AMA(SA) Supports #Crazysocks4docs Day

medic MAGAZINE OF THE AUSTRALIAN MEDICAL ASSOCIATIONSA (SOUTH AUSTRALIA) INC.

AMA(SA) supports #CrazySocks4Docs day

New government: 100 days • National Conference • Queen’s Birthday Honours Outpatient clinic waiting times • Family Doctor Week • Clinical Analytics Unit Regional boards: back to the future? • Gala Dinner 2018 • AMA(SA) Awards Volume 31 Number 3 July 2018 Modbury 10 MRI scanners in SA, State-of-the-art including Whyalla. MRI fleet Stepney (SPORTSMED SA) SAHMRI (CRIC) Dr Jones & Partners is pleased to announce the Calvary Wakefield Hospital St Andrew’s Hospital addition of a third Siemens 3.0T wide bore Skyra Adelaide Kurralta Park MRI, taking our fleet to 10 magnets in SA. This latest addition establishes back to back Skyras at our St Andrew’s clinic for both specialist and GP referred patients, providing greater capacity for Medicare rebated services to patients, including the newly released breast and cardiac item numbers and the new prostate items. Mount Barker Morphett Vale Visit www.drjones.com.au/clinic-locations Southern Specialist Centre

Dr Jones & Partners is pleased to welcome four new partners to the Practice

Dr Nicholas Bajic Dr Chee Chong Dr Tim Kurmis Dr Mitchell Raeside Dr Bajic has special interests Dr Chong has interests in Dr Kurmis has interests in Dr Raeside has special interests in MRI and CT Imaging with Neuroradiology, Chest and Musculoskeletal and Sports in body imaging, particularly particular sub-speciality interest Abdominal Imaging. Medicine Imaging, with a Gastrointestinal, Hepatobiliary, in diagnostic Neuroradiology After medical and radiology particular interest in Ultrasound, Genitourinary, and Pelvic and Head and Neck Imaging. training in South Australia, he MRI and image guided Imaging. He is also interested in Other interests in Oncology and completed an advanced MRI intervention. Oncologic Imaging. Musculoskeletal Imaging. After Fellowship at Flinders Medical Following completion of He completed the South commencing radiology training Centre. He is involved with Radiology and advanced MRI Australian radiology training in South Australia he completed Oncology, Respiratory and Lung training, Dr Kurmis completed program in 2015. Following this, advanced MRI training at the Cancer multidisciplinary team sub-speciality Fellowships he undertook fellowship training Gold Coast University Hospital. meetings in the public and in Musculoskeletal and in 2015-16 in Oncologic Imaging Dr Bajic regularly attends private sector. Orthopaedic Imaging at Royal and Body MRI at Memorial multidisciplinary meetings in Dr Chong is passionate about Tunbridge Wells and Chelsea Sloan-Kettering Cancer Centre in Head and Neck, Neurology education and is a Staff & Westminster Hospitals in the New York City, USA. Dr Raeside and Neuro-Oncology, and Specialist and the Director United Kingdom. also holds positions at the additionally holds a position of Radiology Training at Royal Adelaide Hospital and at the Royal Adelaide Hospital. Flinders Medical Centre. BreastScreen SA.

Doctor Led • Patient Focused • Quality Driven drjones.com.au Contents 9 3 President’s column Cover story 4 News & views 6 Mandatory assessment AMA(SA) supports Drug dependency #CrazySocks4Docs day 7 Regional boards Doctors and medical students Back to the future? around Australia wore odd, silly, 10 Outpatients colourful or simply crazy socks to Clinic waiting times support doctors’ mental health and wellbeing on 1 June. The AMA(SA) 11 Medical fees helped promote the day … ReturnToWorkSA 14 New government First 100 days 22 15 Council news 16 AGM and elections Gala dinner 17 New faces on Council AMA(SA) Gala Dinner 19 AMA(SA) Dispatches goes ‘Eclectica’ 21 Queen’s Birthday Our black-tie charity Gala Dinner in May was a thoroughly entertaining 24 AMA(SA) Awards night out, and an opportunity to 27 Family Doctor Week recognise members’ contributions 32 National conference and celebrate our successes over The DiTs view the last 12 months. 34 AMA Roll of Fellows Dr Nigel Stewart 37 Who’s who? 29 Your LHN heads 39 World view National conference A multifaceted lens Driving policy for a 42 Motoring better health system 45 Book review This year’s AMA National Conference 46 Student news saw a new leadership team voted in; a new format inviting increased 57 Public health member participation in debates; 60 In practice and much discussion about gender 62 Practice notes diversity and discrimination.

Australian Medical Association medicSA Disclaimer Neither the Australian Medical Association (South Editorial (South Australia) Inc. Australia) Inc nor any of its servants and agents will Editor: Dr Philip Harding have any liability in any way arising from information AMA House, Level 2, 61 Ward Street, Managing Editor: Heather Millar or advice that is contained in medicSA. The North Adelaide SA 5006 Director of Policy and Communications: Eva O’Driscoll statements or opinions that are expressed in the PO Box 134 North Adelaide SA 5006 Cover image magazine reflect the views of the authors and do Telephone: (08) 8361 0100 A/Prof William Tam, Dr Hannah Szewczyk not represent the official policy of the Australian Medical Association (South Australia) unless this Facsimile: (08) 8267 5349 By Charlie-Helen Robinson is so stated. Although all accepted advertising Email: [email protected] Advertising material is expected to conform to ethical standards, Website: www.amasa.org.au Heather Millar 0409 196 401 such acceptance does not imply endorsement by Production the magazine. Executive Contacts Typeset and printed for the AMA(SA) by All matter in the magazine is covered by copyright, President Douglas Press Pty Ltd. ISSN 1447-9255 (Print) and must not be reproduced, stored in a retrieval ISSN 2209-0096 (Digital) A/Prof William Tam: [email protected] system, or transmitted in any form by electronic or mechanical means, photocopying, or recording, After hours: (08) 8361 0100 Unsolicited material: without written permission. Unsolicited editorial material should be sent to the Chief Executive AMA(SA) c/- the Managing Editor no later than six Images are reproduced with permission under Joe Hooper: (08) 8361 0109 weeks prior to the target month of distribution. limited license.

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New steps, new tune

outh Australia is still While the wash-up of Transforming sort of ‘transformation’. A lift in morale experiencing the somewhat Health, and the new Government’s and a recognition and celebration of Snovel sensation of a new responses to it, continues to work the many success stories across our government. New premier Steven through the system, the other major health system, from country SA through Marshall has marked his first 100 days, focus is probably the new Royal to metro hospitals, general practice and the wheels are in motion on a Adelaide Hospital. Labor saw it as a and the private sector. We must not number of the Liberal Government’s jewel in the crown of the health system, shy away from tackling problems and policy prescriptions. and strove to have it ready and trouble- drawing attention to them where it is free pre-election. In Opposition, the needed, but there is much more to The AMA(SA) has been asked to Liberal Party was vigilant in highlighting health than makes it to the headlines. comment on a range of Bills before issues and costs. Parliament, making for a busy time, The AMA(SA) stands ready to do its with often short deadlines before … hot button issues part. We have met with the new CEO the next parliamentary sitting week, of SA Health, Chris McGowan, and where matters of interest may be such as ramping, of course the new Health Minister. under debate. ‘100 days’ KPIs seem waiting lists, and We have welcomed Dr John Brayley to have had a ‘fast forward’ effect in various hospital issues back to SA and to the role of Chief some respects, and quality control may Psychiatrist. We will take to government well be an issue where deadlines take command media what we hear from our members, precedence over consultation. attention and raise doctors in SA: the good and the bad. Legislative proposals on the table public concern. It is our As an AMA(SA) member, aside from include stage one of the proposed whatever your personal links may be, restructure of the SA health system to privilege at the AMA you are also, through us, just one introduce local boards; the capacity for to respond to these degree of separation from any health mandatory assessment and treatment issues on behalf of the leader we meet with – which is pretty of under-18s with drug dependency; much all of them. If you raise it with us – and establishing a new Adult profession, and it is no good, bad or complicated, we can raise Safeguarding Unit, to be located in the small responsibility. it with the minister, with the CE, with the Office for Ageing Well. Opposition, with private health, with the Responding to MPs and the media No new hospital comes without its media, if need be. And if the AMA(SA) on Bills such as these is work that sits perils, and history can record what takes up your cause, you can be sure it alongside our business-as-usual policy has been done well and what not-so- will get a hearing. activity, which ranges from feedback well. But bad news stories do nothing That is one reason to be an AMA(SA) on draft SA Health directives and for morale and even less for patient member. Another is as an insurance policies, to the question of what should confidence. Whatever issues may policy. And another is to contribute to be in the next Public Health Plan for arise or need to be worked through, the peak body that represents your our state, and advancing our own doctors want to focus on what is most profession as a whole, on the largest policy prescriptions. important – delivering the best care for stages. And, of course, there are many patients. And we want our patients to Meanwhile, hot button issues such and varied resources and member have confidence in the system. as ramping, waiting lists, and various benefits. The profession needs the hospital issues command media The focus of government and SA Health AMA, and we need you. So to all our attention and raise public concern. It is must be about getting the job done members, thank you for your support. our privilege at the AMA to respond to – so that we can all focus on the top And to any who are not members, now these issues on behalf of the profession, priority of great care. I hesitate to use is the time to join. Help to shape the and it is no small responsibility. the word, but what we need is the right future that is coming.

medicSA JULY 2018 3 AMA(SA)heading Council AMA endorses Uluru

Office Bearers President: A/Prof William Tam statement from the heart Vice President: Dr Chris Moy

Immediate Past President he AMA Federal Council has endorsed the Uluru Statement from the Heart, which calls for a First Dr Janice Fletcher TNations Voice in the Australian Constitution. Chair Dr David Walsh Regarded by some as the “most important piece of political writing in Australia in the past two decades”, Ordinary Members the Uluru Statement was the result of a gathering Dr Michelle Atchison, Prof Randall Faull, of Indigenous elders and academics inviting non- Dr Matthew McConnell, Dr Clair Pridmore, Indigenous Australians to walk with them to create a Dr Rajaram Ramadoss, Dr John Williams, better country. Dr John Woodall The Federal Government rejected the Statement shortly after its release a year ago. Specialty Groups But the AMA has thrown its support behind the document. Anaesthetists: Dr Perry Fabian Dermatologists: Dr Jeffrey Wayte Federal AMA president Dr Tony Bartone said the AMA had for many years supported General Practitioners: Dr Bridget Sawyer Indigenous recognition in the Australian Constitution, and that the Uluru Statement was Obstetricians and Gynaecologists: another significant step in making that recognition a reality. Dr Jane Zhang “The Uluru Statement expresses the aspirations of Aboriginal and Torres Strait Islander Orthopaedic Surgeons: Dr Jeganath Krishnan people in regard to self-determination and status in their own country,” Dr Bartone said. Paediatricians: Dr Patrick Quinn Pathologists: Dr Shriram Nath “The AMA is committed to improving the health and wellbeing of Aboriginal and Torres Physicians: Dr Nimit Singhal Strait Islander peoples. Psychiatrists: Dr Tarun Bastiampillai Radiologists: Dr Nicholas Rice “Closing the gap in health services and outcomes requires a multi-faceted approach. Surgeons: Dr David Walsh “Cooperation and unity of purpose from all Australian governments is needed if we are to Regional Representatives achieve meaningful and lasting improvements. Northern: Dr Philip Gribble “This will involve addressing the social determinants of health – the conditions in which people are born, grow, live, work and age. Public Hospital Doctors Representative “Constitutional recognition can underpin all these endeavours, as we work to improve the Dr Andrew Russell physical and mental health of Indigenous Australians.”

Doctors in Training representative The AMA announced its endorsement of the Uluru Statement during National Dr Hannah Szewczyk Reconciliation Week. Anti-Racism Statement Student Representatives The AMA Federal Council has also formally adopted a new Anti-Racism Statement as University of Adelaide: Mr Simon Cousins AMA policy. Flinders University: Ms Mekha John He said the Anti-Racism Statement demonstrates the AMA’s commitment to opposing AMA(SA) Executive Board racism across the health care industry and in Australian society. Mr Andrew Brown, Dr Guy Christie-Taylor, Mr John McLaren, Dr Chris Moy, Dr John The AMA Anti-Racism Statement is at ama.com.au/equity-inclusion-and-diversity Nelson, Dr Peter Sharley, Dr William Tam This article by Chris Johnson first appeared in Australian Medicine, on 12 June. AMA(SA) Office: Key Contact Chief Executive: Mr Joe Hooper Vinnies CEO Sleepout Federal Councillors AMA(SA) CEO Joe Hooper was glad to support the A/Prof William Tam (State Nominee) Vinnies CEO Sleepout in June, rugging up and sleeping Dr Chris Moy (Area Nominee SA/NT) out to support Australians in need, and raising close to Dr Susan Neuhaus (Craft Group $4000 (12 individual support programs, 31 beds and Nominee: Surgeons) 126 meals). The Sleepout is an initiative of St Vincent The AMA(SA) office is located at de Paul to help break the cycle of homelessness and 161 Ward Street, North Adelaide. poverty. The AMA(SA) thanks all the members who You can contact us by telephone on supported the cause. It’s not too late to help – St Vinnies (08) 8361 0100, by fax to (08) 8267 5349 take donations at any time, and interested CEOs can

or email to [email protected]. already pre-register for 2019 … © istock/anotherlover

4 medicSA JULY 2018 heading Dr Philip Harding Clinical Analytics Unit to drive policy and evaluation Editor’s LETTER culture of excellence implies ongoing independent evaluation and review to ensure we are meeting our objectives. One of the AMA(SA)’s key calls pre-election was for the establishment of an independent clinical analytics unit within the university and A he health system in South Australia research sector – and for a new clinical senate with which it can seamlessly interface. seems to have a feeling like one of While stability is critical to staff retention and research funding, the health system needs Tthose current affairs programs in to be responsive to new evidence. South Australia can learn from the world’s leading an urban region where there has been hospitals and use data more effectively in decision making. an earthquake and people are now wandering around picking up the pieces Transforming Health may be done and dusted (or now part of ‘normal operations’) but the AMA(SA) wishes to ensure that future possible reform endeavours are informed by the and starting to rebuild. No one is quite best possible information. It continues to call for a new, fully funded Clinical Analytics Unit sure what the new city will look like, but to inform decision making in healthcare. The unit should sit in an academic environment there is a sense of optimism about the free of political influence. future. Harking back to the theme of my May column, it feels as if that road we’re Analysis would inform health policy, budget expenditure and service design. The on has developed a new and higher speed unit would also measure performance such as access and health outcomes. The limit. Many of the changes promised by establishment of such a unit, and other key items from the AMA(SA)’s election priorities, the new government are underway or will be part of the AMA(SA)’s case to government for funding and commitments in the have established timelines. Things are upcoming state budget, due to be handed down on 4 September this year. happening that could not have been imagined a few months ago: just for example, local health networks and other health institutions are to have board chairs in place by the end of this month; the promised review of EPAS is imminent; and we even have a health minister proposing to reopen the Repat Hospital for elective surgery. With this pace of action, there may be a need for a note of caution. The Marshall government has certainly made clear its commitment to improve consultation with the profession in undertaking necessary and promised reviews and changes. However, while Dirty Ashtray goes to NT goodwill is at hand, there will need to be more than good intentions over the months Government for 12th time and years to come. Having said that, there is really a great sense he Northern Territory (NT) Government has taken out the AMA/ACOSH Dirty of enthusiasm about good things that are Ashtray Award for the 12th time. It received the award this year for putting in the happening in health at present. Make sure Tleast effort to reduce smoking over the past 12 months and has now won three you read Dr Jane Zhang’s council meeting years in a row. report (page 15) for an informative and entertaining report on some recent events. Federal AMA president, Dr Tony Bartone, noted the serial offender was not improving. The future of AMA(SA) seems well assured “The NT scored an E this year, and continues to fail miserably when it comes to if judged by the quality of the new and protecting Territorians from the harms of smoking,” Dr Bartone said. younger members joining our ranks and Dr Bartone said that all Australian governments must urgently step up their efforts to taking up positions within the organisation. combat smoking, including reintroducing education campaigns, and banning shop The description on page 17 of the three new assistants and employees under the age of 18 from selling tobacco products. members joining our council at this time reveals an extraordinary breadth and depth “While Australia has made remarkable progress in tackling tobacco, we are in danger of talent, skills and experience. Finally, don’t of losing momentum in the face of constant efforts by the tobacco industry to promote miss the description by Dr Deric de Wit on smoking,” Dr Bartone said. page 41 of his reasons for joining the AMA, Victoria was runner up, with Queensland having the cleanest overall act. SA and how he has benefited from it, and why we

medicSA JULY 2018 5 news & views Mandatory assessment and treatment of young people with drug dependency

rugs are firmly in the spotlight doctor-patient relationship. (You can Our overwhelming preference is for under the new Liberal Government, find our submission on the website at well-resourced voluntary treatment, Dwith a number of measures amasa.org.au.) and more early support, education and proposed as part of a ‘war on drugs’. As intervention. New funding would be Similar issues would apply to the proposal reported in the last issue of medicSA, the required for any new services – existing of the new Government for mandatory Liberal Party went to the state election with services must not be cut. If a mandatory assessment and treatment for young a policy to enable mandatory assessment model does go ahead, medical expertise people under 18, and in particular, and treatment for young people under would need to be front and centre. concerns about the lack of evidence. 18 years for drug dependency, via a The medical opinion would need to The Bill and associated information for magistrates treatment order for a residency be the most important factor in the the proposal seem to pose a number of at a treatment facility for up to 12 months assessment decision. unanswered questions. The AMA(SA) earlier this year provided As this issue of medicSA goes to The AMA(SA) absolutely understands feedback to SA Health on a proposal press, the Controlled Substances people wanting to act on the terrible toll of under the previous state Labor government (Youth Treatment Orders) Bill to set for mandatory assessment and treatment ice in our community – which seems to be mandatory treatment proposals in motion for adults for a period of up to two a focus of the proposal – and also wanting is before Parliament, and the AMA(SA) weeks. The AMA(SA) did not support that to help and protect children and young is finalising its submission in response. proposal due to a lack of evidence it would people. But we want people to get the be effective, as well as concerns about best possible support and treatment, Any members with feedback on this such a measure going against patient and there is a lack of evidence for area are encouraged to contact us at autonomy, stigmatizing, and harming the mandatory treatment. [email protected].

6 medicSA JULY 2018 news & views Regional boards: back to the future? The new SA Liberal Government is forging on with its proposal to restructure the SA health system, but there’s a flavor of ‘back to the future’ about it.

he party went to the election with a plan to decentralise the public Thealth system by establishing metropolitan and regional boards. Each of the pre-existing metropolitan Local Health Networks is to have a governing board, as is the statewide Women’s and Children’s Local Health Network. In rural and regional SA, each of the six LHNs is to have a governing board.

Members who have been around a while will recognise a flavor of ‘back to the future’ in this proposal. While the concept may appeal to those who have chafed against centralised control impeding local decision-making, many questions about the new structure remain unanswered, including what will happen with statewide services such as SA Imaging, SA Pathology provisions to be more explicitly inclusive is interpreted and applied. The plan is that and Drug and Alcohol Services SA, of the broader medical and health by the 2019-2020 financial year all regions among others. community – including GPs – and will be operating under Service Level Working to a deadline to have board chairs representative bodies. Interestingly, the Agreements negotiated by Boards with the in place by 31 July 2018 the government amendments do not provide a ‘powers’ CE of SA Health, to “reflect local needs brought a bill to Parliament on 7 June section for the boards. while recognising state-wide priorities”. The to establish board chairs, amending the AMA(SA) will be awaiting the ‘stage two’ Bill This Bill merely represents ‘part one’ of a Health Care Act. Better consultation has with interest. Any members with feedback been a theme of the new government, and broader program of change; as with most or concerns are encouraged to contact us the restructure has been touted to deliver legislation, much will come down to how it at [email protected]. better clinician engagement via participation on boards, and a requirement for boards to have clinical engagement strategies.

In that context it was disappointing that the Power blackout at Women’s and Children’s Hospital first Bill of this reform process was delivered to Parliament without much consultation power blackout at the Women’s and Children’s Hospital interrupted two apparent. The AMA(SA) swiftly provided surgeries on 3 July. Some areas were affected for several minutes, while other a preliminary submission to government, A areas were intermittently affected for up to approximately 30 minutes. The Labor and the Greens, and attended a disruption affected some clinical areas in the Queen Victoria and Rogerson buildings, subsequent SA Health briefing. including the Emergency Department and operating theatres.

In our first look at the Bill the first issue “Uninterrupted power supply is a non-negotiable part of a health system. Any raised by the AMA(SA) was that the unpredictability in supply must be addressed,” said AMA(SA) vice-president proposed boards should each include Dr Chris Moy. at least one member who is a medical “Hospitals deliver highly complex care and equipment failure can lead to serious patient practitioner, and that the board chairs harm. Whilst it appears there was no adverse outcome on this occasion, we expect should be medical practitioners. SA Health will conduct a thorough investigation into the cause of the power failure to We also raised questions about the prevent it happening again. accountability structure, and flagged issues “The transfer of patients to other sites shows the importance of having a spectrum of for regional SA that would need to be services across our health system. The incident emphasises concerns about the lack addressed, as well as stressing that the of investment and poor state of infrastructure at the main hospital treating our precious cost to establish the new Boards should young,” said Dr Moy. not reduce funding to country service delivery. We advocated for broadening the This power outage comes on the back of the blackout at the RAH in February.

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8 medicSA JULY 2018in South Australia, comprising Ashford Hospital, Flinders Private Hospital and The Memorial Hospital. Investing in our future, caring for your patients. doctors’ health AMA(SA) supports CrazySocks4Docs day Doctors and medical students around Australia wore odd, silly, colourful or simply crazy socks to support doctors’ mental health and wellbeing on 1 June. The AMA(SA) helped promote the day and the important conversations surrounding it.

MA(SA) president A/Prof Will Tam donned crazy socks Aand was joined at AMA House by Dr Hannah Szewczyk, chair of the AMA(SA) Doctors in Training, SASMOA president Dr Laura Willington, SASMOA senior industrial With our on-site Medical Officers officer Bernadette Mullholland, Kiara Our 2,200 staff care for the We work with over 1,400 and three Critical Care Units, we care Cannizzaro of Doctors’ Health SA and every need of your patients. caring Doctors. a number of AMA(SA) members from about the safety of your patients. various fields of medicine: cardiology, vascular surgery, general practice and more. The AMA(SA) wishes to thank all who got involved and helped spread the word and goodwill.

A/Prof Tam said: “The AMA(SA) was glad to support CrazySocks4Docs. As doctors, we sometimes hold ourselves to impossibly high standards, and it can be hard to talk about the problems we face. But we are human and, like anyone, sometimes we struggle.

“We need to be better about having these conversations, and supporting one another. We have lost too many With close to 500 beds, Our 32 operating and doctors to suicide in South Australia, We care for your patients with the the light on a very serious health issue The #crazysocks4docs campaign we care about the comfort procedural suites provide care and it is tragic. We have lost friends latest in medical technology. and colleagues. Mental health is within our profession. began last year to normalise and start of your patients. across all surgical specialties. the conversation about doctors’ something we all need to talk about “Last year’s AMA/Doctors’ Health mental wellbeing. more, and CrazySocks4Docs day is Services Pty Ltd National Forum a great way to raise and promote on reducing the risk of suicide in It was developed by cardiologist Dr this conversation.” the medical profession emphasised Geoff Toogood in response to his Federal AMA President, Dr Tony the need for cultural change own experiences of suffering severe Bartone, said the AMA and the State and compassion. depression, and being asked about his and Territory doctors’ health advisory wellbeing only when he started wearing services are lending their support to The AMA(SA) wishes to odd socks to work. this important initiative. thank all who got involved Doctors in Canada, the UK, the US, “The ‘crazy socks’ day has become and helped spread the New Zealand, Spain, France, and a phenomenon, nationally and now word and goodwill. Ireland have now become involved in internationally, to raise awareness #crazysocks4docs. and normalise the discussion “CrazySocks4Docs is a great example Doctors and medical students on doctors’ mental wellbeing,” of a grassroots campaign with willing needing help can get access to the 24/7 Admissions 08 8375 5290 24/7 Admissions 08 8366 3864 Dr Bartone said. 24/7 Admissions 08 8275 3704 foot soldiers driving change within the Australia-wide network of independent, 24/7 Chest Pain Unit 24/7 Chest Pain Centre Acute Medical / Surgical “Research shows that doctors are at profession to ensure that we better confidential, doctors’ health advisory Emergency Department Liaison Nurse 0437 003 496 Rehabilitation Programs higher risk of suicide, suicidal thinking, care for the carers. and referral services. (open 8.00am – 10.00pm daily) (can facilitate admissions from FMC Emergency Department) (Day / Inpatient) and psychological distress. There are 55 Anzac Highway, Ashford SA 5035 1 Flinders Drive, Bedford Park SA 5042 Sir Edwin Smith Avenue, North Adelaide SA 5006 “The AMA encouraged all doctors These services are coordinated by significantly higher rates for female Phone 08 8375 5222 | ashfordhospital.org.au Phone 08 8275 3333 | flindersprivatehospital.org.au Phone 08 8366 3800 | thememorialhospital.org.au and medical students to put their best Doctors’ Health Services Pty Ltd, with doctors and doctors in training. foot forward on the day, covered in funding from the Medical Board of “This campaign has grown rapidly as the craziest socks they could find,” Australia. To contact your local service, Adelaide Community Healthcare Alliance Incorporated (ACHA) is the largest private hospital group a fun and collaborative way to shine Dr Bartone said. visit drs4drs.com.au. in South Australia, comprising Ashford Hospital, Flinders Private Hospital and The Memorial Hospital. medicSA JULY 2018 9 outpatients Outpatient clinic waiting times revealed The AMA(SA) welcomes the government’s steps to provide more information about outpatient clinic waiting times.

he SA Government released data “We want to know people are able to “This is an important first step in about delays in the public health access the care they need on a timely improving transparency and we Tsystem in early July, including basis, and if that’s not happening, we commend the government on this average and maximum waiting times for need to know where the issues are so initiative,” said Dr Moy. non-urgent outpatients at six hospitals they can be rectified,” said Dr Moy. “However, to make this information in Adelaide. “Doctors want to know what advice to more useful in a GP’s consulting room, The AMA(SA) has been calling for the give their patients, and patients need to what doctors need in the future will be government to make outpatient clinic be able to make informed decisions for realtime waiting lists cross-matched to waiting times publicly available online their health.” each medical condition, and based on for years. standardised clinical criteria and urgency Some of the waits reported are alarming, level. This way, GPs will be able to advise “A lot of attention goes to waits for and the AMA(SA) will put questions to SA their patients immediately of expected surgery and in EDs, but the ‘hidden’ waits Health about what is behind them, and waiting times and allow them to consider for an initial appointment as an outpatient whether these numbers reflect people their options. have tended to fly under the radar,” said who actually still need treatment and are AMA(SA) vice-president Dr Chris Moy. waiting to be seen, versus a failure to “We recognise that the government sees Making outpatient waiting times publicly remove people from the lists who have this as an initial step, and we welcome accessible helps improve transparency, been seen elsewhere or no longer need the progress. There will be more work to and will allow more informed decisions, an appointment. We will also be seeking do and the AMA(SA) will be glad to assist hopefully driving improvements in information on the actual numbers of in any next steps. This is an important waiting times. people waiting. area to be addressed,” said Dr Moy.

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APPOINTMENTS AND ENQUIRIES: T 08 7127 2298 E [email protected] www.drxenia.com.au

10 medicSA JULY 2018 fees AMA(SA) concerns regarding fee stagnation for medical specialists in ReturnToWorkSA’s Medical fee schedule The AMA(SA) has expressed concerns to the RTWSA Board about the continued stagnation of fees for medical specialists undertaking professional medical services under the RTWSA scheme.

he AMA(SA) has consulted with “On top of the increased requirements, its Return To Work Reference the changes under the scheme governing TGroup about RTWSA’s Medical fee selection of medical assessors has failed in schedule, effective 1 July 2018. The group our view. This has led to reduced referrals has expressed its disappointment about to many good doctors impacting on the fact that whilst there is an increase of reliability of income, all these issues provide 1.8% to General Practitioner Attendance an increasing disincentive to our members fees in Schedule 1A, there is no increase to to participate in the scheme in the future.” the remaining fees in Schedule 1A and B for 2018-2019. The AMA(SA) was not approached for further discussion on this matter following “The decision to again ‘freeze’ specialist our submission. We found the process the current process and ‘formula’ applied rates on top of the ongoing Medicare of ‘consultation’ with the AMA(SA) has to arrive at decisions on fees to be flawed rebate suspension of fee increases is proceeded without real engagement other and perfunctory,” said Mr Hooper. having a significant effect on the capacity than an exchange of letters seeking our of medical practitioners to sustain provision To this end the AMA(SA) shall be seeking views and then no further ‘negotiation’. discussions with the Minister as a priority. of services to injured workers,” says AMA(SA) CEO, Joe Hooper. Whilst there is no requirement under the “We would hope to see a review new act to ‘negotiate’, something the of the present process and most “The increased compliance requirements, AMA(SA) would wish to see returned in particularly a review of the current rate regular requests for detailed and the legislation, the AMA(SA) also feels the of compensation for our medical sometimes questionably relevant patient present ‘consultation’ to be merely a ‘tick specialists,” said Mr Hooper. information, along with accreditation the box’ exercise with no real opportunity requirements, all create considerations “As we have previously argued, we to discuss or prosecute the merits of the for our members when contemplating would like to see a recognition of the AMA(SA)’s position. entering or continuing to provide AMA fees list applied into the formula for treatment for work injured patients,” “Whilst the AMA(SA) supports appropriate determining appropriate remuneration for said Mr Hooper. and judicious use of public funds, we find the medical services.”

Adelaide Cancer Centre are pleased to introduce three new practitioners who have recently joined our team:

• Dr Amy Hsieh MB BS FRACP – Medical Oncologist Special Interests – Immuno -oncology, lung, GU, colorectal, breast cancers & melanoma Drs Hsieh and Mislang join Drs Parnis, Kotasek, Stein, Bampton, Cheong, Singhal, Bishnoi, Okera, Hocking, Tan and Patel in providing oncology • Dr Anna Mislang MB BS FRACP – Medical Oncologist Special Interests – Geriatric oncology, breast, lung, GI and GU cancers & melanoma consultations, opinions and specialist management of all adult malignancies. Haematology services continue to be provided by Drs • Dr Agnes Yong MB BCh (Hons) MRCP FRCPath FRCPA PhD – Haematologist Wickham, Hui, Chow and Cheung who welcome Dr Yong to the Special Interests – Malignant and non-malignant haematology, stem cell transplant haematology team. All practitioners have access to onsite day hospital facilities for chemotherapy administration and infusion services.

medicSA JULY 2018 11 heading

10 20 50 100 200 300 400 500 600 700 Scale Bar Units in Millimetres

10 20 50 100 CENTRAL STORES AND PAEDIATRICS 200 300 400 500 600 700 Scale Bar Units in Millimetres VIEW FROM LANE LOOKING EAST

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E DESIGN DEVELOPMENT 16/6/17 HA D PLANNING 8/6/17 HA C GENERAL UPDATE 31/5/17 HA B CONSULTANT REVIEW ISSUE 2/5/17 HA A PRELIMINARY PLANNING 26/4/17 HA

Rev Amendment Date Init

CONSULTING SUITE CONSULTING SUITE 189 Wakefield Street Adelaide SA VIEW FROM ENTRY VIEW SHOWING ROF PLANT T 08 8236 2900 hodgkison F 08 8232 3536 E [email protected] architecture www.hodgkison.com.au project management PENNINGTON STREET STORES NORTH ELEVATION interiors - LOADING ENTRY AND STORAGE FACILITY - LOADING ENTRY AND STORAGE FACILITY Adelaide | Alice Springs | Canberra | Darwin | Hobart | Melbourne | Perth PAEDIATRICS ENTRY LOOKING EAST THE MEMORIAL HOSPITAL DESIGN DEVELOPMENT SCOPE STAGING

CONCEPT CENTRAL STORES C:\Revit-Local\A_17033_COMMON_R17_jpmau.rvt

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TS JUN 17 DM JUN 17 Drawing Number Amdt DESIGN DEVELOP DD 27 E Contractor shall check and verify all levels and dimensions on site and report any

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F PLANNING SUBMISSION 16/6/17 HA E DESIGN DEVELOPMENT 16/6/17 HA D PLANNING 8/6/17 HA C GENERAL UPDATE 31/5/17 HA B CONSULTANT REVIEW ISSUE 2/5/17 HA A PRELIMINARY PLANNING 26/4/17 HA F PLANNING SUBMISSION 16/6/17 HA E DESIGN DEVELOPMENT 16/6/17 HA Rev Amendment Date Init D PLANNING 8/6/17 HA C GENERAL UPDATE 31/5/17 HA

189 Wakefield Street B CONSULTANT REVIEW ISSUE 2/5/17 HA Adelaide SA A PRELIMINARY PLANNING 26/4/17 HA T 08 8236 2900 hodgkison F 08 8232 3536 Rev Amendment Date Init E [email protected] architecture www.hodgkison.com.au project management 189 Wakefield Street Adelaide SA interiors T 08 8236 2900 hodgkison F 08 8232 3536 Adelaide | Alice Springs | Canberra | Darwin | Hobart | Melbourne | Perth architecture E [email protected] CONSULTING SUITE PENNINGTON STREET STORAGE FACILITY FOOTPATH VIEW www.hodgkison.com.au VIEW FROM FOOTPATH LOOKING NORTH project management VIEW FROM SIR EDWIN SMITH AVENUE THELOOKING MEMORIAL EAST HOSPITAL interiors

Drawn Date Scale Project Number NOTE : STREET TREES PARTIALLY TRANSPARENT IN VIEWS GA JUN 17 A1 17033 CONCEPT PENNINGTON STORES C:\Revit-Local\A_17033_COMMON_R17_jpmau.rvt Review Date Project Leader Date TS JUN 17 DM JUN 17 Drawing Number Amdt Drawn Date Scale Project Number GA JUN 17 A1 F DESIGN DEVELOP DD 25 Review Date Project Leader Date 17033 Contractor shall check and verify all levels and dimensions on site and report any TS JUN 17 DM JUN 17 Drawing Number Amdt

21/06/2017 3:51:53 3:51:53 PM 21/06/2017 discrepancies to the Superintendent before undertaking any work or shop drawings DESIGN DEVELOP DD 26 F Contractor shall check and verify all levels and dimensions on site and report any

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12 medicSA JULY 2018 heading

10 20 50 100 200 300 400 500 600 700 Scale Bar Units in Millimetres

10 20 50 100 CENTRAL STORES AND PAEDIATRICS 200 300 400 500 600 700 Scale Bar Units in Millimetres VIEW FROM LANE LOOKING EAST

10 20 50 100 200 300 400 500 600 700 Scale Bar Units in Millimetres

VIEW FROM LANE VIEW FROM LANE LOOKING SOUTH LOOKING WEST

E DESIGN DEVELOPMENT 16/6/17 HA D PLANNING 8/6/17 HA C GENERAL UPDATE 31/5/17 HA B CONSULTANT REVIEW ISSUE 2/5/17 HA A PRELIMINARY PLANNING 26/4/17 HA

Rev Amendment Date Init

CONCEPT CENTRAL STORES C:\Revit-Local\A_17033_COMMON_R17_jpmau.rvt

Drawn Date Scale Project Number GA JUN 17 A1

Review Date Project Leader Date 17033

TS JUN 17 DM JUN 17 Drawing Number Amdt DESIGN DEVELOP DD 27 E Contractor shall check and verify all levels and dimensions on site and report any

16/06/2017 4:58:51 4:58:51 PM 16/06/2017 discrepancies to the Superintendent before undertaking any work or shop drawings

16/06/2017 4:58:50 4:58:50 PM 16/06/2017 discrepancies to the Superintendent before undertaking any work or shop drawings

medicSA JULY 2018 13 update New Government’s first 100

y the time you read this, the new • Discussions underway between Government will have reached SAPOL, Department of Education Band breached its first 100 days, and Child Development and working down a checklist of objectives, Independent and Catholic schools including a number focussed on health. on protocols for use of police So, what has been on the agenda? The sniffer dogs in schools against 100 days ‘to do’ list that was published drug use pre-election included: • Prepare and introduce legislation to • Ministerial Development Plan to zone implement the war on drugs program the Repat site for health care services • Introduce legislation to decentralise • Initiate the process to re-open governance of the public health operating theatres on the Repat site to system, including management of reduce the elective surgery backlog budgets by Local Health Network • Commence establishment of a High Boards Dependency Unit at Modbury Hospital • Restore 24/7 cardiac emergency • Suspend the roll-out of the Enterprise capacity at The Queen Elizabeth Patient Administration System (EPAS) Hospital to other hospital sites and establish • Initiate establishment of specialist an independent review into its state-wide Borderline Personality • A timetable for all state disability functionality, performance and long- Disorder service services to be transferred to the NGO term prospects sector, including group homes • Launch SA Healthy Towns Challenge • Commence preparations for the public Program • Re-introduce Disability Inclusion Bill release of information on outpatient clinic waiting times by speciality and • Initiate upgrade of renal unit at Mt At the time of writing we have yet to hospital on a quarterly basis from 1 Gambier Hospital see where all these initiatives stand, July 2018 with various Bills before Parliament, and • Preparations for a community-based various wheels in motion. Members • Establish high-level task force to drive drug addiction rehabilitation pilot in with any feedback on these measures, co-location of new Women’s and the Riverland or other government initiatives as they Children’s Hospital with new Royal • Work commenced to make foster care advance, are encouraged to contact us Adelaide Hospital and kinship care payments available for at [email protected]. You can also find the AMA(SA)’s overview of Liberal • Enhanced partnerships with non- people up to 21 years of age election health policies at amasa.org.au. government organisations to deliver • Reforms initiated in recruitment workshops for parents of children Pictured: A/Prof William Tam with Premier practices for child protection workers with dyslexia and other learning Steven Marshall at the premier’s SA difficulties in regional centres across • Recruitment underway for Assistant Press Club address in April on his plan South Australia Commissioner for Aboriginal Children for his first 100 days.

Transforming Health evaluations out

ransforming Health may Phase one: Insights from an evaluation provide sound clear data to help inform have formally come to a Care Study of Transforming Health. better health policy. close under the previous T Both make interesting if not always Members with an interest in Transforming government but the autopsies have illuminating reading and are publicly Health and its outcomes are encouraged only just come in. available on the SAHMRI and Health to take a look at these reports and In recent months the Health Performance Council websites. Some provide the AMA(SA) with any feedback Performance Council has released its of the limitations of Transforming Health – and also to provide feedback on any last report on Transforming Health, are clear from the findings, which outstanding issues you see with where and the SA Academic Health Science underline the AMA(SA)’s call for an we stand post-Transforming Health, and and Translation Centre has released its independent clinical analytics unit to what next steps should be.

14 medicSA JULY 2018 council news

AMA(SA) Council NEWS

oppose private health insurers (PHIs) position, in the then up-coming election Dr Jane Zhang approach to dictate our health care at the AMA National Conference in from Councillor provision, exemplified by the American- 25-27 May 2018. Janice, your wisdom, AMA(SA) Council Meeting style managed care model. And in the experience and voice of reason are much May, 2018 centre of this dispute, is the most important needed at this time, especially for this consideration of all, of the consumer’s right state as we embark on some of the most to choose based on their individual health important changes of the last few decades. orest Gump said: “Life is like a requirements and location. The AMA has Lastly, this special council meeting is held box of chocolates, you never know strongly defended doctors in the claims by Fwhat you are going to get”. With the the PHI that the increasing cost of private at the spacious and relaxing settings of newly-elected Marshall government, the insurance is largely due to the burgeoning the Naval, Military and Air Force Club of AMA(SA) is faced with a myriad of changes gap charged by doctors. This is a grossly SA, as the AMA(SA) signs off on a new and challenges. That said, our state inflated and inflammatory statement, that is MOU with the Club, whereby AMA(SA) president, A/Prof William Tam, reported not reflective of the overwhelming practice members will be able to share in the that after meeting the new health minister, of the majority of practitioners. The Council facilities and services provided by the Club Stephen Wade, and his chief of staff, he is spent much time strategising our position in a special introductory offer (see details quietly confident that the new government and systematic plan to halt the pervasive in the May issue of medicSA). The Council is seeking collaborations with clinicians, spread of this trend, whereby members’ meeting was followed by the AGM. and committing to the government’s pre- and consumer education, synchronising It is fortuitous that my last Council News election promises on re-opening of the resources with the federal council in a last year was also delivered in the ambient Modbury HDU facilities; and remodelling of public campaign, are seen as key factors. setting of the Naval, Military and Air Force the ‘stranded services’ left behind by the On a bright note, the council unanimously Club, followed by a scrumptious meal upon new RAH – i.e. the Chest Clinic and the endorsed Dr Janice Fletcher – the conclusion of the meeting. Perhaps my proposed Eye Hospital. immediate past president of the AMA(SA) – ‘box of chocolates’ is not predicated on the The momentum is also building for the co- in her bid for the federal AMA vice president thrill of surprise, but taste. location of the new Women’s and Children’s Hospital (WCH) to the new site adjacent to the new RAH; as opposed to the previous Labor-led government’s proposal for a step-wise movement of the women’s Looking after services. In this proposal, our largest tertiary maternity service will finally receive the your dollars comprehensive ICU and clinical support services that parallels comparable maternity Ready to save? services in this country and other developed Your AMA(SA) membership card economies; without causing disruption includes loyalty discounts, with up to to the many mutually dependent services 10% off pre-purchased gift cards. in adolescent gynaecology, paediatric ICU, and specialist medical consultations. It means you can save dollars on retail, Nobody is going to argue on the enormous leisure & travel at San Churro cost of such a move, especially in the Chocolateria, endota spa, Flight Centre, setting of the state’s budget deficit, but JB Hi-Fi, Priceline, Rebel, Target, and there is economical saving in constructing Virgin Australia to name a few! a new hospital as a unified entity, especially for a relatively smaller state such as ours, Your member benefits are there than to do so on an ad hoc basis, that often to look after you. causes more uncertainly, and costs more in the long term.

Another matter of priority raised at the Buy online or via your smartphone; council meeting is the AMA position to ama.ambassadorcard.com.au/ecards.php

medicSA JULY 2018 15 council news AMA(SA) AGM and elections to Council The AMA(SA) Annual General Meeting took place on 3 May. The AGM provided an opportunity to look at some of the highlights of 2018, and give thanks to our dedicated councillors and Executive Board, as well as take care of the official AGM business, including elections to and retirements from the AMA(SA) Council.

Election of office bearers: AMA(SA) president and vice president re-elected The AMA(SA) congratulates A/Prof William Tam and Dr Chris Moy on their re-election to the AMA(SA) Council at the Annual General Meeting. This will be the second year in office for each of them and comes at a busy and interesting time, with the recent change of government and yet more changes A. on the horizon. Elections, re-elections and retirements from Council The AMA(SA) extends its sincere thanks to Dr Nigel Stewart, who has retired from his position as regional representative for the northern region, a role he has held since 2008. Dr Stewart has been a thoughtful and tireless contributor to AMA(SA) policy and advocacy activity and his insights B. C. and council contributions will be much missed. Thank you Nigel! (Turn to page Pictured: 34 for more on Nigel’s contributions and achievements.) A. Dr Chris Fenwick presented a bronze statue he made entitled ‘The Doctor’ to the AMA(SA) – a gesture of gratitude for the guidance and support from the The AMA(SA) also thanks the doctors AMA throughout Dr Fenwick’s career, and an acknowledgement of the fine who are taking up or continuing work undertaken by the AMA(SA) team. Dr Fenwick attempted to embody the in roles as ordinary members on ethos of the AMA in the figure. Council. Prof Randall Faull was elected to the position of ordinary B. AMA(SA) vice president Chris Moy with Dr Dorothea Limmer, one of the member of council, and Dr Rajaram ‘founding’ members of the AMA(SA) Historical Committee. Ramadoss and Dr Michelle Atchison C. A/Prof William Tam was presented with of a signed Valdman cartoon by Council were elected to ordinary member Chair Dr David Walsh. The cartoon appeared in The Advertiser after the power positions, previously held as failed at the new RAH, and was reprinted in the March 2018 issue of medicSA. casual vacancies. Former regional representative Dr John Williams continues as an elected ordinary member of council. Drs Matthew certificates of appreciation for their On behalf of the membership, McConnell, Clair Pridmore and John service. Dr Mudge was inaugural Chair the AMA(SA) congratulates and Woodall were all re-elected as ordinary of the Executive Board, steering the thanks all office bearers and council members, and Dr Philip Gribble Board judiciously over the past representatives for their work continues as an elected regional five years, while Dr Margie Cowling for the profession and the representative for the north. was an inaugural member of the communities we serve and looks Dr Margaret Cowling and Dr Trevor Executive Board. Both retired in forward to working together in the Mudge were presented with December 2017. year ahead.

16 medicSA JULY 2018 council news New faces on AMA(SA) Council The AMA(SA) is glad to welcome new Doctors in Training representative Dr Hannah Szewczyk, regional representative – Northern Dr Philip Gribble and ordinary member Prof Randall Faull to AMA(SA) Council.

Dr Hannah Szewczyk is currently a PGY3 RMO working as a general trainee in the Southern Adelaide Local Health Network (SALHN).

Obstetrics and gynaecology is Hannah’s passion and field of interest, and she is currently working and undertaking further study and research in this area, with a plan to apply for training in South Australia.

Hannah feels that as a female, junior Dr Hannah Szewczyk Dr Philip Gribble Prof Randall Faull doctor working in a time where junior doctors are faced with a training bottleneck that continues to worsen and is leading to increased Medicine (ACRRM) representative Australasian College of Physicians competitiveness, pressure to on the Joint Council of Colleges for (RACP), and a member of the perform, burnout and mental health Anaesthesia (JCCA), and recently the Clinical Examination Committee for issues, and as a person living in GP anaesthetics advisor to Country the College. a world where there are overwhelming Health SA. For eight years until 2016, Prof threats to our health, wellbeing Philip has also been active in overseas Faull was the director of the and planet, she cannot sit by and aid with missions to Benin in Africa medical program at the University do nothing. with Hernia International, providing of Adelaide, and as part of that Hannah’s experience as a member surgical services where none role had a number of associated of council on the Flinders Medical previously existed. positions, including dean, deputy Students’ Society (FMSS) executive dean, and chair of the Philip’s areas of clinical interest and committee and the Australian Curriculum Committee. expertise include anaesthetics, Medical Students’ Association (AMSA) complex medical patients, palliative He has ongoing involvement with council gave her a love for policy care and geriatrics, communication medical students, as patron of and advocacy and an understanding and education. He is also a student both the Adelaide Medical Students of the processes of a council. It is supervisor who works with fifth-year Society (AMSS) and the AMSF, and this experience, and her belief in students who visit Clare. has in the past served as president the influence of the AMA, that has of both the Australian and New led to her interest in becoming Outside of medicine, Philip’s interests Zealand Society of Nephrology and a member of the AMA(SA) include photography – he has the Transplantation Society of Australia Branch Council. exhibited and sold some of his and New Zealand. work; travel – especially camping Dr Philip Gribble is on the Federal in South Australia; squash and Prof Faull has also had terms as AMA Council of Rural Doctors, bushwalking. honorary executive officer of both which oversees the AMA’s work on societies, and representative of rural issues and is now the Regional Prof Randall Faull is currently both societies on key committees Representative: Northern on senior consultant in nephrology at in the RACP. AMA(SA) Council. the Royal Adelaide Hospital, and director of research and training in Since 2008 he has been a board Philip is a partner at the Clare Medical the department. member of the South Australian Centre, in the SA rural town of Postgraduate Medical Education Clare, where he has spent the last He is also a clinical professor in the Association, which is now closely 20 years consolidating a quality Adelaide Medical School, and a associated with the AMA(SA). He general practice. member of the executive committee of has also recently been appointed that school, representing the interests He is also the regional representative as the chair of the South Australian of university clinical titleholders. for the Rural Doctors Association of Medicines Advisory Committee, South Australia (RDASA); chair of For a number of years Prof Faull with responsibility for coordinating the RDASA GP-Anaesthetic group; has been a member of the National medicine usage within the SA Australian Council of Rural and Remote Examination Panel for the Royal Health system.

medicSA JULY 2018 17 heading

18 medicSA JULY 2018 dispatches AMA(SA) dispatches

Family Doctor Week still have your student email listed, for practices early in your career and This year the AMA’s Family Doctor example. To rejoin and rectify, simply reap the rewards. Contact amasa@ Week, with the theme ‘Your Family contact our membership officer Charlie hoodsweeney.com.au. Doctor: here for you’ runs from Sunday 22 Robinson at [email protected] or July to Saturday 28 July. The posters for on 8361 0108 and we can assist you Ready to employ? the annual event can now be downloaded with this process. Most doctors in private medical practice and displayed in your practice. AMA are not employees. You may operate your Family Doctor Week provides the Find a doctor business as a sole trader, partnership, opportunity to highlight the important DoctorPortal is the place to go when company or trust, or some combination role GPs play in serving the community you want to find colleagues and of these. You may have business and the wider health system. specialists for a referral. It enables partners to work with. Some practices you to search for a doctor, anywhere set up service companies to handle To help promote Family Doctor Week, in Australia, by name, address or the administrative side of the business, you can check out resources – including discipline. The search provides a including employing staff. posters – at ama.com.au. For more doctor’s name, specialty, current information, turn to page 27. practice contact details and a scalable The Guide to employment law for medical map that can be printed and provided practices is now available online, at ama. AMA(SA) Council meetings to patients. Go to doctorportal.com.au/ com.au/article/ama-guide-employment- Meetings of the AMA(SA) Council are find-a-doctor. law-medical-practices. open to all members. The AMA(SA) Council meetings are held monthly, Maximise your Reduce your excluding the months of January, April, July and October. The next meetings tax benefits lifestyle expenses Your AMA(SA) membership card are Thursday, 7pm – 2 August and 6 Your membership is tax deductible. September. Any member wishing to attend As a doctor in training your first tax doubles as an Ambassador Card. a Council meeting should contact Claudia return is free via our member partner Use it to maximise savings at Baccanello on [email protected] or Hood Sweeney, plus you receive supermarkets, travel centres, beauty 8361 0109. a 20% discount on all accounting and retail outlets, and even leisure services thereafter. All other member activities or membership with fitness Hood Sweeney Financial classifications receive a 10% centres such as the Goodlife Health Services events discount for their accounting services. Clubs. Access from your Smartphone Start the road to good accounting via ama.ambassadorcard.com.au. Hood Sweeney is the preferred accounting and financial planning provider of the AMA(SA) and a leader in business and financial advice to the health sector. Supporting healthcare professionals, Hood Sweeney is passionate about Looking after partnering with AMA(SA) members and assisting them to make informed financial you decisions during their career journey. To find out more about upcoming education Ready to join? opportunities, please go to the calendar Membership offers you more than on page 61 or visit amaskillstraining.org. you realise. For example, if a full-time au/professional-development. GP, living in South Australia, was already purchasing the AMA Fees List, 1 August 2018: Taking the first step – a DoctorPortal and receiving available guide to setting up your private practice Tax Deductions, they would already be 31 October 2018: Life begins at retirement covering the cost of their membership. 14 November 2018: A guide to practice We encourage members to take structure and fees – avoiding the red flags advantage of the full range of Is your data correct? benefits on offer. Early career doctors are encouraged to review their membership account Your member benefits are there to ensure details kept on the AMA(SA) to look after you. database are accurate. The lag over members.amasa.org.au/join from your student days could mean we

medicSA JULY 2018 19 heading

Dr Robert Baird Dr Robert Fassina Dr Andrew Morris Dr Justin Munt A/Prof Mark Rickman

ADELAIDE’S ONLY ORTHOPAEDIC GROUP DEDICATED TO THE MANAGEMENT OF HIP AND KNEE PROBLEMS EXCELLENCE IN • Urgent Care • 24 Hour, 365 on-call service ORTHOPAEDIC • Hip Surgery • Knee Surgery CARE. • Arthroscopic Surgery • Paediatrics • Robotic Assisted Surgery • Orthopaedic Trauma • Orthopaedic Pelvic Surgery

20 WWW.AHKC.COM.AUmedicSA JULY 2018 / PH 08 7325 4800 / AH 1800 DR BONE (1800 37 2663) congratulations AMA(SA) members named in Queen’s Birthday Honours The AMA(SA) wishes to congratulate the SA medicos honoured in the June 2018 Queen’s Birthday Honours. Each was recognised with the Medal of the Order of Australia (OAM).

Dr Stephen of Australia, and is a senior medical advisor Dr Jeremy to major medical indemnity insurer, Avant. Kinnear OAM Raftos OAM For service to Dick has provided medical support to seven For service to medicine, medicine, particularly to outback cattle drives and has done locum particularly to paediatrics. anaesthesiology. work with the Royal Flying Doctor Service. Chair of the Adelaide Hills Division of Dr Jeremy Raftos OAM is AMA member Dr Stephen Kinnear OAM General Practice for six years, he was also regarded as one of the founding fathers of has a wide range of clinical anaesthetic on the Southern Adelaide Health Service paediatric emergency medicine in Australia experience and a strong interest in Board and chair of the Drug and Alcohol through his work with the Royal Australian teaching anaesthesia, particularly to Services SA for nine years. College of Physicians (RACP), the anaesthetists in developing countries, and Australian College of Emergency Medicine also to Australian anaesthetists who are He lives in Summertown on a vineyard (ACEM) and with Advanced Paediatric Life preparing to work overseas. property, and has been a member of Support (APLS). Rotary for 44 years and was district Dr Raftos was a member of staff at the Steve regularly works in neighbouring governor in 2015-16. developing countries. In 1995, based in Women’s and Children’s Hospital from Suva, Fiji, he initiated the first post-graduate Dr Mary 1985, when he was appointed medical Dr Robert Baird Dr Robert Fassina Dr Andrew Morris Dr Justin Munt A/Prof Mark Rickman medical training program in the Pacific head of the casualty department. He region, which has since placed trained Sutherland OAM remained in this role continuously until anaesthetists in all 13 independent Pacific For service to medicine, and standing down as unit head in 2011 and Island countries. to the community. retiring from the hospital in 2017. Dr Mary Sutherland OAM Steve returned to Australia in 1997 and His passion for paediatric emergency completed her medical training and post- ADELAIDE’S ONLY ORTHOPAEDIC joined Stace Anaesthetists, and has been medicine has reached well beyond the graduate anaesthetic education in Adelaide. working in the practice continuously since hospital with important work in GROUP DEDICATED TO THE that time. He has also from 1997 been a After two years working overseas, she establishing the specialty in Australia visiting specialist anaesthetist at Flinders began a 30-year association with Stace and governing training and education of MANAGEMENT OF HIP AND Medical Centre Anaesthetists. As she worked part time, future clinicians. she was able to pursue other interests You can read more about Steve, who He has had a key role in establishing in fundraising, and strategy and KNEE PROBLEMS received the AMA(SA) Medical Educator the resuscitation course, Advanced governance. She retired from medical Award in June at our annual Gala Dinner, on Paediatric Life Support, in Australia, so practice in 2012. page 24. that all clinicians involved in the • Urgent Care Mary sat on the Foundation Board of St resuscitation of children have the EXCELLENCE IN knowledge and skills they require. As Dr Dick Peter’s College for 25 years. This gave her leader of APLS and its international arm, • 24 Hour, 365 on-call service Wilson OAM the opportunity to serve on the Board of Governors of the school for 13 years, the he has personally taken this course to For service to the community last six as chair. Asia and the Pacific. ORTHOPAEDIC • Hip Surgery through a range of roles, and • Knee Surgery to medicine. She was appointed to the Board of St Dr Desmond Dr Dick Wilson OAM is a GP with many Andrew’s Hospital in 2005 and is currently deputy chair. Hoffman OAM CARE. • Arthroscopic Surgery years of service to the rural and For service to medicine, particularly to urban communities. Mary has always been interested in peer colorectal surgery. review and she has chaired the Peer Review Dr Desmond Hoffman OAM was head of • Paediatrics Dick started his lifelong career in general Committee at St Andrew’s for 25 years. colorectal surgery at the Royal Adelaide practice in London UK, Canada and Hospital from 1993-1998. In the 1980s, he • Robotic Assisted Surgery Germany before commencing rural general For the last six years, she has was instrumental in the establishment of practice in Strathalbyn in 1973. He retired chaired the Foundation of The South the Colorectal Surgical Society of Australia • Orthopaedic Trauma from general practice in December 2017 Australian Museum. and subsequently served as its president. but continues to do aviation medicine and Mary is certain that her medical training He also contributed to the medical surgical assisting. • Orthopaedic Pelvic Surgery has been instrumental in allowing indemnity insurance field as chair of A life member of the AMA, Dick sits on the her to contribute to these many the Medical Defence Association of SA Board of the Prostate Cancer Foundation varied organisations. South Australia.

WWW.AHKC.COM.AU / PH 08 7325 4800 / AH 1800 DR BONE (1800 37 2663) medicSA JULY 2018 21 heading

Annual AMA(SA) Charity Gala Dinner goes ‘Eclectica’

HE AMA(SA)’s annual black-tie charity Gala Dinner at the Hilton Adelaide on Saturday 19 May 2018 Twas a thoroughly entertaining night out, providing an opportunity to recognise members’ contributions to the Association and celebrate our successes over the last 12 months. Attendees included a ‘who’s who’ from across the South Australian medical and healthcare community, from many fields of medical practice and also many stages of practice in attendance. Joe Hooper, Rachael Zaltron from Backpacks 4 SA Kids, A/Prof William Tam The theme for the night’s entertainment was ‘Eclectica’, and guests were treated to an a capella group, a tap dancing ensemble and even a skipping rope routine. The MCs for the evenings’ formalities were Anna and Taylor, eleven-year-old Ding Production performers. Attendees this year included, The Governor, His Excellency The Hon Hieu Van Le, new SA Health Minister The Hon Stephen Wade, Shadow Health Minister Mr Chris Picton, and The Right Honourable, the Lord Mayor of Adelaide, Martin Haese. Federal AMA president Dr Michael Gannon and past AMA federal president Dr Andrew Pesce were also in attendance. Others attending included AMA(SA) councillors and past Jason Ward and Prof Gala Dinner organisers from sapmea, Caitlin Penhall, Jeganath Krishnan Rebecca-Lee Sharkey, Amy Lecons with A/Prof William Tam presidents, AMA(SA) members, preferred providers and corporate supporters. Three prestigious awards were presented on the night – see page 24 for more on the awards. This year the AMA(SA) also presented a cheque for $10,000 to the charity Backpacks 4 SA Kids. More on this in the September issue of medicSA. AMA membership cards double as an Ambassador Card, and Ambassador gave a $500 gift card to a lucky winner on the night – Dr George Zankov. Shevaun Bruland, Dr Chinpo Sam Ling, All who attended deemed the night a marvellous success, Jacqui Ewens and Mark Mullins Anne Krishnan and the AMA(SA) would like to extend its sincere thanks to the major sponsors of the evening – MIGA and Calvary. The AMA(SA) would also like to thank the corporate sponsors along with all the wineries that donated the wines served on the night. For sponsorship and donation enquiries for the 2019 event, please contact event organisers, sapmea, on [email protected]

22 medicSA JULY 2018 The team from MIGA heading

Dr Syd Jacobs, Dr Milind Sanap, Dr Jadu Singh, Dr Shriram Nath, Martin Haese (Lord Mayor), Dr Michael Gannon, Dr Sam Seimon and Dr Lakshmi Nath A/Prof William Tam Mrs Niranjala Seimon

Anna Hooper, Feng Tam, A/Prof William Tam, Martin Dr Michael Gannon, Dr Janice Fletcher, Dr Peter Sharley Chloe Ey and Paul Furst Haese (Lord Mayor), Chris Picton MP, Connie Blefari

Joe Hooper, Rachael Zaltron from Backpacks 4 SA Kids, A/Prof William Tam

A/Prof William Tam, Hon Hieu Lan Le, South Australian Sri Lankan Dr Mark Harris, Janette Harris Feng Tam Doctors Association Gala Dinner organisers from sapmea, Caitlin Penhall, Rebecca-Lee Sharkey, Amy Lecons with A/Prof William Tam

Shevaun Bruland, Dr Chinpo Sam Ling, Anne Krishnan Tracey DiBartolo, Ian DiBartolo Dr Anne Sved Williams and guest

medicSA JULY 2018 23 A/Prof William Tam, Stephen Wade, Dr Margaret Lim, Dr Suchitra Somers, Alex Hanin, Cameron and Louise Mudge, Feng Tam, A/Prof Tam Dr Chris Moy Dr Evelyn Yap, Cathy Nelson, Dr John Nelson awards Outstanding AMA(SA) members awarded at annual Gala Dinner The AMA(SA) awards presentation is a highlight of the annual Gala Dinner. This year there were three awards presented to outstanding AMA members by AMA(SA) president A/Prof William Tam.

AMA(SA) Medical Educator Award Dr Stephen Kinnear

“As a profession, we have a duty to educate those who will carry on our work after us,” said A/Prof Tam.

“And some among us go that extra step to help spread knowledge beyond our local medical schools and hospitals, beyond our country, to areas that do not have what we do. To countries where health care is delivered under often very difficult circumstances, on a shoestring budget, and sometimes against the odds.

“The 2017 AMA(SA) Medical Educator Award goes to a very special person who has taken their knowledge overseas and passed it on.

“As well as his work teaching and (L-R): Federal AMA president Dr Michael Gannon, Dr Stephen Kinnear, Dr Mark Moore, training here in SA and Australia – Professor John Dent, A/Prof William Tam including at Flinders Medical Centre and Tabor College – Dr Stephen Kinnear has made a tremendous contribution to education in “These graduates have gone on to “For 13 years, he also volunteered anaesthesia in our region, particularly careers in Fiji, Tonga, Samoa, American his time teaching in the Real World the South Pacific. Samoa, Vanuatu, Tuvalu, Niue, Anaesthesia course, which gives Micronesia, the Solomon Islands, anaesthetists from high income “He initiated the South Pacific’s first the Cook Islands, the Marshall Islands countries the skills to have an impact training program in anaesthesia, and Timor Leste. on the development of anaesthesia in which has placed medical specialists less affluent countries.” in all South Pacific Island nations in “In fact, this program transformed Polynesia and Melanesia. postgraduate medical training in the AMA(SA) Award Pacific, as it was used as the model “This has been credited as reversing Dr Mark Moore for subsequent programs for the the loss of talented doctors to school in medicine, paediatric surgery, “The AMA(SA) Award is given for affluent countries and led to outstanding contribution to sustainable training in the region for obstetrics and gynaecology. Not medicine or the medical profession,” their field. content with teaching doctors, Stephen also designed a training program for said A/Prof Tam. “Where Stephen went, there was no intensive care nurses. “It provides an opportunity for recognised training program peers to honour the work of in anaesthesia, or any other, run “There is more. Stephen spent colleagues who have given in the region. He designed and a decade chairing the Australian outstanding service. wrote a diploma course and delivered Overseas Aid Committee in the curriculum. Since then, there anaesthesia, and has continued clinical “This year’s winner, Dr Mark Moore, have been over 73 diploma service and teaching trips to an array is a leader in his field and head graduates and 30-odd or more of countries including Fiji, Timor Leste, of a unit here in South Australia. masters graduates. Indonesia, Palestine and Bhutan. He is known to have the magic touch

24 medicSA JULY 2018 awards in soothing patients who may be very AMA(SA) President’s and John has forged a formidable young and afraid. reputation in it. Medical Leader Award “John is a consummate researcher, “He has also done some amazing Professor John Dent work overseas. He has been doing a driven, inspiring and international pro-bono work since the late “This is an award that is extra close to educator who has delivered insights 1990s, and has made a major my heart,” said A/Prof Tam. “It is also into one of the most basic mechanisms contribution and transformed lives an Award that the AMA(SA) president of the body, and a very commonly and bodies – literally. traditionally helps to select. occurring disease. “He is also a highly efficient “He is a surgeon with a great bedside “It is a leader-to-leader award, but I administrator, taking over directorship manner, a wicked sense of humour, confess that I feel extra humble of a local hospital department here in and more besides. His surgical when I think of the achievements of this award winner, which have Adelaide and expanding it into a centre technique has been described as had far-reaching influence of excellence known worldwide. beautiful, quick, neat, and effortless. internationally, and in particular, in “Over the years he has been able “Mark’s work has not gone unnoticed in my field of medicine. to establish networks with the the profession. The Royal Australasian “This year’s special AMA(SA) leader is a Netherlands, Sweden, Japan and the College of Surgeons has awarded gastroenterologist – Prof John Dent. US, that have fostered collaboration him its International Medal, which is and enhanced knowledge. given for ‘lasting contributions of an “John came to Australia from the exceptional nature over a long period UK, over 30 years ago, and has also “He is a doyen in his field, someone of time in the delivery or development undertaken postdoctoral research in who has flown the flag at international meetings and developed with of surgery for underprivileged the United States and Canada. international colleagues carefully communities overseas’.” “John was a clinical professor of researched endoscopic severity “He has also been made a member of medicine at the University of Adelaide, classifications where there were the Order of Australia for services in his and the director of the Department none – that now everyone in his field overseas. of Gastroenterology, Hepatology specialty uses, in the most common and General Medicine at the Royal of conditions. “His field is plastic, reconstructive Adelaide Hospital from 1986 till 2004. “Those classifications are for Barrett’s cranio-maxillo-facial and aesthetic He directed the Nerve-Gut Research oesophagus – which is a notable risk surgery, and his work has included Laboratory at the Hanson Institute, factor for the development of cancer more than 40 missions to Timor Leste which he founded in 1990. as well as outreach visits to Hong – and reflux oesophagitis. In fact, he “He has been involved in the tailoring Kong, Malaysia and Indonesia. This revolutionised how we treat this very and development of quality systems for common condition. has also included 20 years’ service in use in medicine. Darwin, en route overseas, and years “As a younger doctor coming up, he of dedicated work to public patients “This is not a glamorous area of would always make time to speak with here in SA.” medicine, but it is fundamental, you, and you weren’t afraid to ask.”

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SAH029 MedicSA Ad fa 1.0.indd 2 28/6/18 13:56 general practice Your family doctor: here for you During Family Doctor Week 2018, which runs from Sunday 22 July to Saturday 28 July, the AMA celebrates the nation’s general practitioners – our family doctors – and their value to the community and health system as they deliver high-quality holistic health care. This year’s theme is ‘Your family doctor: here for you’.

Ps are trained to treat the whole person and to care for Gpeople of all ages, all walks of life, and with all types of medical issues and concerns.

The Organisation for Economic Co- operation and Development (OECD) says Australia has one of the best health systems in the world. Its strength stems from general practice and the pivotal role of the general practitioner. GPs are the first port of call when Australians feel unwell, and GPs manage 90% of the problems they encounter.

Australians already know the benefits of having a regular family doctor, with 83% of the population visiting a GP at least once a year, 93% of Australians returning to the same practice, and 78% of patients having a preferred usual GP. GPs are also the most used and trusted source of child health information.

Over 90% of Australians have a regular general practice and around 80% have a regular family doctor. People who have an ongoing relationship with a family Your GP doctor enjoy better health. Having a regular GP and/or general is here for you practice enables the long-term and continuous care of a patient through and health an ongoing relationship of respect and your trust. A regular GP becomes familiar with a patient’s medical history and SPONSORED BY their family’s medical history and, through the trusted relationship, can effectively advise patients on the risks #amafdw18 to their health and the factors in their For more information: ama.com.au/familydoctorweek lives that contribute to those risks, including unhealthy lifestyle choices such as excessive alcohol consumption, smoking and poor diet. Since 1993, AMA Family Doctor Week be talking about health reform and has raised the profile of general practice improving the patient journey. The A regular GP can also provide ongoing within the Australian community, speech will be broadcast live on ABC management of risk factors, coordinate highlighting the hard work and TV or for those who wish to attend in allied health services, and deliver other dedication of GPs. person tickets can be booked npc.org. preventive health-care measures such au/speakers/dr-tony-bartone/. as vaccinations and screening tests. The highlight of Family Doctor Week Another important role for the regular will be when the AMA president, Posters for the annual event (pictured) GP is to assist patients in navigating GP Dr Tony Bartone, addresses the can be downloaded and displayed in an increasingly complex and confusing Australian National Press Club on your practice. Go to at ama.com.au/ health and welfare system. Wednesday 25 July, where he will family-doctor-week-2018

medicSA JULY 2018 27 heading

28 medicSA JULY 2018 national conference AMA National Conference 2018: driving policy for a better health system This year’s AMA National Conference, held between 25-27 May, saw the transition to a new leadership team, the introduction of a new format inviting increased member participation in topical debates; and a definite mood underlying the conference of the need to tackle issues of gender diversity, discrimination and participation within health and the AMA itself. Dr Chris Moy provides his report.

utgoing president Dr OMichael Gannon described a busy and successful year for the federal AMA, in which the organisation had used its powerful public standing and influence to achieve significant progress in policy, advocacy, political influence, professional standards, doctors’ health, media profile and public relations. Amongst success in many areas, Dr Gannon spoke of unfinished progress to get nationwide agreement to change the mandatory reporting laws at the recent COAG Health Council, at which he was The AMA(SA) contingent at National Conference (L-R): Dr Matt McConnell, Dr Shriram Nath, given the rare honour of addressing Dr Jill Maxwell, Mr Andrew Craig, Dr Annette Newson, Dr Mark Shepherd, Dr Janice Fletcher, the ministers. He also described Dr Andrew Russell, Prof Bernard Pearn-Rowe, Dr Rob Menz, A/Prof William Tam, Dr Patricia success in battles surrounding major Montanaro, Dr Monika Moy, Dr Chris Moy, Dr Hannah Szewczyk, Dr Peter Del Fante, Mr Joe issues directly affecting doctors such Hooper, Dr John Williams, A/Prof Susan Neuhaus as training, workforce, private health insurance, and the MBS review as well as influence in wider public health the Shadow Minister for Health, and the to opt-out, which he described as a debates including nutrition and obesity, leader of the Greens. major national undertaking to get critical indigenous health, marriage equality, patient health information to the point of the health and well-being of asylum The inspiring highlight of care to help and protect lives. seekers and refugees, and firearms. the Conference was the He said the third wave reforms in the He said that we have a better speech by the president recent budget amounted to $12.4 relationship with Government, but that billion in extra funding to improve the AMA’s job is not to curry favour with of the Australian Medical health in workforce, research, primary those on the Treasury benches. Nor is it care, new medicines, mental health the AMA’s role to do the bidding of the Students Association Ms and aged care. He reiterated the Opposition or the cross bench. “We are Alex Farrell in the final Government’s long-term plan consisting ferociously, furiously, and I am sure the of four pillars – guaranteed access three senior politicians in the room will session in which she to doctors, nurses and medicines; agree, often infuriatingly, independent.” implored and inspired us, strong hospitals – both public and He described the huge honour and as the doctors of today, private; improved mental health for both privilege he felt in serving the AMA to take up our roles as patients and doctors; and research – and the medical profession as federal including a large injection of funding president. He said that he had done mentors and teachers of into genomics research. all of this for doctors and on behalf of the doctors of tomorrow. He said that he is committed to ending those without a voice: the sick, the mandatory reporting – doctors should aged, the frail, the weak, the poor, The Hon Greg Hunt MP spoke of be able to seek help without fear. And, the drug-afflicted, the mentally ill, the working with the AMA to get increased in response to suggestions that the unemployed, the vulnerable, the dying. funding for health, an end to the current Health Care Homes trial was This was followed by the traditional Medicare freeze, the MBS review, and floundering, he emphasised that this addresses by the Minister for Health, the progression of My Health Record was only a trial in line with a new move

medicSA JULY 2018 29 national conference to change the emphasis in health to An interesting session on day 1 instincts. There was agreement about improved quality – both in primary entitled ‘A better health system for the critical importance of the federal and hospital care. He hoped, therefore, doctors and all Australians: how AMA AMA secretariat – “membership pays to work with the AMA on lessons leadership drives health and social for that work to develop good policy” from the trial, with the ultimate aim policy reform’ was moderated by Dr – especially the AMA media and public of finding a new model for quality Michael Gannon and included six affairs director John Flannery who was funding in general practice – that GPs previous federal AMA presidents: Prof described as a master of developing can opt into. Rosanna Capolingua, Dr Bill Glasson, a message which was like ‘berley’ in getting results in health politics. He spoke about the great relationship Dr Mukesh Haikerwal, Dr Steve that he had developed with Dr Michael Hambleton, Dr Andrew Pesce and Prof An interesting discussion followed Gannon who he described as a Kerryn Phelps. During the discussion about the paradox of the AMA getting “guide and friend but also decathlete there was general agreement that the results in working constructively in and Greco-Roman wrestler” – who consultation process carried out for government but failing to inspire generally pinned his opponent down euthanasia and physician assisted increase in membership because – to win an argument. suicide should be a prototype in “crises are what breeds membership”. Dr Michael Gannon asked whether it The Hon Catherine King MP was better to try to negotiate said that AMA advocacy constructively to get results, does matter but emphasised as he had, because the AMA the cuts in funding by the “can’t toot the horn to get current Government had credit”, or should the AMA let forced a current funding “Rome burn” in letting a crisis formula for health which is develop and then come in to not keeping up with need. save the situation, because She said, if her party came only then would doctors to power, it would create understand the value of the a Better Hospital Fund, organisation. Dr Andrew Pesce increase funds for Medicare said that the problem in the as well as doctors and latter option is that Rome nurses, foster innovation and may continue to “burn” – the new models of care in and AMA cannot let crises develop out of hospital, and not only artificially even at the expense focus on penalties – but also of membership. rewards for quality care. Day 2 of the Conference Senator Richard Di Natale heralded a new format of said that tax cuts merely policy debates – with motions take potential money away put forward and debated from health, and he wants by delegates and members. a greater focus on social This included debates about determinants of health. He the effect of booking fees; a pointed out the important change to the AMA position impact of an inadequate to support the controlled AMA(SA) president A/Prof William Tam (right) with new federal Newstart allowance on the AMA president Dr Tony Bartone (centre) and new vice-president introduction of e-cigarettes; a health of the unemployed. Dr Chris Zappala. strengthening of the position He emphasised climate to oppose the dispensing of change as a real threat to medications by doctors for health and spoke about the Greens material gain; a proposal to reduce the push for a decriminalisation of cannabis how to engage membership over emphasis on prevocational research – which was based on evidence from controversial topics. The question in favour of clinical experience in the a paper in the British Medical Journal was asked whether AMA had gotten selection of candidates into vocational suggesting the net benefits of taxing the process for consultation regarding training; a request for survey of drugs over making them illegal. This marriage equality right – because a member attitude to limited registration was disputed by AMA NT president considerable number of members had in transition to retirement; and several A/Prof Rob Parker who spoke of resigned over this issue. Kerryn Phelps motions related to improving gender a recent paper in the American argued that the process of coming to equity and reducing discrimination in Journal of Psychiatry describing this position had been part of a long- health employment, which included a strong association between term process, and that sometimes emotive discussions. A list of the substance-induced psychosis and the there is not time to carry out extensive motions debated is available here: development of schizophrenia and consultation with members – therefore natcon.ama.com.au/article/policy- bipolar disorder. there is a need for leadership to trust its topics-be-debated-national-conference

30 medicSA JULY 2018 national conference and Youtube videos of the debates (on experience and the policy priorities of first priority. Your patients always come 26 May) here: youtube.com/channel/ individual candidates. first. But it doesn’t have to be one or UCp8mOJ-xNi_qO4EzMhCbSgQ the other. It only takes a moment to say The inspiring highlight of the good job, or to answer a question, or The final day of the conference Conference was the speech by the explain how to improve next time. was dominated by the election for president of the Australian Medical federal AMA president and vice Students Association Ms Alex Farrell That moment can make your student’s president. Dr Tony Bartone, a in the final session in which she day. It can keep their love for medicine Victorian, became the first general implored and inspired us, as the going, through all the other parts of this practitioner since Dr Steve Hambleton doctors of today, to take up our profession that may otherwise leave us to be elected as federal AMA roles as mentors and teachers of the disillusioned far too soon. president. Dr Chris Zappala, a doctors of tomorrow: Thank you to all of you here who make respiratory physician from Queensland, that effort to be positive mentors and was elected to the position of “I know it is not always easy. As teachers. You are appreciated. vice-president with a mandate of students we take time away from improving the relationship between your busy days. Sometimes we I believe that we can build a medical the federal and state parts of the don’t know how to help, and we culture that is safe and nurturing. But it AMA. Dr Janice Fletcher, the immediate know that our gaps in knowledge can’t wait 20 years, when my peers are past president of AMA(SA) made fall short of your expectations. All filling these seats. It has to start now, a spirited and close late bid for the students know the feeling of being a and it has to come from the top. In the position of vice-president. The failure burden on their team. But to learn, way you teach, in the way you lead, of the two female candidates for we need to be in the room and able and in the systems you influence, be vice-president to win the position – to ask those questions. part of that change, and I promise, we Victorian Plastic Surgeon Jill will do you proud.” Medical students want to work hard Tomlinson also being a candidate – and to be good, safe doctors. Ms Farrell’s address can be watched brought with it an undercurrent in full at https://www.youtube.com/ of debate about the promotion You hold the power to impact the lives watch?v=-wxY3gGvdA4 of gender equity in leadership of your students each and every day. in consideration alongside past That’s not to say they need to be your Dr Chris Moy is vice-president, AMA(SA).

medicSA JULY 2018 31 national conference View from the floor Dr Hannah Szewczyk, AMA(SA) Doctors in Training representative, attended National Conference this year for the first time. Here’s her report …

went to the AMA Following A/Prof Ruff’s address, the a project to implement a prescription National Conference Doctor in Training of the Year Award service and records database of I with the excitement was presented to Dr Mikaela Seymour. anti-malarial use, which has shown and apprehension of a Dr Seymour graduated from Griffith significant clinical impact a year later. ‘first timer’. I am new University in 2015 and is currently She has been recognised as a Young to my role as AMA(SA) working as a general surgical principal Leader in the South Pacific by the Lowy Doctors in Training (DiT) representative, house officer in Queensland. Her list Institute. I was one of 12 doctors who had never been to the AMA National of achievements is far too extensive nominated Dr Seymour for the DiT of Conference before and had not yet to list here, but most notably she is the Year Award, and cannot think of a most of the other DiT delegates. When an advocate for quality training and more deserving recipient. I met the other DiT delegates, they supervision for doctors in training, The inspiration continued when the were immediately welcoming and passionate about improving the president of the Australian Medical supportive. The Council of Doctors in wellbeing of junior doctors and is Students’ Association (AMSA) Alex Training (CDT) is diverse in terms of committed to humanitarian work in Farrell delivered her address on the experience, level of training, field of Papua New Guinea. Dr Seymour sits final day of the conference. She spoke interest, gender, ethnicity and the list about mental health goes on. The committee issues affecting medical is functional and its students and doctors, members are passionate the training bottleneck and professional. I am and increasing pressure honoured to be joining to add to one’s CV the CDT and am excited and the power of the for the opportunity to collective voice of AMSA work with these people and the AMA. Problems to address issues with the culture of important to DiTs today. medicine were raised A highlight of the including gender inequity, conference was the unconscious bias and Leadership Development bullying, harassment and Dinner held at the racism in the workplace. National Portrait Gallery, The part of her speech where we had the honour that resonated most with DiT of the Year Award winner of being addressed AMSA president Alex Farrell me and the other DiTs Dr Mikaela Seymour by Nobel Peace Prize in the room was when Laureate Associate she spoke of resilience Professor Tilman Ruff. The founder of and what the frequent use of this the International Campaign to Abolish on multiple committees and is the word implies. Ms Farrell stated that Nuclear Weapons (ICAN) spoke of the current chair of the Junior Medical this word has been overused, and widespread, indiscriminate, destructive Officers Forum of Queensland and often at inappropriate times. To quote immediate and flow-on effects of the is the junior doctor representative Ms Farrell: detonation of nuclear weapons. Even as on the Queensland Accreditation “Resilience is a suicidal friend pointed someone who is anti-nuclear weapons Committee. She has been working to towards mindfulness courses. It takes and has a basic understanding of encourage expansion of accreditation students at the darkest point and their possible impacts, I was shocked of prevocational training positions to tells them they just should have been to hear just how catastrophic the increase accountability of hospitals stronger. It acknowledges that the consequences would be for our employing doctors in these roles, medical training environment is flawed, entire planet and its people if even a ensure adequate supervision and but at the same time says that the small number of the world’s nuclear training for these doctors and answer is fixing students, rather than weapons were to detonate. I am also prioritise patient safety. Dr Seymour seeking larger change.” frustrated and extremely disappointed has travelled to Papua New Guinea that Australia is not a signatory to five times as a volunteer doctor and Ms Farrell called on conference the Nuclear Ban Treaty despite most developed an interest in the links delegates to look at what students Australians supporting a ban on nuclear between malaria and tuberculosis with and junior doctors are being resilient weapons. It is time to do better. surgical presentations. In 2017 she led against and urged senior doctors and

32 medicSA JULY 2018 national conference leaders to drive the change in medical female doctor was asked to assure one Ninety-three per cent of delegates culture. The room responded to Ms of her supervisors that she was not voted in favour of this motion, so that it Farrell’s speech with enthusiastic pregnant or planning pregnancy before could be discussed at federal council, applause and a standing ovation. I he would agree to write a reference for which is excellent. What is not excellent hope that all who were present can her, despite the fact that he thought is that 6% of delegates voted against take this enthusiasm back to their she was a fantastic doctor and suitable this motion – that is, 6% of delegates workplaces and strive for the change for the position. I was completely actively disagreed with a motion that we need to see in medical culture appalled to hear of sexist comments suggesting that the AMA provides in 2018. made to a female colleague by another practical recommendations to our hospitals and clinics to help address Ms Farrell’s points about the stress delegate at the National Conference! gender inequality! Gender inequality caused by the training pipeline The viewpoint of Australia’s medical and discrimination still exists, and we and gender inequity rang loud and leaders was made evident when the true and are major issues currently following motion was voted on. cannot ignore it. concerning DiTs. We all know that there As DiT Representative for South is an increasing number of medical We all know that there Australia, I want to advocate for a graduates and an almost stagnant is an increasing number better workforce strategy to address number of training positions, but of medical graduates the training bottleneck, improved the finer details of this problem can wellbeing for DiTs and elimination of be quite alarming. There remain few and an almost stagnant discrimination in the workplace. I want accredited specialist training positions, number of training to engage with South Australian DiTs but doctors are increasingly performing and hear what is important to you the same roles and working the same positions, but the finer and make sure that we have our say hours as accredited registrars but in details of this problem at a state and federal level. I want our unaccredited positions. I have been told can be quite alarming. opinions put forward when it comes to that there are currently approximately public health issues such as drug and 130 unaccredited orthopaedic alcohol strategies, obesity, assisted That, noting the AMA position registrars working in Queensland, dying and climate change. DiTs now statement on Sexual harassment in the where only six to eight accredited make up a huge component of the medical workforce – 2015, our AMA training positions are offered each year. medical community and it is important establishes practical recommendations This is not the only state or specialty that our voices are heard. that takes part in these practices that could be implemented into the and although there is value in gaining healthcare system to address the Dr Hannah Szewczyk is AMA(SA) experience prior to commencing underlying systemic factors that impede Doctors in Training representative. formal training, this system can also the health system’s ability to adequately She can be contacted on ditchair@ be considered exploitative. We are address gender equality. amasa.org.au. told that increasing training positions will dilute the teaching experience, but how can this be the case when there are such large numbers of doctors performing the same work as their peers who have been accepted in to training programs? The Royal Australian and New Zealand College of Obstetricians and Gynaecologists caps applications so that candidates cannot apply for the training program more than three times. The Australasian College of Dermatologists caps applications at four attempts. Restrictions like this further add to the increasing stress and competitiveness that is a reality for all DiTs today. FOR SALE Golfer’s delight - Spectacular Views I am stunned by how much gender 41 Tyrone Street, McCracken (Victor Harbor) discrimination and inequality still exists in 2018. Experiences were shared at • Tri-level 4 bedroom home - 5 distinct living spaces • Master bedroom, walk-in robe and spa/bathroom Registered Agents M.R.E.I RLA 1075 the National Conference about women • Sitting room - Kitchen/Dine - Lounge with bar being asked whether they planned on Enquires • 180 degree under cover balcony with view of the golf course Steve Webber having children and what contraception • Top level has retreat/sunroom/bedroom with a private m: 0418 833 573 www.realtyexchange com.au they were using as part of interviews spacious balcony for jobs and training positions. Another

medicSA JULY 2018 33 national conference SA paediatrician and rural health advocate nominated to AMA Roll of Fellows

outh Australian paediatrician Dr Nigel aims to provide a high-quality Nigel Stewart was nominated to child health service as close to home Sthe federal AMA Roll of Fellows as possible for the children of rural during National Conference in Canberra and remote locations across northern in May, on the basis of his outstanding South Australia. He has a strong service to the Association over many interest in many aspects of children’s years. Nigel has been an AMA member health, including rural children’s for 23 years. health, indigenous health, behavioural paediatrics and developmental Nigel has been a member of the paediatrics. As a rural practitioner, he AMA(SA) State Council over a period has been a strong advocate for rural of 15 years (with a two-year break), health consumers and their access to as an ordinary member and regional health services. representative: Northern. Teaching roles have included honorary Nigel has a passionate commitment clinical lecturer at the University to rural and regional health services of Adelaide since 1995, and in and in particular working towards an 2003 as a senior clinical lecturer for appropriate and supported workforce rural teaching in the Department to service the health of rural and of Paediatrics for the University of regional communities. Adelaide. He is involved in many for outstanding contribution to the Born and educated in Auckland, New significant committees relating to medical profession. Zealand, Nigel has lived in Port Augusta, children’s health and safety and rural health, including chairing the National In 2008 he was awarded with the South Australia for over 20 years and Rural Health Alliance. AMA Excellence in Health Care Award. has worked as a regional paediatrician The award recognises the significant with the Port Augusta Hospital since Nigel has brought his considerable contribution he made to improving 1993, and since 1995 has been head of expertise and insight to AMA state health care in Australia. the Northern Regional Paediatric Unit at and federal advocacy. In 2006, he Port Augusta Hospital. was awarded an AMA(SA) award Nigel has made substantial contributions to AMA(SA) policy and AMA policy more broadly. Locally he has contributed to many, many AMA(SA) submissions, particularly highlighting Dr Tom Wilkinson MSc MDS rural perspectives and issues, but Specialist Prosthodontist also more broadly, contributing to publications, and federal AMA policy Dr Melissa Laohachai BSc BDS and advocacy. He has been an informed and active contributor to AMA(SA) Council My practice is restricted to managing patients with meetings that have informed AMA(SA) Temporomandibular Disorders (TMD) and Orofacial Pain. advice and engagement with federal Please ring me on 8223 7247 if you have a query about AMA activities also. He has a strong a speciﬁc patient. I commonly receive referrals for the belief in the purpose and value of the following reasons: AMA and invests significant time and • Myofascial pain and temporal headaches passion into that belief through the support he provides. • Synovitis referred as ear pain, blockage and giddiness • TMJ clicking and locking Nigel was a member of the AMA Rural 250 South Terrace Council from June 2013 to June 2016. • Limited opening from synovitis or TMJ derangement Adelaide 5000 His years of service to the AMA • Assessment of bite and tooth wear problems Phone: 8223 7247 nationally and at a state level have • Patients requiring dental devices for snoring Fax 8215 0187 taken up countless hours of his and apnea www.ofpadelaide.com.au time, as well as his energy and ongoing commitment.

34 medicSA JULY 2018 event

AMA(SA) supports AMSS annual Health and Wellbeing Week AMA(SA) president A/Prof William Tam attended the Adelaide Medical Students Society (AMSS) annual Health and Wellbeing Week in May, which aims to promote medical student mental and physical health and wellbeing.

he week is scheduled just before the academic year ramps up fully and the week’s schedule includes fitness classes, brunches, football matches and Tspecial days such as ‘Blue Day’, where students are encouraged to wear blue to raise awareness for mental health. A/Prof Tam introduced an afternoon information session titled EdForum: Mind Over Medicine. Other presenters also included Dr Kylie Dodsworth, a GP particularly interested in health and wellbeing, and doctors Penny Need and Simon Hay, both GPs with experience working with mental health in the community. We captured some thoughts on camera from students during the brunch regarding where they are at with their studies, what motivates them into their chosen career paths and the importance of health and wellbeing. You can see their thoughts here: photos.app.goo.gl/9hmEUrtEzz2kxyJg1

medicSA JULY 2018 35 notice AMA outrage forces Bupa backdown An AMA-led outcry over private health insurer Bupa’s decision to fundamentally change its schedules has led to a partial backdown, forced on it by the Private Health Insurance Ombudsman (PHIO).

n March, Bupa – Australia’s largest The AMA(SA) raised the Association’s The AMA Federal Council held lengthy private health fund – announced changes strong concerns with the state government, discussions about Bupa’s proposed Ito its no-gap and known-gap policies. underlining particular concerns for changes and passed two motions formally Planned to start in August, no-gap and SA, where according to a recent rebuking Bupa’s plans. known-gap rates would only be paid Commonwealth Ombudsman’s report, In response to the Ombudsman’s to the practitioner if the facility in which Bupa has 50.4% of the market share. intervention, Bupa promised to restore the procedure takes place also has an future access to no-gap schedules agreement with Bupa. Medical benefit The AMA remains critical for private patients in public hospital rates outside those facilities would only that Bupa policy holders emergency departments. be paid at the minimum rate that the insurers are required to pay – that is, will not be able to use their AMA Federal President Dr Tony Bartone 25% of the MBS. no-gap or known-gap cover said that both the PHIO report and Bupa’s response to it were welcome. The AMA swung into action at state in non-contracted facilities. He said the move restores some level and national levels. It described the move of transparency. as a big leap towards US-style managed State and federal AMAs underlined the care; demanded a ‘please explain’ impacts on patients and the health system, The AMA remains critical that Bupa from Bupa; and called on the Federal with the Association leading a strong public policy holders will not be able to use Government to launch an investigation and social media campaign against Bupa’s their no-gap or known-gap cover in into the move. Federal Health Minster proposed changes. In addition, the AMA non-contracted facilities. The AMA has Greg Hunt subsequently ordered the PHIO has held ongoing discussions with Bupa to spoken strongly against this and will to do exactly that. represent the concerns of AMA members. continue to do so.

Southern ENT and Adelaide Sinus Centre welcomes Dr John Wood who will be joining us from the 1st of July 2018.

Dr Wood is an Ear Nose and Throat interests include the management surgeon with a sub-specialisation in of paediatric airway disorders, paediatric ENT, with a Fellowship in salivary gland disease and vascular Paediatric ENT obtained at The Starship malformations. He will be seeing both Hospital in Auckland. adults and paediatric patients. He has a keen interest in all aspects of For any appointments please contact paediatric ENT including sleep disordered Southern ENT & Adelaide Sinus Centre breathing, head and neck masses, nasal on 8277 0288 at Flinders Private and disorders and ear disease. His special in the CBD.

Adelaide Sinus Centre Southern ENT East Adelaide Medical Centre T 08 8276 2700 | F 08 8219 9908 Flinders Private Hospital T 08 8277 0288 | F 08 8219 9908 Level 1, Suite 16 [email protected] Suite 200, Bedford Park, [email protected] 50 Hutt Street, Adelaide 5000 www.adelaidesinuscentre.com.au South Australia 5042 www.southern-ent.com.au Adelaide, South Australia 5000 Provider Number: 283083TT ABN: 53 689 857 752 Provider Number: 283083UB

36 medicSA JULY 2018 profile Who’s who, and who’s new? medicSA takes a look at who the faces are heading up our Local Health Networks in the wake of the change of government in March 2018.

Lesley Dwyer She was executive director, Nursing, Lindsey Gough Central Adelaide Local Health Midwifery and Redesigning Care for Women’s and Children’s Health Network (CALHN) Flinders Medical Centre. Network (WCHN) Lesley Dwyer has been appointed as the Susan holds an executive MBA, a Masters WCHN CEO Lindsey began her career new chief executive officer, CALHN. of Nursing Science, and is a fellow of as a biomedical scientist, moving on to She will commence in the role on 26 the University of Pennsylvania Wharton manage pathology labs before taking on November 2018. Business School. Susan is an adjunct more senior managerial positions having professor at La Trobe University. responsibility for a broader range of hospital Lesley has more than 30 years’ experience services. Her last position in the UK prior working in public health both in Australia to moving to Australia was as a director of and the United Kingdom. Debbie Chin Northern Adelaide Local Health operations at University Hospitals Coventry Her most recent role was chief executive Network (NALHN) & Warwickshire. of Medway NHS Foundation Trust Debbie Chin stepped into the role of She completed the Fellowship of the and she has held similar roles in interim CEO of NALHN in April 2018, for Institute of Biomedical Sciences, Advanced Queensland, Victoria. Cellular Pathology at Nottingham Trent Lesley is a familiar face at University and a Masters Degree in CALHN, having previously held Public Service Management at several executive positions within Aston University. the network, including chief At the beginning of 2009 she moved operating officer. to Australia, where she took up a role She has led complex change and as general manager of Royal Adelaide improvement programs aimed at Hospital and Hampstead Rehabilitation raising organisational performance, Centre, within the then Central Northern and integrating service delivery across Adelaide Health Service. entire healthcare systems. With some restructuring of the SA Lesley is taking over from Jenny Lesley Dwyer Susan O’Neill Health regions, she later became the Richter who has been acting in the director, Central Adelaide Area Health role over the past 18 months. Service, encompassing the RAH, The Jenny is heading back into retirement Queen Elizabeth Hospital, Hampstead on 30 November. Rehabilitation Centre, St Margaret’s Hospital, and Primary and Ambulatory Health Care. Adjunct Professor From there she spent a little over 12 Susan O’Neill months with Health Workforce Australia Southern Adelaide Local Health leading the implementation of workforce Network (SALHN) Debbie Chin Lindsey Gough innovation and reform projects; spent SALHN CEO Susan O’Neill has six months as the acting executive extensive experience in executive director, Division of Medicine at the Gold Coast Hospital and Health Service; management positions across the a period of three to six months while a and for the last four and a half years she public, private and not-for-profit sectors permanent CEO is recruited. in several states. has been based in Dubbo in regional NSW Debbie has many years’ experience in as director of operations and deputy CEO Susan was CEO of Albury Wodonga health management in New Zealand, of the Western NSW Local Health District, Health, the first cross-border health including most recently as the chief an organisation with around 4,500 FTE and facility in Australia, and prior to joining executive of the Capital and Coast an annual budget of $900 million. SALHN, Susan was most recently District Health Board. She moved to the CEO of St Vincent’s Public She has been the chief executive officer Australia from New Zealand to take up the Hospital, Melbourne. of the Women’s and Children’s Health role in NALHN and is eager to progress Network since April 2018. She has held senior health administrative NALHN’s growth as a high-performing positions across metropolitan and health service that delivers patient- Lindsey has 36 years’ experience in regional health services in South Australia focused outcomes through high-quality, healthcare in the UK and Australia, 22 of and Victoria. compassionate care. those in management.

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In preparing this information, AMA Insurance Brokers is not providing advice. It has been prepared without taking into account your personal objectives, financial situation or needs. 38 AccordinglymedicSA JULY it is important 2018 that you read the Product Disclosure Statement (PDS) of the actual provider carefully, and ensure that the PDS and the exclusions are appropriate for your business and personal needs. AMA Insurance Brokers ABN 40 064 488 106 AFSL No 235312. *Conditions Apply feature The multifaceted lens of ‘world view’ How being conscious of our world view can influence our own lives and those of our patients. By Dr Troye Wallett.

‘ he lens through which A presentation of chronic pain makes Taking ownership of our lives gives us we view the world obvious a patient’s locus of control. a sense of control and power over the T dictates 90% of our Chronic pain is an incredibly challenging direction we are heading. Jocko Willink reality.’ The lens in this quote, condition to manage and even more in his book Extreme Ownership talks by Shawn Achor, professor of challenging to live with. A person with an about this at length and is worth psychology at Harvard1, is a external locus of control will present to the a read.4 metaphor for one’s world view – a much- doctor and hand her the problem. “Doctor, Another concept affecting world view, mentioned, but poorly understood, phrase. my pain is no better, what are you going which is related to but slightly different to do about it?” They will also describe the Since one is always looking through one’s from ‘locus of control’, is ‘growth versus circumstances of their injury or disability as own ‘world-view lens’, it takes conscious fixed mindset’.5 The two are related in something that happened to them. effort to comprehend that other people that a person with an internal locus of interpret the world differently. Exploring “I was walking on the sidewalk and control believes that they – rather than the way we think, and recognising that tripped over a loose brick in the road. My luck – are the source of success. The others think differently, opens up wonderful pain and injury is the council’s fault as they belief comes from a growth mindset opportunities to improve our lives, as well did not fix the road.” which views skills as learnable and related as our personal and working relationships to the effort put in. People with a fixed and more importantly, the lives and mindset often have an external relationships of those around us.* locus of control and believe that Brain plasticity2 gives us the hope talent is innate and fixed. They see that, no matter our circumstances, people as ‘good at’ something or we have the power to change our ‘bad at’ something. The language world view if we so desire. they use is ‘I can’t sing because I am not good at singing’. Fixed A specific influence over our world mindset people tend to give up view and the way we operate is earlier than growth mindset people ‘locus of control’. Julian B Rotter and have less resilience. If you 3 described ‘locus of control’ in consider talent as an external 1966 in Psychological Monographs force, then the relationship as ‘...a generalised expectancy between ‘external locus of control’ for internal as opposed to external and ‘fixed mindset’ world views control of reinforcements’. becomes apparent. Essentially, locus of control is how much control a person feels they The world view of trainees and have over the events in their lives. registrars is obvious when viewed through these lenses. Do they Those who believe that success have an external locus of control or failure is due to an external and believe that luck and an innate force, such as luck or fate, have an intelligence will get them through external locus of control. Life happens to their exams? If they face a setback, do these people. On the other hand, it is rare but satisfying they take ownership of the setback or to work with a patient who has an internal blame bad luck? Health professionals A person with an internal locus believes locus of control. are not immune to these differing lenses, that their success or failure is related to and because we are well-educated, effort and, even though random events “Doctor, the tablet we tried last month intelligent people, we need to be cautious occur, they have the power to direct or helped for a while, but my pain is still of the fixed mindset world view when manage those events. These people bad. I understand that exercises can we find other aspects of life challenging. control their own lives. help with pain; do you know anyone Are you bad at singing, drawing, painting who can help me with an exercise We see it all the time in our patients and – or have you just not worked hard program? Do you have any other our trainees and, of course, ourselves. enough at them? The words we use suggestions I may try?” Before going further, however, it is echo our thoughts, and become our important to highlight that recognising And the same person describing the nature.** Changing one’s self-talk from ‘I a person’s locus of control is not for event would say: “I was walking down the am not good enough’ to ‘I have not tried judgment, but rather for improving road and tripped on a loose brick. It was hard enough’ opens up opportunities our own world view to the betterment stupid of me not to have noticed it, but I and ideas that may not have seemed

medicSA JULY 2018 39 feature

These are just two of many concepts mean and hateful is it easy to attribute Dr Troye Wallett is a GP who co-founded making up the multifaceted lens through malice. However, reframing the reasoning GenWise, the 2017 Telstra Business which we interpret the world – i.e. our for people’s actions to fatigue, stress or of the Year. He can be contacted at world view. Fortunately, these lenses can incompetence will shed a different light on [email protected]. be adjusted or changed completely. The people’s inherent natures, and over time neuroplasticity of our brains allows for new our worldview will change. neural pathways and ways of thinking. * This sentence is an example of a world view. Consciously reframing life events has a Believing that it is more important to help Engaging with a psychologist is the most remarkable effect on our outlook. Often others rather than oneself shows extrospection effective way to explore and adjust our one is so caught up in the quagmire of life and generosity. worldview. How wonderful is it to be able that it is difficult to step back and reframe. ** Blatantly misquoting Lao Tzu – the real quote to spend time with a professional whose In this case, using a trusted person to is ‘Watch your thoughts as they become your job it is to improve our lives? If time or will help us reframe can be tremendously words. Watch your words as they become your do not allow that luxury, then here is one useful. With a bit of practice, this mental actions. Watch your actions as they become your of many mental tools that you can use. tool can become honed and we can find habits. Watch your habits as they become your nature. Your nature becomes your destiny’. Cognitive reframing6, 7 is a technique used ourselves reframing consistently. References: to view events differently and is a tool As with most things, when you explore 1 https://www.youtube.com/watch?v=fLJsdqxnZb0 to shed light on one’s worldview. To use your world view, you will find the details Hanlon’s Razor8 as an example and to aid 2 https://www.medicinenet.com/script/main/art. are fascinating and profound. ‘World asp?articlekey=40362 explanation: ‘Do not assign to malice, that view’ is an all-encompassing term that 3 https://en.wikipedia.org/wiki/Locus_of_control which can be assigned to incompetence includes many aspects of our personality [or stress or fatigue]’. 4 https://www.amazon.com.au/Extreme-Ownership- and cognitive functioning. Realise that Jocko-Willink/ When we receive an abrupt or rude your world view is unique to you, and you 5 https://www.ocd.pitt.edu/Helping-Children- email, it is easy to assign malice; however will find yourself watching with fascination Understand-That-the-Effort-is-Worth-It/255/ reframing the email and assigning stress how others view things differently. Do not default.aspx as a reason for the rudeness can change judge them for their view, but feel free to 6 https://www.ncbi.nlm.nih.gov/pubmed/7455683 our reaction and our world view. If one’s kindly judge your own – as you have the 7 https://en.wikipedia.org/wiki/Cognitive_reframing initial world view is that people are mostly power to change it. 8 https://en.wikipedia.org/wiki/Hanlon%27s_razor

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40 medicSA JULY 2018 membership

Why I am a member of the AMA

Dr Deric de Wit FRANZCO FRCOPHTH MRCSED MBCHB DipCatRefr Taste the best Shiraz Barossa Eye Clinic of the Barossa

became a member of the AMA when I moved interstate to set up I a new practice in South Australia. I needed a professional medical advocate to support and steer me through the quagmire of contractual obligations with the state and local private hospitals. Unfortunately, I had a dossier full of ethical and medico-legal concerns which were in conflict with the current accepted norms. There was also a feeling of powerlessness when nepotistic written communications were nonchalantly sent my way by people and organisations I expected to adhere to a global professional code of conduct in medicine. My own medico-legal cover (which is held with a reputable nationwide organisation) could not extend themselves to cover these challenges. This was a fairly isolating experience until I contacted the AMA(SA) team – they immediately understood my arguments and could help create the locally relevant legal framework structure which I could utilise as a firm base from which I could challenge these communications on an equal footing. It was a relief to have ethical people with powerful legal backing take up my challenges without me having to explain anything further – my faith in the profession was restored and a new source of motivation compelled action.

Friendly, fast, efficient and – above all – expert professional advice. To be a lifelong member of such a reputable, active organisation which advocates for all doctors and on behalf of the public for accountability and transparency in Australian medical practice is an absolute honour. The AMA is our face of modern medicine – it deserves and needs our sustained support at this time more than ever. We need to stand together to face increasing public mistrust, widespread uncensored medical misinformation and the politically targeted destabilisation of the medical fraternity. The AMA has the authority and experience to use media releases judiciously for effective communication and to represent the current, pertinent views of the medical profession for the greater good of the community. The AMA has an unrivalled track record of leadership and advocacy for the profession – it is directly responsible for influencing the ethics, safety and quality of Australian medical care which has made it the world leader that it is today. To purchase visit Truly – when you really look at it from the perspective of all medical disciplines – this is the one medical organisation we www.chateautanunda.com should make it an absolute priority to belong to.

medicSA JULY 2018 41 motoring New Calais V – what’s in a name? Our motoring team takes a look at the luxury version of the new Commodore ZB range, the first to be released by Holden since the closure of the Elizabeth plant. By Dr Robert Menz and Dr Philip Harding.

ob: Hey Phil – can you remember back to October R1978, when Kingswood kowtowed to Commodore? The venerable VB was also an Opel, rebadged and reengineered for Australian conditions. Fast forward almost forty years, and again Holden’s Australian-made Commodores have been replaced by Opels, this time actually made in Germany. You will also recall that we road tested a Calais V (Sportwagen) in 2015, anticipating the closure of the Holden plant at Elizabeth, so now it is time to report on the latest Calais V.

Commodores are available in a range of models, ranging in price from low $30ks to mid $50ks, and the Calais V, although top of the range, is not quite the most expensive at $51,999 list price. We tested the hatchback (known are motoring scribes, but it is very contact phone charging. The satnav as lift back), which is the more popular unlikely that this new Commodore will was similarly simple and straightforward. style. There is a station-wagon variant repeat the car of the year accolade Although there is no automatic parking called sportwagon. Lower spec models awarded to the VB. function, front and rear cameras display are available with a 191 kW 2L turbo clearly on the screen, along with a split- petrol or 125 kW diesel in front wheel It’s packed with all the screen ‘helicopter’ view, which makes it drive. Our test car had the 235 kW 3.6 features you would expect very easy to see how far the car is from L V6 all-wheel drive, common to the the kerb, or other parked cars. more up spec models, with the official in a top end European car, Phil: Good summary of the features, economy figure at 9.1 L /1000 km. Can to the extent that anyone what did you think once behind you believe the Commodore now has a thinking about upgrading the wheel? 9-speed gearbox (auto only), unless you opt for diesel, in which case you only to one of the German Rob: The first impression is one of have 8 cogs? badges, or downgrading very direct steering, and quite firm suspension. Twenty-inch wheels shod The list of features found in the Calais once retirement hits and with 245/35 tyres certainly contribute to V would not be out of place in other affordability becomes an the firmness, but also assure confident German cars with significantly larger handling. There is plenty of poke in the price tags, and all contribute to issue, should seriously V6 (0-100 kph figures around 6 seconds making the new Commodore a look at it. are quoted), and the brakes are even very desirable and value for money more effective. Electronic gadgetry proposition. Unfortunately the Australian Anyway, back to the features, which abounds, with adaptive cruise control public does not see it this way, with include heated and cooled front seats, ensuring a safe distance behind the some less than encouraging early and heated rear seats, heads-up display car in front, warnings about lane drift, sales figures. Maybe we haven’t yet of speed, radio station, GPS directions, pedestrians and other hazards on the forgiven Holden for forsaking over 60 and a variety of other information. A road (a red light flashes on the dash, years of rear-wheel drivetrains, or massage function is provided for the and the radio volume dims), and orange maybe the trend toward SUVs will driver! The large central touch screen flashes in the outside (heated) mirrors lead to continued sales struggles, or can be used to control all sorts of warning of other vehicles lurking in your perhaps Commodore needed locally functions, like the phone, the aircon, blind spot. made competition in the form of and the driving mode. Bluetooth pairing Falcon or Camry to thrive. I am sure to the iPhone was very straightforward, Outside single digit temperatures were there are as many theories as there and there is a device which allows non- ignored on my brief foray into the hills

42 medicSA JULY 2018 motoring on a sunny chilly afternoon. With the European car, to the extent that anyone particularly thirsty. One other thing to heater set at 24, seat heater activated, thinking about upgrading to one of the add: the rear seat is really designed to an open sunroof and Brad Meldhau Trio German badges, or downgrading once seat two in comfort, even to the extent of streaming from the iPhone, motoring retirement hits and affordability becomes individual seat heating with the controls life was wonderful. This would be a an issue, should seriously look at it. in the rear, with the middle passenger very comfortable vehicle for interstate After a couple of days, I felt extremely being a bit optional. travel, provided you stay on the bitumen. comfortable behind the wheel and was Like you, I suspect, I have some reluctant to give it back! Having collected 110 kph saw about 1600 rpm, with difficulty in thinking of this as a Holden the Calais and negotiated my way out of ninth gear being a significant overdrive (‘Australia’s own car’, remember?), the showroom using the forward camera, (0.62:1). And the cruise control was when it really isn’t. Nevertheless, which continues operating at walking very loyal, even coming down relatively rebadging has become so rife in the speed – a new experience for me – my steep hills did not allow variation of more industry, it’s time we got used to the first journey was driving up to Angaston than 1-2 kph from the allocated speed. idea. Going back to the time when at night, and I should add to your Being a hatchback (oops, sorry, lift back) some Rovers were Hondas, cross- comment that the lighting both inside means a huge boot area with the rear naming has progressively increased, and out – the latter including automatic seats down, of 1450L. One of my chores even to the point when one Mercedes- high beam dipping – is extremely good. was to collect my grandfather’s antique Benz model is actually a worked-over office chair from the restorer, and it fitted The return trip was on pretty empty Nissan. At the end of the day, what’s easily. With the seats restored to their Adelaide Hills roads with the Calais in a name? The bottom line is that this usual position, there was plenty of room proving nimble in wet conditions: the car is a great all-rounder which gives for back-seat drivers. grip afforded by the all-wheel drive, value for money. complemented by the low-profile Enough from me, Phil, what was your Calais V was supplied by Holden and Continentals, holding the gear ratios in impression after your weekend away? collected from City Holden in Pirie St. sports mode using the steering wheel Phil: Well, like you, I found this a most paddles, was excellent. With the revs Robert Menz is an Eastern Suburbs GP desirable vehicle which was an absolute well above the figure you mentioned in who has owned several Commodores. pleasure to drive. It’s packed with all the those conditions, the V6 also delivered a Phil Harding is former AMA(SA) president features you would expect in a top end very pleasant exhaust note, and wasn’t who also drives a European car.

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medicSA JULY 2018 43 heading

more than just sport

sportsmed provide personalised and expert healthcare to patients and families of all ages.

We have extensive experience in preventative If you would like to arrange a time for one of care, treatment and rehabiliation for a range of our specialists to meet with the practitioners ailments, injuries and conditions including bone, and staff at your practice to provide further joint, muscle, ligament, tendon, nerve information about our services, please contact and arthritis pain our Business Development Coordinator Rachel White on 0413 759 686 or at Help your patients keep on top of their health [email protected]. and feeling their best at sportsmed!

Orthopaedic Surgeons · Physiotherapy · Sports Doctors · Podiatry · Massage · Exercise Physiology · Diet and Nutrition · Psychology · Pilates · Gym Stepney Healthcare Hub · Blackwood · Henley Beach · Morphett Vale · Mt Gambier · Victor Harbor · Darwin 44 medicSA JULY 2018T 08 8362 7788 | F 08 8362 0071 | www.sportsmed.com.au heading A doctor at large in rural South Australia

There is restrained but accurately Have stethoscope, will travel scathing reference to the workings of medical bureaucracy in SA and its Dr Anthony Radford counterproductive relationship to rural health and hospitals.

The problems of rural doctors, the lack of local graduate recruitment and the his is a book which provides medical immigration of the late ’90s and hours of enjoyable reading, with a early 2000s are described. Twealth of information making an immediate second reading worthwhile. The introduction sets the scene, so that and activities and recreation as well as the individual chapters can describe the It is a book for anyone with an interest in the illnesses of the population of rural SA. journeys, places and people and the South Australian (and Centralian) history, locum at work, expanding only where It can be picked up and put down, or mores, landscape, geography, geology, needed on the themes it introduces. read continuously. flora and fauna as well as rural medicine. It is also a book for medical practitioners, The individual locum experiences It shows a deep appreciation of and written by a GP of vast experience, describe not only the patients and the sympathy for humanity’s foibles and academic achievement, and an ethic medical services required. They describe weaknesses, and the value of vocational of service to individuals, communities, the season, the scenery, the food and professionalism in helping individuals. and his colleagues, the roots of which wine available on the way and on site. From the perspective of my roles as a become evident as he unobtrusively They also outline the lives and work of GP locum in rural practice, and within the describes his family, his personal and some other noted and still active rural AMA and the RACGP, I can vouch for its professional progression, his faith GPs whose service has not yet been authenticity and accuracy. and its practice. adequately recognised. It has helped me to know the author To say that it is written in plain English There is a nice balance between duty, better. He never imposes himself, but the does not do it justice. The style is vocation and enjoyment of the finer book is enriched by his presence. conversational, but there are frequent things in life. There is reference to the vignettes, not drawn to stand out from failure of local graduates to serve in rural I found myself wishing to have been young the narrative, but which detail and enliven practice with the opportunity to provide enough to have been one of his students. it. They may be descriptions of a garden, the ultimate continuity of care. Review by Dr Peter Joseph stock in rich pastures, rock formations or seascapes; they all reflect the eye of This is a book which explores rural You can purchase your copy directly an acute and affectionate observer of the South Australia and the provision of its from [email protected], at people, the weather, and the landscape, medical services with insight, humour, yourbooksonline.com.au or at Dymocks of his home state. honesty and sensitivity. Its honesty in Adelaide City. The cost is $29.99. and sensitivity do not always make it The author has written the book from politically correct, whether from a extensive diaries he kept on the trips ‘liberal’ social background or medical he undertook as a locum. He has political orthodoxy. actively informed himself about the Giveaway places he visited, and shares this with The author’s personal attitudes to topics We have two copies of Have his readers. I hope that the diaries will such as abortion will not find universal stethoscope, will travel by Anthony be suitably archived. favour, particularly as his opposition is Radford to giveaway. If you would like expressed simply, honestly and rationally. one, email your details to books@ In the introduction, the scene is set, amasa.org.au or call (08) 8361 0101. and succinct explanations made to Nor will some medical professionals Winners will be notified directly inform and refresh the memories of non- welcome his views on nurse practitioners. and names published in medicSA, medical as well as medical readers of The wisdom, balance and honesty as September 2018. the historical place of general practice, well as the sense of adventure which and its rapid contraction in scope in Joanne Ong and David Reid are is evident in this book should make the 1990s. It describes the locum life the lucky winners of our last book readers at least give due respect to from the perspective of accommodation giveaway in the May issue of medicSA. these opinions. and provisioning, and the availability of They will each receive a copy of help, either by remote communication This is also a book of historical value in Anaesthesia by Kate Cole-Adams. or by retrieval. its detailing of the life and social structure

medicSA JULY 2018 45 heading

It’s time for mid-year exams for pre-clinical stu

medical students and junior doctors, and The release of the Federal Budget saw Monica Chen decorated the grasslands with cheese, some advocacy wins for medical students a mini golf course and mocktail bar. We across the country. The Commonwealth STUDENT NEWS: also recently ran our Electives Night Medical Internship program has now UNIVERSITY OF ADELAIDE and Inter-Year Debating event, which been consolidated into a broader saw some hilarious, thought-provoking program – the Junior Doctor Training debates between the year levels. The Program – which will continue to fund 100 he Adelaide Medical Students’ close of the first clinical semester saw internship positions open to international Society (AMSS) ran its annual our gender pfficers run our first Pub Quiz, students. The budget also announced THealth and Wellbeing Week in May which successfully raised over $1000 for bonding reforms to improve the student to promote medical student mental and Hutt Street Centre – which helps people experience of bonded medical students; physical health and wellbeing. The week challenged by homelessness and serves funding investment into existing Rural started with Zumba and clinical care over 40,000 meals, as well as offering Clinical Schools; and funding of a National packages delivered to the hospitals. This social work and support services to nearly Rural Generalist Pathway. However, was followed by EdForum mid-week, 2,000 people every year. while previous advocacy successfully where A/Prof William Tam presented a prevented the creation of the 120 CSP brief, enlightening talk. There was also Now clinical students Murray Darling Medical School, the a chill-out zone and Blue Day, where are jetting off all around Government has funded a new medical students wore blue to raise awareness school at Orange with 30 Commonwealth for mental health. We also ran a delicious Australia and the globe for Supported Places (CSP) spots. brunch attended by the AMA(SA), held our mid-year holiday whilst yoga sessions and brought puppies Now clinical students are jetting off to the med school for some destress pre-clinical students settle all around Australia and the globe for puppy therapy. The week ended with in for swotvac and exams. our mid-year holiday whilst pre-clinical our traditional MedFooty day, with plenty students settle in for swotvac and exams. of sunshine, a brilliant turn out and an We have a wonderful week We have a wonderful week of Convention emergency medical challenge. of Convention to look to look forward to very soon, with the annual event this year in Perth. Fortunately, the weather permitted us a forward to very soon, beautiful Jazz Night by the River Torrens If you have any questions or comments where we heard from two jazz bands with the annual event about the AMSS, you are welcome to comprised of some superbly talented this year in Perth. email me at [email protected].

North Adelaide Hospital

46 medicSA JULY 2018 heading dents as clinical students jet off for electives

development sessions, with our peer me to Tanzania and afforded both a Stephen McManis mentorship program continuing to both wealth of practical experience as well support our junior student mentees as the opportunity to juxtapose our STUDENT NEWS: and afford professional development medical systems and examine more FLINDERS UNIVERSITY and enrichment to our senior student deeply the role of the profession in mentors, with Dr Chris Moy speaking and across societies and culture. We to our senior group on developing a should continue to facilitate medical linders Medical Students’ mentoring philosophy. The pilot peer electives abroad for our own students; Society (FMSS) has always been mentorship program has been another and, in particular, look to ways we can Fvigilant around mental health incredible success for us this year, and support overseas students, especially and wellbeing, particularly that of our we are very grateful to the AMA(SA) from developing countries, coming to members. 2018 marks the first year and to our faculty at Flinders for their Australia. There is so much we can learn we hold a whole month for mental continued support. from one another. health in medicine (MHIM), marking a June also marks this year’s World’s renewed commitment to be innovative The pilot peer mentorship Greatest Shave day, with many from in this space and continue to build program has been another our group coordinating, donating and of on the pioneering work of previous course shaving their hair to raise funds FMSS committees. incredible success for for Leukaemia research. A warm thanks MHIM in May (as we have fondly named us this year, and we and congratulations to our brave and it) has been a huge success for us, with are very grateful to the selfless members. each week of the month focusing on AMA(SA) and to our That’s it for now – look for more a different theme for our members to from FMSS in the coming months meditate on. The aim is to empower faculty at Flinders for their on our Aboriginal and Torres Strait our cohorts to better wellness and a continued support. Islander advocacy, as well as a beacon complete, holistic approach to our health of warmth and joy as our Medball and wellbeing in medicine, covering emerges from the depths of the It is timely for me to note the wonderful themes of self-care, emotional growth, winter months. opportunities a career in medicine physical fitness and stress relief. presents to a person, and in its own All photos with special permission, June heralds the second of our AMA(SA) way to medical students too – an Muhimbili Orthopaedic Institute. All staff supported mentorship professional elective in neurosurgery has brought informed, no patients identifiable.

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medicSA JULY 2018 47 heading

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48 medicSA JULY 2018 heading A giant of the profession

Bruce Dalway Shepherd the last independent group in our society AM, MBBS, FRCS, FRACS, and as such I move to control you”. Bruce FAMA, FAOrthA never returned to the public system but gave an enormous amount of time and money to 1932-2018 nurturing and teaching young trainees and fellows. Indeed, as Dr Nelson commented, one of his characteristics was always to r Bruce Shepherd, AMA federal encourage young people to believe in president 1990-93, died in Bowral themselves and to find their own potential. Don 25 May at the age of 85. A memorial service held at St Mary’s In those turbulent times during which both Church in North Sydney on 7 June was government and the private health insurance attended by some 700 people, including industry were active in trying to control AMA president Tony Bartone and past our profession, Bruce Shepherd’s fierce advocacy – while not universally supported presidents Kerryn Phelps and Brendan bring first Penny, and then her brother – was so valued by the AMA that he is only Nelson. Eulogies were delivered by lifelong Daniel, into the hearing world. Through one of two presidents to have been given a friend Chris Meagher, Dr Anne Fulcher from the Shepherd Centre which they founded, third year in office. Those who would like to the Shepherd Centre, Dr Nelson and Dr and the similar organisations it spawned, learn or recall more about his contribution Shepherd’s longstanding friend and fellow thousands of children today can hear and and that of others throughout the latter part orthopaedic surgeon John Harrison. speak – because Bruce refused to listen to of the last century should refer to the AMA those who said they never would. One of eight children, Bruce was born in history More Than Just a Union, published Tamworth, the son of Albert Shepherd and in 2012. Brendan Nelson would speak for many Mary McDonald, and educated there at of us when he said in his tribute that “I Bruce’s other great passion and contribution Mt Carmel Christian Brothers College and admired him. But along with many others, was to the cause of deafness. When his subsequently the University of Sydney. there were times he made me angry. But much loved daughter Penny was born I loved him and will remember always the It seemed somehow fitting that Bruce’s profoundly deaf in the early 1960s, he and gifts he gave me and countless others.” death coincided with the first morning his late wife, Annette refused to accept that of this year’s AMA National Conference, she would never hear and speak. Long The medical profession, the AMA and speaking from which then president Dr before cochlear implants and confronting the nation has lost a man who made an Michael Gannon said that Australia had lost medical orthodoxy, they gave their all to enormous difference. a giant of medicine and health advocacy, noting that Dr Shepherd put the AMA and medical politics on the map, that his tireless advocacy and campaigning for doctors and patients in the Hawke Government years were legendary, and that he continued his medico-political advocacy beyond his AMA leadership years, founding the Australian Society of Orthopaedic Surgeons and the Australian Doctors’ Fund.

In a recently published tribute, Bruce’s successor as AMA president Dr Brendan 72 Fullarton Road, Norwood SA 5067 Nelson recalled how in the mid-1980s Dr Shepherd had led the bitter dispute in New (08) 7231 1703 | Fax (08) 7231 1945 South Wales in which he and some 70 mychildpsychiatry.com.au orthopaedic surgeons resigned from what @mychildadelaide they held near and dear. The then state and federal Labor governments were seeking to effectively nationalise and control the Principal Practitioner | Dr Melanie Turner profession’s independence. Instead of working as honoraries in the public hospital system they were to be paid and access for their private patients restricted.

Then NSW premier, Neville Wran in meeting Bruce said, “Dr Shepherd, you represent

medicSA JULY 2018 49 heading

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50 medicSA JULY 2018 heading Larger-than-life ENT surgeon

There was clearly a great need for ENT Edward Marzec services in the northern suburbs, and MBBS, FRACS when one consulting session a week 1948-2017 became insufficient, Ed and paediatrician Judy Jaensch bought rooms in Ann Street, Salisbury. With his warm manner it was evident to his patients that Ed dward Marzec was the eldest of had a real interest in their welfare. He three children, born 27 November was adept at honing in on psycho-social E1948 in Germany where his parents issues causing symptoms and providing had been taken as forced labour during firm reassurance and was always the war. His father, a captured Polish prepared to see urgent add-on cases. soldier and his mother, who was taken Four of his staff were each with him for from a Russian orphanage, met while over 30 years. working on adjacent farms. The little of the SA Section of the Australian When he was eventually compelled family arrived in Melbourne on the SS Society of Otolaryngology – Head and to dramatically reduce his workload Goya in 1950 with nothing to their name, Neck Surgery. because of illness, Ed was pleased to be no English language, trade or skills. able to find young surgeons to continue They moved to Adelaide and lived in a With his first wife Lila, Ed had four his Salisbury and North Adelaide ENT adored children, and his life very frugal manner, initially in a tent, on practices as he felt a great responsibility subsequently with Leanne and her a block of land at Royal Park on which to his patients and referring doctors, daughter was a wonderful 17-year Ed’s father gradually built a house room particularly in the northern region. partnership. Apart from his very by room. No doubt his parents’ example busy ENT practice, Ed embarked on was a factor in the development of Ed’s With his warm manner other ambitious projects with typical prodigious work ethic. it was evident to his fervour. A great passion was his Santa Ed’s parents instilled in him a strong Gertrudis cattle stud on Hindmarsh lifelong Christian faith and were very patients that Ed had Island. Ed delighted in trips interstate to involved with the church where he and a real interest in their buy bulls and competing successfully his sister used to perform, Ed with his at the Royal Adelaide Show with the banjo and his sister Barbara, who had a welfare. He was adept children helping. fine voice, with the piano accordion. at honing in on Ed’s illness was long and difficult and the After schooling at Woodville High and psycho-social issues need to slow down very much against graduating in Medicine in Adelaide in causing symptoms… his nature. Yet he was always outwardly 1972, Edward undertook three years cheerful and uncomplaining. Long hours of RMO rotations at The Queen At the Lyell McEwen Hospital at of dialysis and later multi-system disease Elizabeth Hospital (TQEH) and a year Elizabeth, Ed carried out public surgery, forced him to cease active clinical as surgical registrar at the Daws Road being essentially the sole ENT surgeon practice in 2014. Repatriation Hospital followed by ear, doing so, for some 20 years. He also The end came with Leanne by his side nose and throat (ENT) postings at the provided a visiting service to Loxton and the family close by, just four days Royal Adelaide Hospital (RAH), TQEH and carried out monthly surgery at short of his 69th birthday. and the Adelaide Children’s Hospital Naracoorte for the local ENT specialist, (ACH). He gained his fellowship from the Comments from the colleagues with both over a long period. For a shorter Royal Australasian College of Surgeons whom Ed worked include: “We were time he visited Roxby Downs also. (RACS) in 1980 while a registrar at amazed by his energy and workload, Flinders Medical Centre and then As consultant at the ACH and its behind which was a driving desire travelled to the USA to visit various successor the Women’s and Children’s to improve the quality of lives he ENT departments. Hospital (WCH), Ed supervised and crossed. Ed was a true larger-than-life taught many trainee doctors. Even in character. He was such a pleasure to Ed entered private practice with particular his registrar days, he was known for his be around: always a joke, always a interests in paediatric ENT, otology tremendous enthusiasm for ENT and his funny story – but behind it all a very and rhinology, and commenced a 30- inspirational influence is known astute mind. As someone who worked year association with the ACH. With to have drawn younger colleagues into with him for many years at the WCH, David Close he bought David Tonkin’s the specialty. He was Head of Unit from I count myself lucky to have crossed old rooms in Melbourne Street where 2007 to 2012. his orbit.” they practised independently for eight years before Ed decided he wanted to Ed served as treasurer, committeeman, Compiled by Dr David Close, with demolish and rebuild. vice-chairman and in 2003-4 chairman Dr Leanne Collie.

medicSA JULY 2018 51 heading

The experts recommended for health experts by the AMA(SA) & ADASA.

Lisa Hickey+ Adrian Zoppa* Mark Mullins* Business Advisory Financial Planning Risk Insurance

Heang Lay+ Trien Ly+ Simon Starr Accounting Accounting Coaching

Hood Sweeney is a preferred provider of Accounting services and Financial Planning services to members of the Australian Medical Association of South Australia, an exclusive provider of accounting services to members of the Australian Dental Association of South Australia, and a long-standing sponsor of both organisations. Our team has more than 10 experienced specialists who understand the inherent complexities of everything from setting up a medical practice – including IT and service fees – to selling it, along with personal financial planning, wealth protection, tax strategies and performance coaching. For a second opinion on the fiscal fitness of your practice or your personal finances, email our Health team on [email protected] ACCOUNTING & BUSINESS ADVISORY or call 1300 764 200. CONSULTING & PERFORMANCE COACHING FINANCIAL PLANNING TECHNOLOGY SERVICES FINANCE +Lisa Hickey, Heang Lay and Trien Ly are Representatives of Hood T 130 0 76 4 20 0 F 08 8232 1968 Sweeney Accounting & Business Advisory AFSL 485569 [email protected] * Adrian Zoppa (239866) and Mark Mullins (323919) are Authorised www.hoodsweeney.com.au Representatives of Hood Sweeney Securities Pty Ltd AFSL 220897 52 medicSA JULY 2018 heading Respected anaesthetist and teacher

and honorary clinical assistants (mainly Pauline Margaret Nicholson GPs) anaesthetised on others. Being young FRACS, FANZCA and female, Pauline had to have a strong 1926-2018 personality to run the department, but she had it running well by the time Maurice Sando was appointed director late in 1962. Pauline reverted to being deputy director. auline was born to Robert Sydney Lyn and Vic remember Pauline and and Florence Jane Daniels on 7 PFebruary 1926 in Harrow Weald, Bernard Nicholson, medical superintendent London, UK. She had two sisters Monica at the RAH, as being tremendously and Ann. Pauline was educated at local welcoming and hospitable in their Her lessons in anaesthesia, career and life schools and studied medicine in London. early years. are appreciated still, all the more because She arrived in Adelaide in1954 as a Her lessons in they were given with humour and a trained anaesthetist. Pauline was initially anaesthesia, career and twinkle in her eye. appointed as senior registrar at the life are appreciated still, Retirement was long and full. Pauline Royal Adelaide Hospital (RAH). In 1956, strengthened her ties with her family, both Graeme Marshall was made director of all the more because they here and in the UK and Europe. She kept the newly formed Department of were given with humour contact with colleagues who became Anaesthesia at the RAH. Pauline was friends, such as Tony Rieger, Peter Hetzel appointed deputy director. and a twinkle in her eye. and Vic Dreosti. The last years were Vic (Aldo Victor) Dreosti was in marred by failing eyesight, but even this Pauline and Bernard married in 1963. correspondence with Dr Marshall from did not dampen her spirit. They had a daughter, Ann, and Pauline the UK. When offered a job in Adelaide, became mother to Bernard’s four children. Pauline went to visit her daughter, Ann, in Vic accepted, arriving in 1962. On arrival Port Lincoln, where she died peacefully in To facilitate this load, Pauline became he found that Dr Marshall had gone to her sleep on Mothers’ Day 2018. a sessional visiting anaesthetist. She New Zealand and Pauline was acting continued in this role until the regulations At a wonderful service of celebration, it director of a department comprising a required her to retire at the age of 60. was said that she came to Adelaide for a director, Pauline, a vacant staff position, year and stayed for a career and a life. six registrars and some RMOs. Honorary Pauline is remembered as an excellent anaesthetists anaesthetised on some lists anaesthetist and an inspiring teacher. Compiled by Dr Dave Fenwick.

medicSA JULY 2018 53 training From apprentice butcher to aged care worker with qualification from AMA Skills Training! A recent graduate of the AMA Skills Training qualification, Certificate III in Individual Support, Matthew is now working in one of the growing areas of workforce demand – aged care. Here’s his story.

welve months ago, Matthew and diligence, not only during the training was embarking on a three-year but also when she provided supervision Tapprenticeship as a butcher. of his placement at Helping Hand. He decided at the age of 23 that he “AMA Skills Training staff provided wanted to make more of a positive me with excellent support when I difference in the world and was needed it,” said Matthew. “Particularly looking for employment that would with some of the new concepts that meet this need. I needed to grasp.” This helped Friends and family worked in aged care, him to successfully complete the 13 and Matthew heard how much they were units online. enjoying their jobs, helping elderly people stay in their homes. “I feel good about the Matthew contacted AMA Skills Training fact that I am making a a difference to the clients that I visit. and learnt how he could enrol in the difference to the clients I am really proud to have completed Certificate III in Individual Support. He this qualification and received then commenced group training at ESAR that I visit. I am really my certificate.” Home Care which involved first aid, proud to have completed personal care and manual handling AMA Skills Training is a recognised over a number of separate days. this qualification and provider of Nationally Accredited Individual units commenced, and received my certificate.” Qualifications and Units from the Health, Matthew also had to embark on the Community Services and Business required 120 hours of placement in At the end of his placement, ESAR Services Training Packages. a residential aged care facility. This employed Matthew and he is now For more information, call training occurred at Helping Hand. working in the casual pool. manager Michelle Cockshell, on Michelle, the trainer at ESAR was “I love this work,” he said. “And I feel 8274 6058 or visit www.amaskillstraining. impressed by Matthew’s commitment good about the fact that I am making org.au.

Study with AMA Skills Training Do you work as a Practice Manager or in Administration within a Medical Practice and want to have your skills formalised? AMA Skills Training is an approved WorkReady Training Provider and is able to offer subsidised training in the following courses as from July 1st 2018.

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54 medicSA JULY 2018 charity The DREAMIN Foundation The DREAMIN Foundation is a charitable organisation created in 2003. It began as a project of the Rotary Club of Prospect to provide international medical aid to neighbouring developing nations in conjunction with reconstructive surgical specialists from the Royal Adelaide Hospital.

REAMIN is an acronym for the Dean Richards Endeavour to DAssist the Medically Ill and Needy. It honours the memory of the late Dean Richards, a stalwart of the Rotary Club of Prospect.

The project began with a young man from Sarawak, East Malaysia who had a disfiguring facial tumour which required surgery. His plight was brought to the attention of the Rotary Club of Prospect, and as funds were not available, monies were raised to treat the man under the banner of the DREAMIN project. The DREAMIN group then began responding to requests from Rotary colleagues in South East Asian countries for other medical projects.

In 2015, the DREAMIN Foundation officially joined with Faith, Hope, Charity, an initiative commenced by Mary Tarzia, which assists women in South Australia with breast cancer. The goal of the Faith, Hope, Charity group is to build a house that women with breast cancer and their families can live in while they are receiving treatment in Adelaide.

The scope of medical and surgical endeavours has been expanded to include conditions encompassed within ear, nose and throat (ENT) surgery and plastic and craniofacial surgery. Health and Literacy Project – Davao supported by a South Australian The DREAMIN Foundation is currently City and Mindanao in Southern and Ugandan Board. The DREAMIN involved in several projects throughout Philippines – based on the success of Foundation has provided financial neighbouring countries – providing the HEARS Project. and in-kind support. This includes specialised medical training, care, and raising funds towards the construction support. It is currently involved in funding The goal of the Faith, of facilities and equipment such as the following projects: Hope, Charity group humidi cribs and oxygen concentrators, and visits to provide ENT consultation HEARS Project, Tonga – Hearing, is to build a house that and surgery and support for the Evaluation, Assessment and women with breast Rehabilitation providing hearing services training of local staff. for children with chronic ear infections cancer and their families The DREAMIN Foundation also assists in Tonga. This has also involved can live in while they other individuals with specific needs. the education and training of a Tongan ENT Registrar and Clinical Nurse are receiving treatment The DREAMIN Foundation is provided who were able to come to Adelaide in Adelaide. with secretariat support from the under the supervision of ENT specialists AMA(SA) and with financial bookkeeping Dr Suren Krishnan, who is chair of Marantha Project, Uganda – Maranatha assistance from Hood Sweeney Pty the DREAMIN Foundation Board, and Health project is run by Dr Michael Ltd. For more information, go to Dr John Tomich. Findlay and his wife Kim and is dreamin.org.au.

medicSA JULY 2018 55 heading

MICHELLE WELLMAN TORY TOOGOOD Gynaecological Surgeon, Women’s Health Fertility Specialist and Director Physiotherapist of Fertility SA

56 medicSA JULY 2018 public health Hospital food – more than a meal We have all complained about the quality of hospital food, but at the end of the day what really matters is that it’s safe and nutritious. Karen Ferres explains what is required to ensure vulnerable patients and residents in our healthcare system are protected from the effects of foodborne illness.

hen we enter an Australian food safety auditor. Table 1 refers to the trips. Combining audits of food and water hospital – whether for a planned businesses captured by this standard. (where other than mains water is used) operation, as an emergency in country areas avoids multiple trips/ W A small team within SA Health’s Public patient or even as a visitor – the safety of excess travel. Health Services conducts regular the food and water being provided is not standardised audits of public hospitals, Hospital audits are classified by size and generally a concern. In fact, it is assumed range from small hospitals to extra-large. that public health is being managed when not-for-profit delivered meal organisations Small hospitals produce meals for less eating or drinking anywhere in Australia. and domiciliary care organisations. This ensures that consistent standards than 40 patients/day (to both aged and Yet food safety considerations are of food safety are applied across SA’s acute care patients). Extra-large hospitals extremely important when providing food public hospitals and that the department produce meals for more than 250 patients/ to vulnerable people, especially when maintains a critical mass of skills and day. As an example, the Royal Adelaide these people are under a hospital’s care. expertise. This is especially important Hospital may prepare approximately 2400 meals/day. The audit team for extra-large When assessing the vulnerability of where the auditing of specific high-risk hospitals may consist of three to four certain population groups to foodborne processes such as cook/chill, requires auditors with audits taking a whole day. disease, the susceptibility or frequency auditors to hold additional qualifications. of infection in specified groups only tells All other businesses are audited by SA Auditors travel the breadth of the state half the story. Equally as important is the capturing hospitals as far away as Coober sensitivity of these groups to the Pedy, Ceduna, Mt Gambier, infection, which is represented by Port Lincoln and Renmark. As the severity of the outcome once an example, in eight years of infected. This is the case with auditing, one of our auditors Listeriosis – whilst mild in nature conducted 506 audits, across to healthy people, it can be deadly 50 council areas and travelled to those who are vulnerable, with 105,000 kms in the process. a 20-40% mortality rate. As part of the food safety In December 2003, the Australia legislation, hospitals are required New Zealand Food Regulation to examine and identify all Ministerial Council (now the hazards in their food handling Australia & NZ Ministerial Forum operations, determine critical on Food Regulation) endorsed limits, monitoring frequencies the Ministerial Policy Guidelines and corrective action and provide on Food Safety Management in evidence of compliance. Australia. These policy guidelines Hazards particularly associated identified those food businesses with the vulnerable sector, that should be required to have a food requiring specific hazard control include safety program, based on the food Health approved food safety auditors high risk Listeria and texture modified safety risk that they pose. Food (a register is available on the SA Health foods. Patient menus must be carefully businesses involved in food service where website). Facilities include private designed to minimise the risk of high potentially hazardous food is served to hospitals, acute care hospitals, psychiatric risk Listeria products being served to vulnerable populations were identified as hospitals, nursing homes for the aged, patients (refer Table 1). These products being high risk. hospices, same-day establishments for if purchased for other hospital events or This policy guideline was translated into chemotherapy and renal dialysis services, staff functions must be kept separate same-day aged-care establishments legislation in 2006 when Food Safety from patient food items. Texture modified where rehabilitative or therapeutic Standard 3.3.1 (Food Safety Programs for products (i.e. made soft or lump-free treatment is provided, low-care aged-care Food Service to Vulnerable persons) was for patients with difficulty chewing or establishments where provision of meals adopted into the Food Standards Code. for young infants) can undergo multiple occurs and child care centres. Standard 3.3.1 requires businesses that operations including cooling, texture provide food services in/to vulnerable Of the 68 public hospitals that are audited, modifying and reheating, and are usually population facilities to have food safety 56 are located in country areas. Travel prepared with the use of mechanical program implemented, documented to these sites is generally coordinated equipment which introduces another

medicSA JULY 2018 57 public health prepared for those people who are the Table 1 most vulnerable. Examples of some higher risk Listeria foods Other processes considered a priority to assess in a risk-based audit are those Food type Examples already identified as causing disease outbreaks such as Salmonellosis. These Unpackaged ready-to-eat from delicatessen include cross contamination from use of Cold meats counters, sandwich bars, etc. raw eggs and the cleaning and sanitising Packaged, sliced ready-to-eat of mechanical equipment. To prevent the growth of toxin producing spore formers Cold cooked chicken Purchased (whole, portions, or diced) ready-to-eat (e.g. Bacillus cereus or Clostridium perfringens) the cooling of food must Pate Refrigerated pate or meat spreads be managed appropriately and this is Pre-prepared or pre-packaged salads e.g. assessed as a priority at audit. Salads (Fruit and vegetables) from salad bars, smorgasbords, etc. The role of a food safety auditor is to verify Raw (e.g. oysters, sashimi or sushi) that a hospital is appropriately managing Smoked ready-to-eat food safety. It is the responsibility of the Chilled seafood Ready-to-eat peeled prawns (cooked) hospital to ensure it provides only safe and e.g. in prawn cocktails, sandwich fillings, suitable food to its patients. and prawn salads Whilst food safety may not normally be Soft, semi soft and surface ripened your first thought when entering a hospital, Cheese cheeses (pre-packaged and delicatessen) hopefully you will now know that food safety e.g. brie, camembert, ricotta, feta and blue is actively being managed in the facility. Patients and residents who are in care Ice cream Soft serve should not be put at risk from unsafe food. Unpasteurised dairy products Karen Ferres is manager of the Food Safety Other dairy products e.g. raw goats milk & Audit, Public Health Services, SA Health.

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AKIC_General Info Ad - MedicSA A5 - 06.18_V2.indd 1 25/06/2018 9:33:32 AM 58 medicSA JULY 2018 spotlight ECPs assisting GPs to keep their patients out of hospital SA Ambulance Service Extended Care Paramedics (ECPs) provide a key role in managing keeping people out of hospital following calls to Triple Zero (000). ECPs can treat patients at home or in their home surrounds, without having to transport to a hospital emergency department if it is not necessary.

CPs have undergone intensive skills enhancement and training Eand are able to treat patients for a range of common medical issues before referral back to the GP or other health provider if needed. The principle types of care provided by ECPs include emergency continence management, wound closure, infection treatment and palliative care.

An ECP is based within SA Ambulance Services Emergency Operations Centre. They can assess a patient’s requirements through phone consultation and either refer directly to another health care provider or dispatch an ECP single responder in an ambulance response vehicle to support the patient receive emergency care at home.

AMA(SA) vice-president and GP Dr Emergency Department presentation The ECP consulted with the GP about Chris Moy noted that while some GPs which the family did not want. Mrs K’s situation and was able to provide provided after-hours care or home details including basic observations, a 12 visits to their patients, others were ECPs do not aim to lead ECG and the results of the point-of- unable to do so. ECPs do not aim to replace a patient’s usual care blood tests performed by the ECP replace a patient’s usual GP. Instead, showing a mild electrolyte imbalance, they hope to support GPs in caring for GP. Instead, they hope anaemia and moderate renal impairment. their patients at home when the GP is to support GPs in caring unable to attend, to provide treatment A decision was made to initiate IV which will allow a patient to remain for their patients at Ceftriaxone and s/c rehydration, which at home instead of being transferred home when the GP is was supplied and started by the ECP. The to hospital. Ideally, care for a patient ECP referred through the Metropolitan by an ECP is provided in close unable to attend Referral Unit (MRU) for continued treatment with the prescription supplied by the GP. collaboration with the GP, with care A thorough assessment by the ECP Anticipating a decline the GP also ordered transferred back to the GP as soon identified Mrs K was semi-conscious and PRN Morphine and Haloperidol which the as possible. agitated, tachycardic, hypotensive and ECP supplied and drew up into individual febrile. She appeared to have developed doses. The family were shown how to give Case study: sepsis as a result of her pre-existing and flush s/c doses as required. They were Mrs K and the ECP sacral pressure sore. The family were advised if they had any concerns at all to Mrs K was a 95-year-old lady living consulted along with Mrs K’s Advance call 000 where they could speak to an ECP with her daughter. She suffered severe Care Directive and Resuscitation Plan-7 for advice (it now being after midnight). dementia and spent a lot of time in bed. Step Pathway. It was clear that this One afternoon her daughter noticed patient did not want to go to hospital but At 0245 the ECPs did get another call, an abrupt decline in her condition. did want a trial of limited active treatment. re-attended and were able to provide The GP was contacted but unable to The ECP explained to the family that, additional advice, a small amount of attend immediately and so called for while active treatment could be initiated haloperidol for further agitation and an Extended Care Paramedic (ECP) to and was in keeping with her wishes, they sometime later that night Mrs K died assess her and report back. The only should be prepared for her to succumb peacefully at home with her family around other alternative would have been an to this infection. her as she had intended.

medicSA JULY 2018 59 in practice Applications open for 2018 National Advance Care Directive Prevalence Study Are older Australians receiving the medical care that they want, and how well does their care align with their personal values and preferences? To help answer this question, researchers are looking for health care organisations to take part in a study about Advance Care Directives (ACDs) in health care services.

dvance Care Planning Australia “Currently, there is a lack of data on how (ACPA) has opened applications prevalent Advance Care Directives are for Afor the National Advance Care older Australians in health and residential Directive Prevalence Study 2018, the first aged care services, which is why the study of its kind in Australia. is so vital. The available evidence suggests prevalence is low but we need to better Following a successful pilot study understand the situation if we’re serious last year, the Australian Government- about supporting more Australians to funded research involves auditing the receive the end-of-life care that they want.” health records of people aged 65 and over to determine the prevalence of The study has been funded to run each ACDs and other advance care planning year until at least 2020 and will inform documentation. The overall aim is to create state and national advance care planning a national dataset of ACD prevalence policy. Findings will influence advance and evaluate how well an individual’s care planning initiatives and be used to how well advance care planning is being clinical care plan aligns with their personal benchmark performance and track areas implemented within their service and will preferences, as outlined in their ACD. for improvement. support their quality improvement and ACPA is inviting general practice clinics, A key benefit for participating organisations accreditation standards requirements. aged-care facilities and hospitals to apply is that all staff members involved will The study is open to all accredited to take part in the study. receive a training package and ongoing public and private general practices, support to upskill their knowledge of ACPA Medical Director Karen Detering hospitals and residential aged care advance care planning. facilities in Australia that meet a set of says: “Advance Care Directives are most eligibility criteria. valuable at the point of care, where they After the data has been collected, can be used to guide treatment decisions. participants will also receive a More information and an online application If they’re not easily accessible in people’s customised report presenting their results form are available at advancecareplanning. records, they’re less likely to receive the benchmarked against other de-identified org.au/prevalence. Applications will close care they want. participating organisations. This will show on Thursday 26 July.

Changes to driver licensing dependency assessments

hanges have been made recently driving offences within a period of time; or, People wanting an assessment by an to the arrangements for alcohol and from the 24 April 2018, when a child under addiction specialist will be advised Cdrug dependency assessments 16 is present in the vehicle at the time of by the department that they need to be under the Motor Vehicles Act 1959. a drink or drug driving offence; or where a referred by their GP and will need to pay medical practitioner notifies that a person for the assessment. Patients will From 24 April 2018, dependency has a substance use disorder and it is be responsible for meeting the cost of assessments undertaken by certain necessary to determine whether they meet the assessment. addiction specialists can be used to inform the medical standards to drive. the decision by the Registrar of Motor Previously only Corporate Health Group Vehicles, about whether a person should A person who needs to show that they could conduct assessments. For are not dependent on alcohol or drugs be reissued with their driver’s licence after more information on who can become being disqualified for certain drink or will receive a letter from the department an ‘approved assessment providers’, drug driving offences. The Registrar can explaining this. how an assessment should be also take into account whether someone The Registrar will issue a person’s driver conducted and how the the new treatment has completed a drug and/or alcohol licence if an addiction specialist advises program option works in practice, treatment program. that they are not dependent on alcohol (for go to: towardszerotogether.sa.gov.au/ Generally, an assessment is required when drink driving offences) or drugs (for drug Safer_behaviours/Drug_driving2/new_

a person commits multiple drink or drug driving offences). penalties_proposed_for_drug_drivers © istock/KatarzynaBialasiewicz

60 medicSA JULY 2018 the schedule

The Schedule: Upcoming Events

July SEPTEMBER cont… Menopause & MHT: Including National Pain Week RANZCOG 2018 ASM New MHT Available in Australia Monday 23 – Sunday 29 July 2018 Royal Australian and New Zealand Wednesday, 11 July 2018 from 6.00 – 8.30pm nationalpainweek.org.au College of Obstetricians and Cove Civic Centre, Hallett Cove Presented by Dr Jane Elliott, special interest ACMA ASM Gynaecologists general practitioner Australia Chinese Medical Association Sunday 16 September 2018 Saturday 28 July 2018 Adelaide Convention Centre ranzcog.edu.au ‘Too Hot to Touch’ Management Adelaide Health & Medical Sciences of Burns in Rural Regions Building, North Terrace To book: trybooking.com/396048 OCTOBER Tuesday, 17 July 2018 from 6.00 – 9.00pm Berri Hotel, Berri AUGUST Australian Society of Anaesthetists Presented by Prof John Greenwood, plastic National Scientific Congress surgeon & medical director – Adult Burns Centre Taking the first step – a guide to 6-9 October 2018 RAH & Mr Stuart Harper, nurse practitioner – setting up your private practice Adelaide Convention Centre Adult Burns Centre RAH Hood Sweeney Financial Services asa.org.au 1 August 2018 ‘Let’s have a Heart-to-Heart’ AMA House, North Adelaide SA Annual Dinner and An Update on Heart Failure & amaskillstraining.org.au/professional- Anstey Giles Lecture Pulmonary Hypertension in development Royal Australasian College of Surgeons General Practice Friday 12 October 2018 AMA(SA) Council meeting Tuesday, 24 July 2018 from 6.00 – 8.30pm. The Sanctuary, Adelaide Zoo Thursday 2 August, 7pm Rydges South Park Hotel, Adelaide To register, call 8239 1000 or email AMA House, North Adelaide Presented by Dr Michael Stokes, cardiologist [email protected] Members welcome [email protected], 8361 0109 ‘Let’s have a Heart-to-Heart’ Preparation for practice An Update on Heart Failure & Royal Australasian College of Surgeons SEPTEMBER Pulmonary Hypertension in 19-20 October 18 General Practice Adelaide Convention Centre AMA(SA) Council meeting Tuesday, 31 July 2018 from 6.00 – 8.30pm Thursday 6 September, 7pm For younger fellows, final year trainees and practice managers Cove Civic Centre, Hallett Cove AMA House, North Adelaide Presented by Dr Michael Stokes, cardiologist Members welcome To register, call 8239 1000 or email [email protected] [email protected], 8361 0109 ‘Too Hot to Touch’ Management PMASA CME & Gala Dinner Life begins at retirement of Burns in Rural Regions Pakistani Medical Association SA Hood Sweeney Financial Services Tuesday, 7 August 2018 from 6.00 – 9.00pm Saturday 8 September 2018 31 October 2018 Wallaroo Coopers Alehouse, Wallaroo National Wine Centre Venue TBC Presented by Dr Marcus Wagstaff, burns Enquiries: [email protected] amaskillstraining.org.au/professional- consultant – Adult Burns Centre RAH & Mr development Stuart Harper, nurse practitioner – Adult Burns General Practice Training and Centre RAH Education Conference 2018 11-13 September 2018 NOVEMBER To register for sapmea education, visit Adelaide Convention Centre ACMA Foundation Charity www.sapmea.asn.au gptec2018.com.au Gala Dinner ACMA AGM Australia Chinese Medical Association Australia Chinese Medical Association Saturday 3 November 2018 About medicSA Friday 14 September 2018 Adelaide Oval Venue TBC Enquiries: [email protected] EDICSA is the official publication Enquiries: [email protected] of the Australian Medical A Guide to Practice structure and Association (SA) Inc. Six issues SAIMA AGM fees – avoiding the red flags M are published each year, and are sent to South Australian Indian Hood Sweeney Financial Services Medical Association 14 November 2018 all AMA(SA) members. Twice a year, we Saturday 15 September 2018 AMA House, North Adelaide publish special ‘bumper’ issues which are Venue TBC amaskillstraining.org.au/professional- larger in size and are sent to members Enquiries: [email protected] development and non-members in SA. To find out more, or to join, visit www.amasa.org.au.

medicSA JULY 2018 61 heading

Your Membership Benefits Looking after Looking after Looking after your practice you your referrals

Ready to Employ? Ready to join? Need to find a Doctor? Most doctors in private medical Membership offers you more than The place to go when you want to practice are not employees. You you realise. For example, if a full- find specialists for a referral. may operate your business as a time GP, living in South Australia, was sole trader, partnership, company already purchasing the AMA Fees List, It enables you to search for a or trust, or some combination of DoctorPortal and receiving available doctor, anywhere in Australia, by these. You may have business Tax Deductions, they would already name, address or discipline. partners to work with. Some be covering the cost of membership. practices set up to only handle the Your search results provide a administrative side of the business, Paying for membership provides this doctor’s name, specialty, current including employing staff. and more. We encourage members practice contact details and a to take advantage of the full range of scalable map which can then be The guide to employment law benefits on offer. printed and provided to patients. for medical practices, is available online. Your member benefits are there to look after you. jobs.doctorportal.com.au amasa.org.au/join doctorportal.com.au/find-a-doctor/

AMA(SA) More information is Your Profession. available via Your Voice. members.amasa.org.au/join Your AMA. or email www.amasa.org.au [email protected]

62 medicSA JULY 2018

practice notes

DOCTORS’ HEALTH SA provides 470 Goodwood Road Cumberland Park NOTICES an anonymous and confidential 24/7 with special interests in skin cancer and Advice Line for doctors and medical hand surgery. students. Call 8366 0250 to discuss ADELAIDE CANCER CENTRE would He also consults fortnightly at Morphett any concern you may have with an like to introduce three new practitioners. Vale and McLaren Vale as well as experienced medical colleague. See our ad on page 11. monthly at Victor Harbor and Mount DR GLEN CARTER, oral and For more information, go to Gambier. He is ravailable for telephone maxillofacial surgeon, is pleased to www.doctorshealthsa.com.au. advice to GPs on 8272 6666 announce that he will be joining the or 0408 818 222 and he readily After working in the public hospital team at Oromax Clinic & Day Surgery, accepts emergency plastic and hand system and for SA Health, DR ZENON Levels 2 & 3, 1 Hutt Street, Adelaide surgery referrals. HERZBERG is completing his alongside Drs Bruce Robinson, Miles appointment as senior visiting urologist For convenience, referrals may be faxed Doddridge, Paul Sambrook, Tom Jaunay at the Modbury Hospital on 30 June. He to 8373 3853 or emailed to admin@ and Justin Collum as of Monday 2 July will continue with his private urological hamiltonhouse.com.au. 2018. Glen will continue to consult at practice. He consults at 183 Tynte Dulwich Victoria Park Specialist Centre, For all appointments phone his friendly St, North Adelaide, 83 Smart Road, Ground Floor, 164 Fullarton Road and staff at Hamilton House on 8272 6666. Modbury and 4 Ann St, Salisbury. He Glenside Level 1, Suite G, The balcony, See www.hamiltonhouse.com.au continues his regular operating theatre Burnside Village Shopping Centre. For sessions principally at Calvary Hospital, DR MICHAEL MCEVOY, convenience, referrals may be faxed to North Adelaide. All appointments, gynaecologist, wishes to announce 8232 3527 or emailed to reception@ phone 8267 5355. that has commenced gynaecological oromax.com.au. For all appointments or private practice in association general enquiries, phone 8232 3525. See RICHARD HAMILTON MBBS, with Drs Stephen Lane, Simona www.oromax.com.au. FRACS, plastic surgeon, wishes Fischer and Alison Munt at DR RACHEL GRONKE, cosmetic to announce that his private clinic Adelaide Obstetrics and Fertility at physician, musculoskeletal GP wishes Hamilton House Plastic Surgery 38 King William Rd, Goodwood, to announce she is now consulting at remains fully re-accredited under phone 8272 7755. the new National Standards Specialist Central He has special interests in general (NSQHS) and also by the American gynaecology, colposcopy, prolapse, Dr Gronke has a special interest in Association for the Accreditation fertility, transgender management, foot and ankle disorders. In 1995 she of Ambulatory Surgical Facilities medicolegal reporting and second began working with Dr Linda Ferris as International (AAAASFI). a surgical assistant gaining valuable opinions. He has recently resigned knowledge of foot and ankle function Richard Hamilton continues to practise from Flinders Fertility and will be and pathology. At that time Dr Gronke plastic surgery at Hamilton House, operating at Ashford Hospital. also branched out into Cosmetic Medicine, primarily focusing on the treatment of leg veins. Rachel joins our multi-disciplinary ‘Taking the Pain Out of Private Practice’ assessment clinic for patients with musculoskeletal problems who are We have a proven track record. What we do. proving to be a diagnostic challenge Specialist Central provides medical consulting rooms and first class from a musculoskeletal point of view and administrative services to our valued providers giving the ultimate in care and those requiring a more comprehensive customer service to all our patients. Virtual secretarial and transcription services. work-up prior to seeing our surgeons at Specialist Central. We provide consultancy services to the medical industry offering a range of critical business services to surgical specialists, physicians, GPs and allied health. Tailored In 2007, Dr Gronke became the owner bespoke services include: of a Cosmetic Medical Practice acquiring extensive training and qualifications • Setting up and fast-tracking • Marketing and sales business to profit • Brand management and in that field, gaining her Diploma in • Implementing lean business strategy Cosmetic Medicine and subsequently her Medical Business processes • Change and project Consultancy Services Fellowship of the Australasian College of • Building agile businesses management Aesthetic Medicine. She has now been • Infrastructure and operations • Risk management a board member of ACAM for several • Attracting and retaining • HR, recruitment years. Her practice has relocated to practitioners • Training and education • Contracts and negotiation • Mediation Specialist Central. Medical Consulting Rooms

For all appointments or queries: PH: 22 Walter Street, North Adelaide • Contact: 8334 5900 8334 5900, F: 8267 2776 E: info@ [email protected] • www.specialistcentral.com.au specialistcentral.com.au

medicSA JULY 2018 63

practice notes

The Board meets monthly. Please note ROOMS FOR SALE OR LEASE that this is a voluntary position. Please direct all inquiries to Dr Suren HAWTHORN welcome Krishnan on 0413 514 628. Room or sessions for lease in a to our new members! psychiatry/psychology practice. Quiet location at Egmont Tce, Hawthorn, with NOTICEBOARD The AMA is here for excellent patient parking. Great peer members in adversity: support available. Contact Dr Michelle MEDICAL BENEVOLENT membership is like an Atchison on 0411 728 033. The Medical Benevolent Association of SA can provide financial assistance insurance policy. POSITIONS VACANT to medical practitioners in need and By being a member, you help their loved ones. To contact the support the AMA(SA)’s advocacy MBASA contact the AMA(SA) office on behalf of your medical AWARE WOMEN’S HEALTH: on 8361 0107. We are looking for specialists and profession and help set the GPs with an interest and qualifications AMA’s advocacy priorities on OTHER in women’s health to join our private local, state and national levels. Women’s Health Clinic. Please contact the medical director at reception@ MAKE AUSTRALIA DRY WORKSHOP awarewomenshealth.com.au. FREE GP workshop presented by Dr Alice Mae Terrett, Adelaide Practice information is available at Continence Matters. Dr JinLi Gan, Elizabeth Vale www.awarewomenshealth.com.au. TOPICS: Recurrent UTIs, nocturia, Dr Leong Ung Tiong, urinary retention, interstitial cystitis and Board Member Ferryden Park bladder pain, haematuria, enurisis and The DREAMIN Foundation is a neurogenic bladder. Dr Linda Pufan Bi, Adelaide charitable organisation which funds Dr Stephen Bryce Kinnear, the medical and surgical practices for WHEN: Tuesday 18 September 2018, Erindale underprivileged children in Australia 5.30pm to 8.30pm and around the world. WHERE: Connery House, Calvary North Prof Derek Peng Beng Chew, Adelaide Hospital, 89 Strangways Tce Millswood A vacancy has become available North Adelaide on the Board so we are seeking Prof Jodie Michele Dodd, Expressions of Interest from Medical REGISTRATION: St Peters Practitioners who are early in their www.trybooking.com/376980 Dr Michael Ghan, career path, are seeking to network ENQUIRIES: David Bowes – Elizabeth Park and gain Board experience. [email protected] Dr Qi-Zheng Ong, Marden Dr Elyse Jade Seal, Adelaide Dr Matthew Papageorgiou, Birkenhead Newland House Dr Zhihong Kuah, Adelaide 80 Brougham Place, North Adelaide, SA 5006

• Offices Medical/Consulting • For Lease $70,000 P.A. Exc. GST

GRAND VICTORIAN-ERA OFFICES The whole Upper Level of a 2-storey building with City views from a large We are excited to have you balcony. Back end comprises an as part of our membership. open plan area with reception, 8 work Membership is a lifelong journey stations, 2 large offices, 3 storerooms and we look forward to helping and kitchen. Front section features 3.3m ceilings in 2 oversized offices you start yours. Please let us know and a large boardroom set-up for 20 if you have any questions about delegates. Ducted R/C A/C, security your membership by contacting system, M & F toilets and 4 car parks. Charlie, our Membership Available for long-term lease at a gross Enquiries to Trevor Dunsford 0412 231 014 Officer on 8361 0108 or email rental of $70,000 p.a. Furniture items or email: [email protected] [email protected]. optional subject to negotiation.

64 medicSA JULY 2018 Making a difference. It’s a shared duty.

24 clinics The responsibility to play an active We are – and have always been – role in the management of a patient’s 100% locally owned and operated 42 radiologists health outcomes is a commitment we by our radiologists. take seriously. More than 450 staff And for us, this is critically important. But most importantly, we know it’s a It means that we understand the local duty we share with our fellow medical medical community and the needs of professionals, our referrers. the patients who come to us. This focus, in part, comes from our For more information, visit ownership and our origins. bensonradiology.com.au

Experience Precision Care Your Membership Benefits Looking after Looking after you your business Membership of the AMA(SA) is open to medical practitioners who Your membership provides access to are registered to practise medicine in South Australia. services at a reduced cost, such as;

By being a member, • Hood Sweeney (Finance) you help support the AMA’s advocacy on behalf of your medical • Jobs - DoctorPortal profession and help set priorities on local, state and national levels. • Norman Waterhouse (Legal) • Professtional training Ready to join? • Referral network Membership offers you more than you realise. • and much much more...

For example, if a full-time GP, living in South Australia, was already purchasing the AMA Fees List, DoctorPortal and receiving available Tax Deductions, they would already be covering the cost of membership.

Paying for membership provides this and much more. We encourage members to take advantage of the full range of benefits on offer.

Your member benefits are there to look after you.

AMA(SA) More information is Your Profession. available via Your Voice. members.amasa.org.au/join Your AMA. or email www.amasa.org.au [email protected]