing and account auditing practices

7 July National Registration and Accreditation forum

8 July Minister Andrews - ACOSH/AMA awardBeth Wilson, Health Services CommissionerDHS - Tobacco Amendment Bill

Accident Compensation Act review stakeholders

9 July Minister Andrews - regular catch-up

13 July Lance Wallace, DHS - EBA

23 July Allison McMillan, DHS - ICT and quality issues

24 July 17th Ministerial Forum on Rural Health

vicdoc AUGUST> 09 7

Advocacy

In The Media

New Royal Children’s Hospital

“The Government must ensure the new Royal Children’s Hospital lives up to expectations and, in particular, has the capacity to treat all children in need of its expert care,” editorial

(The Age 10 July 09, p10).

“Given the rate at which the Victorian population is growing, we need to make sure that vulnerable people such as children are well looked after in the future,”

Dr Harry Hemley (The Age 9 July 2009, pp.1-2).

“The zoo is a wonderful idea and would be fantastic for the kids, but the reality is, how many beds will we miss out on to pay for it?”

Dr Zoe Wainer (The Age 10 July 2009, p6).

“AMA Victoria recommends the Royal Children’s Hospital adopt a no-junk-food policy in the creation of their new facility. Adopting this policy would be an important symbol which demonstrates a real commitment from the hospital and the community it serves to tackling the obesity epidemic and promoting healthy eating,”

AMA Victoria (Herald Sun 10 July 2009, p1).

AMA Victoria’s war on red tape“General practice is under-funded, and we know that the Government is happy to add more stress on us. Our job is important, but we can’t make people better if we bury GPs in paperwork,”

Dr Harry Hemley (Medical Observer 10 July 2009, online).

AMA Victoria’s rural rescue package – Gippsland “Doctors relocating to take Latrobe Valley jobs often have to uproot their families and partners who then had to find new jobs and schools in the region. The incentives just haven’t been sufficient and what meagre incentives have been made available haven’t hit the spot,”

Dr Harry Hemley (Latrobe Valley Express 6 July 2009, p2).

For more media information go to www.amavic.com.au

Mr Daniel Andrews Mrs Lisa Neville Mr Tim Holding

AmA Victoria and its related entities at times receive non-subscription income through commissions and other forms of income paid by service providers that provide commercial benefits to members. Through this we can provide improved services to members and keep subscriptions to a minimum.

T: (03) 9280 8722

T: (03) 9835 3035 T: (03) 9348 1111 T: (03) 9280 8768 T: 1300 278 732 T: (03) 8646 0299 m: 0438 140 553

T: (03) 9696 8844

‘Car Buying Made Easy’

[email protected] | www.abvs.com.au

AVBS

1 300 76 49 [email protected]

T: 1800 088 022 T: (03) 9280 8722 T: (03) 9280 8722T: (03) 9835 3035 T: 1300 76 49 49

AMA VictoriA’s preferred proViders

mpstaff

mppracticesolutionsgiving you results2mp practice solutions delivers quality practice

management services, including free telephone advice on basic aspects of practice management, as well as cost effective consulting to practices that require a more tailored solution.

Andrea Ravas(03) 9280 8768andrear@mppracticesolutions.com.auwww.mppracticesolutions.com.au

To get the most out of your practice, call us today for a no-obligation discussion about your practice’s requirements.

mpstaff are leaders in medical practice recruitment, drawing

on our extensive networks and candidate sourcing strategies

to deliver the best candidates to your business. We also assist in

developing position descriptions, KPIs and best practice management tools.

Katrina Cox(03) 9348 [email protected]

great ways to improve your practice’s performance

vicdoc

vicdoc AUGUST> 09 9

Main heading to a story can go here.

News

vicdoc AUGUST> 09 9

Events

DiTs engage with Minister

TressCox has over 50 years experience representing Medical Practitioners in areas of Health Law. Our Health Services Group is one of the largest, most well connected groups in Australia.Some of our areas of expertise include:

Purchase and sale of medical practicesMedical indemnity claimsEmployment and Industrial Relations

General practice and specialist practice issuesDispute resolution and litigationDisciplinary matters and proceedings

Our professionals can advise you on protecting your business and your staff, because we have a deep understanding of many of the issued currently faced by practising clinicians.Please visit our website: www.tresscox.com.au

Call one of our experienced professionals to receive a complimentary initial consultation:

John PettsPhone 03 9602 9736Fax 03 9642 [email protected]

Hayley PetronyPhone 03 9602 9448Fax 03 9642 [email protected]

Eve Temple-SmithPhone 03 9602 9421Fax 03 9642 [email protected]

The Minister for Health, the Hon Daniel Andrews, was present for the AMA Victoria Doctors

in Training forum in July. Minister Andrews fielded questions from DiTs for over an hour, covering a range of issues including supervision, increased graduate numbers, unrostered overtime, the role of junior medical staff, and health information technology.

More than 40 doctors attended, including many new faces, and we

received very positive feedback. This was a great opportunity for the Minister to hear stories from the front line of health care. The Minister was attentive, and appeared willing to listen.

The Minister encouraged AMA Victoria and doctors in training to maintain dialogue with his department, and offered to return to speak to doctors in training again in the future.

Look out for the next Mythbusters session due on 5 October.

Australia’s Leading MDO

Thanks to Avant for sponsoring the Mythbusters session in late May. Their support has been invaluable. For more information about Avante visit www.avant.org.au or call (03) 9341 5900

50% Tax Rebate on

Your Next New Car

As part of the Rudd Government business stimulus package, small business related capital purchases over $1000 in value completed between 13th December 2008 and 30th December

2009 may qualify for a one off 50% tax rebate on the business component of the item.

This is an unprecedented opportunity for anyone who is contemplating the purchase of a new car or other related business purchase to benefit from these government incentives.

Speak to your financial advisor to see if you are eligible or contact AVBS to learn more.

[email protected] • www.avbs.com.au • 4/297 Ingles St Port Melbourne 3207 • 1300 76 49 49

Australasian Vehicle Buying Service“We make it easy.”

vicdoc

vicdoc AUGUST> 09 11

From the GP Section

I was in Canberra the first week of July, the week after the politicians had deserted the city – not a sniff of

a ute anywhere. Canberra’s changing winterscapes of barren trees were a stark reminder of the changing landscape confronting general practice with the passage of the enabling legislation for nurse practitioners’ clients to access the PBS and MBS before Parliament. Unfortunately there is no seasonality about this…..no promise of better to come..

By the time you read this report there is a chance that the NHHRC and related primary care strategy reports will have been publicly-released, after being delivered to the government on 30 June. Early indications are that there are further changes afoot.

The juggernaut continues. There is the potential for so much change without adequate checks on quality, patient safety and coordination of health care. We are making vigorous and robust presentations and arguments on behalf of our patients.

It is clear now that we may have to rethink many of our positions or risk being disenfranchised by the debate.

Despite clearly recognising that one driver is cost-cutting we need

to demonstrate that the resulting fragmentation of care is bad for patients. Clearly the model for best care is a team-based model and we must push our message that GP-led care is the best model. GPs must do the health care planning because as GPs we practice whole-patient care.

What is needed is good collaboration as this will enhance patient care. We need to use the nursing workforce to help to reduce time pressures. Better use of nurses’ skills and expertise will assist patients and lead to better work-life balance for doctors.

Nurses are not taught to diagnose - that is the doctor’s role. We need to empower practice nurses using the legislation to drive outcomes which will assist patient care in our practices and the communities we serve.

Eighty percent of Australians see a general practitioner at least once in a year. Studies have consistently shown that we have one of the best primary care systems in the world. Australians generally have great health outcomes in the community. We cannot put this record at risk.

The independent nurse practitioner legislation remains the thin edge of the wedge for many GPs. We need to be at

the table to ensure that ideology does not trump utility. We need to ensure that patient safety and quality of care is assured. AMA could help to design protocols.

The impending debate on voluntary patient enrolment also requires care and consideration. The question we need to ask is whether the enrolment of a patient (with chronic and complex care needs) with their regular GP will improve the patient’s care.

Concerns will arise around whether it will be truly voluntary and whether it will restrict enrolled patients visiting other doctors. Will voluntary enrolment assist GPs managing patients with chronic medical conditions or could it be just more regulatory hurdles to access services through EPC and other allied health care?

The AMA needs your views at this time more than ever. The AMA Victoria Section of General Practice will be holding a forum on patient registration in October. I encourage you to participate.

Dr Tony Bartone Chair, Section of GP AMA Victoria

thursday 3 september 2009

6.30pm for 7pm

rAcV club Level 2 Bourke room 1501 Bourke streetMelbourne

AmA Victoria and the Section of General Practice invite all financial General Practitioner members to the annual general meeting dinner.

Partners and non members are welcome, at a payment of $88 (incl. GST).

Guest speaker Dr mukesh Haikerwal

rsVp by monday 31 August 2009

facsimile (03) 9280 8786 telephone (03) 9280 8734 email [email protected]

Section of General Practice Annual General Meeting dinner

SPonSoreD by

Professional Development

2009 SHORT COURSES

August Time Course title Cost

Tuesday 11 August 9am - 12pm ECG Update $150

Tuesday 11 & 25 August 6pm - 9.30pm Professional Presentations (Session 1 & 2) $480

Thursday 20 August 9am - 4pm Working in a Medical Practice $100

Wednesday 26 August 9am - 12.30pm Developing High Performance Teams $180

September

Thursday 3 September 9am - 1pm Understanding General Practice MBS Items $150

Thursday 10 September 6.30pm - 9.30pm Becoming a Doctor for Year 11 & 12 Students $400

Wednesday 16 September 9am - 4pm Common Psychiatric Conditions $300

Tuesday 22 September 9m - 12pm Marketing on a Shoe String $150

Wednesday 23 September 9am - 4.30pm Professional Presentations (Session 1 & 2 Full Day) $480

Thursday 24 September 10am - 12.30pm Disinfection & Sterilisation & Safe Handling of Sterile Stock $100

Friday 25 September 9am - 1pm Introduction to Budgeting $150

October

Thursday 1 October 1pm - 5pm Writing Policies & Procedures $150

Saturday 3 October 9am - 4pm Setting Up a Practice $300

Friday 9 October 9am - 4pm Medical Terminology $2980

Tuesday 20 October 9am - 1pm Managing Workplace Relationships & Conflict $150

Friday 30 October 9am - 4.30pm Wound Management $300

November

Wednesday 4 November 9am - 12.30pm Treatment of Leg Ulcers $150

Thursday 5 November 9am - 4pm Working in a Medical Practice $100

Wednesday 25 November 9am - 1pm Recruitment & Retention of Staff $150

December

Tuesday 1 & 8 December 6.30pm - 9.30pm Professional Presentations (Session 1 & 2) $480

Friday 4 December 9am - 1pm Conducting Appraisals to Get the Best from Your Staff $150

Monday 7 December 1pm - 4pm ECG Update $150

Tuesday 8 December 9am - 12pm Marketing on a Shoe String $150

Education &training AMA Victoria’s education and training

program delivers specialised courses for practice staff including medical practitioners, practice managers, practice nurses and support staff. We can also deliver training in your workplace at a time that suits you.

For full course details, go to the Training & Development tab at www.amavic.com.au or call Julie Mineely on (03) 9280 8750.

12 vicdoc AUGUST> 09

vicdoc



vicdoc


Medical Business

During the past year I have discussed recruitment services with many doctors. The issue

which continues to puzzle me is why there are so many complaints about staff not performing to expectations. Is this really the case or is it just a perception? The following tips will help you identify if you are getting the most out of your staff.

Job description

Before you can assess whether a staff member is performing, you must have a benchmark on which to measure them. The job description forms the basis of the role requirements along with expected behaviour. This will allow you to map and understand whether the output matches the requirements of the job. A job description should have been developed before staff were hired but if you haven’t got one, it’s worth the time to create one.

Staff performance appraisals

Underpinning the job description are the measuring tools for success. This is known as a performance appraisal. This should be made up of clearly defined areas known as Key Performance Indicators (KPIs) and then further broken down into competencies. The appraisal should be a measurement of how an employee is meeting (or not meeting)

the requirements of the job. Breaking the KPIs into groups is a more effective approach as it allows you to measure each aspect of the job.

There will be a lot more activities that can be broken down into categories and measured. The more you do break them down, the more effectively you will be able to assess performance.

AMA Victoria will be conducting a series of sessions to assist you or your practice manager to develop and manage the appraisal system effectively. The next program is being held on Friday 4 December. For

more information visit the training and development section of the AMA website www.amavic.com.au

I am available on (03) 9384 1111 if you would like some advice on measuring staff performance.

Katrina Cox, mpstaff Recruitment Manager

Get the most out of your staff

Example of KPIs assessment tool

Customer Service Doe

s no

t mee

t re

quir

emen

ts

Som

ewha

t mee

ts

requ

irem

ents

Mee

ts

requ

irem

ents

Som

etim

es e

xcee

ds

requ

irem

ents

Alw

ays

exce

eds

requ

irem

ents

1 2 3 4 5

Answers the phone promptly and deals with patient queries effectively.

Is able to assess and prioritise needs.

Notifies the doctor promptly of patient test results and manages the follow up process.

Ensures reception area is neat, tidy and welcoming.

All consultation rooms are prepared for patients.

Administration 1 2 3 4 5

Manages the patient booking system accurately and effectively.

Is able to prioritise work load and is flexible to take on further duties when required.

Manages outstanding accounts within required timeframe to ensure minimal outstanding debt.

Accurately types reports, patient letters and other documents within the required timeframe.

mpstaff

PMS VERSION: GREEEN: PMS 354 DARK BLUE: PMS 2756

PROCESS VERSION: GREEEN: C90, M0, Y100, K0DARK BLUE: C100, M94, Y0, K29


Last month’s AMA Victoria / Australasian College for Emergency Medicine (ACEM) forum on the

challenges and opportunities of a career in emergency medicine facilitated some lively presentations and discussions.

AMA Victoria and ACEM presented the forum at AMA House to talk to trainees about the specific challenges of emergency medicine.

Emergency department directors Dr Helen Stergiou, Professor George Braitberg and Dr James Taylor provided the junior doctors with a rare insight into working in a busy ED.

Emergency medicine is a dynamic and challenging career. Attendees were given advice on how to cope with the pressures of being on the frontline and how to avoid burn out.

Another helpful part of the evening was essential tips to assist in preparation for fellowship exams.

With nearly 8 million presentations to emergency departments throughout Australia in the 2007/08 year and an annual increase of 3.6 per cent in presentations since 2003/04, the pressures on Emergency Physicians are great.

AMA Victoria Vice President Dr Steve Parnis facilitated the forum’s panel discussion, where the speakers were joined by Dr Peter Archer.

There was a lot of interesting debate and discussion, from pressures on workforce through to exam preparation. The discussion was lively, and continued well after the close of formal proceedings.

Both AMA Victoria and the College would like to thank those involved in the presentations and panel discussion at the forum.

AMA Victoria will continue to run forums in collaboration with other Colleges throughout the year.

Legal

Life in emergency

AMATravel Service

7 NIGHTAlaska Cruise

from only

Alaska & Canada Specials for 2009-2010Alaska &

Canada from

Alaska/Canada fly/Cruise/Stay13 days from

Alaska Inside Passage, 4 day

cruise from

$128 p/day in 2010

$2399*until 10 SEP 2009

$965until 30 SEP 2009

$1079 in 2010 Northern Lights

of YukonGrizzly & Polar Bear Viewing

Arctic Cruise Expeditions

Native American History & Culture

Ski Canada -Super deals for Whistler, Sun Peaks, Big White & Fernie for 2010. Includes:• airfares ex Australia• Accommodation• Lift Passes• Airport TransfersAlaska Heli-ski or board

March 2010Book by 31 AUG for earlybird specials

Your contact is Sally Freund at AMA Travel Victoria: call (03) 9835 3035 or email: [email protected] Freecall 1800 815 445 Fax (03) 9835 3030 AMA Travel Service - VIC 407 Canterbury Road, Surrey Hills Vic 3127 Australia For more great holiday ideas and useful travel information, please visit our website: www.amatravelvic.com.auBooking conditions and cancellation fees apply. Please refer to the above office for full details and conditions. Lic No 30140

Contact us today for more information and a detailed itinerary.

BOOK EARLY!! SELLS OUT EVERY YEAR!!

only

*plus taxes from $925

vicdoc

vicdoc AUGUST> 09 15vicdoc AUGUST> 09 15

Banish bad presenting habits, control those jitters and better articulate your point of view.

The Spruikit team consisting of a media presenter, voice coach and corporate CEO are returning to AMA to deliver this well received program.

Visit www.amavic.com.au Training and Development section or call us on (03) 9280 8722 for additional information.

Do you present well?

Date 11 and 25 August (workshop over two evenings)

Time 6.30pm to 9.30pmVenue AMA House, 293 Royal Parade, ParkvilleCost $480 (includes GST)

News

Tobacco control award

As noted in the last issue of vicdoc, Victoria has been ranked best

performer on the 2008 National Tobacco Control Scoreboard, an award bestowed by AMA and ACOSH, the Australian Council of Smoking and Health.

Recognising this achievement, AMA Victoria President Dr Harry Hemley presented a certificate to the Minister for Health, the Hon Daniel Andrews, in early July. Minister Andrews accepted the certificate on behalf of his government and his department.

At a presentation held at the Royal College of Surgeons, Dr Hemley noted that Victoria won the award with 71 points, narrowly beating New South Wales and Western Australia. While he said he was happy to offer the Minister advice on how Victoria could pick up the remaining 29 points,

Dr Hemley noted that the new Tobacco Control Strategy got Victoria over the line.

Minister Andrews thanked ACOSH and the AMA for the award, and noted that the legislation to implement the Tobacco Control Strategy was now before Parliament.

Key changes include:

• Banningsmokingincarscarrying children from 1 January 2010

• Banningthedisplayoftobacco products in retail outlets, with an exemption for ‘specialist tobacconists’ and on-airport duty free shops from 1 January 2011

• Banningthesaleoftobacco at temporary outlets and providing for bans of youth-orientated tobacco products and packaging from 1 January 2010

• EnsuringGovernmentschool grounds are

smoke-free from 1 July 2009

• Implementingimprovedcessation services, and

• IncreasingVictoria’scommitment to social marketing.

AMA Victoria is supporting the new legislation, and will now

be asking the government to ensure appropriate enforcement.

As Dr Hemley said, “The only benefits of smoking are addiction, disease and death.”

Listen to the presentation at www.amavic.com.au

NewsNews

AMA Victoria presents to Inquiry

Government responds to Hanks report

mppracticesolutionsgiving you results

The right treatment for your practice mp practice solutions are experts in practice management, offering free over-the-phone advice on all aspects of practice management, as well as cost effective consulting to practices that require a more tailored solution.

AMA Victoria members

enjoy a 10% discount

on selected consulting

services

mp practice solutions services• Free telephone advice• Marketing• HR• Practice set-up• Practice closure• Legal advice• Recruitment• Staff training• Accreditation• Systems, policies

and procedures• Business model review• Refurbishments & renovations

To discuss your practice requirements, call Andrea Ravas today on (03) 9280 8768.

www.mppracticesolutions.com.auandrear@mppracticesolutionss.com.au

The Victorian Government has recently released its response to the Hanks review of the Accident Compensation Act. The response, which took some time to be made public,

contains some wins for doctors and their patients, but rejects a key proposal which was supported by AMA Victoria.

AMA Victoria proposed an independent review of fees paid to doctors and other health professionals for accident compensation work, which was recommended by the review.

While the government has rejected this recommendation, AMA Victoria will continue to lobby for a better system of payments.

The government has supported in principle the need to pay

doctors for telephone consultations and AMA Victoria will continue to lobby for this.

Wins for AMA Victoria relate to protection of patients’ rights: A proposal that Worksafe should have ongoing access to patient records regardless of patient consent was rejected by the government; a proposal to allow workplace health and safety representatives to aid return to work was rejected after AMA Victoria noted the risks to patient privacy; and there will be no substantial change to the current operation of medical panels.

Changes to the Act will be introduced by the end of the year. The government response is available at www.compensationreview.vic.gov.au

AMA Victoria has been invited to present to the Parliament of Victoria’s

Legislative Council Standing Committee on Finance and Public Administration Inquiry.

The Inquiry is investigating public health care shortfalls: the capacity of hospitals to

meet demand, standards and quality of care, resourcing and access levels, and the accuracy and completeness of performance data for Victorian public hospitals.

AMA Victoria will provide evidence on a range of

issues, including hospital culture, safe hours, training and resourcing constraints, at a public hearing on 17-18 August.

The Committee is chaired by the Hon Gordon Rich-Phillips, and has members from each party represented

in the Legislative Council. A copy of AMA Victoria’s submission to the Inquiry is available at http://www.parliament.vic.gov.au/council/SCFPA/Hospitals/. Several AMA Victoria subdivisions have also made submissions, available from the same site.


News


vicdoc

EBA 2009 update

News

AMA Victoria members

enjoy a 10% discount

on selected consulting

services

• Registered Day Hospital Facility

• Vasectomy specialist – 30 years experience

• Over 13,100 Ops performed

• Painless procedure

• Asleep with sedation

• ISO 9001:2000

03 9887 8188www.vasops.com.au

The signing of the Heads of Agreement (HoA) has topped off two years

of lobbying and action to change the health system. However the agreement signified the end of the beginning. More work is still to be done in ensuring members employed in public hospitals gain the most from the changes.

The implementation process has proceeded with AMA Victoria focusing on key logical steps. Ensuring payments (and backpay) to all medical staff was our initial focus. Once significant progress was obvious, we moved to specific issues affecting smaller numbers of members such as proper payment of allowances for DiTs.

The third phase is advancing on other conditions within the HoA that require discussions with Department of Human Services (DHS) and Victorian hospitals (VHIA). The changes include 80/20 clinical/non clinical funding, simplified lodging of CME expenses and development of leadership training programs. The final step is to “lock in” all HoA changes

into statewide public hospital Workplace Agreements.

To keep hospitals honest we developed our enterprise bargaining league table. The table is located at www.amavic.com.au. The league ladder highlights the value hospitals place on their medical staff. Hospitals such as The Alfred, Ballarat and Barwon Health worked to pass on pay increases quickly whilst services such as Southern Health and Royal Children’s lagged behind or were inconsistent in their efforts.

Member updates remain crucial to ensuring hospitals do the right thing. If there is a problem, please let us know.Some of these problems include:

• Slow progress in DiT allowance changes. (No longer an issue.)

• Pay increases for specialists employed under a ‘ZZ’ salary code being overlooked. (Doctors with a ZZ classification need to check that they have received their increases and let us know if not.)

• Translating Directors of Medical Services to the specialist’s stream not occurring in all instances. (Discussions continue.)

• Eligible fulltime 9th year specialists with “overaward” contract payments not receiving a translation increase from moving to the new classifications for years 10 and 11. (Those on the statewide minimum salaries are receiving the translation increases. Discussions continue.)

While we are mopping up some issues, the vital task is now implementing 80/20 clinical support time. The task includes establishing local implementation working groups, developing terms of reference and the methods of assessing the current breadth of non clinical time and how best to work towards 80/20 by speciality.

Progress is slow, and in some instances painfully slow. However AMA Victoria is steadily working to ensure that implementation is thorough and the changes become embedded into the public hospital system.

If you have not received your payments contact AMA Victoria’s Workplace and Advocacy unit on (03) 9280 8722.

doctors4hospitalscaring4patients

IT doesn’T pay To be a docTor In a vIcTorIan publIc hospITal

Solutions for

ageingParticipants at the recent Forum

on General Practice and Care of the Older Person brainstormed

a range of issues and challenges and suggested solutions to what many agreed were endemic problems within the sector.

The forum, hosted by AMA Victoria at AMA House and attended by about 40 people, identified many themes common across various professional groups.

Groups represented at the forum included General Practice, Alzheimer’s Australia, Aged and Community Care Victoria and the Pharmacy Guild of Australia.

Representatives from the Ministerial Advisory Council for Senior Victorians, the National Ageing Research Institute and Aged and Community Care Victoria were among those who addressed the forum.

Attendees were asked to come with three ideas for positive change in the aged care sector. The result was a whiteboard of solutions – many of them creative and innovative.

Recurring issues and suggestions included:

• AgreaterneedforbetterITfacilities in residential aged care facilities (RACF) to allow for ease of communication of patient information between RACF, hospitals, and GPs.

• Improvedtreatmentoutcomesbyinvolving the patient in the decision-making process.

• Aneedtoaddressaculturewhichperceives older people as lacking in the ability to make choices about their healthcare.

The growing burden of disease among older Australians, most notably dementia, was a major concern. Twenty-five per cent of people aged over 85 suffer from dementia and, as the population ages, this disease

burden will increase. Suggestions about how to cope with this trend included earlier referrals from GPs and more funding for dementia planning.

The issue of culturally and linguistically diverse communities in aged care was raised by several attendees, with the suggestion of a Medicare item number for bilingual heathcare workers as Australia’s post-war migrants joined the aged population. Many attendees saw a need to integrate bilingual healthcare workers into all RACFs.

The need for basic RACF infrastructure, such as a separate room for consultations, was raised several times throughout the day. GPs and allied health professionals felt that RACF often did not provide adequate space for private patient consultations.

An issue raised several times throughout the day was the number of Enhanced Primary Care consultations currently allocated through Medicare. Most attendees felt that five allocated consultations were inadequate to treat patients in RACF, particularly those with chronic diseases.

A key message from the day was that health care workers providing services to older Australians were not lone service providers. While it was agreed that GPs were central to coordinating patient care, they were also part of a network of service providers who needed to work together to provide best patient care.

While the aged care sector was facing problems, the forum decided, there was room for improvement and forums such as these were effective vehicles for discussion and the development of ideas. Many innovative solutions were suggested at the forum and we are currently working through the policy development process.

Armed with the issues that were raised, AMA Victoria will continue to lobby and press for change to respond to the areas of need in this sector.


Positive

ageingSeniors do want to be involved in

the planning and decision making for themselves and for their

communities; they have thought deeply about issues and often have creative solutions to problems. Their capacity to contribute, however, is often, at best, overlooked and, at worst, ignored.

People want to live full productive lives no matter what their age. They want to be respected and valued. They want to be in control and make choices just as the rest of the community makes choices about how they will live their lives. Most want to participate in and contribute to their community and, when less independent, they want the support which will enable them to continue to do so. They do not wish to be patronised by professionals who will make decisions for them.

They want services which respond to their individual needs, they want to be understood and to understand, and they want to part of the decisions which are made. In other words they want a philosophy of care which places them at the centre of decision making.

But how do you remain at the centre of the decision making when professionals with whom you have contact doubt that you have the capacity to understand or fail to explain the complex array of services which may be available for you. Many older Victorians lack health literacy. They do not understand how their bodies work or the right questions to ask to increase their understanding of a particular issue or condition. Addressing these questions requires time to be spent with the patient or service recipient and good communication skills are essential. Even those with an understanding often fail to ask the questions because the way in which a service is being delivered discourages them to do so.

But most senior Victorians have a high respect for their GPs and pharmacists. They are regarded by many as the

fount of all knowledge and people at the consultations believed that they should be encouraged to be providers of broad information. But there was also recognition that there was rarely enough time during normal consultations to provide all the information patients needed. Suggestions were made that GP practices could employ nurses with highly developed community links to the community to fill this role.

In order to be able to link people into appropriate activities and services all health professionals should develop a detailed understanding about the communities in which they work, and a detailed knowledge and understanding of the organisations in those communities. This may seem to be an impossible task for doctors, particularly specialists, who may work across a large geographic area which would require knowledge of a large service system. But the doctor who has a basic understanding of the structure of community service provision can use that knowledge to find a way through.

I would urge you all to be visionary, take the time to actively listen to the voices of Senior Victorians broadly, including those for whom you are providing services, realise that you are not a lone service provider but just one part of a network of service providers with whom you work. Working within that structure I’m confident that you will be responding to people’s needs in a much more effective and efficient way.

For more information, please visit www.seniors.vic.gov.au.

Merle Mitchell Chair Ministerial Advisory Council of Senior Victorians.

This is an edited version of her address to the AMA Victoria Section of General Practice forum on ageing and aged care.

Twenty-five per cent of people aged over 85

suffer from dementia

‘‘ vicdoc


vicdoc


Australia’s aged care system is structured around two main forms of care delivery — residential aged care and community aged

care. Aged care operates as a broader system of health delivery, income support, and housing and community services.

Residential aged care homes provide accommodation, hospitality services and personal and nursing care to older people who can no longer live in their own homes.

Community aged care involves older people receiving assistance in a community setting and can range from high to low level care. It can be characterised as formal or informal. Family and friends are the main providers of informal care. Eighty-three per cent of older Victorians received care from informal providers.

The Commonwealth Government, under the Aged Care Act 1997, has primary responsibility for planning, funding and regulating the residential aged care industry. Australia’s aged care system is highly subsidised. The subsidy amount is allocated on an ‘aged care place’ basis and is dependent on the level of care required by residents. Since 1 January 2001, the government subsidy has been contingent on the provider being accredited by the Aged Care Standards and Accreditation Agency, an independent company.

One of the major issues in aged care distribution in Australia is the disjuncture between supply and demand. For example, a large part of the sector relies on the services provided by informal carers. The demand for informal carers is expected to rise by 160 per cent from 2001-2031, and supply is expected to decrease to less than 60 per cent. Initiatives need to be taken to reconcile supply and demand in order to provide good quality care to older Victorians.

Australia’s aged care system is shaped by centralised planning and administrative processes, extensive government regulation and high levels of public subsidy. High levels of bureaucracy create fragmentation, and this fragmentation can be a barrier to the aged in understanding what services best meet their needs and to improving service interfaces with other sectors of the health system.

A recent Senate inquiry and several recommendations included in the National Health and Hospitals Reform Commission Interim Report has brought issues in aged care to public attention.

Funding issues and mechanisms for residential aged care

The Federal Government provides funding to providers through licenses to operate aged care beds through demographic formulae, rather than a consumer model based on entitlement.

Facilities will generally not make beds available until they are granted licenses, leading to a significant delay in availability. There is no incentive to build excess capacity, and patient choice is often limited.

An alternate model is a consumer-based entitlement model, where eligible persons are given vouchers and aged care providers compete to be attractive to potential residents. This model may provide a greater incentive for innovation and excess capacity, but may also see some facilities unable or unwilling to compete.

GP - aged care interface

GP-aged care interface in Victoria needs significant improvement. GP participation in residential aged care facilities has declined in recent years. Only 16 per cent of GPs visit nursing homes on more than 50 occasions per year. AMA has recommended in the past that a Medicare attendance item for comprehensive on-site aged care consultations is needed to provide incentives for on-site visits in order for aged care residents to receive the health care they deserve.

Life expectancy and co-morbidity

The Government’s second Intergenerational report of 2007 noted that changes in Australia’s demographic would present challenges to economic growth. The report projected that the aged population would increase, which would create pressures in spending, particularly in the areas of health and aged care. The proportion of people aged 65 and over is projected to nearly double to 25 per cent of the population. The proportion aged 85 or over is projected to triple to 5.6 per cent of the population.

Australians are living longer than we used to, but we are also living longer with diseases, as formally fatal conditions are now becoming manageable. As people live to older ages, the prevalence of chronic diseases increases. For example, the number of Australians with dementia is expected to increase. > p22

34 per cent private16 per cent State Government 50 per cent non-profit organisations

Who runs residential aged care services in Victoria?

private

state government

non-profit organisations

Who runs residential aged care services in Victoria?

16 %

34 %50 %


vicdoc


vicdoc


Key issues in aged care

Mental health and aged care

Dementia is rapidly becoming one of Australia’s greatest public health challenges. Well over half a million Australians will have dementia by mid-century, which equates to 2.3 per cent of the population. There is no current national strategy for early identification of dementia, which is key for delivering appropriate treatment, support, and counselling. There are also issues around consent to medical treatment with people suffering from dementia.

Advanced care planning

Advanced care planning (ACP) provides patients with a means to articulate their current health care goals and values on the premise that s/he may lose their decision making capabilities in the future. These include advance care directives, granting enduring power of attorney (EPA), verbal instructions, or other forms of communications which articulate instructions about how they wish to be treated when they are no longer capable of making decisions about their health care as a consequence of physical or cognitive incapacity. AMA supports the premise that the competent patient can have a role in anticipatory decision-making should they lose decision-making capacity in the future. ACP in aged care is an important issue as many people coming through the aged care system suffer from illnesses which affect their decision making capabilities, such as dementia.

Cultural sensitivity

Older age cohorts will also progressively reflect greater ethnic diversity as Australia’s post-war migrants age. As a result, the demand for culturally appropriate, flexible and consumer centred age care services is expected to increase.

Increased levels of care

Today, those aged 65 years or older comprise around one in seven Australians. By 2050, about one in four will be aged 65 years or older. As the level of care increases with age, and as people move into older age cohorts, particularly for those aged 85 years and over, there will be a greater demand for high-care places in aged care services.

Changing patterns of disease will create greater diversity in the care needs of older people, especially among the ‘old old’ where it will present new challenges in caring for the very frail.

In 2004, the Commonwealth Government introduced the new Transition Care Program with an expected annual budget of $150 million to achieve better integration between acute hospitals and the aged care sector. This program is intended to improve the functional capacity of older patients to keep them at home as long as possible. This reflects the wishes of an ageing demographic that wishes to maintain independence for as long as possible.

Workforce

The aged care sector is currently facing a workforce shortage. Nurses employed in aged care are paid at least 10 per cent less than their peers in the acute care sector for performing similar or equivalent work. Some sources suggest the pay disparity is as high as 25 per cent.

The effectiveness of aged care services in Australia relies heavily on informal carers who directly care for older people. 83 per cent of older Victorians received care from informal providers. These carers play an important role in coordinating and facilitating formal community care services and are often unaware of the government benefits available to them.

Hospital demand

There are reports (not verified) that there has been an increase in aged care residents visiting emergency departments because a general practitioner is not available, or the facility does not have a division one nurse on site. The Victorian Government believes it is paying for shortfalls in staff and in GPs visiting aged care facilities.

IT infrastructure

Aged care facilities are behind in their use of technology in the treatment and management of residents. Improved IT systems could streamline communication between aged care facilities, GPs and hospitals. It would also serve to reduce the regulatory burden on aged care facilities, which are already marked by a high level of government regulation.

Other capital issues

Some states have reported that bids for bed licenses for aged care facilities have declined significantly because operators cannot make a good business case to bid for the licenses. The major complaint is that the aged care funding from the Commonwealth does not allow enough for capital improvements.

Recent developments in aged care

In March 2008 the Commonwealth Government launched the Aged Care Funding Instrument (ACFI), the new funding model which is used to determine residents’ level of eligibility for care payments.

In October 2008, COAG recommended the creation of a national aged care system for community and residential care, replacing the Home and Community Care Program (HACC).

In March 2009, the National Health and Hospitals Reform Commission interim report focused on what it calls ‘increasing choice in aged care’. The report recommends, among other things, that HACC become a Commonwealth responsibility, an ‘eligibility for care’ assessment system be created, that funding be provided for the increased use of electronic clinical records and aged care homes, and for a modification of the hospital discharge referral scheme.

Existing AMA positions

The below positions were taken from a submission made by AMA Federal to the Senate Standing Committee on Community Affairs inquiry into aged care in 2004.

• GivingolderAustraliansgreater access to quality aged care services wherever they live, whether that be in residential aged care homes, or in the community

• Addressingtheculturalproblems surrounding the perceived lack of value of aged care residents, older Australians and their carers

• Puttinggreaterfocusonthe issue of dementia as an increasing public health issue in Australia, and

• IntroducingMBSitemsthatreflect the clinical service provided in aged care facilities, and fostering innovations in other areas of the MBS that promote team-based care, introducing clinical management and prescribing systems, and providing access to clinical treatment rooms in residential aged care facilities.


vicdoc


Newsvicdoc


Accreditation improving careIf you speak with staff who worked

in aged care a couple of decades ago they could tell you some horror

stories.

Stories of incontinent residents being left all night lying on newspaper to save bed linen costs; others were tied to commode chairs and left there all day to save on incontinence pads and staff time to toilet them; residents being showered at 5am in the cold to ensure night staff were better utilised; massive bed ulcers; development of contractures or foot drop being common; or of aged residents being placed in front of children’s television for the morning with no chance of escape.

It was common for two or three residents to be fed at the same time and for residents to be pushed to the bathroom on shower chairs in varying stages of undress. Bathrooms became production factories providing no privacy and certainly no dignity as residents were showered, dried and dressed in front of each other.

This was before resident committees, aged care recreation or leisure staff or aged care standards addressing not only care but all other operational areas of a residential facility.

Residential aged care became known within the industry as the ‘refuge of the incompetent’. There was a general belief that no skilled health professional would want to work in aged care. It was erroneously believed that if you worked

in this industry it was only because you couldn’t get a job anywhere else.

Fortunately there were some very good people working in aged care at this time, staff who delivered quality care and some who were trialling new patterns of care. For instance the outcomes of dementia resident care trials are still in practice today.

However it was the horror stories that received the attention.

Time has passed, the community is better educated, health staff are better trained and there is an acceptance that aged care is a specialty. This is good news for the 30.4 per cent of the population who will be aged over 60 by 2041.

However, work remains to be done on conditions for visiting medical practitioners.

Fewer GPs are prepared to take on the medical care of patients in residential aged care facilities. The problems presented such as a lack of electronic communication between the facility and the doctors practice, there not being an appropriately equipped medical examination room within the facility, and there often being no division one registered nurse available to supply background care information, need to be rectified. It is impossible to provide quality medical attention if none of the basic elements needed to conduct a medical assessment are available.

A key recommendation of the AMA Victoria forum on ageing and aged care was for general practice to take a more active role in aged care standards. Aged care is much better than it was, but it needs to be easier for doctors to provide care to residents.

On the positive front residential aged care facilities must now be accredited to attract government funding. The Aged Care Standards and Accreditation Agency monitors standards. This agency was appointed by the Department of Health and Ageing as the accrediting body under the Aged Care Act 1997.

The accreditation process addresses four areas of management systems – staffing and organisational development; health and personal care; resident lifestyle; and physical environment and safe systems. Within these four broad areas there are 44 standards addressing regulatory compliance, continuous improvement, care, information systems, education and staff development, ancillary services, OH&S, security and others. For further details visit www.accreditation.org.au

Gone are the days of poor care and lack of choice by residents and their families. Residential aged care facilities close down if they are not up to standard.

Judith Merrick Director, Training and Practice Support

The best value referral tool for members Finding the right specialist to refer your patients to has never been easier. The Victorian Medical Directory lists specialists by location, speciality and languages spoken. And best of all, it’s free for members!

Login at www.amavic.com.au/victorian_medical_directoryFor more information call (03) 9280 8722

News


AMA Victoria is concerned about the number of inferior, legally dubious and unfair independent GP contracts that we have seen recently.

The most common issues we have encountered are: unfair conditions, remuneration or share of billing arrangements significantly below the market, unfair restraint of trade provisions, and contracts so poorly drafted that it is unclear what obligations and entitlements they create.

AMA Victoria encourages all independent contractor General Practitioners to take advantage of the association’s contract review service to avoid signing up to something less than you deserve.

Contract reviews are individual and completely confidential. You will be provided with a report reviewing a proposed contract, or your current contract, and recommendations and arguments for improvements if they are indicated.

For further information please call AMA Victoria’s Workplace and Advocacy Unit on (03) 9280 8722.

Until midnight on 30 June 2009, the law that would have enabled a former employee to lodge a

claim for an “unfair dismissal” would apply to only a very few private medical practices. In fact the practice would need to have 101 or more employees to be exposed to any such risk.

However, as from 1 July 2009 the next stage of the Federal Government’s implementation of their Forward with Fairness changes to workplace laws came into effect. Under these laws there are two classes of employer – those with 15 or more full-time equivalent employees; and those with fewer than 15 full-time equivalent employees.

An employer with fewer than 15 full-time equivalent employees is immune from an “unfair dismissal” claim from an employee with less than 12 month’s service. An employer with 15 or more full-time equivalent employees will only have such immunity from an employee with less than six month’s service.

In practical terms, an employee who has been employed over 12 months at the time their employment is terminated will be eligible to lodge an unfair dismissal claim.

An unfair dismissal occurs when the employee’s dismissal has been “harsh, unjust or unreasonable”. Fair Work Australia (FWA), which replaces the Australian Industrial Relations Commission, will make a ruling with regard to:

• whether there was a valid reason for the termination

• whether the employee was notified of that reason and given an opportunity to respond

• if related to unsatisfactory performance by the employee, whether the employee had previously been warned about that unsatisfactory performance

• the degree to which the size of the employer’s business, or the absence of a dedicated human resource management specialists, may have had an impact on the termination procedures; and

• any other matters that FWA considers relevant.

An employee will not be eligible to lodge an unfair dismissal claim if they are: serving a probationary period (which must be determined in advance);

engaged for a ‘specified period or task’; not employed under an award and earning $106,400 a year or above in remuneration; or engaged as a casual.

AMA Victoria will be conducting briefing sessions on these changes. Call us on (03) 9280 8722 for details of these sessions or any other questions on unfair dismissal.

Doug Bishop, Industrial Relations Adviser, AMA Victoria

Legal

New termination of employment laws

GP contract reviews

What is a ‘full-time equivalent’ employee?

A full-time employee is deemed to work a 38 hour week, so fifteen such employees would work a total of 570 hours [38 × 15 = 570].

Take the example of a medical practice that employs 3 × full-time medical practitioners; 6 × full-time and 8 × part-time (24 hours) clerical/reception staff. Although this practice has 17 actual employees, it has fewer than 15 full-time equivalents therefore would be immune from an ‘unfair dismissal’ claim from an employee with less than 12 month’s service.

vicdoc


vicdoc


The Professional Services Review (PSR) is a body independent of Medicare Australia that is charged

with the responsibility of investigating, following referral from Medicare Australia, alleged inappropriate practice by medical practitioners in connection with the rendering or, initiation of services under the Medicare Benefits Schedule (MBS) or the Pharmaceutical Benefits Schedule (PBS).

Inappropriate practice means conduct in providing services that a committee of a medical practitioner’s peers would consider to be unacceptable.

Each year the PSR is required to report to Parliament on its activities for the past year. The report provides a review of the issues which came to the PSR’s attention, and provides a useful review mechanism for medical practitioners and other health professionals to review their current practices to ensure compliance with the requirements of the MBS and PBS.

In the latest annual report Dr Webber, the Director of PSR, notes that the number of cases referred to PSR has increased significantly since the period 2006 – 2007, and whilst there is a changing mix of the types of medical specialities subject to review, general practitioners continue to comprise the majority of referrals to PSR.

The PSR reviewed the behaviour of 50 practitioners in 2007- 2008 as compared to 27 practitioners in 2006 – 2007. This increase during the reporting period coincided with Medicare Australia’s preliminary revision of its investigative processes. Inevitably, the further changes Medicare Australia introduced on 1 January 2009 suggest that the increase in the number of referrals is set to continue. Indeed, as at March 2009 the PSR had received 119 requests from Medicare Australia to review medical practitioners for the 2008-2009 year.

The Director reported an increase in the number of ‘repeat offenders’ before the PSR. The PSR reviewed 19 medical practitioners who had previously been referred to the PSR whereas, in previous years, there had been just one or two re-referrals. Consequently, Dr Webber reported that the PSR will re-examine the adequacy of sanctions the Determining

Authority imposes to deter future inappropriate behaviour.

During the course of clinical reviews of medical practitioners noted, inter alia, the following particular areas of concern were noted:

• The increasing propensity for inappropriate prescribing by general practitioners of narcotic analgesia, benzodiazepine drugs and the inappropriate use of antibiotics, lipid lowering drugs and anti-inflammatory medications contrary to the PBS guidelines

• General practitioners were routinely ordering a wide range of diagnostic imaging and pathology tests for all patients irrespective of clinical need or relevance

• The inappropriate use of MBS attendance items, specifically, the ‘up-coding’ of consultation items and chronic disease management items, and

• The inappropriate use of MBS procedural items such as ‘up-coding’ of MBS items for skin cancer removal, laceration repair and fracture items and excessive use of skin flap items when treating skin lesions.

The report reiterates the need for medical practitioners to exercise care and diligence when recording clinical findings in medical records. With the increasing use of computerised records, it is reported that ‘cut and paste’ methods adopted by practitioners for convenience, which result in the same clinical examination results being recorded for different patient consultations irrespective of a particular patient’s clinical presentation, will not be considered credible evidence of appropriate clinical practice.

Medical practitioners who are the subject of an investigation by Medicare Australia should seek early advice from their medical indemnity insurer and AMA Victoria, as timely resolution of Medicare Australia’s concerns may prevent an ultimate referral to the PSR.

This article is re-produced with the permission of TressCox Lawyers. TressCox Lawyers are experts in health law and are Preferred Providers of AMA Victoria.

More doctors before PSR

Legal

Dictation to tapes driving you crazy?$100 off Olympus DS-4000Digital Dictation Recorders

Save time and money with a Digital Dictation Recorder.

• Tapesareexpensiveandpronetofailure.• Emailingallowsyoutodictateanywhere.• Clarityofrecordinggreatlyimproved.• Tapeplayersnolongermanufactured.• Tape-likebackspacingfor

correctionispossible.• Originalvoicefilescan

bekeptoncomputer.• Repairingtapeplayers

noteconomicallyviable.• Deskspacegained

(computerisnowtheplayer).

• CompatiblewithOzescribetranscriptionservice.

Max Roberts Practice Serviceswww.practiceservices.com.auTelephone:0398190700

AMA Victoria

Peer Support Service

For anonymous and confidential support call 1300 853 338

(for the cost of a local call)

Peer support for doctors by doctors


Subdivisions spark debate

Subdivisions

C

M

Y

CM

MY

CY

CMY

K

WIB_travel ad_print ready_210x153_updated.pdf 2/6/09 11:25:14 AM

Have you attended a subdivision meeting recently? Yes? No?

Sometimes? Never?

If you are in the No/Sometimes/Never group, how about making a point of attending the next meeting in your area?

Subdivisions meetings provide excellent opportunities for members to network with colleagues across all disciplines of medicine.

To recap on some of the events over the last couple of months, on 9 June the Western subdivision met in Williamstown to discuss the ‘war on red tape’, where Ben Harris, AMA Victoria’s

Director Policy and Public Affairs, discussed some of the issues concerning the medical profession. Mr Dean Raven from the Department of Human Services (DHS) focused on the links between workforce policy and health outcomes.

The Geelong subdivision had an interesting meeting on 16 June at the Barwon Edge Boathouse where Dr Andrew Howard, CIO-Health Services, DHS, provided members with an insight into the future of information communication technology. Dr Harry Hemley was also there, embarking on his presidential tour of the subdivisions around Victoria.

The future direction for Latrobe Regional Hospital (LRH) aroused much discussion between Gippsland members and Mr Peter Craighead, Chief Executive of LRH. Mr Craighead outlined proposals for the redevelopment of the hospital, which is already over-capacity, 10 years after being built. Plans for development are extensive, and would involve taking up adjacent land as well as increasing the floor space of some existing buildings by adding floors.

Mr Craighead acknowledged the need to attract more staff to the hospital, especially

specialist medical practitioners. Currently there are many specialists who make the drives to Traralgon once a week but there are few incentives for them to make more of a commitment to the area. He had few answers, other than to create an attractive culture and flexible employment options.

He acknowledged ongoing problems with the costs of leasing private rooms at the hospital. AMA Victoria has advocated for some years that the rooms should be available at peppercorn rentals to encourage specialists to commit to the area.

vicdoc


vicdoc


Members present cited the need to organise better systems for rotating trainees to the hospital, the need for research programs based in regional hospitals and better pay and conditions.

AMA Victoria President Dr Harry Hemley also addressed the meeting, noting the Victorian government’s continued failure to adequately address rural incentives for

doctors. He undertook to take the group’s concerns to the Health Minister and to continue to work for better support for rural and regional health.

For more information about subdivision meetings visit www.amavic.com.au or call Lisa Busuttil on (03) 9280 8722.

Subdivisions

C

M

Y

CM

MY

CY

CMY

K

WIB_travel ad_print ready_210x153_updated.pdf 2/6/09 11:25:14 AM

Medilink and Billing Submit Health Fund Claims online (8 day payment).Verify a patient Fund, Medicare and Vets details online in seconds.Bulk bill on line (2 day payment).Medilink, Medicare Online and Eftpos - bill, receipt and claim for the patient on the day. You are paid immediately and your patient receives their rebate in 3 working days.

Medilink and Appointments, Recalls, Medical Reports. Medicare Online and EclipseA Windows based, stable afford-able and comprehensive practice management system.Integrates tightly with popular Prescribing Software, HIC Online, Word, Excel. Scanning/Data Management Software, Pathology and Day Surgery Software. Supports multiple doctors as

standard, with individual or whole practice reporting/banking.Seventh Windows version incorporates the suggestions of our 2500+ doctors.Appointment Book is the best in the business. Tightly integrated individual appointment lengths for each session, waiting room. surgical audit, and all doctors on the screen at once.Users are our best sales people as we sell mainly from their referrals.Backed by a national training and support team who come to your surgery.

Olympus Digital Dictation RecordersEmailing allows you to dictate anywhere. Your secretary will thank you.

Grebins Medical SpellcheckerReplaces that supplied in Word (not American spelling).

Health Fund Claims in 8 daysMax Roberts Practice Services web : www.practiceservices.com.au telephone : 03 9819 0700

Western subdivision meeting.

? ? Are you ready for the new Award?

From 1 January, practice clerical staff will be covered by a new Award. Ensure you’re ready

for the change by registering your interest in AMA Victoria’s updated Award Subscriber

Service - a ready reference to the Common Rule Award minimum employment conditions

for medical practice staff.

Existing subscribers will automatically receive Award updates as they

become available.

Email [email protected] or call (03) 9280 8722.

AMA Victoria’s Award Subscriber Service

News


Member services

Peer Support helping DiTs

Many of the calls to the Peer Support Service come from doctors in the early stages of

their careers – doctors who are often feeling stressed and do not know where to go for help or to whom to talk.

AMA Victoria’s Peer Support Service provides an anonymous and discreet point of first contact.

At the recent meeting of the Peer Support Service, guest speakers Dr Sarah Mansfield, Chair of the AMA Victoria DiT subdivision and Mr Andrew Lewis, Senior Industrial Relations Adviser AMA Victoria provided an update to the volunteers on the major issues currently facing doctors in training.

At the same meeting Dr Kym Jenkins, Senior Clinician and Medical Director of the Victorian Doctors’ Health Program (VDHP), detailed health

issues for doctors and the role of the program.

The volunteers represent a range of specialities and include some doctors in training; many are in the later stages of their careers.

The Peer Support Service often refers doctors to VDHP because it can help them find appropriate ongoing medical support. Dr Jenkins noted that when a doctor becomes a patient his or her needs are different and they benefit from an ongoing relationship with a doctor who is experienced in treating other doctors.

The Peer Support Service could not operate without the volunteer doctors who give back to their profession by making themselves available to their colleagues. Not only are these doctors rostered to take calls but also they commit to regular training sessions throughout the year.

COGUS is one of the largest gynaecological ultrasound clinics in Australia. Obstetrics (pregnant) and Gynaecological (non-pregnant) patients are charged a modest fee.

All patients in need of surgery, operations or delivery of babies are referred back to their GPs and original Obstetricians Gynaecologists.

Ultrasound scanner has 3D and 4D facilities.

COGUS is accredited by Fetal Medicine Foundation (London) and RANZCOG to perform nuchal translucency measurements for 1st trimester risk assessment of Down’s syndrome.

Dr Steven L.S. ChowMB BS FRCOG FRANZCOG DDU Consultant Obstetrician Gynaecologist Ultrasonologist

Monday to Saturday pm170 Thompsons Road Bulleen 3105

Telephone: (03) 9850 8100 (03) 9850 8133Website: www.cogus.com.au

MELBOURNE, VICTORIA

At the Melbourne Cricket Ground immediately preceding the 2009 AFL Football Grand Final

[email protected]

Learning and Leisure Pty Ltd196 Melbourne StreetNorth Adelaide 5006South Australia p +618 8267 6660

www.learningandleisure.com.auABN 96 129 409 463

The conference will cover aspects of sports injuries, assessment and management through a series of rigorous academic sessionsand practical workshops extending participants’ knowledge and practice of sports medicine.

NOW AVAILABLE2009 Toyota AFL Grand Final Packages. AFL Authoristed on-seller OSA09/44.

23-25 SEPTEMBER 2009

The Peer Support Service can be contacted 365 days of the year between 8am and 11pm on the toll free number 1300 853 338.



News


vicdocMedical Business

Renovating can breathe new life into a practice. Renovations offer an opportunity to revamp

the practice, improve efficiency and increase productivity.

Setting up a new medical practice can be quite thrilling – an indication that you will soon be open for business. An existing medical practice renovation or refurbishment – complete with some new furniture – can do wonders.

However, renovations can be extremely challenging. They involve a great deal of time and effort planning, coordinating, scheduling and overseeing each stage. Whether your renovation will consist of no more than fresh paint, new carpeting, and changing the pictures on the wall or a total makeover, mp practice solutions can assist.

A typical medical practice renovation or refurbishment will include several different stages. These include:

Design. All renovations begin with ideas and visions. When thinking about what you’d like your medical practice to look like, remember to take into consideration storage needs, lighting,

patient and staff requirements and number of rooms needed.

Quotes. Once you have decided to renovate you will need to organise quotes. You will need several quotes to compare and they should include everything from the layouts right through to the suggested colour schemes.

Planning approvals. It’s often necessary to obtain certain approvals before undertaking any renovations. You may need to get approval from your local council, landlord, or body corporate.

Getting started. Once a tender has been accepted and any approvals received, work can begin. This is most often when the problems really start happening. Managing the project at this stage is critical to success.

Whether you are considering a small refurbishment or a major renovation, careful planning and management is vital. Even the most minor medical practice fitouts can be costly.

mp practice solutions can manage your project from start to finish. We can assist with coordination or simply

provide advice to ensure the process is as straightforward and stress free as it possibly can be. We work with a group of experienced, qualified and trusted tradespeople who know medical practice and the importance of running a patient-centred business.

Importantly, we understand how valuable your time is, so let mp practice solutions take the stress out of your next renovation so you can concentrate on what’s most important to your medical practice - your patients.

If you would like to discuss your renovation project, please contact Andrea Ravas, mp practice solutions, on (03) 9280 8768 or email [email protected]

Andrea Ravas, mp practice solutions, Practice Services Manager

Renovations

mppracticesolutionsgiving you results

The pre-eminent directory for doctors to refer patients to other doctors Listing in and accessing the Victorian Medical Directory is free for members. The VMD is a valuable resource for GPs to refer patients to specialists, and for specialists to receive maximum patient referrals.

Log in today using your membership number and Member Zone password.www.amavic.com.au/victorian_medical_directory For more information call (03) 9280 8722

At Bendigo Bank we realise that to help your community become successful we must first help you. That’s why we’re committed to the financial well-being of AMA Victoria members.

So we’re offering you attractive savings on your:

> Personal banking, such as home loans and deposit accounts

> General Practice banking, such as margin loans, merchant EFTPOS facilities and cash management rates

And every time you do your banking with Bendigo Bank a percentage of profits will go to AMA Victoria, to assist them support doctors who in turn deliver quality healthcare to all Victorians.

Bendigo Bank is a bank with a difference – and we’d love U to join us.

To find out more contact Garry Hunt, Relationship Banking Manager on 0438 140 553 or email [email protected]

www.bendigobank.com.au

Banking benefits for

Bendigo and Adelaide Bank Limited ABN 11 068 049 178 AFSL 237879. (S24602) (06/09)

“I have now been a happy customer for the past four years and found Bendigo’s EFTPOS services are invaluable to my business.”

Travis Davies, Exercise Physiologist




vicdocvicdoc

News

Share your passion

Doctors in Training

Pablo Picasso once said, “Every child is an artist. The problem is how to remain an artist once he

grows up.”

Prior to studying medicine we are like pluripotent stem cells: we possess a range of talents and interests and have the potential to pursue many possible paths. Amongst these interests are creative pursuits, such as painting, sewing, writing, photography, music, dance, theatre, film-making, technical design, languages and cooking.

The demands of a medical career often mean that these creative sides are neglected. Yet expressing ourselves creatively can relieve stress and anxiety, and help us to reengage with our humanity, making us more effective doctors.

AMA Victoria’s Doctors in Training Subdivision is developing a forum for Victorian doctors to share ideas and opportunities within the community for

creative engagement, such as drawing or music courses, art exhibitions, or cooking or language classes. We also hope that it will enable the formation of links between doctors who have similar interests, who may choose to start up their own groups.

For example, are you are part of a book club and would like to invite other book-lovers along? Perhaps you are interested in getting a regular group together to see the latest NGV exhibition. Or maybe you’d like to share your love of classical music with someone.

The DiT Subdivision is currently seeking doctors to establish and administer this creative doctors’ forum, as well as contribute ideas. Anyone interested is invited to contact Maitreyi Modak [email protected] or Dr Sarah Mansfield [email protected] .

As part of this project, we also are planning to hold an art exhibition later

this year to explore the experiences of doctors’ work in the developing world. If you would like to contribute photos or other artwork related to this theme, please email Dr Christolyn Raj, AMA Victoria’s DiT Public Health and Community Projects Officer, at [email protected].

AMA Victoria’s primary aim is to advance the medical profession and the health of our patients. To advance the profession, AMA Victoria facilitates networking between doctors of all backgrounds across the state through its many activities and subgroups.

The DiT Subdivision hopes that a creative doctors’ forum will provide further opportunities for Victorian doctors to link with one another and explore broader interests, enriching their lives both in and outside of work.

Dr Sarah Mansfield President, AMA Victoria Doctors in Training Subdivision

The manual provides doctors and practice managers with a user-friendly and practical guide with comprehensive advice to assist with commencing and managing a private medical practice.

The second edition contains many improvements and updates, including:

• medical record/document destruction legislation

• record keeping requirements

• template employee records

• payroll tax improvements, and

• Medicare and WorkSafe Victoria

guideline updates.

The second edition of AMA Victoria’s Private Practice Manual: the essential guide to a successful practice is now available. Visit www.amavic.com.au or call (03) 9280 8722.

Private Practice maNUaL


From the CEO

Medical practitioner and professional dancer Dr Grace

Walpole shares her infatuation with the

daily slumber.

Equat laore ming enisl ullamconse dolobortin ea Ut

laoreet dolobore cor secte magna facilit iure con utem dolortinim volortie commy

“

For Dr Grace Walpole sleep is much more than the collapsed section of our life which separates the days.

“On a purely physiological level, sleep is just a sequence of electrical states in the brain,” she says. “But you only need to look at the complex social rituals, structures and taboos associated with sleep to see that it is as much a cultural as a biological phenomenon.”

Dr Walpole has spent the past six months researching the culture, philosophy and science of sleep for her full-length solo dance work, Short Dissertations on Sleep.

The self-choreographed work uses movement, voice, images – including EEGs and hypnograms, and a soundscape of eminent local medical practitioners and famous philosophers to answer the question ‘what is sleep?’

Dr Walpole presents five answers, or short dissertations, and concludes that a comprehensive scientific answer impossible because while our brain is active when we sleep, the subject is unconscious and therefore cannot self-report. Plus the observer is always removed from the activity. “In many ways sleep sits on

the edge of science; we don’t really know what happens,” she says.

For Dr Walpole, this makes studying sleep all the more fascinating and has led her to investigate the philosophical underpinnings of sleep: whether it is as unique as the rest of our lives and what happens to our identity of sleep.

Dr Walpole uses dance as a way to explore possibilities of what might take place as we lay motionless for a third or a quarter of our day and “to communicate aspects of sleep that exist beyond language”.

Short Dissertations on Sleep, performed for a short season last month at Melbourne’s Dancehouse theatre in Carlton, was the first of a trio of full-length solo dances by Dr Walpole, with works on pain and breath to follow. When she can squeeze it between her medical work, that is.

Dr Walpole says she is as much a medical practitioner as she is professional dancer but choreography and dance are the crafts which regularly need to be put on hold as she moves further into her medical career.

Medicine comes first simply because it has to. Since she began her graduate medical degree in 2000 dance has regularly been pushed aside as medical pressures have mounted, particularly in her intern year.

At times long hours and on-call pressures have left few hours to prepare for performances but she has always done some form of movement, even if it was just “rolling out the mat for some Pilates”.

Being born into a medical family, Dr Walpole initially avoided medicine and studied art history and neuroscience. “I resisted for a long time,” she says, but after being convinced by a friend to sit the GAMSAT exam she found herself on the same path as her kin.

Her early placements strengthened her desire

The science (and art) of sleep

“Sleep: it pauses the personality, renders us vulnerable, links us to the animals, and dictates the very architecture of our society…

and yet sleep is so ordinary, so invisible, that we rarely stop to acknowledge its importance in our lives.”

Dr Grace Walpole

vicdoc



Newsvicdoc


to become a doctor as she found medicine’s patient-contact more rewarding than her work in neuroscience. As part of a PGPPP program she worked with two GPs in Groote Eylandt in remote Arnhem Land. Together they cared for five Indigenous communities.

The transitions between Dr Walpole’s medical and dancing careers have been surprisingly seamless. In 2003 she studied at the Victorian College of Arts for a Postgraduate Diploma in Dance Animateuring (choreography that includes other art forms) while taking a break from her medical degree.

Opportunities to locum have afford her the flexibility to dance and practice medicine – for now at least.

A self-confessed study addict, Dr Walpole wants to pursue her interests in women’s and Indigenous health, probably in gynaecology. She will start an O&G Diploma soon and hopes to become an O&G Registrar in the future.

In the meantime she is content juggling dance and medicine as she begins planning for her next full-length solo performances on pain and breath.

News


Classifieds

POSITIONS VACANT

Boronia GP VR, Flexible hours for accredited, computerised family practice. High remuneration, allied health and nurse support. Contact T: (03) 9761 1244 or M: 0413 808 350

Belgrave/Tecoma FT/PT VR GP to join computerised, modern, accredited practice in Dandenong Ranges. Great team environment and family. Excellent admin support with sociable & negotiable hours. 19AB/DWS welcome. Phone Dr Dennis Gration T: (03) 9757 8000 or M: 0411 190 396

Bendigo Friendy GP clinic owned by 4 doctors requires an associate VR. 1.5hrs from Melbourne. Near arts and sports precincts. Modern heritage building with nursing support. Near public and private schools. Minimal after hours roster. Contact Dr Chan/Manager T: (03) 5443 5299 E: [email protected]

Berwick FT/PT, VR doctor. Practice as you aspired with a supportive group of practitioners. Established, innovative, and accredited with A/C, broadband and IT. Located in main town precinct. Good specialist support. Local private and public hospitals with 24 hr A&E. 40 mins from Melbourne. Some a/hrs and on call. Contact Dr. W. Jame T: (03) 97071444 E: [email protected]

Dandenong GP required for supervision of patients in clinical research trials. 1-2 sessions per week. Inquiries T: (03) 9791 2388

Glen Waverley FT/PT GP required for general practice. We are a 2 doctor, accredited, purpose built clinic. Happy, caring family orientated practice. Inquiries M: 0403 037 640

Ivanhoe Medical clinic sessions for FT/PT VR GP. Supportive colleagues, modern, large group. Computerised/paperless. Accredited, FT nurses, CDMs, mixed billing, flexible and friendly. No A/H and good remuneration. Contact Dr Stephen D Smith or Dr David Doig T: (03) 9499 1245

South Yarra VR GP Req. Long established medical practice, flexible hrs, RN. Ideal location for extended hrs. Special interest encourage. Contact M: 0413 525 132 or E: [email protected]

St Kilda GP required. FT/PT. Busy accredited family medical practice. Computerised, private billing with nurse support. Registrars welcome. Contact Rosemary Russo T: (03) 9525 5200 M: 0417 306 385 E: [email protected]

FOR SALE OR LEASE

Caulfield North Rooms available in specialist medical practice. FT and sessional rooms available with flexible rental

arrangements. Located close to Cabrini Hospital. Renovated Victorian building with onsite parking. All rooms have access to computer network/internet and high tech telephone system with voicemail. Inquiries: Kim T: (03) 9509 7252

Kew Beautifully renovated and furnished medical rooms available for sessional use. Small treatment room available. Close to public transport, on site car parking for staff and some secretarial service available. Contact Lisa T: (03) 9819 2299

North Ballarat Medical consulting rooms, 16 Errard Street. One block from hospital precinct. Free standing brick building with office, waiting procedure and consulting rooms. New reverse cycle heating and cooling system. Contact Brett Clare at Gull and Co. Estate Agents, 632 Sturt St. T: (03) 5331 2222 F: (03) 5332 1204 M: 0419 311 522 SERVICES

Neil Finnegan Pty Ltd Architects Design of new medical centres and alterations to existing. Full service anywhere in Victoria. T: (03) 9877 9552 F: (03) 9877 9561 M: 0411 138 064 E: [email protected]

Power & Associates Pty Ltd IT Consultants. Computer systems setup and support.

W: www.powerassociates.com.au Melbourne T: (03) 9670 2255 Geelong T: (03) 5278 3242

COMMENCEMENT OF PRACTICE

Dr Aviva Nathan wishes to announce commencement of practice in obstetrics and gynaecology at 109 Wattletree Road, Malbern 3144. Contact T: (03) 9500 1244 F: (03) 9500 2868

Dr David Gill and Dr Rohan Crouch, dermatologists, have commenced practice at Skin & Cancer Day Surgery in Ashwood with particular interest and expertise in skin cancer, melanoma and MOHS micrographic skin cancer surgery. Contact T: (03) 9888 3590

CLOSE OF PRACTICE

Dr Diane Neill Psychiatrist, has closed her private practice and rooms at Millswyn Clinic, South Yarra. Postal address is now PO Box 493 Elwood 3184. T: (03) 95311010

CHANGE OF ADDRESS

Mr Tiew Han Neurosurgeon, has moved his main rooms to Suite 6, Level 3, 55 Victoria Parade, Fitzroy. He continues to consult at Werribee, Coburg, Traralgon and Warrnambool. Contact T: 03 9417 3138 or M: 0448 118 118

PROPERTY VALUATIONSSpecialising in the Valuation of:• Consulting Rooms• Clinics• Day Procedure Centres

For• Financial Reporting • Partnership Addition or Reduction • Family Law• Mortgage

ContactJohn Welch Karl Cundall

Level 4, 271 William Street, MelbourneT: 9670 2116 or 0416 080 345E: [email protected]

Confidential Shredding Service

Quick-Shred

Patient records and other confidential documents securely shredded on or off-site, then recycled. X-ray disposal service.

Call Karen or Michael. Telephone (03) 9551 5327Mobile 0408 122 645


NewsvicdocFor the diary

Thursday 20 AugustNorthern Subdivision Meeting

Time 6.30pm-9pmVenue Rydges - Bell City, 215 Bell Street PrestonTopic Private Practice in Global Financial CrisisSpeakers TBC RSVP Monday 17 August E: [email protected] T: (03) 9280 8722

Monday 24 AugustInspiring Women in Medicine Series

Time 6.30pm-8.30pmVenue AMA House 293 Royal Parade ParkvilleSpeakers Dr Sally Cockburn (Dr Feelgood) Dr Kym Jenkins, VDHPRSVP Thursday 20 August E: [email protected] T: (03) 9280 8722

Thursday 27 AugustJoint South Eastern Suburban, Maroonda and Dandenong Subdivision Meeting

Time 6.30pm-9pmVenue Wheelers Hill International, 242 Jells Road Wheelers HillTopic Is your practice equipped for the new Fair Work Act?Speaker Mr Geoff O’Kearney, Director Workplace & Advocacy, AMA VictoriaRSVP Monday 24 August E: [email protected] T: (03) 9280 8722

Thursday 3 SeptemberSection of General Practice Annual General Meeting Dinner

Time 6.30pm for 7pmVenue RACV Club Level 2, Bourke Room 1 501 Bourke St, MelbourneSpeaker Dr Mukesh HaikerwalRSVP Monday 31 August E: [email protected] T: (03) 9280 8722

Events CalendarAugust 2009 August Time Region Speaker Topic Tue 4 August 7pm Swan Hill Dr Damien Cleeve Early detection of Breast Cancer

Wed 5 August 12.30pm Albury Dr Karl Bleasel Allergy & Immunology

Thu 6 August 12.30pm Horsham Sgt Rodney Hiam Safe working environment for General Practice

Thu 6 August 7pm Terang Dr Rodger Brough Management of Drug Seekers

Mon 10 August 7pm Ararat Dr Michael Bardsley Dysfunctional uterine bleeding

Thu 13 August 12.30pm Portland Dr Andrew Bradbeer Asthma - COPD

Thu 13 August 12.30pm Sale Dr Andrew Churchyard Parkinson’s in the Elderly

Thu 13 August 12.30pm Warrnambool Mr John Hounsell Transfusion Medicine Update

Fri 14 August 12.30pm Hamilton Dr Kathy McNamee Family Planning - contraception update

Wed 19 August 12.30pm Mildura Dr Alan Soward Echo Cardiography

Wed 19 August 12.30pm Colac Dr Diarmuid McCoy Chronic Pain Management

Thu 20 August 12.30pm Sale Dr Ken J Harvey Rational Use of Antiobiotics

Thu 20 August 7pm Inverloch Dr Austin Erasmus Paediatrics - ADHD

Thu 20 August 12.30pm Warrnambool Dr Dominique Robert Surgery in France

Tue 25 August 12.30pm Colac Dr Chris Cooper Paediatrics - Changing trends

Wed 26 August 12.30pm Albury Dr Ramesh Arora Update and Management of Rhuematoid Arthritis

Thu 27 August 12.30pm Sale Dr Peter Rehfisch Orthopaedics - Shoulder/Elbow

Thu 27 August 12.30pm Warrnambool Dr Michael Stewart Advanced Medical Transport

Fri 28 August 12.30pm Hamilton Mr Rodney Moran Swine Flu

For more information contact Louise Avery on +61 3 9415 1177 or email [email protected] VMPF Level 8, Aikenhead Building, 27 Victoria Parade, Fitzroy VIC 3065 www.vmpf.org.au

mpstaff.com.au

PMS VERSION: GREEEN: PMS 354 DARK BLUE: PMS 2756

PROCESS VERSION: GREEEN: C90, M0, Y100, K0DARK BLUE: C100, M94, Y0, K29

Don’t leave the success of your practice to chanceDuring these tough economic times, it’s more important than ever to recruit experienced, skilled and qualified staff to your practice.

mpstaff are leaders in medical practice recruitment.

So don’t leave the success of your practice to chance – let mpstaff be your partner in sourcing and selecting the best people for your practice.

Call us today on (03) 9348 1111 to discuss your recruitment requirements

Experien is a subsidiary of Investec Bank

Plus one

Investec Experien Pty Ltd ABN 94 110 704 464 (Investec Experien), Investec Bank (Australia) Limited ABN 55 071 292 594 (Investec Bank). Deposit products are issued by Investec. Before making any decision to invest in these products, please contact Investec Experien, a division of Investec, for a copy of the Product Disclosure Statement and consider whether these products suit your personal financial and investment objectives and circumstances. We reserve the right to cease offering these products at any time without notice.Deposits made with Investec are guaranteed by the Australian Government as part of the Financial Claims Scheme for amounts up to AUD$1 million per client. Amounts in excess of AUD$1 million are also eligible to be guaranteed on application under the Australian Government Guarantee Scheme for Large Deposits and Wholesale Funding. The terms of the government guarantee may change in the future and Investec reserves the right to amend these terms accordingly.The interest rate of 5.25% p.a, inclusive of the 1% p.a. bonus interest, is current as at 1 June 2009 and we reserve the right to change the interest rates in relation to this product at any time without notice. The extra 1% interest rate is only available on new d-POD or POD+ accounts opened by qualified Medical or Accounting professionals with Investec Experien from 5 June to 31 August 2009, with online access activated. The bonus interest will apply to the variable interest rate for 90 days from the date the account is opened. Bonus interest only applicable on deposit facilities with a maximum investment of $500,000. All finance is subject to our credit assessment criteria. Terms and conditions, fees and charges apply. Income Protection/Life Insurance is distributed by Experien Insurance Services Pty Ltd (Experien Insurance Services) which is an authorised representative of Financial Wisdom Limited AFSL No. 231138 (AR No. 320626). Experien Insurance Services is part owned by Investec Experien.

Ou t o f the O rd ina r y®

Deposit accounts that give you more – plus 1% more.

Get more for your money with a secure, Government guaranteed deposit account, earning 5.25%p.a – that’s an extra 1% interest p.a. in addition to our already premium rate for the first 90 days (bonus interest available for a limited time only).

With no ongoing fees or minimum deposits, and online access that gives you quick and easy control of your finances, you can rest assured your investment is hard at work for you.

Call 1300 131 141 for more information.

Deposit Facilities • Home Loans • Income Protection & Life Insurance

Documents

vicdoc: August 2009