medicJUNE 2019 SAVOLUME 32 NUMBER 3 P23 GALA DINNER

NATIONAL CONFERENCE IMPRESSIONS OF A NEW RECRUIT DOCTORS’ HEALTH A COOL CHANGE NEW TEAM, NEW VISION SERVING MEMBERS, PATIENTS, COMMUNITY

VARIETY BASH: A DOCTOR’S PERSPECTIVE

PLUS

ELECTION • STARTING A PRACTICE • LEGISLATIVE REQUIREMENTS FOR SA DOCTORS ACCELERATED SILICOSIS • RURAL DOCTOR SURVEY • NEW CHRONIC PAIN PATHWAY You’ve read 10 times your Contents 120 years’ experience helping medical professionals weight in 5 President’s report Medico-legal advice 24/7 emergency 6 News support Work burnout; Australia second journals for for healthcare systems; new chronic pain pathway Risk education for SA doctors learn to manage this career. your risk 6 Editor’s letter 13 From the CEO’s desk

15 Federal Election

With 120 years as a specialist 17 Council news It deserves insurer to the medical profession, 19 Council elections

protect yourself with the experts 21 Dispatches in medical indemnity insurance.3 expert GALA 27 AMA(SA) Awards DINNER For a competitive quote, 38 Doctors’ health protection. call 1800 777 156 or visit 40 Motoring www.miga.com.au 43 100th birthday

44 Student news

46 Public health New customers earn Plus earn one Qantas 49 Vale 75,000 Point per eligible $1 Dr Piers Robertson bonus Qantas Points by insuring paid to MIGA for your Medical 51 Accelerated silicosis with MIGA by 31st July 2019.2 Indemnity insurance.1 23 53 Death & dying ‘OPENING NIGHT’ AT THE 2019 AMA(SA) GALA DINNER 56 Buying a practice The experts in medical and The AMA(SA)’s annual black-tie charity Gala Dinner 58 Variety Bash professional indemnity insurance. was a thoroughly entertaining night out. Turn to page 23 for all the fun in pictures. 61 Recipes Doctors, Eligible Midwives, Healthcare Companies, Medical Students 63 Practice notes

 A business must be a Qantas Business Rewards Member and an individual must be a Qantas Frequent Flyer Member to earn Qantas Points with MIGA. Qantas Points are offered under the MIGA Terms and Conditions (www.miga.com.au/qantas-tc). Qantas Business Rewards Members and Qantas Frequent Flyer Members will earn 1 Qantas Point for every eligible $1 spent (GST exclusive) on payments to MIGA for Eligible Products. Eligible Products are Insurance for Doctors: Medical Indemnity Insurance Policy, Eligible Midwives in Private Practice: Professional Indemnity Insurance Policy, Healthcare Companies: Professional Indemnity Insurance Policy. Eligible spend with MIGA is calculated on the total of the base premium and membership fee (where applicable) and after any government rebate, subsidies and risk management discount, excluding charges such as GST, Stamp Duty and ROCS. Qantas Points will be credited to the relevant Qantas account after receipt of payment for an Eligible Product and in any event within 30 days of payment by You. Any claims in relation to Qantas Points under this offer must be made directly to MIGA by calling National Free Call 1800 777 156 or emailing [email protected]  75,000 bonus Qantas Points offer only available to registered Australian medical practitioners who first insure with MIGA in a fully insured category, as a doctor in private practice, for cover commencing in the period between 30 June 2019 and 31 July 2019, and who pay in full by 31 July 2019 or enter into a direct debit arrangement with MIGA by 31 July 2019, and pay at least one instalment by 31 July 2019, who have not exercised their rights to cool off or had their insurance cancelled by MIGA, as per the terms of the Policy. MIGA Terms and Conditions for bonus Qantas Points for Fully Insured are available at www.miga.com.au/qantas-bonus-tc-pp.  Insurance policies available through MIGA are underwritten by Medical Insurance Australia Pty Ltd (AFSL 255906). Membership servicers are provided by Medical Defence Association of South Australia Ltd. Before you make any decisions about any of our policies, please read our Product Disclosure Statement and Policy Wording and consider if it is appropriate for you. Call MIGA for a copy or visit our website at www.miga.com.au © MIGA March 2019

2 | medicSA medicSA | 1 SIMPLE_DJQ_MIGA001

MIGA001 AMASA MedicSA 210x297 DJQ V1.indd 1 3/5/19 1:13 pm Australian Medical Association (South Australia) Inc. AMA House, Level 2, 161 Ward Street, North Adelaide SA 5006 PO Box 134 North Adelaide SA 5006 Telephone: (08) 8361 0100 Facsimile: (08) 8267 5349 Email: [email protected] Website: www.amasa.org.au Executive Contacts President Dr Chris Moy: [email protected] After hours: (08) 8361 0100 Acting Chief Executive 28 30 Dr John Woodall: (08) 8361 0109 medicSA VISION UPDATE Editorial NEW AMA(SA) PRESIDENT: GENDER EQUITY Editor: Dr Philip Harding WHAT IT IS TO BE A SUMMIT Managing Editor: Heather Millar DOCTOR 2019 Cover image At the 2019 AMA(SA) Gender inequity does exist Blue Razoo Charity Gala Dinner, our new in medicine. Those who Advertising AMA(SA) president Chris attended the AMA Gender Heather Millar 0409 196 401 Moy explained his vision for Equity Summit in Sydney Production Dr Robert Baird Dr Robert Fassina Dr Andrew Morris Dr Justin Munt A/Prof Mark Rickman the AMA(SA) – and why he recently found it helped Typeset and printed for the AMA(SA) by loves toy stores so much. with understanding why. Douglas Press Pty Ltd. ISSN 1447-9255 (Print) By Hannah Szewczyk. ISSN 2209-0096 (Digital) Unsolicited material: Unsolicited editorial material should be sent to the AMA(SA) c/- the Managing Editor no ADELAIDE’S ONLY ORTHOPAEDIC later than six weeks prior to the target month of distribution. GROUP DEDICATED TO THE Disclaimer Neither the Australian Medical Association MANAGEMENT OF HIP AND (South Australia) Inc nor any of its servants and agents will have any liability in any way arising from information or advice that is contained in KNEE PROBLEMS medicSA. The statements or opinions that are expressed in the magazine reflect the views of the authors and do not represent the official • Urgent Care policy of the Australian Medical Association EXCELLENCE IN (South Australia) unless this is so stated. Although all accepted advertising material • 24 Hour, 365 on-call service is expected to conform to ethical standards, such acceptance does not imply endorsement ORTHOPAEDIC • Hip Surgery by the magazine. 32 36 All matter in the magazine is covered by copyright, and must not be reproduced, • Knee Surgery NATIONAL REFLECTION stored in a retrieval system, or transmitted CONFERENCE TIME – THE DANCE OF in any form by electronic or mechanical • Arthroscopic Surgery IMPRESSIONS OF A PRIORITIES CARE. means, photocopying, or recording, without ‘NEW RECRUIT’ What are your priorities? written permission. The AMA National What do you value most? • Paediatrics Images are reproduced with permission Conference is a stage for Time slips by fast, so consider under limited license. debating what the medical how you spend it, and spend • Robotic Assisted Surgery profession’s future can it wisely … by GenWise co- and should hold, as founder Troye Wallett. • Orthopaedic Trauma AMA(SA)’s new media advisor discovers. • Orthopaedic Pelvic Surgery By Karen Phillips.

2 |WWW.AHKC.COM.AU medicSA / PH 08 7325 4800 / AH 1800 DR BONE (1800 37 2663) medicSA | 3 REPORT

YOUR AMA(SA): LET’S HEAR YOUR VOICE

t’s a great pleasure to greet you as safety, that support valuable research, president of the Australian Medical and that enable the next generation of DR CHRIS MOY Association in South Australia. This pathologists to receive the training they PRESIDENT’S REPORT association means a great deal to need. The future of SA Pathology will be Ime as the one voluntary membership become clearer in coming months, and Your Local Partners organisation that represents the the AMA will continue to express the entire medical profession. I cherish importance of both public and private New Clinics at Gawler my membership of a group seen and providers in that future. respected by government, industry The quality of doctors’ education & Angaston and our patients, because we act and and training is essential to a high- speak for the people who matter most: performing health system. Last year our patients. we supported members of the Flinders Dr Jones & Partners now offers a comprehensive range of radiology I want to enhance the legacy of Medical Students’ Society amid major services with new state-of-the-art equipment for the Barossa my predecessor, Associate Professor changes to the Flinders University community. William Tam, by building an even medical course and proposed moves to stronger, more effective AMA in this end their much-treasured Qualifying This includes a range of specialised imaging for the easy access Dr Mitchell Raeside state. William has shown us what is Ceremony. I will continue to support Clinic Director, Angaston & Gawler possible and much of what I hope to our younger colleagues at FMSS on of referring clinicians and patients. Conveniently located in the achieve as president will be largely due these matters. P: 0422 415 840 Gawler Health Service and Angaston Hospital, from May 2019. to his efforts. As I write this, South Australia E: [email protected] It was exactly a week – almost to the remains in the grip of an unprecedented Special interests in body imaging, hour – after I accepted the President’s influenza epidemic. But the experience  particularly Gastrointestinal, Medal from Will, when the result of the has been valuable in demonstrating Gawler - Low Dose Digital X-ray & Digital OPG Ultrasound Federal Election was announced on 18 to our members, to SA Health, to the Hepatobiliary and Pelvic imaging. including MSK and Elastography  Low Dose CT - including May. The election and its ramifications Minister and everyone connected to this Interventional  Digital Breast Tomosynthesis  Fluoroscopy certainly gave my fellow Council epidemic that we must be partners. The members and I much to talk about at AMA(SA) has been extremely active  the National Conference in Brisbane the behind the scenes in working to ensure Angaston - Low Dose Digital X-ray Ultrasound ... The quality following week (more on that on page the maximal distribution of influenza 32), but it may be some time before the vaccines to GPs. of doctors’ impact can be calculated in detail. Finally, I’d like to highlight the aspect One issue that has loomed large in that I believe will be critical to my education and recent months has been the fate of success as president: communication. SA Pathology. The AMA has argued I can only lead the AMA if I know what Dedicated to Referrer Education training is steadily for the continuation of a you all think about the issues that come Danielle Delbridge Dr Jones & Partners will continue to provide our referrers with tailored system in which public and private before us and understand how you want Medical Liaison Officer essential to a education sessions in 2019. For information on upcoming events, including pathology providers work side by me to advocate for you. The AMA(SA) P: 0499 088 488 side and complement each other in is looking to enhance the ability for all Renal Imaging and Imaging of the Head, visit www.drjones.com.au high-performing E: [email protected] providing best-quality services for the members to contribute to, and therefore or email [email protected] health system ... SA community. Pathology as a whole has influence, what we advocate for and borne the brunt of inadequate funding, what we say. So, please provide feedback having been the victim of decades when we seek it for the government of freezing of Medicare rebates. The submissions on matters of interest to AMA(SA) has repeatedly highlighted the you. This is your organisation; I hope Enquiries & Bookings: importance of pathology services across that you will be able to better hear your Gawler Health Service Angaston Hospital We look forward to caring the state that are efficient, that meet voice in our advocacy during the time I 21 Hutchinson Rd, Gawler East 29 North St, Angaston the highest standards of quality and serve you as its president. (08) 8505 1599 (08) 7523 8919 for your patients. medicSA | 5 Doctor Led • Patient Focused • Quality Driven drjones.com.au NEWS NEWS

WORK AMA(SA) BURNOUT COUNCIL A DISEASE Office Bearers President: Dr Chris Moy The WMA has welcomed a Vice President: Dr Michelle Atchison new decision on burnout. Immediate Past President A/Prof William Tam he World Medical Association has given a warm welcome to the decision Ordinary Members EDITOR’S by the World Health Assembly to classify work related burnout as a Dr Daniel Byrne, Dr Matthew Tproblem that influences health status and to include it in the new version McConnell, Dr Penny Need, Dr Clair LETTER of the international code of diseases. Pridmore, Dr Rajaram Ramadoss, WMA President Dr Leonid Eidelman said: “For too long burnout among Dr John Williams, Dr David Walsh DR PHILIP HARDING physicians has been largely ignored. Emotionally exhausted physicians are a Specialty Groups here are years and there are years. danger to patients and a danger to themselves. The cost in terms of human lives Anaesthetists: Dr Simon Macklin There is the calendar year and the and money is appalling. Dermatologists: Dr Patrick Walker Tfinancial year, which have very “The number of suicides among doctors resulting from burnout is a scandal Emergency Medicine: different implications as they come to and I hope that the WHO’s new classification will shine a spotlight on this Dr Thiruvenkatam Govindan an end or a beginning. Now it’s time for a disgraceful situation. General Practitioners: new AMA(SA) year, with the election and “I hope that the World Health Assembly’s decision will lead to a new approach Dr Bridget Sawyer induction of our new president Chris Moy that addresses multiple factors including working conditions for physicians CHRONIC PAIN MANAGEMENT Obstetricians and Gynaecologists: and a number of new councillors (page 19). around the world.” PATHWAY FOR SA DOCTORS Dr Jane Zhang Chris introduces himself as president on page The decision to classify burnout in its International Classification of Diseases Ophthalmologists: Dr Edward Greenrod 5, and if you don’t read everything in this was taken during the World Health Assembly in Geneva in May. A new pathway supporting SA doctors caring for patients Orthopaedic Surgeons: issue, don’t miss the extracts from his speech Dr Jegan Krishnan Turn to page 38 for more on doctors’ health. at the Gala Dinner (page 28) which was with chronic pain has been launched. Paediatricians: Dr Patrick Quinn greeted with wild enthusiasm and contains Pathologists: Dr Shriram Nath an interesting echo back to childhood. The opioid epidemic and chronic Dr Tim Semple, a pain medicine Physicians: Dr Andrew Russell Apart from a new president, we have a re- AUSTRALIA RANKED pain management are complex physician and a contributor to the Psychiatrists: Dr Tarun Bastiampillai elected federal government which will have Public Health Doctors: and inextricably linked issues pathway, said: implications for our approach to advocacy. Dr Nimit Singhal SECOND IN REGION with increasingly serious clinical Representing the profession and our patients “South Australian doctors working Radiologists: Dr Jill Robinson management and legal implications for is always paramount for the AMA, but in this at the coal-face have been crying out Regional Representatives issue of medicSA, there is much good reading Australia has been ranked number two overall in a recent all doctors. for this ‘one-stop’ shop for best practice Northern: Dr Philip Gribble, about how to look after yourself outside of study of healthcare systems in the Asia-Pacific. Practical management of a patient management, resources and referral Dr Simon Lockwood work. Must-reads are Troye Wallet’s article with chronic pain in the consulting options for too long – now they have it.” Doctors in Training Representative on time management on page 36 and Roger The research was analysed by ValueChampion Singapore, a consumer room is difficult because best practice Dr Simon Lockwood, a GP and Dr Hannah Szewczyk Sexton’s review of Doctors’ Health SA on spending information service. advice on management, resources and Student Representatives incoming AMA(SA) councillor who page 38. As your editor, I do go to quite a few The study aimed to examine which countries in the region were leading the referral options are complex, disparate, University of Adelaide: edited the pathway, said: funerals to glean information about sadly way in terms of healthcare quality, accessibility and affordability. and limited – leading to suboptimal care Mr Patrick Kennewell departed colleagues, and it’s also amazing “This pathway gives me immediate Japan ranked first, due to its “exceptional healthcare outcomes, accessibility and increased risks for both the patient Flinders University: Ms Diana Hancock what one learns about their life that was access to the concise information that and affordability” and because its “citizens enjoy long lives and have access and the doctor. AMA(SA) Executive Board little-known. At the last one I went to, I to healthcare that provides quality treatment for common health conditions, I need to care for a patient with chronic With this in mind, HealthPathways Dr Michelle Atchison, discovered that one of our past presidents suggesting quality healthcare is a priority” even in old age. Mr Andrew Brown, Dr Guy Christie- South Australia – a combined initiative pain: how to assess and manage them, had recently turned 100 – I’m pleased to say Australia came next, followed by New Zealand, Singapore and South Korea to and who I can refer to in my local area if I Taylor, Dr Chris Moy, Dr John Nelson, it was somebody else’s funeral – see page 43 of SA Health and the Adelaide and make the top five. need more help.” A/Prof William Tam for details. Elsewhere in our pages, you’ll The study’s analyst, Anastassia Evlanova, said: “Australia ranked second in Country SA Primary Health Networks AMA(SA) Office: Key Contact The HealthPathways South Australia see how recent Order of Australia awardee our study due to its robust government expenditure on healthcare, good citizen – has launched its newest pathway: Acting Chief Executive: Dr John Woodall Bronte Ayres has been devoting his spare health and high concentration of doctors and nurses per capita. Chronic Non-cancer Pain in Adults website was launched last year and now Federal Councillors time over the years, and get some really good “It scored exceptionally well on the Health Access and Quality index, to support all frontline SA doctors includes a steadily growing number of A/Prof William Tam (State Nominee) cooking advice from CarrMen Chung. And if suggesting that individuals have access to necessary treatment for life- faced with the care of patients with localised pathways, related to a range of Dr Chris Moy (Area Nominee SA/NT) you’re interested in the health of the planet threatening illnesses such as cancer, diabetes and respiratory infections. In fact, chronic pain. common medical conditions. Dr Matthew McConnell (Specialty as well as your own, there is one of the latest Australia’s cancer mortality-to-incidence ratio is one of the lowest compared to HealthPathways South Australia Group Nominee: Physicians) electric cars to look at as well. other developed countries. is a website that provides general Access to the HealthPathways South The AMA(SA) office is located at So read on, and get that work/life balance “However, despite Australia’s rank for government health spending, its practitioners and other health Australia website is free for all doctors 161 Ward Street, North Adelaide. right! citizens pay higher out-of-pocket expenses than seven other countries on this professionals with fingertip access and other health professionals – all that is You can contact us by telephone list. This may stem from Australia’s high rate of private healthcare coverage. on (08) 8361 0100, by fax to to comprehensive, evidence-based required is an online login and an internet “The conscious decision to pay out-of-pocket for private healthcare may be (08) 8267 5349 or email to assessment, management and localised connection. Jump onto the project site part of the reason for the relatively high individual expenditure.” [email protected]. referral resources for an array of for information and register for access at

A full analysis can be found at: valuechampion.sg/top-5-healthcare-systems-asia-pacific © istock/humonia © istock/didesign021 health conditions. saproject.healthpathwayscommunity.org.

6 | medicSA medicSA | 7 Keep on caring

Dr Eric Richman Emergency Department Specialist, QLD Joined MDA National in 2006

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n 11 May, the AMA(SA) had its our sponsors and the fun in pictures annual Gala Dinner and feedback on p23-25). Oindicates it was a great occasion. Where to from here for the AMA(SA) One highlight was the people gathered in in 2019? I think it vitally important to their best form and finery, including the encourage membership growth – the Minister for Health and Wellbeing and his ‘life force’ of the AMA(SA). The AMA(SA) Shadow Minister. A second highlight was must regularly reflect on and revise the exuberant entertainment provided by its ‘value proposition’ – that which Ding Productions, introduced masterfully distinguishes it – marking the core DR TONY BARTONE by Rob Mills. from which strategic objectives and The third highlight was the ceremonial operational purposes arise. I urge existing passing of the Medal of AMA(SA) and prospective members to re-envision Presidency from A/Prof William Tam to the value proposition of AMA(SA), by (L-R) AMA(SA) vice president Dr Michelle Atchison, reflecting on three attributes that could Attorney-General Vickie Chapman, AMA RURAL Dr Chris Moy. Guests heard a first-rate define our membership: courage, curiosity AMA(SA) president Dr Chris Moy, address by Dr Moy, replete with reflection and AMA(SA) councillor Dr Thiru Govindan. DOCTOR and commitment. and visionary inspiration (see p28). It is courage that enables AMA(SA) SURVEY The fourth highlight of the evening, members to listen to concerns of ural doctors around the nation true to the mission and values of the colleagues, especially the most are crying out for an urgent AMA(SA), was the presentation of a vulnerable, such as medical students AMA(SA): BLOOD BORNE investment in funding and $10,000 donation to charity Foodbank R and doctors in training. With curiosity, resources to improve staff levels and (SA), to support the neediest members of members will ask questions on how our hospital facilities in the struggling rural VIRUS ADVOCACY our communities in SA. healthcare teams, systems and processes health system, a new survey has found. MA(SA) president Dr Chris personnel with bodily fluids, This gala event would not have might be changed to better serve our The AMA Rural Health Issues Survey Moy has emphasised the including blood, urine and saliva. been possible without the generous patients and communities. Commitment 2019 found that more staff and workable DR JOHN WOODALL contributions of our sponsors, notably to the four principles of ethical medical Aneed for legislation to deter Introducing the Bill’s second rosters was the most critical priority for FROM THE CEO’S DESK MIGA, ACHA, Calvary Hospitals, and individuals who might use bodily reading, Ms Chapman stressed the improving rural health outcomes as rated practice – autonomy, justice, beneficence, Hood Sweeney, AMA(SA)’s platinum fluids to assault doctors acting in Bill’s importance in better protecting by rural doctors, unchanged since the last and non-maleficence – will see us well emergency situations, in a productive front-line responders and medical survey in 2016. preferred partner. As (acting) chief positioned to lead change within the meeting with Attorney-General officers from harm. That was followed closely by more executive, I thank all our sponsors for social, political and environmental Vickie Chapman. In their discussions with the trainee doctors in rural areas, and the their generous support. (See more about determinants of health and wellbeing. Dr Moy, AMA(SA) vice president Dr Attorney-General, the AMA(SA) need for modern hospital facilities Michelle Atchison and the emergency argued strongly to ensure the and equipment. legislation adequately covered doctors medicine representative on the “These survey results paint a picture and other emergency workers such as AMA(SA) Council, Dr Thiru Govindan, of a struggling system being held police officers and ambulance officers. together by hard-working and dedicated met Ms Chapman to discuss AMA(SA) “We helped provide the Minister doctors,” federal AMA president, Dr Tony suggestions to improve the proposed with a more comprehensive Bartone, said. Criminal Law Consolidation (Assaults definition of body fluids, and “All of the groups surveyed – GPs, non- on Prescribed Emergency Workers) advocated strongly for the inclusion GP specialists, salaried doctors, doctors in Amendment Bill 2019. of all doctors working in emergency training, and other medical professionals Dr Moy advised the Attorney- settings, whether they worked – identified extra funding and resources General of the AMA’s strong support within an emergency department for staff, including core visiting medical for the legislation, which proposes or were responding in the field, with officers (VMOs), to allow workable rosters harsh criminal penalties for people particular reference to our wonderful as their top priority. convicted of assaulting emergency country colleagues,” Dr Moy said. “This reflects rural doctors’ long-held concerns about the lack of staffing in rural hospitals, the high workload, and the significant levels of responsibility placed on hospital doctors and VMOs. CODEINE DISPENSING “Poorly designed rosters and staff shortages lead to fatigue, and doctors in he decision to ban over-the- that alternative over-the-counter training often have a significant burden counter sales of codeine has painkillers were just as effective for of responsibility placed on them in Tbeen vindicated by figures short-term pain as low-dose codeine rural hospitals. showing that the amount of products, but without the codeine- “It’s not surprising that the survey potentially addictive and harmful related health risks. results have barely changed since the last codeine products dispensed to The TGA has now released an AMA Rural Health Issues Survey in 2016 Australians halved in 2018, federal analysis of pharmaceutical industry – because the conditions in rural and AMA president, Dr Tony Bartone, remote Australia have barely changed. sales data, which found that 17.1 has said. “While there have been some positive The Therapeutic Goods million packs of codeine-containing developments as a result of the 2016 Administration (TGA) up-scheduled products were sold in 2018, about 50% survey, the impact of these initiatives codeine to prescription-only in lower than the yearly average of 34.7 will not be felt in rural communities February 2018, following evidence million for the previous four years. for years.”

12 | medicSA medicSA | 13 FEDERAL ELECTION

It is planned that the BMD program will be introduced at the beginning of 2021. Some changes are already being made to specific courses to ensure a smoother transition in 2021. It is important to note that students who AMA CONGRATULATES graduate with an MBBS degree are unable to convert their degree to a BMD. COALITION ON The BMD program will be six years duration, as is the current MBBS program. Students will need to successfully complete the Bachelor of Medical Studies ELECTION VICTORY (first three years) before embarking on the Doctor of Medicine (second three years). Students will be awarded both degrees at the end of the six years. Students will be The AMA has congratulated the Liberal-Nationals allowed to exit after three years, and achieve a Bachelor Coalition on its election victory and remains of Medical Studies at this point. committed to working with the Government to The program has a semesterised structure, with strengthen Australia’s health system. year-to-year progression through the program managed through course-level prerequisites. The overall learning outcomes will align with the four domains as defined NEW BMD AT by the Australian Medical Council (AMC): Science and he Coalition defied the odds and Coalition, Labor, and the Greens, but Labor have made funding commitments Scholarship, Clinical Practice, Health and Society, and unexpectedly won a third term there were also some glaring omissions and investments, but the reality is that ADELAIDE MEDICAL Professionalism and Leadership. in office at the federal election or significant underfunding in some key there is still no leadership in funding Another large change is that both the Bachelor on 18 May. areas, most notably aged care, mental evidence-based policies across Australia SCHOOL EXPLAINED of Medical Studies and the Doctor of Medicine will TMr Morrison and the Coalition beat health, rural health, and prevention,” that help people access the services and comprise courses for which students will obtain a graded Bill Shorten’s Labor Party in the face of Dr Bartone said in releasing the supports they need.” The Adelaide Medical Student’s Society explains the pass, using the M10 grading system (HD, D, C, P, F). opinion polls strongly suggesting the AMA’s overview. On Indigenous health: Indigenous Government would fall. On specific issues throughout health policy announcements by move away from the MBBS degree to the ‘new MD’. For more information, contact Victoria Langton Federal AMA President Dr Tony the campaign, the AMA’s voice was Labor are a good start to a much- [email protected]. Bartone has congratulated Mr Morrison heard consistently on health policy. needed, strongly-funded, long-term and his re-elected Government, saying Dr Bartone made numerous, well- strategy to close the life expectancy he Adelaide Medical School is the AMA stands ready to continue targeted comments during the election. gap between Aboriginal and Torres moving away from its current CALLING ALL MBBS working cooperatively to bolster the On private health insurance: “The Strait Islander peoples and non- TBachelor of Medicine Bachelor health system to meet the needs of the major parties must commit to ensuring Indigenous Australians. of Surgery (MBBS) degree and towards GRADUATES FROM THE nation’s growing and ageing population. the long-term value of private health “Aboriginal and Torres Strait the ‘new MD’ – a Bachelor of Medical UNIVERSITY OF ADELAIDE! insurance and the sustainability of Islander people have the right to enjoy UNFINISHED BUSINESS the private health sector in Australia Studies/Doctor of Medicine program “There is a lot of unfinished business the same level of good health that is should they be elected to form the (BMD). So, what’s the rationale in the Coalition’s health reform agenda experienced by other Australians. A next Government. behind this? to be completed. We cannot stand still,” key part of achieving this goal is to “Just as we need to ensure our public Firstly, the BMD is a Masters level Dr Bartone said. provide culturally responsive services hospitals are funded and supported qualification (AQF level 9) which better “The policy priorities highlighted for Indigenous people, where and when appropriately, so too must our reflects the length of study and depth in the AMA’s Key Health Issues they need them.” governments ensure that the private of knowledge required to complete a document for the election remain our On hospital funding: “The AMA is health sector remains strong to help medical degree (the current MBBS is policy priorities. calling on all the major parties to make a meet growing community needs for a Bachelor level qualification – AQF “We look forward to working closely meaningful election promise to commit high-quality affordable healthcare level 7). The BMD allows students with the Government on its health to significant new long-term funding for where and when it is needed.” to exit after three years of study and agenda for the next three years.” Australia’s public hospitals. On rural health: “People in rural, graduate with a qualification (Bachelor Dr Bartone also acknowledged the “The ability of the hospitals to cope regional, and remote Australia face of Medical Studies). health platform put forward by Mr with ever-increasing patient demand many obstacles when they require Secondly, the BMD brings the Shorten and Shadow Health Minister continues to decline, and it is a access to the full range of quality University of Adelaide into alignment Catherine King at the election. trend that will only accelerate unless medical and health services. There are with what is occurring across the something is done.” AMA EVER PRESENT shortages of doctors and other health “It is a sad reality Australian sector. The BMD offers On cancer care: The AMA was ever-present during the professionals. that every Australian is touched by the Adelaide graduates the same election campaign, keeping all parties “It is harder to access specialist scourge of cancer, directly or indirectly, opportunities and post-graduate aware of the importance of health policy services such as maternity and through their own experience or that of prospects as interstate students (who n the spirit of the much-loved MedBall With special guest professors including to the outcome. mental health. a family member, neighbour, colleague, graduate with both a Masters level and Skullduggery celebrations, MBBS Frewin, Devitt, Horowitz and MacLennan, During the campaign, the AMA “And country people often have to workmate, or loved one. qualification and with a GPA). Igraduates are invited to attend a series these events will be filled with Traditio, released its Public Hospitals Report Card, travel to capital cities and large regional “Easing the financial burden of many Thirdly, the BMD improves the of reunion events in 2019. Spiritus, Gaudium – tradition, spirit, its Rural Health Issues Survey and its centres for vital services such as major cancer patients and families will help portability and global recognition Saturday 27 July – graduating classes of good times. overview of election campaign health surgery or cancer care. We need to see them focus on the primary challenge of of the program. An MBBS degree is 1990, 1991, 1992, 1993 and 1994 policy announcements, which rated tailored and targeted policies to address treatment and recovery.” common in Australia and the United Friday 18 October – graduating classes For more information and to register policy announcements against the these inequities. Rural Australians Kingdom, whereas an MD degree is of 1985 and 1986 please contact Emily Kemp on 8313 3317 or AMA’s Key Health Issues document. deserve nothing less.” This article by Chris Johnson was first recognised more in North America Saturday 2 November – graduating [email protected] or visit the “There were some very welcome On mental health: “The AMA published in Australian Medicine on and Asia. classes of 1995, 1996, 1997, 1998 and 1999 website: ua.edu.au/alumni/reunions. © istock/artisteer © istock/zhz_akey policy announcements from the acknowledges that the Coalition and 20 May 2019.

14 | medicSA medicSA | 15 COUNCIL NEWS

The Council and Executive took this other public hospitals. This may have opportunity to thank A/Prof William been well represented by SASMOA, Tam for his inspiring term as president which is taking the lead. There has been of the AMA(SA), and also endorsed the some reassurance from the CEO of SA appointment of Dr Chris Moy as the Health that no changes are anticipated incoming president of the AMA(SA) until 1 July 2019, after which is it is and Dr Michelle Atchison as the vice- unclear as to what the outcome will president of the AMA(SA). be. One of the potential outcomes is The Council also approved A/Prof Tam that the LHNs would have to lose funds as our representative on Federal Council, and reimburse the Treasury for the and noted that he has now been made Medicarised payments. The other option DR JEGAN KRISHNAN a member of the Federal AMA Board. is that specialists would be made to pay He continues to serve on the AMA(SA) back any incomes generated. This is still COUNCILLOR Executive Board, of which the new being debated and no clear solution is yet determined. AMA(SA) COUNCIL MEETING chairman is Dr John Nelson. Reports from doctors in training were The meeting ended with an May 2019 also presented, with particular emphasis acknowledgement of the contribution on the Gender Equity Forum, which made by Dr David Walsh as Chair of Council. Under his chairmanship the he May Council meeting, opened was well attended and represented by meetings have been run efficiently by Dr David Walsh, chairman of AMA(SA) members. A wide range of and effectively, with opportunity the Executive Council, was an issues were addressed and there was T for all members to participate in abbreviated meeting due to the AGM great enthusiasm from the delegates who attended (see p30). discussion freely. which followed. The meeting was closed after Four submissions were approved by The first issues that that were this acknowledgement and the Council to be placed on the AMA(SA) discussed in the meeting were AGM commenced. nominations and appointments to State website – on EPAS, the LHN’s report, the ReturnToWorkSA report, and the Council. Dr David Walsh has now been SATAC report. nominated as an Ordinary Member Other issues that were raised involved of Council in alignment with the ABOUT the relationship between the AMA(SA) constitution and precedent. Dr Penny and Doctors for Environment. There MEDICSA Need and Danny Byrne, and Dr Simon was general consensus that the Lockwood were also nominated and medicSA is the official publication AMA(SA) should continue to develop of the Australian Medical appointed to the State Council. its collaborative relationship with Association (SA) Inc. Six issues are Reports were presented from the this organisation. published each year, and are sent president, the CEO, and the Membership Changes to the private practice to all AMA(SA) members. Twice a Council, and these reports were arrangements in public hospitals year, we publish special ‘bumper’ endorsed by the Council. The Council were discussed. This is of particular issues which are larger in size and also endorsed the Audit Report and the importance at the moment with the are sent to members and non- need to have the Auditor reappointed Women’s & Children’s which was members in SA. To find out more, through a proper tender process. thought to be probably extended to the or to join, visit amasa.org.au.

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medicSA | 17 COUNCIL NEWS

AMA(SA) 2019 COUNCIL ELECTIONS

The AMA(SA) Annual General Meeting took place on 2 May. The AGM provided an opportunity to look at some of the highlights of 2019, 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 PRESIDENTIAL TEAM: the AMA(SA) Council. Dr Michelle Atchison and SPECIALIST SUITES NOW AVAILABLE Dr Chris Moy MA(SA) councillors have Nominations for specialty Emergency Medicine been at the forefront of health group representatives were called earlier Dr Thiru Govindan The 480 Specialist Centre at Windsor Gardens is now open and offers purpose built Asystem and clinical policy this year and we sought representation General Practitioners medical specialist accommodation along with a state-of-the-art Day Surgery facility. development, covering a wide range of for the following positions: Dr Bridget Sawyer issues including a new Women’s and PRESIDENT: Obstetricians and Gynaecologists Children’s hospital to be co-located AMA(SA) congratulates Dr Chris Moy Dr Jane Zhang with the RAH, the re-configuration of on his election to president. Ophthalmologists Join the following We are also delighted to 480 SESSIONAL SUITES the Repatriation Hospital, free flu shots Dr Edward Greenrod VICE-PRESIDENT: and meningococcal B immunisation Orthopaedic Surgeons specialists already announce that AMA(SA) congratulates Dr Michelle NOW AVAILABLE Prof Jegan Krishnan program for children, limitations to Atchison on her election to vice- enjoying the brand new Paediatricians • Icon Radiation FIVE (5) Fully serviced availability of e-cigarettes and sought a president. first class facilities: Dr Patrick Quinn Oncology; and different approach to providing health suites are available for care in regional South Australia. SPECIALTY REPRESENTATIVES: Pathologists AMA(SA) congratulates the following Dr Shriram Nath Windsor Gardens • Qscan Radiology sessional usage. AMA(SA) councillors are responsible Specialty Group Representatives who Physicians for representing the views of their Day Surgery Please contact us to were elected by their peers: Dr Andrew Russell will soon be opening in specialty group and the medical 08 7078 5978 arrange an inspection or Anaesthetists Psychiatrists the centre. profession. They play an influential role Icon Cancer Centre visit our website to submit Dr Simon Macklin Dr Tarun Bastiampillai in the debate and the decision making Dermatologists Public Health Doctors 08 8164 3600 your booking enquiry. that will ultimately lead to policy Dr Patrick Walker Dr Nimit Singhal Adelaide Cancer Centre development and sustained political Doctors in Training Representative Radiologists engagement and advocacy. Dr Hannah Szewczyk Dr Jill Robinson 08 7132 0480 For information about leasing opportunities Australian Clinical Labs please contact: • Dr Andrew Russell, retiring from 0488 400 856 ANDREW McINTYRE ELECTIONS, RE-ELECTIONS AND his position as Specialty Group Colorectal Surgery MRS Property Representative – Public Hospital RETIREMENTS FROM COUNCIL Doctors, a position he has filled since 08 8267 3355 M 0422 303 585 he AMA(SA) AMA(SA) State Council between 2013. Eye Surgeons SA [email protected] extended its 2006–10. • Dr Nimit Singhal, retiring from 08 8239 0118 Tsincere thanks Dr Fletcher has also contributed to the his position as a Specialty Group to Dr Janice Fletcher AMA Federal Council, and the AMA(SA) Representative – Physicians, a position Medical Lasers & who has retired Executive Board. he held since 2015. from her position AMA(SA) also acknowledges and Dermatology On behalf of the membership, as immediate past thanks the doctors who are retiring from AMA(SA) congratulates and thanks 08 8213 1899 president (2017–19). their current position on Council, some SA Group of Specialists Dr Fletcher was the fourth of whom are assuming another role on all Office Bearers and Council female president of AMA(SA), Council, namely: Representatives for their work for the 08 8465 6370 between 2015–17, and vice • Dr Michelle Atchison, retiring from profession and the communities we president of AMA(SA) 2013–15. She her position as Ordinary Member, a serve and looks forward to working 480specialistcentre.com.au represented Women in Medicine on position she has filled since 2017. together in the year ahead.

18 | medicSA medicSA | 19 DISPATCHES The experts recommended for AMA(SA) health experts by the AMA(SA) & ADASA. DISPATCHES

AMA(SA) COUNCIL MEETINGS Hood Sweeney, plus you receive Meetings of the AMA(SA) Council are a 20% discount on all accounting open to all members. AMA(SA) Council services thereafter. All other member meetings are held monthly, excluding classifications receive a 10% discount the months of January, April, July for their accounting services. Start the road to good accounting practices early and October. in your career and reap the rewards. The next meeting will be held on Contact [email protected]. Thursday, 1 August at 7.00 pm. Phone 1300 764 200 or amasa@ Any member wishing to attend Council hoodsweeney.com.au. meetings should contact Claudia Hood Sweeney also hold regular Baccanello on [email protected] Lisa Hickey+ Adrian Zoppa* Mark Mullins* seminars at AMA House, so don’t forget Business Advisory Financial Planning Risk Insurance or 8361 0109. to look on our events page. WHAT’S HAPPENING WITH THE AMA(SA) WEBSITE? HAVE WE RECEIVED YOUR FAMILY DOCTOR WEEK NEW DETAILS? We have taken your feedback and This year AMA’s Family Doctor Week, Have you recently moved, changed ideas on board and will be making the with the theme ‘Your Family Doctor and AMA(SA) website more user friendly. your mobile phone number or You: partnering for health’, will run from your workplace? A project has begun to improve the Sunday 21 July 2019 to Saturday 27 July user experience and we are aiming to Please contact AMA(SA)’s membership 2019. The posters for the annual event officer Karen Flinn to discuss on have this finished prior to the renewal can be downloaded and displayed in period at the end of the year. Heang Lay+ Trien Ly+ Simon Starr 8361 0108 or email your practice. AMA Family Doctor Week Accounting Accounting Coaching Please bear with us as we navigate [email protected]. provides the opportunity to highlight Helpful hints – logging into the through this, we want to get this right the important role GPs play in serving so taking our time to ensure this will be Member Portal the community and the wider health Having trouble logging on to update the key. Hood Sweeney is a preferred provider of system. To help promote Family Doctor If you have any ideas and feedback your details or pay your fees? Here’s a Week, you can check out resources – Accounting services and Financial Planning for improvement, please contact simple tip to help: including posters – at ama.com.au. services to members of the Australian Medical Head to: members.amasa.org.au AMA(SA)’s membership officer Karen Flinn to discuss on 8361 0108 or email Association of South Australia, an exclusive Username: your email address [email protected]. Password: whatever you have set provider of accounting services to members EVENTS/SEMINARS this as. of the Australian Dental Association of South We have an excellent array of Australia, and a long-standing sponsor of seminars scheduled for 2019 and many REDUCE YOUR LIFESTYLE both organisations. more new events to come. Please see EXPENSES the link to our website, where you can Your AMA(SA) membership card Our team has more than 10 experienced view and book online at ama.com.au/sa/ doubles as an Ambassador Card. Use it sa-events-seminars. specialists who understand the inherent to maximise savings at supermarkets, Don’t forget to keep checking the complexities of everything from setting up travel centres, beauty and retail AMA(SA) PLATINUM PARTNER page regularly so you don’t miss out! a medical practice – including IT and service outlets, and even leisure activities HOOD SWEENEY OFFERS Members are free, non-members $40 or membership with fitness centres fees – to selling it, along with personal financial MEMBER DISCOUNTS planning, wealth protection, tax strategies such as the Goodlife Health Clubs. Thinking about tax time and Access from your Smartphone via ama. and performance coaching. who understands your specific FIND A DOCTOR ambassadorcard.com.au. requirements when it comes to For a second opinion on the fiscal fitness of your This is the place to go when you claiming? Need a financial health want to find colleagues and specialists practice or your personal finances, email our check-up? Want to plan for your for a referral. It enables you to search GET SOCIAL WITH US! Health team on [email protected] financial future? for a doctor, anywhere in Australia, by @amasamembers ACCOUNTING & BUSINESS ADVISORY or call 1300 764 200. Hood Sweeney, our platinum partner, name, address or discipline. The search CONSULTING & PERFORMANCE COACHING offers AMA(SA) members special provides a doctor’s name, specialty, AMA(SA) Doctors Group & AMA(SA) FINANCIAL PLANNING discounts for accounting services. current practice contact details and a Doctors In Training Committee TECHNOLOGY SERVICES Your membership is tax deductible. scalable map that can be printed and Don’t forget to add the #amasamember FINANCE +Lisa Hickey, Heang Lay and Trien Ly are Representatives of Hood As a doctor in training your first tax provided to patients. Go to doctorportal. to your pictures so we can see them Sweeney Accounting & Business Advisory AFSL 485569 T 130 0 76 4 20 0 F 08 8232 1968 © istock/Cecilie_Arcurs return is free via our member partner com.au/find-a-doctor. and share! [email protected] * Adrian Zoppa (239866) and Mark Mullins (323919) are Authorised www.hoodsweeney.com.au Representatives of Hood Sweeney Securities Pty Ltd AFSL 220897 20 | medicSA medicSA | 21 Supported by: ‘OPENING NIGHT’ AT THE 2019 GALA DINNER

THE AMA(SA)’s annual black-tie charity Gala Dinner at the Adelaide Convention Centre on Saturday 11 May 2019 was a thoroughly entertaining night out, providing an opportunity to recognise members’ contributions to the Association and celebrate our successes over the last 12 months.

ARE YOU ADEQUATELY COVERED? TAKE THE ONE MINUTE TEST Is your current insurance, including those within your super fund YES enough to cover your debts such as mortgage and loans, and keep NO your family comfortable for the rest of their lives? UNSURE

If there was a stroke/heart attack/cancer in your family, would YES you be able to afford a nanny to look after the children? NO UNSURE

If there was a major illness in your family, would you be able to cover YES your medical bills, medicines, and/or ongoing rehabilitation costs? NO Andreina Adames & Dr Ingo Weber UNSURE

ttendees included a ‘who’s entertainment into his MC duties on Rex Airlines proudly presented a IF YOU ANSWERED ‘NO’ OR ‘UNSURE’ TO ANY OF who’ from across the South stage for the night. The audience loved lucky raffle winner with two flights Australian medical and it! DJ Josh brought the evening home, to Port Lincoln, an overnight stay and THESE QUESTIONS, THEN GIVE US A CALL TODAY. healthcare community, as people danced the night away. exclusive dinner for two. Second prize Afrom many fields of medical practice Attendees this year included Minister was for two tickets to the SA school and also many stages of practice The Hon Stephen Wade, Shadow Health musical production of Wicked. in attendance. Minister Mr Chris Picton and Federal All who attended deemed the The theme was ‘Opening Night’, and AMA president Dr Tony Bartone. Ding Productions certainly brought the night a marvellous success, and the Others attending included AMA(SA) entertainment. The audience was led AMA(SA) would like to extend its AMA FINANCIAL SERVICES councillors and past presidents, doctors through a night of amazing musical sincere thanks to platinum sponsors of in training, medical students, AMA(SA) theatre, dance and song. Guests the evening – MIGA and ACHA – gold members, preferred providers and clapped in their seats to the tunes of sponsor Calvary and Hood Sweeney, Free call 1800 262 287 or visit corporate supporters. Wicked, Abba, Aladdin, Rocky Horror platinum preferred partner of the and more. Three prestigious awards were amafinancialservices.com.au to learn more... AMA(SA). MC for the evening was Rob Mills, presented on the night – see page 27 for Thanks also to corporate sponsors Australian actor, television host and more on the awards. singer-songwriter, and Australian Idol This year the AMA(SA) also the Country Health Network and season one finalist. Rob surprised presented a cheque for $10,000 to the Healthscope/Parkwynd. © Blue Razoo All wines on the night were donated In preparing this information AMA Financial Services are not providing advice. It has been prepared the audience in the opening act charity Foodbank SA. More on this in AMA Financial Services without taking into account your personal objectives, financial situation or needs. Accordingly it is is an Authorised Representative of by sashaying his way out of the the August issue of medicSA. by Bird in Hand winery. important that you read the Product Disclosure Statement (PDS) of the actual provider carefully, and Consultum Financial Advisers Pty Ltd 22 | medicSA ensure that the PDS and the exclusions are appropriate AFSL 230323 ABN 65 006 373 995 for your business and personal needs. Connie & Chris Picton, Dr William & Feng Tam BACK: David Rynes, Noelene Cooper, Inara Beecher, Sarah Wiles, Litza Myers, Helen Rob Mills, and Ding Productions Prof Richard & Dr Mika Logan, Olivia & Derrick Jee, Dr John Woodall Exley and Stephanie Combs. FRONT: Chris Sexton, Liz Kennedy, Keiran Mether. William & Feng Tam, Nick & Louise Brook & Philippa Rowland

Dr Robert Whitfield, Gayle Bradbrook , Andy Brown, Amanda Brown, Kathy Allen, Dave Allen Dr Chris & Dr Monika Moy Dr Daniela Ciccarello, and Dr Ashani Couchman

Dr Peter Joseph, Dr Philip Harding, Dr Janice Fletcher, A/Prof William Tam, Dr Chris Moy, THE HOOD SWEENEY TEAM: Heang Lay, Olwin Cole, Samantha Good, Dr Nick & Effie Vlachoulis Dr Tony Bartone, Dr Patricia Montanaro, Dr Andrew Pesce, Dr Andrew Lavender, Dr Peter Ford Leigh McMahon, Helen Hadjisavva, Lisa Hickey

Dr Nimit & Dr Deepti Singhal, Dr Phil & Julie Worley, Dr Bill and Daria Oberda Dr William & Feng Tam

The team from Arkaba Medical Centre, with Dr Chris Moy Raymond Barber Dr Chris Moy, Minister Stephen Wade, Dr Tony Bartone, Dr William Tam AWARDS

(L-R) Dr Patricia Montanaro, A/Prof William Tam, Dr Janice Fletcher AMA(SA) AWARDS PRESENTED AT GALA DINNER

The AMA(SA) awards presentation is a highlight of the annual Gala Dinner. This Dr Montanaro is passionate about year there were three awards training, teaching at both the University presented to outstanding of Adelaide and Flinders University. AMA members by outgoing In addition to being a GP supervisor, AMA(SA) president A/Prof she is a coordinator of GP training, an expert clinical teacher and an examiner. William Tam. She is also a former AMA(SA) president.

Congratulations to Dr Patricia Montanaro. Prof Ted Mah AMA(SA) AWARD FOR OUTSTANDING SERVICE IN AMA(SA) PRESIDENT’S MEDICINE MEDICAL LEADER AWARD PROF TED MAH DR JANICE FLETCHER he AMA(SA) Award for he AMA(SA) President’s Medical Outstanding Service in Medicine is Leader Award is awarded to Tawarded to an AMA(SA) member Tan AMA member who has who has demonstrated an outstanding demonstrated outstanding leadership contribution to the medical profession. amongst medical peers. AMA(SA) MEDICAL Prof Ted Mah is nominated for his Dr Janice Fletcher trained in Sydney EDUCATOR AWARD tireless work in teaching, research but has spent much of her career in DR PATRICIA MONTANARO and practice of orthopaedic surgery. Adelaide, initially in paediatrics and Generous with his time, he has worked genetics and later in administration and he AMA(SA) Medical Educator to advance knowledge of his specialty in genetic pathology. Award is awarded to an AMA(SA) Australia and internationally. Formerly executive director (medical) Tmember who has demonstrated Prof Mah graduated from Flinders of the Children, Youth and Women’s an outstanding contribution to medical Uni with a medical degree in 1984 and Health Care Service, Dr Fletcher is education. received a doctorate of medicine in 1994. clinical director of Genetics and Dr Patricia Montanaro has been Currently professor of the College of Molecular Pathology and deputy in general practice for more than 25 Medicine and recognised for excellence director for SA Pathology. years and has done much to advance in hand and upper limb surgery, he She has done much to advance outcomes in community health, drug has a string of awards for research, newborn screening, postgraduate and alcohol treatment and Indigenous publications and training. medical training and the interface health. He has also been instrumental in between the lab and the clinician. An As well as working in general practice establishing international and local active researcher and an examiner, where she held leadership, advisory training programs. she is also a former president of the and mentoring positions, she has also AMA(SA). worked in hospitals, in accident and Congratulats to Prof Ted Mah. (Prof Mah emergency, in intensive care, and in was unable to attend the dinner to accept Congratulations to Dr Janice Fletcher. maternity and palliative care. his award.)

26 | medicSA medicSA | 27 VISION STRAP

NEW AMA(SA) PRESIDENT: WHAT IT IS TO BE A DOCTOR

At the 2019 AMA(SA) Charity Gala Dinner, our new AMA(SA) president Chris Moy explained his vision for the AMA(SA) – and why he loves toy stores so much.

ver since my mentor, former We enter the profession with the AMA(SA) president Dr Peter purpose and intent that patients will Ford, first signed me up for always be our first concern – and that Council, I have never felt quite our careers will be altruistic, heroic Eable, or qualified, to clearly express to and of service to our patients and others why the AMA is so important. I the community. felt it, but I could not explain it. The problem is that there is a thing Now, after years of seeing the called reality. In our area of work, the incredible work that the AMA does at a population is growing and ageing, and state and national level, I get it. And the there are the increasing pressures of DR CHRIS MOY best way I can explain it is this … economics and patient expectations. At AMA(SA) President When I was 10, I remember standing a career level, it has never been harder to in the old David Jones toy department become a doctor, and then never more where I bought this much-loved toy: competitive in navigating career paths. membership organisation representing own seniors may have regarded as FRONT (L-R): Dr Michael Haynes, a Luke Skywalker Star Wars figure. I And, on a personal, individual level, our ALL doctors. It brings all doctors too modern. Please give them room Dr Lucy Haynes, Dr Hannah Szewczyk loved this toy so much that when Luke’s lives may not always go as planned. together, focusing on the important to grow and express the incredible and Dr Chris Moy FACT FILE: CHRIS MOY head later fell off, I tried to melt it back Because of these pressures, it’s easy things we have in common and acting as leadership qualities that I have seen in on … with limited success. I remember to stray off the track. Our minds can a united force for good. our medical students and Doctors in BACK (L-R): Dr Jess Garwood, Dr James Graduated: University of standing in the toy department that trick us into starting to think about our This is why I would like to declare Training members. Besanko, Dr Peter Ford, Dr Gordon Goh, Adelaide, 1991. day, looking at all the adults with their patients merely as a fee, a unit cost, my intent to bring the generations of Please help me to teach them the Dr Georgia Walter, Dr Riche Mohan, Practices: full-time GP serious, glum faces and wondering why model of care, a process, or – worst of all doctors together in my upcoming term history of the profession and all that Dr Mekha John, Dr Denise Braica, in Parkside. they didn’t like toys anymore. – a problem, rather than a human being as president. the generations before them have Patrick Kennewell, Dr Maud Mussared Then I thought, with a mind unspoilt who we are privileged to care for. While enhancing the respect of our done for them. And help me to teach and Diana Hancock. Professional interests: aged by a life of worries and responsibility, It’s easy for minds to become cynical senior doctors and legends, and all them – as Peter did with me – how to care, palliative care and health that this toy department represented all and hearts to become hard. that they have done for us, I would also advocate for the things that matter to communication systems. the joy … and that this toy represented For me, the AMA is about maintaining encourage our younger doctors to join them, but also in understanding the I leave you with an image. all the spirit of heroism and adventure the resolve that our patients come first, Federal AMA: member the AMA and to take up the mantle of concurrent responsibility to undertake About being inspired by observing that I would ever need. and because of this, that being a doctor Federal AMA Council – on the upholding the values of our profession the service for the whole profession a gathering of our 50-year AMA(SA) At that moment I made a promise that is more than a job. To keep the promise Medical Practice Committee into the future – to keep the toy which is often behind-the-scenes and members who were debating I would always love toys and toy stores – to love the toy store. and Ethics and Medico-legal store open. unacknowledged, but, for those that enthusiastically about medical something that my wife Monika and my Because on this foundation is built Committee (Chair). So, to my more experienced know, ultimately has huge impacts to issues with as much passion as any children will confirm that I have held the trust that patients have for us – colleagues, I would encourage you to make things better for others. new graduates. Awards: AMA(SA) Presidents true to. for without it we are nothing – and give the next generation the room to To the doctors of the future: They still have the joy and pride in Award 2012; AMA Roll of from this trust comes the power to WITH PURPOSE AND INTENT advocate for the things that matter to remember that our senior doctors were their profession which reflects careers of Fellows, 2015. advocate and stand up for patients and My belief is that the AMA is them – such as gender equity, bullying you once. substance and joy. Family: married to Monika, about maintaining and fostering the community. in health, and the health effects of To our senior doctors: you were one of They still love the toy store. also a GP; two young the very aspirations, spirit, values BRINGING DOCTORS climate change. those young doctors once, and they will I hope that I will experience this. adult children. and commitment that all of us, as TOGETHER Some of you may say why? To that be you in the future. And I hope that I can count on the Hobbies: Crows-specific AFL medical students and young doctors, This leads me on to, what I believe, I would ask you to remember that Our legacy through the AMA should support of all the senior members and (tellingly) Xbox games. enter the profession with – like is the other role of the AMA. The you were young once, with fire in be to help them to uphold the profession to help our younger colleagues to my promise in the toy store. AMA stands as the only voluntary your bellies about issues that your and what it is to be a doctor. have this future in the toy store.

28 | medicSA medicSA | 29 UPDATE

It’s time to set targets … to change the system GENDER EQUITY SUMMIT 2019

Gender inequity does ow inspiring it was to sit in skewed the other way. O&G is one of the a room full of passionate few specialties where women run the exist in medicine. Those women and men, from show right? Well, no. The RANZCOG who attended the AMA different industries around Board is made up of only 14% women. I Hthe country and discuss the issue of suppose this is better than the Australian Gender Equity Summit in Sydney recently gender inequity in medicine. College of Emergency Medicine board I grew up understanding that men that currently has exactly 0% women. found it helped with and women were equal and thinking Research has shown that women understanding why, and that they had equal opportunities. I’m in medicine perform equally on helped spark ideas for grateful that this was my perspective all measures, so why is there such how to create equity for growing up. I was never deterred by gender disparity in high level roles? my gender. I did well in school, as girls Unconscious bias plays a major role. We everyone. so often do, and went on to do well in tend to assume that we live and work in university. I was never held back by my meritocratic systems, however research shows that for identical CVs where only BY HANNAH SZEWCZYK gender and during serious discussions I’d confidently state that I didn’t believe the name differs, male candidates are in gender-based quotas and that women more likely to be seen as hireable than should be given jobs based on merit, not women. Start-up businesses using a their sex. male narrator in promotional material are deemed twice as investible as These biases and workplace structures will help over-ride those well-ingrained I knew that there was no shortage of CLOCKWISE (from top left): 1) SA DiTs who those using female narrators. Female aren’t just to the detriment of women, unconscious biases and seeing women women with the skills, knowledge and attended included (L-R) Dr Annie Collinson, postdoctoral applicants need to be two but to men too. Men are twice as likely in leadership will inspire other women to education to make them suitable for Dr Hannah Szewczyk, Dr Jarrad Hopkins, and a half times more productive than as women to have requests for flexible almost any job, so why shouldn’t they be seek leadership roles. Dr Jemma Wohling, Dr Victoria Cox. 2) male applicants to be hired. working arrangements rejected and getting these jobs? We need to encourage capable women Dr Jemma Wohling 3) Dr Annie Collinson 4) are often seen as ‘non-committed’ if CONSIDERING COMMITMENTS to apply for leadership roles. We need Dr Cathy Ferguson of RACS. A CHANGE IN PERSPECTIVE they make these requests, and it is to gather and publish data so we can While that question remains the OUTSIDE WORK rare for men to take any significant see where improvements are needed same, my perspective has changed. It Another major contributor to parental leave. and strive to do better. ACEM have changed when I realised that despite gender inequity is the traditional recognised their deficiency of women their capabilities, women aren’t getting structure of our workplaces that favours NOW IS THE TIME FOR CHANGE high-level jobs and leadership positions unencumbered workers who can work It’s difficult to summarise all of the in leadership and have committed long hours and don’t have commitments at anywhere near the rate that men are. complex issues that contribute to to improve. We need to provide outside of work. Whilst almost everyone gender inequity in medicine in one Only 16.5% of CEO positions in Australia breastfeeding and childcare services at has commitments outside of work, men short article, but at the Gender Inequity are filled by women and a gender pay gap work, exams and conferences to help tend to fit in to these roles more easily, as Summit this was done extremely well. still exists in every industry. bring down barriers. DR HANNAH SZEWCZYK is an women are more likely to take parental Attendees put their heads together to We need to disrupt the system and unaccredited O&G registrar, SO WHAT ABOUT MEDICINE? leave and take on the majority of come up with practical strategies to make changes so that flexible work at Flinders Medical Centre Forty per cent of the medical domestic and care roles. A large jump in tackle these issues head on. The woman arrangements and access to parental and and chair of the AMA(SA) workforce are women including 53% the gender gap occurs when workers are who was once against quotas is now all carers leave are more widely available to of early career doctors, but this doesn’t … We need to Doctors in Training Committee. in their thirties, as this tends to be the for targets. We’ve understood that we women and men. A groundswell can be translate to higher up with only 10% of She can be contacted at time when people either get promoted or need to improve gender equity for some felt, and I believe that now is the time for change the system department directors being female. I [email protected]. step out to have children. Getting back time, but simply stating that this should change. so that culture will shouldn’t complain though. I work in into the system isn’t easy with a lack of happen has not led to any change. obstetrics and gynaecology, a specialty flexible employment options and having We need to change the system so For more on the Gender Equity Summit, go follow … which tends to have a gender balance to start back in lower-level jobs. that culture will follow. Setting targets to ama.com.au/ges19

30 | medicSA medicSA | 31 NATIONAL CONFERENCE NATIONAL CONFERENCE

about it than the people caring for them, Professor Robinson said. “Our undergraduates are educated in siloes,” AT THE LECTURN: he said. “We need to bring the curricula AMA(SA)’s A/Prof William Tam into the 21st century so students can address the issues they face.” On Saturday morning clinicians were alerted to the increasing risks of ignoring AI, both in its implications for efficient care today and its potential for transforming processes and replacing fields of expertise – probably within 10 years. Data will diagnose known diseases such as Alzheimer’s and could define new patterns for diseases such as schizophrenia. The medical profession has a key role in leading AI innovations and ensuring they are developed, trialled and introduced to support patient-focused care. As attendees were warned, ignore AI at your peril. AI won’t replace doctors, but doctors who use AI will replace those who don’t. ... NatCon is a place where MENTAL HEALTH Later, participants heard that “your team and others meet” ... integrated approaches to developing mental health services – approaches that seek and include the range of professions, careers, academic dominated discussion. In a session Quality and Safety Commissioner Janet specialties and on-the-ground jobs entitled ‘Protecting doctors and their Anderson, Australian Nursing and that contribute to care in hospitals, families: a call to action’, keynote Midwifery Federation Federal Secretary aged-care facilities, rural settings and speaker Dr Michael Myers, the American Annie Butler, geriatrician Dr Chris Davis, ‘doctors’ doctor’, noted pointedly that dementia specialist Professor Andrew in homes and communities across IMPRESSIONS OF A ‘NEW RECRUIT’ “wounded healers wound”. Dr Myers Robinson and Aged & Community the country. Dr Bartone was joined was joined by Dr Toogood, Avant Chief Services Australia CEO Pat Sparrow in by Professor Ian Hickie, A/Prof David The AMA National Conference is a stage for debating what the medical profession’s future can Medical Officer Dr Penny Browne, discussing how AMA members can best Mountain, Dr Margaret Kay and chair doctors’ clinician Dr Helen Schutz Dr Sebastian Rosenberg in discussing and should hold, as AMA(SA)’s new senior policy, media and communications advisor discovers. work to improve care for the aged. and intensive care trainee Dr Jessica The panel agreed there was no the devastating impacts on individuals, Dean on a panel, chaired by Dr Mukesh simple answer – but that more doctors, families and the people who care for BY KAREN PHILLIPS Haikerwal, that highlighted how nurses and care workers, and including them. Clinicians were left considering essential it is for doctors to look after education training for the students in how to most effectively lead the design themselves, if they are to help others, all healthcare professions about how to and implementation of evidence-based, quick scan of the program From impassioned pleas from SA DELEGATION AT GALA DINNER (L-R): today and tomorrow. Throughout the care people with dementia, were vital. It adequately funded and resourced, multi- outlined briefly what I’d see, students and doctors in training to Dr Annette Newson, Dr Andrew Russell, conference, the prevalence, impacts and was all too common for family members disciplinary services for maximum hear and undoubtedly learn the presentation of the President’s A/Prof Susan Neuhaus, Dr Daniel Byrne, risked posed by bullying, of overwork, of people with dementia to know more community benefit. much more about during the Medal to CrazySocks4Docs founder A/Prof William Tam, Dr Michelle Atchison, of working in understaffed emergency Athree-day for the 2019 AMA National Dr Geoff Toogood at the Gala Dinner, the Dr Chris Moy, Dr Hannah Szewczyk, Karen departments, by sexual harassment, by PRESIDENT’S MEDAL: Conference in May. recognition that doctors’ physical and Phillips, Dr Matthew McConnell, Dr Monika training systems that haven’t kept up Protecting doctors, improving care for Dr Geoff Toogood won for mental health and safety is essential Moy and Dr Tarun Bastiampillai. with students’ needs and expectations CrazySocks4Docs. the aged, the implications of artificial if they are to provide good care was – all were illuminated and reinforced as intelligence (AI) for healthcare, and evident in policy proposals, coffee-break having potentially catastrophic effects issues plaguing Australia’s mental on medicine and the people who want to huddles and Twitter feeds. AMA has advocated for people affected health system – these and more would practice it to the best of their abilities. The conference began with a by all these and more, at state and be discussed and deliberated and reminder from federal AMA president federal levels. “While governments disputed in about 30 hours of official AGED CARE Tony Bartone of the work the AMA underfund (public hospitals), they This is not to underplay the important and less formal gatherings over two- had done since last May to foster and are making a choice to constrain the of the other themes. In the ‘Aged Care and-a-half days. build resources for better health care. supply of public health services,” – Improving Clinical Care in an Era of DOCTORS’ HEALTH Sub-standard aged care, the lack of Dr Bartone said. Financial Constraint’ session, Dr Richard But it soon became clear what resources in rural communities, the cost But it was the dangers posed by Kidd – who represents the AMA on the would be remembered as providing and quality of care in public hospitals, doctors ignoring their own health Ministerial Aged Care Clinical Advisory the tenor of debate: doctors’ health. mental health, domestic violence – the and that of their colleagues that soon Committee – was joined by Aged Care

32 | medicSA medicSA | 33 NATIONAL CONFERENCE NATIONAL CONFERENCE

THE AWARDS boldly and forcefully as a representative everything I saw and heard in Brisbane. In between, awards were presented for of the next generation – but in doing so, “Learn science technology” – we were the best and most effective promotional reminded everyone that today’s students certainly reminded of that. “Make your and advocacy campaigns and programs and doctors in training are part of the dreams all come true” – obvious for the – the activity that highlights most AMA now. They represent 27.5% of the people who have chosen medicine as TWO SA DOCTORS vividly to the public the ongoing work to AMA membership. Their issues are the their vocation. Members help people improve their health. The Queensland AMA’s issues. It is a constituency that who “need a hand”. NatCon is a place must not be ignored. Government won the ‘best health where “your team and others meet”. INDUCTED INTO initiative’ award for introducing the Ms Yang’s speech preceded the And, especially after the final morning, health promotion agency Health and Soapbox. We heard members talk “make a stand”. As Ms Yang said, “the AMA ROLL OF Wellbeing Queensland. AMA Victoria passionately of the pressing concerns medical profession can do amazing produced the best state publication of climate change and sustainability. things when they stand together for a and the best public health campaign; Preventing organ transplant tourism. FELLOWS its advocacy for a medically supervised Credential creep. The problems of common cause”. injecting centre contributed to the rural practice. Issues of opening of a centre in North Richmond medical training. And, on AMSA PRESIDENT: in July 2018. AMA Tasmania’s daily a slightly different note Jessica Yang with The AMA has inducted seven new members email that collates and alerts members from South Australian Dr Dr Tony Bartone into the AMA Roll of Fellows, in recognition to all health-related media coverage Daniel Byrne, a first-time of their outstanding contributions to both was judged the most innovative attendee’s appreciation of use of new media. All winners and the “spirit of collegiality” the medical profession and the AMA. nominees demonstrated the power of he relished at the Two were from South Australia … the AMA voice, and the importance of conference. It was an partnerships and technology to ensure apt finale. it is heard. As I write this, I have NEXT GENERATION The Village People’s In he two new South Australians inducted into Many people told me the Australian the Navy ringing through the AMA Roll of Fellows are anaesthetist and Medical Students’ Association (AMSA) my head. There are a AMA(SA) past president, Dr Andrew Lavender; and president’s speech would be a highlight. surprising number of consultant surgeon and ex-Army officer, A/Prof They were right. Jessica Yang spoke lines that align with TSusan Neuhaus. The other new inductees were immunologist and past AMA NSW President, Professor Brad Frankum OAM; distinguished neuroradiologist and past Royal Australian and New Zealand College of Radiologists (RANZCR) A/PROF SUSAN NEUHAUS President, Professor Mark Khangure AM; orthopaedic A/Prof Susan Neuhaus is a long-standing member of the surgeon and AMA WA President, Dr Omar Khorshid; past AMA, a highly respected senior surgeon, distinguished ex- AMA ACT President and dermatologist, Associate Professor Army officer, and an experienced Board Director and Chair. Andrew Miller AM; and dermatologist and past AMA NSW She was awarded the AMA(SA) Award for Service to President, Clinical Associate Professor Dr Saxon Smith. Medicine in 2011, and in 2014, she was elected to the AMA AMA President, Dr Tony Bartone, announced their Federal Council as the specialty representative for Surgeons addition to the Roll at the AMA National Conference and served in this role until 2018. During that time, she in Brisbane. contributed her expertise as a member of the Defence Health Working Group, and was a member and then Chair of the DR ANDREW LAVENDER Health Financing and Economics Committee (2016-2018). Dr Lavender spent 10 years on State Council and five At National Conference in 2017, excerpts of a play Hallowed years on Federal Council. But it is his work in steering the Ground: Women Doctors at War, by The Shift Theatre, adapted AMA(SA) in his two years as president that he considers the from her book Not for Glory: a century of service by medical highlight. women to the Australian Army and its Allies were performed to “It was a period of intense political and media interest,” acclaim. he said. “We were trying to get the organisation through an A/Prof Neuhuas said she was “deeply honoured” to be election period where health, and the proposal for the new awarded the honour alongside fellow South Australian RAH, were the main issues. Dr Lavender. “A lot of our members were very attached to the old RAH, “I have been so fortunate through my career to have had while others could see the advantages of a new greenfields varied opportunities, both clinical and non-clinical, that have hospital. The challenge was to steer the organisation each shaped my next career step, whether that be through the through that process while maintaining a focus on the military or surgery or in academic life,” A/Prof Neuhaus said. key issue: ensuring that the final decision would provide a “Each of these roles has brought a richness that I value quality facility and adequate staff for the best possible care.” immensely, along with new experiences and learning. Dr Lavender said inclusion in the Roll of Fellows was “I do recognise that no-one gets to some of these positions “a great honour” that acknowledged the time and effort by themselves. I hope those I have worked with over the years, individuals contributed to the AMA on behalf of members. particularly my colleagues, fellow committee members and “All of us who do that work are on the coattails of those staff, will take as much pride in this as I do, as it is as much who have done the work before us,” he said. “I hope we can acknowledgement of their support and hard work as it is be role models for others to step up in our place.” of mine.”

34 | medicSA medicSA | 35 REFLECTION

What are your priorities? What do you value most? TIME – THE DANCE OF PRIORITIES

Time slips by fast, so ime as a precious resource to the path and the journey in-the- is a concept we all respect in now restarts. consider how you spend theory, but often we spend it The concept of being in the now it, and spend it wisely … without consideration. Yet is stated beautifully and profoundly Tconsciously making time to consider in the Japanese phrase, Ichi-go ichi-e. its management helps us gain a sense Translated it means, this moment, never BY TROYE WALLETT of control. Life pressures, both external again. Even if we see a patient every and internal, weaken our grip on month, that particular consult is unique that control. and will never return. Tonight’s dinner Unlike our finances, it is impossible to with our family will only be for that measure how much of the resource we instant and will never return. When the have left (unless we believe the actuaries wheel of life turns and becomes mean and their life expectancy tables). and painful, that too is transient and will Similarly, time cannot be earned and is pass. Remember Ichi-go ichi-e in the joys constantly flowing – a flow from which and sorrows. we can only drink, not store. TAKING CONTROL A suggested way to revolve the mental time factor that is sacrificed when the of patients seen. Charging more for the If every moment is for itself, then ZOOMING OUT conflict is to set rules for yourself. If your pressure mounts. work we do is an uncomfortable thought managing our days, hours and minutes The stoic philosophy of contemplating vision for the year is to teach and learn Because we are discussing time, for many, but it is an option. The concept is vital. One way to regain space is to our mortality has the intriguing effect or you need space to practise your best let’s address the problem of running of supply and demand applies here, practice saying ‘no’. In James Alturcher’s of focusing and honing the blade of our medicine, you will make a no-coffee- late on our consulting days. Running but in health, it is complicated as our thoughts. Surprisingly, thinking about book The Power of No, he explores how meetings-with-strangers rule. You then, late is stressful for us and irritating to product is people’s health. A discussion the shortness of our lives can give a one ‘no’ leaves space for a million ‘yes’s. our patients. for another time perhaps. gracefully and with genuine regret, sense of peace and clarity. Obstacles It is a simple way of thinking about But what can we do about it? It If the priority is time and income is decline the invitation. In your reply, you seem less challenging and beautiful ‘opportunity cost’. depends on what we prioritise. less important, the options are more explain your reasons and rules which moments seem sweeter. Let’s say you are invited for a coffee Let’s say we need to see 32 patients straightforward. Decrease the number removes any sense that it is personal. There is a poster on Tim Urban’s blog chat by a friend-of-a-friend and it will (four patients an hour for eight hours) of patients seen per day and go home on Wait but Why that is a grid of blocks, take an hour. When you reply ‘yes’, you A PRACTICAL APPLICATION a day to generate the income required, time. Due to excess demand and lack of DR TROYE WALLETT divides 52 by 90 – that’s 52 weeks in a year and say ‘no’ to everything else you could be The same concept of making rules and we run 45-60 minutes late 80-90% supply, the pressure to see more patients doing. Seeing patients, going for a run, his time between being a GP, 90 years. Colouring in the blocks as applies to our day-to-day work. Many of the time at the end of the day. There is high, but in Australia, very few people supporting doctors as the reading, practising mindfulness and the the weeks pass forms a topical map of of us find ourselves running late during are two options to solve this problem. miss out on treatment because they clinical director of GenWise, other infinite opportunities that come our lives. The details diminish, but the our consulting days. Granted, elements The first is to schedule a nine- are not able to get in to see a doctor. and loving his wife and kids. our way. hour day and incorporate catch-up Managing a long waiting list is outside landscape is visible. The mountains of that are patient-factors, but blaming He also enjoys writing and It is tough to say ‘no’, however. FOMO appointments. In practice, we do not of the scope of this reflection, but is, become hills and the direction we are it all on them is contrary to the idea that speaking and will say ‘yes’ to (fear of missing out) kicks in, and you lose out on time, because we work frankly, a good problem to have. going becomes clearer. we are in control of our lives. coffee-chats relating to those. start wondering if the coffee-chat that long day anyway. This option In the end, it is about choice. What What are you going to do with the few He has 990 million seconds could be the start of something big. Consulting days are driven by the decreases stress and the annoyance of are our priorities? What do we value hundred million seconds you have left? left to live. Contact t.wallett@ What if the chat is about a speaking dance of three elements – patient our patients. This is because the gap more? Everything we do is our choice genwisehealth.com.au. ZOOMING IN engagement or a business opportunity demand, daily income required between expectation and reality is and involves balancing demands. In our One can only stand at the top of the or a new friendship? This is the dance and consulting time. The three are where unhappiness lies. busy world, time is precious. It slips by mountain and enjoy the view for so of conflicting priorities, opportunities intermeshed and influence each The second option is to increase the fast and runs out unexpectedly, so please

long. At some stage, the gaze returns and commitments. © istock/bernie_photo other. Interestingly, it is often the fee for service and decrease the number consider it when you make your choices.

36 | medicSA medicSA | 37 DOCTORS’ HEALTH DOCTORS’ HEALTH

• allowed medicine to exclude their remote and dangerously under- ahead of personal relationships and revitalising non-medical interests, e.g. resourced. Think ED … think remote NT! interests, and privately self-treat their music or gym. Our work practices are variable and own symptoms. Medicine will squeeze everything out if sometimes in stark contrast to other We may also be reluctant to you let it! sectors and industries where safety acknowledge, assist or associate with a We all want to be a ‘sustainable’ protocols, fatigue avoidance and other struggling colleague. Other industries and sectors such A COOL individual who has personal and work health and safety measures are as accounting and local government professional longevity and productivity. taken very seriously. and the airline industry recognise the CHANGE FOR Achieving this requires: Everyone places very high • good lifestyle choices and optimising expectations your 24-hour day with sound habits on doctors to … Other industries recognise the DOCTORS such as sleep be self-reliant. We’re regarded as value of sustainable high-achieving • time spent fostering good people for whom relationships at home, with non- individuals and resource them to support is often medical friends and at work unnecessary remain so … • advocating for home and work The winds of change are finally starting and our capacity environments in which we can excel to blow across the profession, and they to adapt and work independently in value of sustainable high-achieving and reach our potential. signal a refreshing awareness of the challenging workplaces can be taken individuals and resource them to When doctors’ health deteriorates, for granted. importance of our own health. That is it is also fair to look outwardly at how remain so. We may also assume that we have These resources include a personal what I call a really ‘cool change’. we work. endless ‘reserves’ to call upon and that assistant, a GP/medical advisor, Our medical careers require us to these will continue to sustain us through psychologist, peer support, professional transition through many career stages difficult times with no additional inputs BY ROGER SEXTON mentor and CPD which includes such as medical school entry, our intern required to survive. year, Fellowship, private practice, Our own culture can reaffirm this. Our comprehensive health checks. mid-career and retirement. These are profession values independence, self- We can learn from this. Medicine is mostly stressful. reliance and the ability to go ‘above and a laggard when it comes to such things We work in a variety of workplaces, beyond’ to help others and sustain the and ignores the real return. some of which are well-organised and system. We are ‘tolerant’ of colleagues We must value and invest in ourselves. he momentum for this change to stop work but make work and life pleasant but others which are unsafe, who work when unwell, prioritise work This drives the sustainable doctor. has been building for some more difficult. time now through the efforts of Burnout is a good example. It is seen motivated individuals, leaders especially in caring health professionals Tand advocates within doctors’ health with high workloads. It is reported to of confidential ways to seek timely (smoking, nutrition, alcohol, physical DOCTORS HEALTH SA – services, our Colleges and the AMA. affect 50% of doctors, amongst female YOUR DOCTORS’ HEALTH assistance and to enable access to a activity, good sleep hygiene) Importantly, practical solutions are doctors under 30, with those working PROGRAM SINCE 2010 network of skilled, special-interest GPs • access to a GP of choice for timely, who can connect them with the wider preventive care finally emerging. Three points: in emergency departments and general Planning for the Doctors’ Health practice being at particular risk. health system. • healthy workplaces that help us • The impact of investing in our own SA program started in 2006¹ and the Symptoms include feeling mentally This model has been very health is enormous. model was derived from the large state- to excel and physical exhausted; being annoyed successful and has been shown to • The impact of creating a working wide survey in 2007 and input from a • healthy work practices that optimise by and having a lack of be a most effective model of care for environment in panel of academics from the Adelaide our efforts which doctors can … What lifestyle empathy for patients; the profession. • interests alongside medicine which DR ROGER SEXTON is medical University Business School in 2008. irritability with staff and It is your program and it is unique in are re-invigorating. director, Doctors’ Health SA excel is enormous. choices have we Significant lobbying from leaders in • The impact of colleagues; cynicism Australia. Doctors Health SA values the and Doctors’ Health NT. He can AMA(SA), the Doctors’ Health Working It recognises the importance of: healthy doctors made? What have about medicine as a important and long-standing be contacted at roger.sexton@ Party and SA Health secured seed- • education – knowing where to go on society is we foregone that career; and feeling partnership we enjoy with both the doctorshealthsa.com.au. inadequate for the funding from Minister for Health, John for assistance enormous. AMA(SA) and RDWA. was good for us? … job. Have you ever felt Hill in 2010 who allocated residual • prevention – comprehensive health Let’s look at We also value the strong partnership like that? funds from the superseded Medical check-ups especially at times of examples: better we have with Country SA PHN to When doctors’ health deteriorates, Board of SA for the purpose. career transition though medicine patient outcomes, fewer sentinel events, promote the health of rural workforce it is fair to look inwardly in the first The not-for-profit company Doctors’ • timely intervention – offering doctors fewer errors and complaints, fewer in SA. instance. How do we live our lives? What Health SA Ltd was constituted in 2010 a choice of ways to access care – the unnecessary investigations, greater For further information: lifestyle choices have we made? What with two members, the AMA(SA) and after-hours South Terrace clinic, • Visit our interesting website: www. productivity at work and across society, have we foregone that was good for us? the Rural Doctors’ Workforce Agency telemedicine consultations, website, less unplanned leave, rural retention It is not unusual to see a hard-working and a board of directors, most of whom rural outreach visits and the 24/7 doctorshealthsa.com.au and recruitment. The list goes on! but struggling doctor who has: are doctors, with the mission to improve phone advisory service. • 24/7 phone advisory service Seventy-five percent of doctors report • ignored the basics of good food, the health of the medical profession for Patients deserve to see a doctor who (anonymous and confidential advice being ‘well’ but, at any one time 25% adequate water, aerobic fitness and the good of the community. Doctors’ is well. We enjoy our life and our work from a colleague: 8366 0250 of doctors report feeling mentally or regular exercise Health SA has also initiated the so much more when we are well. We • After-hours assessment clinic physically unwell. (DHSA state-wide • impaired sleep quality and Northern Territory program in 2016. all want to be sustainable people. This bookings: 8232 1250 or via the website doctors health survey) That is, they have duration due to daytime coffee and The strategy has always been to offer needs attention to: ¹Doctors Health Working Group, Chair,

symptoms which don’t require them evening alcohol © istock/juliedeshaies doctors and medical students a choice • good lifestyle choices SNAPS Dr Richard Hetzel.

38 | medicSA medicSA | 39 in 50 minutes. You can readily locate your closest charging station on the multimedia touch screen, or on the eKona phone app. The cost is variable, and in some car parks, is included in the cost of parking. HYUNDAI eKONA: Driving the eKona is very much like driving any other small luxury car, with a couple of notable exceptions. The IT’S ELECTRIC driving position is very comfortable, with an electric multiadjusable front seat and adjustable steering wheel, it It’s five years since medicSA first ran a feature is possible for just about any shaped driver to be in the correct position. Push on electric cars. With the current publicity and the ‘Power’ button on the dash and political interest in the subject, our motoring instruments and screen light up. There team Robert Menz and Philip Harding thought is a speedo only, with a variety of other it was time to have another look. screens and views to monitor progress, power usage, and the all-important distance left before needing to top up. There is no gear stick, only some buttons towards the front of the centre hil: In August 2014, we drove the items like sunroof and keyless entry, on other drivers, concentration alert console for ‘reverse’ and ‘drive’ (I did not Nissan Leaf and Holden Volt – the the fully electric front seats are heated monitoring, and static cornering lights. use ‘neutral, being unable to think of a former an all-electric unit with a and cooled and even the steering There are three driving modes, Eco, reason). It took only about three clicks P to Bluetooth connect the iPhone to the limited range and what seemed then wheel is heated. There is also plenty Comfort and Sport, and although most car, and the phone remains charged a rather futuristic ambience, and the of electronic gadgetry to make driving of my driving was in Eco, the little SUV with wireless charging. The digital radio latter driven by electric motors but safer and closer to autonomous. The was much more dynamic in Sport. The was very clear, and as is the way these with a petrol engine to keep the battery cruise control maintains a safe distance long-range battery capacity of 39.2 kWh, days, there is no CD player, but there are charged. We were quite impressed with behind the car in front, even if that car provides driving range of up to 470km both. In the meantime, we have driven several USB ports as well as an ‘auxiliary’ stops, and when you want to go again, a and delivers a maximum output of plug to connect the phone by cable to the Tesla, which certainly has the wow touch of the cruise control button sets 150kW. There is 395Nm of immediate the car. One of the minor drawbacks factor, but at a high price. Now we see the car in motion. There are also G force torque available and an acceleration was that the phone voice-control politicians and industry executives sensors such that if you enter a corner of 7.6 seconds from 0 to 100 km/h. system only worked when the phone debating targets being set for sales a little fast on a country road, the cruise These numbers mean there was no and car were cable connected. SATNAV of electric vehicles to become quite control slows the car. The cruise control range-anxiety with this car. However, worked well, and it was possible to aid significant by 2030. Already Norway is at also maintains the speed navigation with a compass setting on 31%. So, what’s around now and what do DR PHIL HARDING: down long hills like the dash screen. you get for your dollar compared with … There are also G force sensors motoring enthusiast Willunga. Performance is fine even in Eco, and five years ago? We just looked at one The list of other active such that if you enter a corner a as mentioned above quite quick in example – tell us about it, Rob. safety and driving Sport mode, with instant torque and Robert: Well, we have the first little fast on a country road, the assistance technologies surprisingly good handling courtesy The Kona handled the winding road to electric small SUV on the Australian (badged SmartSense) cruise control slows the car … of the low centre of gravity. One of Victor well. Its biggest test was a day market and not surprisingly it comes … Driving the include: the changes to driving style is due trip to Deep Creek Conservation Park, from South Korea. Hyundai introduced eKona is very • autonomous emergency braking with being front-wheel-drive means not all to the regenerative braking. This is, and unsealed roads were also handled petrol and diesel Kona models last year pedestrian detection the instant torque is available and the however, adjustable depending on driver with aplomb. We parked at Goondooloo much like driving where it competes in this busy and preference and when set on max means cottage and had a very pleasant 8-km growing sector of the market, and has • blind spot detection including rear anti-skid override helps ensure the any other small cross traffic alert front tyres will have some longevity. driving with minimal use of brakes, as walk along part of the Heysen Trail to just released the fully electric version in the eKona pulls up quite quickly. This • lane departure warning with lane There are no plans to introduce a 4wd Blowhole Beach and back. Despite being luxury car, with a April 2019. Hyundai has a commitment adds to keeping running costs down. keep assist electric Kona. late April, there were sunny skies and couple of notable to sustainability, and the Kona is one During the Easter weekend we had 30-degree air temperature, so we braved • driver attention warning and When you buy an eKona, you will of two fully electric vehicles in their the eKona, there was a variety of driving, the shivery waters of Backstairs Passage exceptions. The • speed limit information function. also need to purchase a home charging range, the other being the interestingly from city commuting, to four days at for a quick dip in the Mediterranean Some of these along with current station which will fully recharge the driving position is named Ioniq which also is available as a Victor Harbor. We had the car pretty well coloured waters. Cooler temperatures eKona in nine hours. The emergency self-contained or plug-in hybrid. One of speed appear on a retractable heads-up loaded, as the boot is not very spacious later in the weekend meant the drive to very comfortable, Hyundai’s key aims is to minimise waste display panel. charging cable provided with the being filled with two eskys and two the Goolwa Barrages and then the beach with an electric at the end of a vehicle’s life, ultimately Other features I really liked and were car can be plugged into your home largish overnight bags. Fortunately, we meant a refreshing coffee at Bombora hoping to achieve a 95% vehicle- useful on an evening drive to Victor 240V plug, and takes 28 hours to fully could use all the back-seat area for the Cafe, rather than a swim. multiadjusable recycling rate by weight. Harbor included the high beam assist, charge. With around 15 manufacturers other paraphernalia and food needed Any other downsides? Some front seat and eKona is available in two trim levels which detects both oncoming vehicles offering electric vehicles in Australia at to feed the hungry visiting family. passengers found the position of the and our test version was the top of and vehicles in the same lane ahead present, there is an increasing number During some of the weekend, four head rest, with its forward angulation, adjustable range Highlander, which is very well at night, and changes to low-beam as of DC rapid charging stations available, adults fitted comfortably, and we had meant it was hard to find a comfortable steering wheel … optioned. Along with the usual lux appropriate, reducing blinding effects and these will provide 80% charge five for one short trip to King’s Beach. position. The main disadvantage is the

40 | medicSA medicSA | 41 Hyundai says that servicing costs are less, which indeed they should be on what is not much more complicated than the combination of your home hi-fi system and a very large vacuum cleaner, compared with the engineering HAPPY sophistication of a modern internal combustion engine, but even that’s not going to be a huge saving. It seems to 100TH me that uptake of this technology, which will be of great benefit environmentally and probably for the economy, will need BIRTHDAY to be encouraged by a combination of big-picture government and industry initiatives. Otherwise purchasing a Kona will be about individual motivation to help the environment and be up with the latest – and of course it's just sooooo smooth and silent! : In summary, a very cost at $71,000, which is an almost $30k charge the battery at the domestic Robert t has come to the attention of medicSA still plays bridge three times a week at the BACK (L-R): Dr Dick Kimber, Dr Jill premium over the similarly specced price of around $0.34 per kWh would competent small SUV, with enough that Dr Mark Sheppard, who was Adelaide Club, and was, remarkably, still Maxwell, Dr Bob Cooter, Dr Brian turbo diesel Kona Highlander. Resale cost around $12 or would be free if you gadgetry to satisfy the technophile, AMA(SA) president in 1965-66, turned driving until six months ago. Cornish, Dr Rod Pearce, Dr David value is an unknown now, but it does have enough solar panels and a battery and enough driving pleasure for the 100 on 9 April this year – no small He is pictured here in a photograph Gill and Dr Mark Sheppard. come with a five-year car unlimited km system, whereas buying 449 km worth of electric enthusiast. Iachievement! A party to celebrate the taken 20 or so years ago at a dinner to MIDDLE: Dr Jeanette Linn, warranty and eight-year or 160,000 km petrol would cost around $30, although Test car provided by Hyundai milestone was held at the nursing home mark the retirement of Tina Evans (then Dr Robert Steele, Tina Evans, battery warranty. no doubt that figure will increase as Australia. www.hyundai.com.au/cars/ where Dr Sheppard now lives. AMA Branch Secretary). The president at Dr Peter Mellows and Phil: Agree with all that, but the time goes by. Nevertheless, if you drive suvs/kona/kona-electric A second party was then held at the time was Dr Rod Pearce (whose wife Dr Max Moore. question for me is what's in it to be 15,000 km per year, that will amount to Dr Robert Menz is a GP who loves Dr Sheppard’s son’s Unley Park home, Sally took this picture). The dinner was worth spending the extra money – quite a saving of at the most $1600 per year to drive and medicSA editor Dr Phil attended by 75 people. The younger Dr attended by all past presidents still living FRONT: Dr Philip Harding, a lot of it, in this case. There is certainly so, on that basis alone, it will take a long Harding loves gadgets but is living on a Sheppard, also called Mark – a cardiologist at that time and Dr Mark Sheppard is on Dr Trevor Pickering, Dr Randal a saving in running costs. To fully time to get your $30,000 back! retirement income. at SA Heart – told medicSA that his father the far right. Butler and Dr Peter Joseph. Looking after your dollars Ready to save? Your AMA(SA) membership card ANZAC HIGHWAY includes loyalty discounts, with up to WHY I AM A MEMBER 10% off pre-purchased gift cards. OF THE AMA It means you can save dollars on retail, leisure & travel at San DR JILL ROBINSON Churro Chocolateria, endota joined the AMA because it is a professional organisation spa, Flight Centre, JB Hi-Fi, that represents the needs and interests of all doctors and I Priceline, Rebel, Target, and Iam proud to be a long standing member. Virgin Australia to name a few! It is a strong political advocate in a climate of cultural and economic shift in healthcare. It is an organisation that cares for individuals and our Your member benefits are community and should be supported by a strong and there to look after you. active membership. Buy online or via your smartphone: Dr Jill Robinson is a partner at Benson Radiology and senior ama.ambassadorcard.com.au/ecards.php visiting medical specialist at BreastScreen SA. She is also the AMA(SA)’s new Council representative for radiologists. members.amasa.org.au/join

42 | medicSA medicSA | 43 STUDENT NEWS STUDENT NEWS

JAZZ NIGHT: Med Student Band on River Torrens MENTAL HEALTH NIGHT: ACTION-PACKED MENTAL supporting medical students TIME FOR AMSS HEALTH MONTH From overseas electives for sixth May was FMSS’s mental health month years to local fun with Jazz Night and – a time for students to reflect on their MedFooty, AMSS students now gear up own mental health and to look out for for mid‑year exams. one another.

TOM GRANSBURY JARROD HULME-JONES STUDENT NEWS: STUDENT NEWS: ADELAIDE UNIVERSITY FLINDERS UNIVERSITY

une marks the long-awaited holidays a chance for members to bring a partner a guest appearance from first-year upporting the mental health of came with barrier exams. Although, the to fill that knowledge gap so students medical students is a key role for multiple assessments per week are high aren’t forgotten when the inquiry delivers for clinical-year students, with many or friend and pull out their dancing musical recruit Liam Halford. However, the Flinders Medical Students’ stakes enough to create a year-round, its final report in September. sixth years, including myself – as I shoes. The functions team put together the true musical highlight of the past S J Society (FMSS), so this time every year sustained elevated stress level and we In the meantime, I’d ask all medical write this article from Dublin – jetting a stellar night with fine food and wine, month has been the Adelaide University we celebrate the model clinicians who know very little about what this does to students and medical officers to use this off for some travel prior to overseas even managing to organise a food truck Medical Orchestra concert ‘The Next achieve a healthy work-life balance, a student. time to reflect on their mental health and electives. It also marks a small hiatus in of delicious Argentinian delicacies, a Beat’, who put on a musical spectacular discuss methods for managing stress, Improvements to hospital work remember to look out for one another. the action-packed 2019 calendar where beautiful sunset over the River Torrens with Vocal Ensembles, Big Bands, Dance and engage in frank discussions about environment safety are required to pre-clinical students can settle into and most importantly some sweet tunes Crews and a full Symphony Orchestra at mental illness. improve student mental health. On the REFERENCES 1. Beyond Blue. National Mental Health study before mid-year examinations. from two medical student bands. the Adelaide Townhall. The National Mental Health Survey wards clinical year students assume the Survey of Doctors and Medical Students. Mock OSCEs and peer-led tutoring Whilst the annual MedFooty was Educational advocacy wins have of Doctors and Medical Students role of the team’s most junior medical February 2019 programs such as ClinPrac, MedTransit, rained out, it didn’t stop the Emergency included reviewing the maximum commissioned by Beyond Blue was officer. Here, they are exposed to the 2. Stevens G. SA Health Adult Community Peer2Peer and the AMSS Teaching Series Medical Challenge. Five teams competed number of hours students are expected updated in February this year and it shows same risk of bullying, harassment and Mental Health Report. 2017 continue to run. At the second EdForum in four challenging emergency to spend on placement each week, that medical student levels of general discrimination that is prevalent in 3. Australian Medical Association - NSW. 2–5 for the year, students heard from the medicine scenarios, finishing with a with the intention to put measures distress (K10) and rates of specific mental Australian medical workforces , and that Hospital Health Check 2018 inspiring 2019 Australian of the Year, Dr final between the AMSS and FUSPA in place that will prevent students health diagnoses are higher than in the the 2019 Inquiry into Workplace Fatigue 4. Australian Medical Association - Richard Harris, about his experiences (Flinders University Student Paramedics being required to do late night shifts general population. Indigenous and and Bullying in South Australian Hospitals Queensland. 2018 Resident Hospital Health 6 diving into the unknown. Student- Team). The Adelaide University Critical followed by early clinical or teaching female students reported worse mental and Health Services seeks to investigate Check Survey run Electives Night and Honours Care Student Society (ASSCC) are to sessions the following morning. The health than their non-indigenous and and address. 5. Australian Medical Association - Victoria. information nights were also a success, be congratulated on the event and all focus on wellbeing continued with the male colleagues.1 We have more work to SA students are not surveyed to see if Hospital Health Check Survey. 2018 with previous students discussing the doctors involved in adjudication AUU De‑stress Day, and our Health and do in this space, but some positive steps they are experiencing the same bullying, 6. Occupational Safety, Rehabilitation and personal tips and tricks from honours thanked, despite narrowly awarding a Wellbeing Workshop, a reminder for have already been taken. For example, the harassment and fatigue that medical Compensation Committee, Parliament and overseas electives. well-deserving Flinders University team all students to keep an eye on their own ‘do-many-small-tests-often’ assessment officers do, so FMSS’ inquiry submission of South Australia. Inquiry into Workplace Jazz Night celebrated the end of Term the victory. The evening continued at mental health and wellbeing in the lead- model that Flinders has adopted has was limited to anecdote and extrapolation. Fatigue and Bullying in South Australian 1 for pre-clinical students and provided President’s Keg with a live band and up to exams. removed the spikes in stress that once As a May activity FMSS will create a survey Hospitals and Health Services. Looking after your dollars Ready to save? Your AMA(SA) membership card includes loyalty discounts, with up to 10% off pre-purchased gift cards. . . . printers & designers of MedicSA It means you can save dollars on retail, leisure & travel at San Churro Chocolateria, endota spa, Flight Centre, JB Hi-Fi, Priceline, Rebel, Target, and Virgin Australia to name a few! • Stationery • Publications • Brochures • Posters • Labels • Light Packaging • Annual Reports • Presentation Folders Another way we add value to your membership [email protected] 8268 7877 Buy online or via your smartphone:

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44 | medicSA medicSA | 45 STRAPPUBLIC HEALTH

LEGISLATIVE REQUIREMENTS OF SA MEDICAL PRACTITIONERS

BY A/PROF NICOLA SPURRIER

In this article, medical his article provides a brief information to parents around the risks e) within 24 hours of being discharged 2A of the Consent to Medical Treatment Act provisions. First, the Consent Act practitioners are given overview of current legislative of co-sleeping. from a hospital or having sought and Palliative Care Act 1995 (‘Consent applies to all people with ‘impaired requirements for medical The mandatory requirement for emergency treatment at a hospital Act’) in paragraph (g) which was decision making capacity’ which includes a reminder about what practitioners under the medical practitioners to take blood for f) while the deceased was a inserted into the Coroners Act in July a broader range of people than in the TSA Coroners Act 2003 (and some blood alcohol testing from patients ‘protected’ person 2014 when the Advance Care Directives is required legally under Guardianship Act which used the term the Coroners Act and the related legislation) and the Road involved in road traffic accidents g) while the deceased Act 2013 came into operation. On the ‘mental incapacity’. Second, a broader • was a protected person under the same date, sections of Part 5 of the Road Traffic Act. It also Traffic Act 1961 regarding reporting similarly has significant public health range of people can give consent in this deaths to the Coroner and collecting benefits. This process ensures all drivers Aged and Infirm Persons’ Property Guardianship and Administration Act situation (see interpretation of ‘person covers how this relates blood samples following road traffic and riders of motor cycles involved in Act 1940 or the Guardianship and 1993 (‘Guardianship Act’) were repealed. responsible’). Third, the definition of to population health and accidents, respectively. a collision are tested for alcohol and Administration Act 1993; The repealed sections related to powers medical treatment is expanded under preventative health. This legislation applies to all medical certain recreational drugs. These are • was under a custody or guardianship for limited relatives to consent to health Part 2A of the Consent Act to also practitioners, regardless of whether they significant contributors to serious and order under the Children and Young care on behalf of adults who by reason include health care which is defined as; ; of mental incapacity were incapable of work in private practice, locum practice fatal injury on South Australian roads People (Safety) Act 2017 ‘any care, service, procedure or treatment • was a patient in an approved or in the public health care system. and ensuring blood is taken, stored and provided by, or under the supervision of treatment centre under the Mental Legislative non-compliance can have transported correctly and analysed in a a health practitioner for the purpose of Health Act 2009; diagnosing, maintaining or treating a very significant consequences, including forensic laboratory are important steps … Legislative • was a resident of a licensed supported physical or mental condition of a person’. hefty fines, imprisonment, or both. towards preventing road trauma. residential facility under the non‑compliance can It is also worth noting that the Consent IMPROVING POPULATION REPORTING DEATHS TO THE Supported Residential Facilities have very significant Act considers treatment to a person HEALTH CORONER Act 1992; to include withdrawal, or withholding The Coroners Act 2003 requires consequences, Importantly, both requirements • was in a hospital or other facility of medical treatment to the person medical practitioners to report deaths contribute to improving population being treated for drug addiction including hefty (including life sustaining measures). which have occurred within South health. Reporting deaths of a particular h) during, as a result or within 24 hours Finally, there is nothing in the Consent Australia in certain situations to fines, imprisonment, nature to the Coroner ensures that the of medical treatment to which Act that stipulates that consent by the Coroner. The situations where causes and circumstances of reportable consent had been given under or both … the ‘responsible person’ needs to be in deaths are interpreted as reportable deaths are fully understood and Part 5 of the Guardianship and writing, so consent can include oral or are paraphrased (as per the Coroner’s or A/PROF NICOLA SPURRIER is documented. This allows for potentially Administration Act 1993 Part 2A giving effective consent for medical or indeed, implied consent. the deputy chief medical officer, website) from the Act as follows; of the Consent to Medical Treatment dental treatment. These provisions are It is important to note that, by preventable factors in patient deaths SA Health. She can be contacted Reportable deaths are those which and Palliative Care Act 1995 now contained in the Consent Act such operation of the Consent Act and being recognised. In a small number of on [email protected] have occurred: i) when a cause of death was not that all consent provisions relating to Coroners Act, deaths must be reported cases, the Coroner may determine that a) unexpectedly, unusually or by a certified by a doctor health care are now in the Consent Act. to the Coroner in circumstances where further information and investigation violent, unnatural or unknown cause Clearly, medical practitioners need to In particular it sets out who can consent the above types of health care (including are required, usually because there is the b) on a flight or voyage to not only be familiar with the Coroners to health care on behalf of a patient with the withdrawal of care) were consented opportunity to prevent future similar South Australia Act 2003 but also six other pieces of impaired decision-making capacity to by persons responsible. deaths, and an inquest will be called. c) while in custody legislation. This includes being aware if there is no Advance Care Directive Obviously, if in doubt as to whether A recent example includes the inquest d) during, as a result or within 24 of changes to the legislation which in place. a death is reportable to the Coroner it into infant deaths associated with hours of certain surgical or invasive occur from time to time, which are There are three major differences is advisable to contact the Coroner’s co-sleeping. The recommendations medical procedures, including the publically gazetted. to the consent provisions comparing Office, medico-legal department of your from this inquest resulted in clearer giving of an anaesthetic for the An example of a change within the the previous Guardianship Act health service or your medical defence

guidelines and broad dissemination of purpose of performing the procedure © istock/AndreyPopov last five years is the reference to Part provisions with the current Consent organisation to seek advice.

46 | medicSA medicSA | 47 VALE

BLOOD SAMPLES – ROAD TRAFFIC ACCIDENTS Section 47I of the Road Traffic Act FAREWELL TO A 1961 mandates that it is the duty of a legally qualified medical practitioner to take a sample of blood from a person HIGHLY RESPECTED ‘apparently of or above the age of 10 years’ who has suffered injury in an accident RAH SENIOR involving a motor vehicle and who attends a hospital to receive treatment ANAESTHETIST for the injury. This includes pedestrians involved in motor vehicle accidents and also cyclists. Of most importance from a public health perspective is that all drivers of motor cars and PIERS WILLIAM ROBERTSON riders of motor cycles are correctly B.MED.SC (HONS), DA (UK), FANZCA tested for alcohol and other drugs which may impact a person’s ability to 1961 - 2019 effectively control a vehicle. This may be crucial for prosecution if required but also contributes to improving road traffic safety in the long term. Because medical practitioners are alcohol and drug testing. Not only iers Robertson was a highly USA for a year furthering his interest Drugs other than alcohol are called not always available in regional areas, is this change likely to assist with respected senior anaesthetist in hyperbaric medicine and regional ‘prescribed drugs’ in the Act, with the the current legislation allows for patient flow in the metropolitan at the Royal Adelaide Hospital, anaesthesia. He returned to Adelaide term ‘prescribed’ referring to those qualified nurses to take forensic blood emergency departments but it will who achieved more than most in 1998 and immersed himself in the samples under some circumstances. assist with ensuring all required blood Pin a career brought to a premature end. Department of Anaesthesia. He was set out in the Road Traffic Regulations Machines with motors gave him The State Government is reviewing samples are taken in the required Piers was a quiet contributor, as to his deputy director in the department for 2014 under the Act being delta-9- enormous pleasure and he owned a involvement in departmental matters two years from 2006 to 2008. tetrahydrocannabinol (cannabis), the Road Traffic Act with the aim to time frames required for police succession of Alfa Romeos. He was due at RAH and with the Australian Society Outside the operating theatre, he methylamphetamine (‘ice’) and 3, amend it to allow nurses working investigations. This change to the Road to take possession of a brand new Alfa of Anaesthetists. He had the ability to was the department’s liaison officer for 4-methylenedioxymethamphetamine in metropolitan hospitals to be able Traffic Act is expected to be brought Stelvio, except that his sands of time see clearly, grasp issues and formulate eye surgery and liaison officer for the (MDMA or ‘ecstasy’). to take forensic blood samples for before Parliament later this year. ran out before he added this one to his solutions. Piers worked his way into Post Anaesthesia Care Unit. He was a stable. Stable is the correct term for it, positions of authority, not for personal member of the RAH Disaster Planning as his garage kept expanding and he gain, but because his skillset was ideally Committee, and he orchestrated even installed a hydraulic lift to stack suited to making a difference to many. the Adelaide Regional Anaesthesia one car above another! Pride of place The Robertson family were Workshop. He was coordinator of went to his 1974 Montreal, extensively From January 2020, we’ll be making the CLINIC SURGEONS pastoralists at Chowilla, a station on the departmental Quality Assurance refurbished in 2008, one of only 1600 BENJAMIN ALLEN the Murray near the NSW border, and Program, and resident medical officer MOVING exciting move to our new home at right hand drive models ever made. BEN BEAMOND although Piers’ life was in Adelaide, supervisor for Anaesthesia. Further, Calvary Adelaide Hospital. In the early 2000s, he took up cycling INTO THE COLLIE BEGG he retained close ties with the country, he was a member of the Anaesthesia and in typical ‘Piers’ fashion, worked SAMUEL BENVENISTE enjoying Chowilla and the Murray with Management Group, the Clinical FUTURE. In the meantime, our orthopaedic surgeons hard to become one of the stronger SCOTT BRUMBY friends and family. He graduated from St Pathways Taskforce – PACU and ICU, and riders in cycling group ‘The Lanterne will continue to practice at Calvary Peter’s College in 1978 to embark upon the Equipment Committee. He was also DAVID CAMPBELL Rouge’. Not only did he ride, his Wakefield Hospital as well as at other a career in medicine at the University editor of What a Gas, the department’s NICHOLAS CHABREL sartorial elegance drove him to design hospitals throughout South Australia. RICHARD CLARNETTE of Adelaide, graduating in 1986 after weekly newsletter the group’s cycling strip with a new ANDREW COMLEY obtaining a Bachelor of Medical Science Piers had the ability to see what iteration every couple of years. We’re also consulting at locations around WILLIAM DUNCAN (Honours) in the Department of Clinical needed to be done and this was In 1988 he married Libby, a and Experimental Pharmacology under nowhere more evident than in his the State including: Angaston | Berri CHI KANG GOOI radiographer at the time, who was a PETER LEWIS Prof Derek Frewin along the way. involvement with the Australian Blackwood | Clare | Flinders Private Hospital tower of strength through all these DAVID MARSHALL Piers started his anaesthetic career Society of Anaesthetists (ASA). He was activities, which also included skiing Gawler | Glenelg | Golden Grove RORY MONTGOMERY as a senior house officer in 1989 at the the scientific program convenor for and travelling. They have three Kangaroo Island | Loxton | Naracoorte LUKE MOONEY Royal Hallamshire Hospital in Sheffield, the ASA National Scientific Congress children, John, Alexa and Caroline. Port Lincoln | Stirling | Victor Harbor RICHARD POPE during which he gained the Diploma (NSC) in 2002 and 2006 and was overall Piers sadly lost his struggle Wakefield Orthopaedic Clinic | Wallaroo MICHAEL SANDOW in Anaesthesia from the College of Convenor in 2015, a position that with cancer on 30 March at home, Anaesthetists (UK) (the College gained incorporated all aspects of the NSC. surrounded by his family and at peace. its Royal accolade by charter in 1992). This feat was even more remarkable in As a brother, husband, father, friend, He returned to Adelaide and joined that the meeting was held in Darwin, colleague, mentor, quiet voice of reason the South Australian Vocational not Adelaide! A great organiser, he was and authority and Alfa enthusiast, he Anaesthetic Training Scheme, gaining also ASA Federal Scientific Programme will be sorely missed. his fellowship in 1996. Never one to let Officer 2003-10; Chair, NSC Federal grass grow under his feet, he joined the Scientific Programme Sub-committee LEADERS IN ORTHOPAEDICS | SPORTS INJURIES | ARTHRITIS CARE This obituary was prepared by colleague Hyperbaric Medicine Unit at RAH as a 2003-08; ASA NSC Scientific Congress and friend Dr Simon Macklin. The Level 2, 270 Wakefield Street, Adelaide, South Australia 5000 | (08) 8236 4100 | [email protected] | woc.com.au provisional fellow and then joined Duke Officer2010-18; and Chair, ASA NSC AMA(SA) extends its condolences to Piers’

© istock/robeo University Medical Center, Durham, Federal Committee 2010-18. family, friends and colleagues.

48 | medicSA medicSA | 49 IN PRACTICE

ACCELERATED SILICOSIS: WHAT YOU NEED TO KNOW

SA doctors should be aware of an occupational lung disease – accelerated silicosis – which may affect an unknown number of workers in this state. celebrating 30 years BY CHRIS BOLLEN WITH BEATA BYOK here for you and all south australians ccelerated silicosis is a over 90%. The rate of change in lung SA workers in the engineered stone preventable occupational function deterioration for workers with bench-top industry, or their treating lung disease occurring in accelerated silicosis is on average 10 medical practitioners, can arrange young workers as a result of times faster than the normal age-related for a free health assessment via the Athe manufacture and installation of deterioration. The latent period from Mining and Quarrying Occupational artificial stone bench tops in kitchens, exposure to development of disease Health Safety Committee by calling bathrooms and laundries. To date, (symptomatic or asymptomatic) is from 8204 9842 or emailing maqohsc@ proud to provide the best patient care and experience* there is no known treatment so early one to ten years. Therefore the disease sa.gov.au. The health assessment is detection, diagnosis and management can continue to progress even after a available for workers and employers ONLY HOSPITAL LEADING is essential. worker has left the industry. who have been exposed and involves IN SOUTH AUSTRALIA THE WAY An audit conducted in Queensland Any worker who has worked with health questionnaires, spirometry, a full BEST SA SCORING since September 2018 identified 800 artificial stone, either now or in the medical examination with particular 95 workers in the artificial stone industry past, should be assumed to have been focus on the respiratory system and OVERALL OF MEMBERS SURVEYED RATED that require health screening – of these, exposed to silica dust and undergo PATIENT THEIR PATIENT EXPERIENCE IN A chest x-ray. EXPERIENCE .5 10 0 BEST just over half have undergone heath health screening, whether or not they Employers and workers eligible for SCORE 9 PRIVATE assessments. Already 108 workers have symptoms. the silicosis health assessments in this IN PATIENT HOSPITAL PATIENT have been diagnosed with accelerated Diagnosis is based on a industry sector can also access free and 10 RECOMMENDATION 8/10 OR HIGHER EXPERIENCE silicosis and of these 20 have progressive comprehensive clinical and radiological confidential counselling by contacting pulmonary fibrosis, for which the only assessment consisting of: either one of two Employee Assistance treatment is lung transplantation. • an occupational history with details Program providers – Corporate Health New South Wales, Victoria and South of current and/or previous work sites, Group on 8354 9800 or Access Programs Australia have started health screening job tasks, use of personal protective on 8215 6799. Counselling is also Refer your patients with confidence for accelerated silicosis and worksite equipment and exposure to silica dust available to the worker’s immediate audits. The number of workers who may • respiratory symptoms such as cough family members. More details for Our rankings, our treatment, our care - make us a clear option for your valued patients. be affected in this state and nationally is (productive or non-productive) and this support service are on the as yet unknown. shortness of breath on exertion RTWSA website. Let us partner with you in their better health. Stonemasons who cut and grind • a clinical examination, focusing on If one of your patients is diagnosed artificial stone, particularly dry cut, the respiratory system with silicosis and wishes to make which contains a high proportion of • lung function testing to Thoracic a workers compensation claim, crystalline silica, into kitchen, bathroom Society of Australia and New Zealand ReturnToWorkSA has a specialist team and laundry bench tops are at risk of standards to assist with the claims process. They contracting accelerated silicosis as a • an ILO chest x-ray to be read by an ILO can be contacted by email at silicosis@ result of being exposed to unsafe levels qualified B reader rtwsa.com or on 8233 2545. of silica dust. • a high resolution CT scan of the chest. For further information or for Silicosis is a fibrotic disease of the Workers with positive findings must support with referrals to appropriate lungs caused by the inhalation and be referred to a respiratory physician services, email [email protected] or deposition of respirable crystalline for confirmation of the diagnosis. call 8238 5757. silica in the lung tissue. Unlike natural An occupational physician can assist stone such as granite, which typically with management. Ongoing health Dr Chris Bollen is ReturnToWorkSA contains only up to 30% silica, artificial monitoring of exposed workers will medical advisor and Dr Beata Byok is an

© istock/South_agency stone can have silica concentrations of be required. occupational & environmental physician. T 08 8130 1222 | www.sportsmed.com.au 50 | medicSA medicSA | 51

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To do this effectively it’s • TMJ clicking and locking of us and is the focus of widespread Online resources, for patients, important for GPs to know research, including to expand support families, carers, clinicians and other • Limited opening from synovitis We encourage members to end-of-life law. Visit the for dementia patients and their health workers, have been compiled by or TMJ derangement ELDAC legal toolkit for take advantage of the full families, and older Australians with experts – with Australian Government high quality, state specific • Assessment of bite and tooth 250 South Terrace progressive chronic and acute diseases funding – at the free CareSearch website range of benefits on offer. information about end-of-life wear problems Adelaide 5000 and symptoms. – caresearch.com.au – and specialised Phone: 8223 7247 Your member benefits are “We need to equip patients, their End of Life Directions for Aged Care site law in clinical and aged care • Patients requiring dental Fax: 8215 0187 families and carers and health – eldac.com.au – and delivered to the practice – eldac.com.au > devices for snoring there to look after you. professionals with positive and helpful toolkits > legal – or call the and apnea www.ofpadelaide.com.au community via online courses including information – particularly given the the mooc-list.com/course/dying2learn- ELDAC Helpline on 1800 870

members.amasa.org.au/join © istock/gilaxia demographic rise in the baby boomer mooc-death-and-dying-openlearning. 155 for assistance.

52 | medicSA medicSA | 53 IN PRACTICE IN PRACTICE

NEW OCCUPATIONAL CANCER E-LEARNING MODULE Cancer Council has developed an e-learning Excellence • Made More Accessible & Affordable module to increase GPs’ www.thejointreplacementclinic.com.au awareness of workplace carcinogens and cancers. T: 1300 000 572 | F: (08) 7123 6320 | E: [email protected] The module includes sections on occupational carcinogens in the Australian No out-of-pocket expeNse context, the role of an • State-of-art Joint Replacement exposure history, common to pAtiEnts for service providing knee, hip and occupational cancers shoulder replacement. • Surgeon • Anaesthetist • Physician including lung, skin, bladder • Hospital Stay • Physiotherapy • Transfer and mesothelioma, and the • Comprehensive patient-centric to and from home • RDNS home care Australian compensation care pathway. following discharge system. The 60-minute module is accredited with both RACGP and ACRRM. Visit elearning.cancer.org.au/

shehara silva courses. prof Jegan Krishnan Dr sunil p reddy Business Development Manager MBBS Ph.D FRACS.Orth FAOrthA MRCS.Ed MS.Orth FRACS.Orth FAOrthA Patient Liaison Officer www.krishnan.com.au www.drsunilreddy.com.au 0433 312 519 PROTON PUMP UPDATED GUIDELINES INHIBITORS Doctors prescribing proton ON SEXUAL BOUNDARIES pump inhibitors (PPIs) for their patients under the PBS The AMA has updated its guidelines on maintaining now need to take additional Study with AMA Skills Training sexual boundaries between doctors and patients. steps to comply with clinical guidelines following changes Online • Self Paced • Workshops • RPL to the PBS restriction he new guidelines on sexual new document, it clearly states that criteria. High dose PPIs are Full Qualifications • Skill Clusters • Individual Units boundaries between doctors and doctors have an ethical and legal duty now authority required patients now include a section to maintain appropriate professional (telephone) and standard RTO No. 40880 acknowledging that the power boundaries with patients. dose PPIs are now authority BSB51918 – Diploma of Leadership and Management Where knowledge + health meet Timbalance may lead patients to feel Essentially, professional boundaries required (streamlined). vulnerable and exposed. HLT57715 – Diploma of Practice Management define the limits of the therapeutic For authority required The AMA’s Patient Examination HLT47315 – Certificate IV in Health Administration relationship between doctors and (telephone) listings, Guidelines 2012 and the Position patients not only in terms of physical Statement on Sexual Boundaries doctors must write the CHC43415 – Certificate IV in Leisure and Health space but also social, emotional and Between Doctors and Their Patients item on an authority psychological space. BSB31115 – Certificate III in Business 2012 were recently updated as part prescription form and gain “There is a potential power imbalance of the AMA’s routine, five-year policy prior authority approval Administration (Medical) in the doctor-patient relationship. While review cycle. from the Department of doctors have the highly specialised CHC33015 – Certificate III in Individual Support As there was a fair amount of Human Services for PBS knowledge and skills patients require to Specialisations repetition between the two documents, subsidisation. Doctors can obtain good quality health care, patients • Ageing they have now been combined into one either call the PBS authority may feel vulnerable or are potentially • Home and Community – the Guidelines for Maintaining Clear approval telephone line on Sexual Boundaries Between Doctors vulnerable and exposed due to the • Disability 1800 888 333 for authority and Patients and the Conduct of Patient very personal and physical nature of requests; or request BSB30415 – Certificate III in Business Examinations 2019. the doctor-patient relationship,” the Administration The AMA’s updated guidelines Guidelines state. “For example, patients electronic PBS authority were written to be consistent with the who seek care may be sick, injured, approval through the Online Medical Board of Australia’s Guidelines: anxious and distressed”. PBS Authorities system via Visit www.amaskillstraining.org.au Phone (08) 8274 6062 Sexual Boundaries in the Doctor-Patient HPOS. Email: [email protected] Relationship, which was released The full guidelines can be accessed at: ama. For further information, go

© istock/PeopleImages in December last year. In the AMA’s com.au > position-statements. to humanservices.gov.au.

54 | medicSA medicSA | 55 IN PRACTICE

What you need to know before buying a practice PRACTICE MAKES PERFECT

If you thought qualifying to become a private practitioner etting up or buying into a medical members to pay tax at a lower marginal practice can be overwhelming, rate also can reap immediate benefits for was hard work, the particularly if it’s your first foray your business. transition from wage into business. Be prepared And you should have documented Sfor a steep new learning curve of systems (including unit holder earner to business owner takes even more administrative, legal and financial agreements and a practice handbook) responsibilities. from the outset about how to manage study and whole lot of SEEK PROFESSIONAL ADVICE retirement, death of a business partner expert advice. Getting professional advice is or any other issues to reduce any … As a practice owner, you will need to work absolutely key to help you manage the damage caused by conflict. string of compliance, human resources, It pays to ensure that everyone continually on improving financial management, BY LISA HICKEY Medicare rules, accounting and taxation understands clearly how the business considerations that come with being a will run if something happens to a key information technology, human resources, private practitioner. person, or how the business will deal regulatory compliance … As a practice owner, you will need to with leadership succession. work continually on improving financial It’s also important to understand management, information technology, Medicare rules around billing before human resources, regulatory starting out, and equally important Whilst these are beneficial you should business plan. If you are buying existing Many people do not know that they risk to keep detailed records that can be compliance, strategy and marketing. be cautious if the selling parties premises, you need to ensure it’s suitable large fines for non-compliance with understood by other clinicians, of your You will also need to put in place an are staying on and the culture isn’t for medical practice operations or can be employment laws. appropriate business structure and clinical treatment, in case you are adaptable to change. easily converted. 5. Protect your investment financial management systems when investigated. If the practice is long held by the 4. Find the right people Funding your practice is key to getting starting out, to maximise the return on TOP FIVE TIPS current owners, then you also need If you are going into practice with off the ground, regardless of whether your investment (both time and money) Here are some top tips before you take to consider the goodwill component others it is important to ensure your you are investing your own funds or and to protect your assets. the plunge to own a practice: of the purchase price. Goodwill is an thoughts and vision for the practice relying on bank funding. Remember, once you cross the line 1. Make a plan intangible asset which builds value align. It is also crucial to decide on It is important to insure your assets into owner/practitioner, you ARE Prepare a detailed business plan to overtime. You are paying a premium for the appropriate operating structure and income to allow you to run your the business. communicate your vision and document receiving an established practice that for your practice, ensuring you receive practice without added stress. If you PROTECT YOURSELF your roadmap for success. This will has already achieved a level of success. advice from professionals prior to are going into practice with others, There is more to the scenario than ensure all bases are covered and enable Starting a new practice will enable you making decisions will put you in the just being a business owner. There are you to benchmark progress over time. to build the culture from the ground up best position. then additional protection may be huge responsibilities and it’s your job A business plan should be regularly and create your own vision. Of course, You and your partners should also required such as key person insurance, LISA HICKEY is a representative to ensure that all the protections are in reviewed and updated as the business the downfall of starting from scratch, align with professionals who understand unitholders or shareholders agreements of Hood Sweeney Accounting & place in case something goes wrong. grows. inclusive of the patient base, is it will your industry and share your vision and buy/sell agreements. Business Advisory. She can be That means having the right 2. Decide whether to buy into a result in a longer establishment time including fit-out, building, legal, contacted on 1300 764 200 or insurances — professional indemnity, practice or start from scratch and return on investment. banking and accounting professionals. Hood Sweeney is the AMA(SA)’s preferred [email protected]. building, business, public liability, Buying into an existing practice can 3. When securing your premises … As a future employer, you are also provider for financial services. Find out how personal and life insurances. have less risk associated, particularly When securing bricks and mortar responsible for remaining on top of Hood Sweeney’s Health Team can work Establishing a trust or company to if it is one where you already work, for your practice, ensure the building any changes to provisions around with you to ensure that you are primed to protect assets from legal action and as you have a strong patient base and has easy access, car parking, visibility, leave, superannuation and wages, and take advantage of your decision to go into

to distribute income to allow family understand how the practice runs. Mitchell © istock/Dean and fits the vision outlined in your ensuring that the business complies. professional practice.

56 | medicSA medicSA | 57 GOOD NEWS STORY 1996 BASH: Dr Alfred Ho and Dr Bronte Ayres, with a grateful patient.

DID YOU HAVE TO DEAL WITH ANY SERIOUS SITUATIONS? I think it was more about safety and making sure people could continue to do the Bash. But I did feel I needed to undertake some more training – I was scared that I was underqualified for a potentially severe trauma. At that stage, I was president of the Royal Australasian College of Physicians state branch. But I went to the College of Surgeons and did their management of severe trauma course. There were many people making a joke of the fact that the state president of the College of Physicians was doing a surgeon’s course! We had a fellow who chopped the top off his finger once. He was a mechanic on one of the vehicles, and we were somewhere between Alice Springs and Darwin at that time. We felt that we popped the mechanic in the plane you just try to make sure everything is as we couldn’t safely re-fix the tip of his and flew him up to Darwin. He arrived safe for them as you can. finger out in the bush, although we put before nightfall, got operated on, and in sutures. It was a much bigger injury WHEN DID YOU FINISH UP next morning at sunrise, was flown back than we would have liked. I rang the GOING TO THE BASH? In 2006. I went out on my last two Darwin Hospital to speak to the surgeon to the Bash. He did not want to miss the bashes as Chief Barker (that’s like on duty and it turned out he was a rest of it. Chairman of the Board), which I felt Flinders surgeon I’d known since he was These are good people – they’ve spent very privileged to be able to do. But I was a boy, and he agreed to stay behind. We a whole year fundraising for the Bash, reaching an age where it was getting had a plane with us on that Bash, and to spend one week out in the bush. So, harder to get up out of a swag! THE VARIETY BASH: A There was also the fact that my wife STAYING HYDRATED: said: ‘Do you know that you’ve spent Dr Alfred Ho over half a year of our married life in the and Dr Bronte Ayres. bush with Variety?’ (laughs). DOCTOR’S PERSPECTIVE I thought then that perhaps it would be a good time to become more involved in Variety in a consulting position – so AMA(SA) member Dr Bronte Ayres AM was recognised in this year’s Australia Day Honours I’ve been chairing the Appeals and for significant service to children’s charities, and to medicine as a cardiologist. Heather Millar Grants Committee now for over 10 years. asked what drew him to volunteering as Bash doctor for 15 years running and about his ongoing WHAT DOES THE work with Variety – The Children’s Charity. COMMITTEE DO? We assess the children and their HOW DID YOU GET INVOLVED WHAT DREW YOU TO THE disturbances or people concerned that families, and we give away three-and- a-half million dollars a year to those WITH THE VARIETY BASH IN VARIETY BASH? they were having a heart attack. So, I grew up in the country, so I enjoy we were doing ECGs out in the bush, in need. THE FIRST PLACE? We provide equipment or facilitate I got a phone call from Variety back in being out in the bush. Also, I have a but more often than not, treating sore sister with Down’s Syndrome, so I was throats and injuries and sewing up a cut. the purchase of things that could help 1992. Someone had had a heart attack children in some way. We also, as a aware of children who are challenged, Part of having medical responsibility a week after the Bash, and people were committee, fund events for children and Variety helps needy, disabled, was planning to make the event safer. thinking, ‘What if someone has a heart – a Christmas party with well over a isolated and impoverished kids and Speed is never an issue on these events attack, what would we do?’ thousand children, and an Easter event. their families. – it’s just getting from point A to B as We also provide vehicles for wheelchair- There was a GP there in that first It really pressed a button for me, and safely as you can on dirt roads. bound children to help their families. year, so they asked me if I could provide I became addicted to being a doctor on We started having a car in front of When the family has got no money and extra cover, thinking a cardiologist the Variety Bash and the Variety 4WD the event, putting up signs saying can’t afford a wheelchair-accessible out in the bush might be handy. We Adventure. Alfred Ho and I, we did this there’s a dangerous corner ahead, vehicle, we provide those. had a defibrillator in case something for about 15 years as a team – he’s a GP slow down, or things like that. So that Schools apply to us for special buses from Valley View. happened, and blood thinners if people was our medical prevention plan, called Sunshine coaches, so children had a heart attack – stents hadn’t been DID ANY HEART ATTACKS and we also kept in touch with the with special needs can get to swimming invented then. The plan was to use OCCUR? Flying Doctor Service, so we always classes or other events that the school blood thinners and fly people out by the Not any acute heart attacks. We knew where there was a landing strip wants to arrange for them, or when they Flying Doctor, if need be. had minor cardiac issues – rhythm nearby, in case we ever had a need. need to get to and from school.

58 | medicSA medicSA | 59 GOOD NEWS STORY RECIPES

WHAT DO YOU PERSONALLY FIND REWARDING ABOUT THE WORK YOU DO WITH VARIETY? There are people from all walks of life Cooking with out there who want to do some good, and to give thanks for how lucky we are. CarrMen: I’ve been lucky. I grew up on a farm in the South East. I went to school in Mt Gambier and I’ve got to be a cardiologist, who just loves what he does. LAMB CURRY So, you’ve got to say thank you, and I’m now meeting all these wonderfully FOR COLD big-hearted business people who give away enormous amounts of their WINTER NIGHTS time to help disadvantaged kids and HOW’S THE MEDICAL SET-UP their families. ON THE BASH TODAY? There’s a lot of good doctors who TELL US YOUR GOOD NEWS! “I often bring small curry dishes DID YOUR WIFE EVER GO ON A are now volunteering – GPs from the to work to share, especially over BASH WITH YOU? country, anaesthetists, a urologist, We want to hear your good (Laughs). She went on one 4WD Adelaide doctors. It takes a lot of news stories. Members are winter months. I know too well invited to contact medicSA to Adventure with me – she drove, while I planning – you have to prepare all year how time-consuming making to have the equipment available to be submit ideas for articles about navigated. She took all the challenges of curry from scratch can be. So, like a mobile emergency department in your good news – whether it’s driving on tough roads really well, and I’ve reverted to using a paste, the bush. to do with medicine, research, at the end of it I said, ‘Do you want to do This year’s Variety Bash starts from charity or your hobbies and but with added spices to make that every year?’ She said, ‘No I’ve done Mawson Lakes on Saturday 10 August and interests. Contact heather@ the curry tastier. Here’s a quick zestcommunications.com.au. it once, and that’s enough!’ So, it’s not finishes on 17 August in Murray Bridge. For version to spice up your winter for everybody! more information, go to variety.org.au/bash/. nights.”

CARRMEN CHUNG PREPARATION TIME 10 minutes Management of work-related mental health conditions COOKING TIME 30-40 minutes Work-related mental health conditions are challenging to diagnose and treat with most injured workers seeking care from their GP. ReturnToWorkSA is pleased to have INGREDIENTS supported and contributed to the development of the 600g lamb (I usually use the rump so I can fry up the lamb fat), slice or Clinical guideline for diagnosis and management of work- diced depending on your preference related mental health conditions in general practice. 4 lemongrass sticks 3 cinnamon sticks The guideline provides advice to GPs about diagnosis 5-6 cardamon pods 1-2 star anise and assessment of severity of mental health conditions 1 jar of massaman curry paste from your friendly neighbourhood within a work-related environment. supermarket

For more information, including how to access the 2 potatoes (diced, optional) clinical guideline, please contact the Scheme Support Helpline on 8238 5757 or email [email protected]. METHOD CARRMEN CHUNG is an 1. Heat 2 teaspoons of grapeseed/olive oil and fry lemon grass, obstetrics and gynaecology cinnamon sticks, cardamom pods, star anise and some trimmed registrar at the Women’s lamb fat until aromatic (or about 5 minutes) and Children’s Hospital and 2. Remove star anise, cardamom pods, cinnamon sticks and the lamb a clinical lecturer at the fat. With the lemon grass remaining, add the massaman curry paste www.rtwsa.com University of Adelaide. She and fry for a further 2 minutes also runs a food blog and 3. Then add the lamb and continue stirring under medium heat until 8238 5757 food Instagram with her cooked through and tender (approximately 20 minutes) partner @doctorfoodies. 4. Serve with rice or, roti pratha.

60 | medicSA medicSA | 61 PRACTICE NOTES

NOTICES DR GREG SMITH, respiratory upskilling, and a respectful and paediatrician, wishes to advise that collaborative team. Private billing, DR KYM DIAMANTIS, ear, nose he has now commenced consulting shared Saturday morning roster, no and throat surgeon, wishes to advise (including Telehealth) at Adelaide after hours. Enquiries to manager@ referring general practitioners and Paediatrics. He will be continuing in murrayclinic.com.au colleagues that he will be relocating his position as senior staff specialist, NORTH TERRACE, CITY his southern suburbs rooms from May Department of Respiratory and 2019 to Blackwood Hospital. His new Sleep Medicine, at the Women’s and Brand new consulting rooms visiting rooms will be at Specialist Children’s Hospital. Please phone available for lease on a fixed term or Clinics at Blackwood Hospital, 13 7123 0820, or email enquiries to sessional basis. Located in very close Laffers Road, Belair. Dr Diamantis will reception@adelaidepaediatrics. proximity to nRAH and Adelaide also continue to visit Victor Harbor com.au. BioMed City. Located within an ongoing medical facility on North Terrace. and his main rooms are Parkwynd ENT, WAKEFIELD ORTHOPAEDIC Enquiries to Jane Kelly, tel 7088 7900 or 137 East Terrace, Adelaide. Referrals CLINIC is now conducting a satellite [email protected]. Your Membership Benefits may be forwarded to our city location, clinic at Golden Grove Family phone 8223 2633 or fax 8223 3811. Our Health, 205 The Golden Way, Golden FULLTIME OR PART-TIME VR GP website is www.diamantisent.com.au Grove, SA, 5125. For Orthopaedic REQUIRED, GAWLER and email is maddy@diamantisent. Surgery appointments: Lower limb – We are a privately owned, family com.au. Looking after Looking after Looking after Dr Benjamin ALLEN – phone 8236 friendly, fully computerised and DR PHILIP GAME, general 4140 and Upper limb – mixed billing practice. Our aim is your practice you your referrals surgeon, wishes to advise that he A/Prof Michael SANDOW – phone to provide holistic health care. In has retired from his consultant 8236 4166. Further information is addition, we have a proactive approach position in the Oesophago Gastric available at www.woc.com.au to preventative health, involving Unit and Bariatric Unit at the Royal or email [email protected] out practice nurses. Gawler offers Adelaide Hospital. He continues to a great blend of town and country. conduct his private practice in general Contact 8522 1844 or jsalagaras@ surgery including gastrointestinal gawlermedical.com. and bariatric surgery, laparoscopy, ROOMS FOR SALE OR endoscopy and colonoscopy at Dechert LEASE House, 89 Payneham Road, St Peters. BLACKWOOD/BELAIR Contact 8382 9898 or OTHER Professional consulting rooms [email protected]. available on a sessional or permanent MEDICAL OFFICE FITOUT RICHARD HAMILTON MBBS, basis. Located in Belair on the site of Australasian Construction offers Ready to Employ? Ready to join? Need to find a Doctor? FRACS, plastic surgeon, wishes to the old Blackwood Hospital, these professional and quality design and The place to go when you want to notify colleagues that his private Most doctors in private medical Membership offers you more than newly renovated consulting rooms also construction services specifically clinic Hamilton House Plastic Surgery practice are not employees. You you realise. For example, if a full- find specialists for a referral. offer minor procedure and treatment tailored to the medical industry. We remains fully accredited under the rooms. Free on-site car parking. understand every medical practice may operate your business as a time GP, living in South Australia, was Australian National Standards (NSQHS) sole trader, partnership, company already purchasing the AMA Fees List, It enables you to search for a Radiology, pharmacy and blood has different needs and priorities. A for health care facilities and also by collection services also provided on or trust, or some combination of DoctorPortal and receiving available doctor, anywhere in Australia, by the American Association for the project manager from Australasian site. Administration services available Construction will be assigned to your these. You may have business Tax Deductions, they would already name, address or discipline. Accreditation of Ambulatory Surgical by negotiation. Contact Karen on Facilities International (AAAASFI). medical clinic fitout or renovation right partners to work with. Some be covering the cost of membership. 8472 3232 for more information. from the start, from the initial design Richard Hamilton continues to practices set up to only handle the Your search results provide a through to final finish. Contact Mr practise plastic and reconstructive NORTH TERRACE, CITY administrative side of the business, Paying for membership provides this doctor’s name, specialty, current Milutin at [email protected], surgery at Hamilton House, 470 Brand new consulting rooms phone 1300 623 049 or 0411873633. including employing staff. and more. We encourage members practice contact details and a Goodwood Road Cumberland Park with available for lease on a fixed term or to take advantage of the full range of scalable map which can then be special interests in skin cancer and sessional basis. Located in very close MEDICAL SECRETARIES ON The guide to employment law benefits on offer. printed and provided to patients. hand surgery. Excellent free car parking proximity to nRAH and Adelaide SITE OR VIRTUAL – SPECIALIST for medical practices, is available is available. BioMed City. Located within an ongoing CENTRAL NORTH ADELAIDE AND online. Richard also consults fortnightly at medical facility on North Terrace. GLENELG Your member benefits are there to Enquiries to Jane Kelly, tel 7088 7900 or look after you. Morphett Vale and McLaren Vale as Highly professional medical practice well as monthly at Victor Harbor and [email protected]. administrative support, fast internet, jobs.doctorportal.com.au amasa.org.au/join doctorportal.com.au/find-a-doctor/ Mount Gambier. He is available for option to utilise your own or our patient telephone advice to GPs on 8272 6666 clinical database, communication or 0408 818 222 and he readily accepts POSITIONS VACANT systems and stationery. Ultimate in emergency plastic and hand surgery patient experience. Excellent customer referrals. MAGILL FAMILY PRACTICE service. Locations central to all AMA(SA) More information is For convenience, referrals may (formerly the Murray Clinic) facilities. Sessions available on a service be faxed to 8373 3853 or emailed to Various sessions available for VR GP fee basis. Practice manager and multi- Your Profession. available via [email protected]. For all in our new purpose-built GP-owned disciplinary providers onsite. Fully Your Voice. members.amasa.org.au/join appointments phone his friendly staff family practice. We encourage special furnished stylish rooms. Onsite parking. Your AMA. or email at Hamilton House 8272 6666. interests, in-house opportunities Contact Julie Fallon 08 8334 5900, www.amasa.org.au [email protected] See www.hamiltonhouse.com.au. for professional development and [email protected].

62 | medicSA medicSA | 63 PRACTICE NOTES Benson Radiology

MUST ATTEND OCCUPATIONAL workplace health issue – MEDICINE CONFERENCE – www.anzsom.org.au/asm-2019. WANT TO ADVERTISE IN now open in the ADELAIDE OCT 2019 WRITER/EDITOR– BOOKS, MEDICSA? The Australian and New Zealand MEMOIRS, LIFE STORIES Society of Occupational Medicine Have you information to medicSA’s Heather Millar is also advise about your practice (ANZSOM) is proud to partner with the a ghostwriter, content writer and Barossa Valley Australasian Faculty of Environmental details, rooms for sale or lease, accredited editor. If you have a book or a vacant position to fill? Book and Occupational Medicine (AFOEM) to you need edited, she can help. She deliver an exciting educational event! a classified advertisement in also does ghostwriting and life story medicSA’s practice notes section. In ‘Making it Work, Adelaide’, 27-30 writing, helping to capture a person’s To find out more, visit our October 2019 at the Playford Hotel, story or family history, and writes website at amasa.org.au or call us we offer networking, collaboration and content for websites, blogs and education, with a focus on practical magazines. For more information, go on 8361 0106. aspects of occupational medicine, to zestcommunications.com.au or To find out more or to make an featuring Dr Gary Franklin as our 0409 196401. article suggestion, call Heather international guest and keynote on 0409 196401 or email presenter. Renowned for his leadership heather@ zestcommunications. across many aspects of occupational NOTICEBOARD com.au. You can also write to medicine, Dr Franklin will share his the Managing Editor c/o of the practical expertise, innovative thinking MEDICAL BENEVOLENT AMA(SA), PO Box 134, North and research experience throughout The Medical Benevolent Association Adelaide SA 5006. the three days of the conference. Also of SA can provide financial assistance featured is a special session on ‘Silicosis to medical practitioners in need and Manufactured Stone’ with separate and their loved ones. To contact the registration offered to accommodate MBASA contact the AMA(SA) office on the wide interest in this remerging 8361 0107.

By being a member, you help support the AMA(SA)’s advocacy on behalf of WELCOME your medical profession and help set the AMA’s advocacy priorities on local, state to our new members! and national levels.

Dr Krishnendu Ghosh, Dr John Kane, Dr Adrian Lee, Dr Prabhath Wagaarachchi, Dr Jonathan Dutt-Gupta, Dr Joseph De Zylva, Dr Blake Fidock, Dr Valerie Thompson, Dr Craig Nancarrow, Dr Jessica Willis, Dr Tuan Vo, Dr Dania Qatarneh, PLAYFORD CLINIC Dr Sean Chang, Dr Mohamed Afzal, Dr Gurpreet Kharay, Dr Bhavin Jadav, Dr Penelope Cohen, Dr Mthulisi Viki, Dr Chen Tu, Dr Benjamin Beamond, Dr Chukwudiebube Ajaero, Dr Stefan Court-Kowalski, Dr Alexandra Dr Clare Maley, As the state’s largest Comprehensive imaging services are Monday to Friday Dr Elizabeth Ellis, Dr Luke Wheeler, Delahunt Smoleniec, Prof Gelareh Farshid, now available in the Barossa Valley. 8.30am – 5.00pm Dr Jarrad Hopkins, Dr David Fang, Dr Mozhdeh Dr Jennifer Roy, locally owned imaging Bassiri Esfahani, > CT 13 Gawler Street, Nuriootpa Dr Alisha Evans, Dr Helen James, Dr Dheeraji Guterres, Dr Senthil Govindasamy, Practice, Benson Dr Samuel Moffat, Dr Peter Nguyen, Dr Robin Geddes, > x-ray Telephone: 8564 7000 Dr Jose Valerio, Dr Riche Mohan, Dr Asha Thalisha Dr James Kollias, Radiology is delighted > ultrasound For more information visit Bala Krishnan, Dr Kareeann Khow, Dr Michael Riceman, Mr Jimmy Eteuati, > dental imaging Dr Christopher Nirmal, to announce the bensonradiology.com.au Dr Megan Deakin, Dr Anne Collinson, A/Prof Sarah Thompson, Dr Sudheer Ahamed Puthiya > onsite radiologist Dr Claudia Cheng, Dr Jemma Wohling, A/Prof Phan Nguyen opening of its Veetil Shahul Hameed, Dr Courtney Lloyd, Dr Muhammad Availability for specialist consulting Mohamad Fadzli, Dr Jacqueline Adams, Nuriootpa clinic. Dr Luzinda Lo, on sessional basis.

We are excited to have you as part of our membership. Membership The AMA is here for members is a lifelong journey and we look forward to helping you start in adversity: membership is yours. Please let us know if you have any questions about your membership by contacting Karen Flinn, our membership officer on like an insurance policy. 8361 0108 or email [email protected].

64 | medicSA Your Membership Benefits Looking after you Looking after 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, you help support the AMA’s advocacy on • Hood Sweeney (Finance) behalf of your medical profession and help set priorities on local, • Jobs - DoctorPortal state and national levels. • Norman Waterhouse (Legal) • Professional 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]